9. Jenn Johnson on Trusting Your Nursing Intuition

In this episode of The Bossy Nurse Podcast, Marsha speaks with In this episode, ER nurse and author Jenn Johnson, BScN, RN and Jenn shares how to trust your gut with science behind it, and how storytelling can be both a coping tool and a career-builder. 

Find the all the resources mentioned in the show and full details at The Bossy Nurse website.

Don't forget to subscribe to The Bossy Nurse Podcast on your favorite app, and please leave a quick rating and review. It helps more nurses find the show!

Want early episode drops, behind-the-scenes action, special invites to virtual and in-person events, and chances to be featured on the podcast or The Bossy Nurse blog?

Signup for our newsletter at TheBossyNurse.com/join.

Transcript

Welcome And Jen’s Book Origin

SPEAKER_02 0:03

Giving that story to dad to say, A, here's here's her story, and then B, here's the rest of the book. Um, please go through it. If you want me to change anything, if you want me to take it out, if you want me to trash the whole book, I will trash the whole book. I don't care. But I need you to be okay with this.

Marsha 0:23

Welcome to the Bossy Nurse Podcast, a show about nurse creators, innovators, risk takers, and the ideas that shape their success.

Early Life And Serendipity Into Nursing

Marsha 0:32

I'm Marcia Batti, and on the show today, how ER nurse and author Jen Johnson is sharing how a pandemic breaking point and years of untold ER stories became nursing intuition, a playbook helping nurses trust their gut and stay in the profession. During COVID, frontline nurses like Jen were stretched to the limit. To make sense of it all, she started writing down her ER stories. First, so her kids would understand why she kept showing up. Then, as a way to take that bedside judgment nurses built over the years and turn it into something teachable. Jen grew up in Cambridge, Ontario, small-town vibes that shaped her early years. Her first ER job was at a small rural hospital with scarce resources. Later, a move to a larger, better-equipped ER showed her what strong teamwork and solid systems can really look like. But before nursing, there was a younger Jen still figuring out who she was.

SPEAKER_02 1:42

I was a fairly good student. It was only in grade 12 that I kind of slipped off because the you know love affair with my high school sweetheart was um all-consuming. Grades kind of slipped, but you know, looking back now, you go, oh, so I wouldn't, so had my grades not slipped, I wouldn't have been going only to Lakehead University because you know, that was the only university I got into, and it was for biology. Um, so I wouldn't have gotten into Lakehead. Then I probably wouldn't have failed out of second-year chem class, which is how I ended up in nursing in the first place. Um, and if I hadn't have fallen into nursing, I probably wouldn't have met my husband. I probably wouldn't have had my kids. So, like when I take a very fun, very large step back, it's like, oh, had I not goofed off in high school, I wouldn't have been here. Um what would that look like? I don't know. So, you know, to all the people who, you know, high school isn't everything. Um, and you're you're supposed to land on the track that you're supposed to land on, even if it's hard or it seems like it wasn't meant to be, or or roadblocks were put up. Maybe the roadblocks were for a reason. For a reason.

Marsha 2:59

And you were, yeah, and you made it to right where you were supposed to be. Yeah. Absurdly. Yeah. Talking on podcasts, right? Right. Exactly, exactly, right where you're supposed to be. I know um there is a story that I've heard that you were a biology major. I know you mentioned that just now. You were a biology major and it wasn't your thing, or it didn't turn out the right way. So you have a friend who's introduced you to another path. So you can you share a little bit about why biology, first of all, and then why not?

SPEAKER_02 3:30

Yeah. So I mean, going into you know, university, I never even had really thought about nursing ever. It was never really presented as an option. It was never talked about. I just knew that I really liked human biology and I did quite well at it. So I'm like, okay, biology sounds like a good path. I thought I was gonna be a forensics major who, you know, sat in a lab and and analyzed DNA uh for my entire lifespan. Like I already had the job picked out in first year. I knew that I was gonna make like $60,000 a year. I was cool with that. Uh it was that was a lot back then.

Marsha 4:03

Yeah.

SPEAKER_02 4:03

That was a lot back then. Yeah. I mean, yeah, 60, 60 then and 60 Canadian is like, yeah, that was 60 Canadian.

Marsha 4:10

Okay, yeah.

SPEAKER_02 4:11

60 Canadian. We have to all the exchange rate. Joy. Um, so you know, just thinking about like, okay, that's what I'm gonna do. Well, the university that I got into was it's northern Ontario, and I'm talking like way northern. So 24, it's a 24-hour drive from Toronto area. Like you actually go up and around Superior to get to Thunder Bay.

Marsha 4:35

And, you know, Ontario, Ontario.

SPEAKER_02 4:39

Yeah, yeah. So northern, northern, northern Ontario.

Marsha 4:42

Like, and I just discovered how big it is when I I said, let me look at the map because I sort of know where Ontario is.

SPEAKER_02 4:49

Yeah, if you could, if you could put, I mean, I want to say it is I can't remember if it's the size of Texas or not. Um, I'd have to triple check that. Yeah. Yeah. So I'm just like, oh, okay. So, you know, it's a 12-hour drive to get up and around Superior, or you drive through uh Michigan and Minnesota to get up to um, you go underneath. You could go under. So well, actually, we've different boats.

Marsha 5:13

Yeah, so it may be about the same size because I've driven through Texas straight through. So from El Paso all the way to like Louisiana, which is where I grew up, um, is about four 12 to 14 hours drive, depending. Yeah. So and then that's straight across. So yeah.

SPEAKER_02 5:31

Yeah.

Marsha 5:31

So okay, gosh, that's huge.

SPEAKER_02 5:33

Um, yeah. So just you know, driving up there and and I didn't realize that they actually had a huge biology program, but they also had a huge forestry program. So their main focus in first year biology was plants. And I'm like, I kill everything I touch when it comes to plants. I can't with this, I don't care what tree bark is. So so here's you know, a $10,000 tip. Tree bark is actually just it's called phloem and xylem. And it's two strands that you know, they they bulk onto each other, and that's the whole thing. And I'm probably still getting that wrong. Um, but that was like my whole first year was was plants and all this. I'm like, this sucks. Like, I can't, like, I I got not through it. I had like I got there, but I was like, oh man, this is awful. I thought like human biology, like this is that's more what I want. So second year comes along, and we've got this year-long organic chemistry course. And so I go through the first half, I fail the first half and going, I've never failed anything before. Like, what is this? Like, I'm freaking out, not knowing what to do. I'm a year behind now. If I try to retake it and I still can't even wrap my head around it, I'm like, uh, this is not going well. And so thankfully, there was a friend who I'd met in first year who was in nursing at the time. And she, she and I would go through like her Mosby's dictionary. And so, like, look at all the gross pictures, and you're like, oh, this is so cool. Like, this is this is what I want. Like, I don't want plants. I have no interest in plants. I'm not good with plants. I'm good with people. Um, so to figure that out and then to switch in. So they thankfully had a three-year compressed uh degree program. So I was like, thank God, you know, I could work it at the four-year pace because I already had like a year and a half worth of credits to kind of um transfer over. And it was by far like the best thing and the best life decision. And I was petrified to tell my parents that I wanted to switch into nursing. And I look at their reaction to be like, oh, thank God, we didn't know, we didn't know what you were gonna do with biology. We we didn't want to say anything, but like we didn't know what the hell you were gonna do with. But nursing, nursing's great. You fantastic. They were thrilled that I was going to nurse. Yeah, they're like, oh, by the way, your aunt's like uh the president of the the nurses union. I'm like, pardon me. She's like, they're like, oh yeah, the Ontario Nurses Association, the the nursing union for the Ontario whole province. She's the head. I'm like, why, why, why, why am I looking at this? Why didn't I know? Why didn't I know this? I don't understand. So just so funny that that was the, you know, one of the ways that the universe kind of kicked me into gear on that one.

Marsha 8:13

So I know you've been an ER nurse, and was that where you first started when you left school, or how did nursing start for you? Actually on the floor, I guess.

SPEAKER_02 8:23

The floor. So I ended up meeting my husband in my last year of university. He lived in a very small town that was less than like 5,000 people. Um, and the Canadian government was like, hey, that certain town is deemed an underserviced area. For every year, you work full-time hours. We'll give you one year's tuition back. I was like, sold. I'm already coming up there. This is a win-win. I can make this work, whatever. And so ended up starting with the hospital, and the hospital was so small that it was just one RN for the eMERGE and one RN with two LVNs or RPNs on the floor. And the floor, no, you called in your family doc who also covered the eMERGE. No RT, no vent, no lactate, no X, very little X-ray, very little ultrasound, no CT, no MRI, no nothing, no mental health services, no nothing. So real health, true real like the most rural. Like if you had a stroke, um, and you came in immediately when you had stroke-like symptoms, we would be exceedingly lucky if we actually got you to Thunder Bay, which is about two hours um west, going back to Thunder Bay, um, to get a helicopter, yeah, or driving even. Oh, a two-hour drive. Um, or we could try to get a helicopter, but again, sometimes the helicopter couldn't come in. I mean, there was a situation where I begged a 20-year-old for six hours while we waited for um for orange so our helicopter to come in and and pick them up. It was just chaos. And so when you actually had something of substance that came into the ER, you were usually either calling in the next shift early, you were trying to reach out to see if you could pull anybody else. Um, because again, on a you know, evening, night, weekend, there's two RNs in the building. That is it. That is it.

Marsha 10:26

How many beds? So one or two beds. 14 beds for the whole hospital.

SPEAKER_02 10:32

Total for the whole hospital. There was a long-term care section attached also, and the majority of the people on the floor had been there three, six, nine months waiting for long-term care. Like anything that was actually truly medical for the most part would go out.

Marsha 10:49

Now, so I'm curious about that. Working in that type of environment. Now, when the patients

Rural ER With No Resources

Marsha 10:55

would come into the ER, would they be the sickest of the sick by that time? Because oh no. Okay.

SPEAKER_02 11:01

They they typically, because the whole town knew how the system worked. So in the mornings, you had your on-call doc. So your on-call doc was supposed to be at the hospital from eight to noon, then they were supposed to get an hour lunch, and then they were gonna go off to the walk-in clinic, which was, you know, in town another five minutes down the street, um, to work the walk-in clinic. So hopefully that only the emergencies came in from eight to noon.

SPEAKER_01 11:24

Yeah. Hopefully.

SPEAKER_02 11:26

Hopefully. And then, you know, they were they were free to go to the walk-in clinic in the afternoon. And then, you know, if anything was to come in in the afternoon, you know, if they're well enough, we could redirect them to, you know, the clinic, we could call ahead to be like, hey, so-and-so is coming over. I'm concerned about XYZ, whatever. Like there, there really wasn't a lot of high acuity. Um, but we had a lot of medical directives to kind of work off of where, you know, I looking back now, I'm like, we could have given morphine and nitro uh for chest pains. We, you know, so you did the blood work, you did the ECG, you could put in the IV, give morphine, give nitro, all these things for chest pain. And I'm like, I was brand new, like not realizing the implications of too much nitro or too much morphine. Or yeah, you know, I think they only gave us like two to six milligrams, which again, fine, you know, a nice little starter dose. But I mean, depending on what's going on, if you didn't have the you know, the the brain cells to put together because you're new, um, that oh, their pressure's like hovering like 100 on 60. Well, but they're having chest pain. I'm gonna give them nitro. No, you don't. No. Like, no, you don't. No, you stop, you stop, you know, and again, like, do you do you then you know, call the doc? Do you wait for the first opponent? Do you do all these things? Like it just we had a lot of leeway in the in the eMERGE portion, but man, you could have gotten yourself into so much trouble. Yeah, sounds like trouble.

Marsha 13:01

So, how long were you in that environment being in that small hospital? Because I know at one point you did go to a bigger area, I guess back south. Yeah.

SPEAKER_02 13:09

Yeah. So I was there for almost five years. Wow.

Marsha 13:13

Wow.

SPEAKER_02 13:14

And looking back, I am so, so unbelievably thankful that I did that first and not second. Um, because I think I would have had a full-on heart attack coming from a large or even a medium size medical center with actual supports to that, I think I would have just died.

Marsha 13:38

Oh, okay. I I misunderstood you. I thought you meant if I would have gone into a busy hospital first off versus knowing what the smaller hospital was before going in.

SPEAKER_02 13:50

Well, I think I just I I would have I think I would have been so concerned to be like, you know, oh, I know this is how this is supposed to work, but we only have this. How am I supposed to make this work? kind of thing. I'm I'm so very thankful that it was like, this is all I've got access to. And um, I've got a buddy who, when I did move downs back down south and went to a stroke center, so a very large center. And he tells a story of the first time he was orientating me, and I was just so excited. And the first time we got an order for CT, and I thought, and I asked him, I said, okay, so how are we gonna get like who's gonna go on the transfer? And how do we get to go? You know, how do we arrange the ambulance and do all these things that I was used to doing when we needed to be? Yeah, sending them out. Yes. Marty goes, What are you talking about? It's in the basement. And I'm like, Pardon me. I'm like, and my mind was blown that they're a C T we have a CT at the basement? You're kidding. Like, just mind was blown. And he tells me that story now. And I'm just like, I don't even remember that, but I I can believe it for sure.

Marsha 14:56

Next thing he'll tell you, you have a cafeteria too. Guess what? Yeah, holy crap, a cafeteria. Oh my god. Oh yeah. What was the mood? What made you go from the north to the south? What happened in that transition? Because yeah, I imagine those are two very different places because you're closer to Toronto, correct? Yeah. Right now. Yeah.

SPEAKER_02 15:17

Yeah. So right now I'm about an hour outside of Toronto. Um, and I'm I'm an hour from where I was also. So we've moved twice now. And um, I mean, it was the bullying, the being up north and having your immediate supervisor be absolutely miserable to you, nitpick everything you do, second guess you in front of patients as you're trying to figure out what nursing actually is. Um, you know, she was in charge of scheduling. And even though we had a union who said you can't schedule double backs, so a night shift and then coming back um the day after for a day shift when you only have like a very short turnaround time, those were, you know, quote unquote illegal that you couldn't do those, or you couldn't at least have them scheduled. If you chose to do that yourself, fine, that's what you do. Right. Um, but they couldn't schedule you those as per the union. And she would schedule me those constantly, absolutely constantly. And I'm just like, you know, you're young, you think, oh, I've got to put in my, I've got to put in my time. I have to put in my dues, and I you just need to be quiet and you don't know how things work, and and she's your boss, and what do you do? Like she's gonna do it.

Marsha 16:31

She wouldn't do anything that would hurt me.

SPEAKER_02 16:33

Right? Like, she's not that vindictive. Yeah, she is a thousand percent that vindictive.

Marsha 16:38

Yeah, yeah, yeah. And so working in that environment in the north with the bullying, that was the impetus for moving down south with you and your husband and just going straight down. Okay. Yeah. So we can't he was okay leaving. I'm assuming he had his other work too. So how was the decision to move? Yes.

SPEAKER_02 16:59

So he was a paramedic supervisor. And so um we had had um a fight. We had recently gotten married, and of course, you know, your first big fight is a married couple. And and I remember him saying, you know, and me bringing up like I'm not happy here, like I'm miserable. I don't really have friends that aren't really super fake, that are are aren't already your friends first. Um, I don't really have a place here. Work is awful. Like I've I've come to the point of having um ideations at time of harming myself. And that had never happened before. So, you know, I need to get the hell out of here. Like I'm done. I've done five years, I've I've put in my time, I've collected my, you know, roughly, you know, 16K from the government uh for sticking it out for the first four years. I I need to get the hell out. Like this is I'm done. And so I remember him saying, well, then fine, just like, you know, go litter the internet with your your resume. And I'm like, I know you probably don't actually mean that, but guess what I'm gonna do? I'm going to litter the internet with my resume. And so thankfully, um, one of the very first jobs that I'd applied to, um they they called me up very quickly and were like, oh my God, you've got ER experience, you've got bedside, you theoretically have got a little bit of OB experience, you've got a little bit of surgical experience, you've got a little lot of long-term care experience. Um, oh my gosh, we would love for you to come on down here. And I'm like, yes, absolute yes. I said, however, like my husband needs a job, like we can't, you know, the cost of living in Northern Ontario, you know, a home in Northern Ontario was like what, uh two, two and a half, two bedroom, two and a half bath or one and a half bath. And he bought it for like $70,000. Like that was Canadian dollars. In Canadian, yeah. And and for the Canadian market, that is yeah, you cannot find uh a detached home, um, let or any home for that matter at $70,000. Like it just does not happen. So trying to like sell that home, like we needed to sell that home in order for us to be able to move down there. I said, we need two full-time incomes to move down because Southern Ontario is much more expensive and and all these kind of things. And so she's, you know, she's oh yeah, not a problem. We'll hold out for you. They held out for me for months while Trev looked for work. Um, he ended up, he couldn't find anything in paramedicine at the time. They were kind of um full to the brim. And so, um, you know, and the new place would call every now and again, hey, have you have we heard? Like, we don't know. And I'm like, honestly, like my husband can't get a job. And if he can't find a job, like I can't come down. They're like, why don't you just send us his resume? We'll we'll find something for you. Oh, wow. And so I'm like, Oh, yes. So sent his resume. And they said, Oh, um, you know, this infection in infection control was just starting to come up as kind of a specialty at this point. And they said, Well, he actually does have like assessment skills. He's a paramedic. Um, we've just had a very public death, a C diff death, like very public C diff death where the hospital's System itself has gotten a lot of backlash. So we are really pushing the infection control practitioner portion. Guess what? We will take him, we will train him. He's gonna make RN wages because most of the people who are in infection control are licensed professionals. So they're DI, they're lab, they're nursing. Um, but he'll make RN wages. I'm like, absolutely, let's go. Like for sure, let's go. And so they took him on, they trained him, they, you know, it was a wonderful job, great change of pace. You can't beat the paramedic out of him. It's it's been almost, you know, 15 years, and and you can't beat the paramedic out of him. But, you know, was he happy leaving? Are we have talks about this, you know, routinely about like, oh, I'd like to go back. He says, I'm like, absolutely not. Not in a lifetime. Not in a lifetime. I understand

Bullying, Burnout, And The Move South

SPEAKER_02 20:55

that your family lives up there and whatever else. Can't do it. I just I can't see going. I still have panic attacks. Like, even thinking about like as you drive up to the town and and the turnoff for the town, there's like this, you know, kind of uphill, and then it turns to the to the right a little bit. And even thinking about that turn gives me palpitations.

Marsha 21:15

Yeah.

SPEAKER_02 21:16

So I'm just like, I I'm good. I I'm what your mama can do. Yeah. 100%. Yeah. 100%. Yeah.

Marsha 21:23

So with the move and now working in a bigger city, how was the nursing for you there? Oh my God. It was you went straight into the emergency room. Straight into the emerge.

SPEAKER_02 21:34

And then um, and then learned all that I'm sold. Like, this is what a real emerge is supposed to do. This is how a real eMERGE is supposed to work. Like, holy cow, this is absolutely magical. And like, you know, then all of a sudden you're getting the acuity. Then you're, you know, it's a stroke center. So then I'm getting stroke trained and and all these other things. I'm like, oh, this is the greatest thing ever. Yeah. Yeah. You know, it's busy and the ratio is five to one, which is pretty heavy for for emerge. But I'm just like, oh no, like this is this is it. The people were so wonderful. I mean, yeah, I was so done with that town that the people could have been absolutely miserable and I still would have been so happy with it. But they were just the nicest people that I've ever met in my life and like true ER rock stars that I aspire to be them one day. Yeah.

Marsha 22:23

The change of pace, the change of environment, yeah, I'm sure did a lot for mental health, your mental health. What around what year was that? Do you remember?

SPEAKER_02 22:32

Um so 2022. We got married in 11, so that was 2012. That I 2012. Okay. Yeah.

Marsha 22:39

And I I know that you started to document stories. How did that come about for you?

SPEAKER_02 22:45

Yeah. So that it took me, you know, getting to the point of COVID and and breaking during COVID that um, you know, I kind of thought, well, what happens if I die during COVID? And my kids ask the question of like, well, why did mom go to work? She didn't have to go. We all had the option not to go in. And so I thought, well, why don't I why don't I write down my stories for my kids? Let me just kind of the really good stories about the times I helped and and all these kind of things. So I wrote down my stories. And it was just like, oh my God, like, okay, that's kind of cool. And because, you know, it was COVID and I was exhausted and not sleeping and anxious and scared and all these things, the the trauma of the past 14, 15 years at that point just spilled all the way out onto the page. And things that I didn't realize had been bothering me that much all of a sudden came rip roaring out. So, you know, my first, my first patient death, my first PEADS death, my um, you know, the traumatic scenarios that I hadn't thought about. Um, you know, all the times that I felt like I made a mistake and I missed something, and those had stayed with me. And so I wrote everything down and I'm like, well, I I don't know what to do with this now.

Marsha 24:10

Was it just a journal or how were you?

SPEAKER_02 24:12

It was just it was just Microsoft Word, God bless it. Okay. Um, a lot of it's um just typing out, and it got to the point where I was um voice dictating at points. Um, and there was something about going through that two-minute story that I, you know, you you condense your stories down for each other at 3 a.m. It's a little two-minute tidbit of like, oh, this is how what I think about pancreatitis, or this is what I think about this. And it, you know, going back into them and and lengthening them out and actually putting yourself physically back in that mindset, in that room, going, whoa, like I didn't realize that I could still do that. Like I didn't realize I even had the memory or the capacity to to go back into that story like that. And, you know, was extremely triggering, especially like obviously the not so great stories. But there was something about being able to go in, kind of immerse myself and and thinking like, okay, like I'm in this scenario, what am I hearing? What am I thinking? What am I smelling? Who's around me? Um, you know, what does the layout look like? You know, do I remember um what time of day it was or any of this? And to put yourself into it and to kind of purposefully trigger yourself where you're you're trying to work through it because you can pull out. If it gets too much, you can just pull out and go, oh, okay, that was uh was a little too much. I'm I'm gonna pull out and come back to it in a few days. And so it's turned into a phenomenal coping mechanism that somehow ended up turning into a book.

Marsha 25:51

Yeah, I was gonna ask when you were writing these stories and triggering yourself and writing so much detail. Um, did you know at the time of writing the detail that this could be something that I can turn into a book, work into my journals, or was this just a practice of getting your stories out so your children can read them? How were you thinking about that in the writing process? Because the detail is what strikes me that you were writing the detail, not just saying, oh, this happened this day, but actually the sounds and the sights that you hear and see and feel and touch and you know.

SPEAKER_02 26:26

Yeah. I was not thinking about a book. The book was was the furthest thing from my mind. I just found that it was just really, I felt better after getting the detail out and purposefully putting myself in. I I when I would come out, yes, I'd cry and I'd be upset, but yet I felt a little bit lighter. Like I, oh, I don't have to worry

Discovering A Fully Resourced ER

SPEAKER_02 26:50

about carrying that story in that detail because now it's down. It's it's I've put it down, I don't have to worry about it anymore. I don't have to, yeah, you know, I don't have to carry that story for that patient anymore. I don't have to carry that story for the the family. I can write that down. And that can be, it can be down and it can be out of my head. And it creates this feeling of lightness where I was like, I was not expecting that. I, you know, just the what do they call it? I think in ADHD they call it just like um uh brain um, oh my gosh, I can't remember what the wording was, but it's just like a brain toss where you you write everything down and you just let it all out. Yeah, brain dump. Yeah, yeah, perfect. And so just let it all out. Just let it all down because then you can let go of that, you know, internalized worry that you're gonna forget about something because now it's down. Right. And with the stories, it was the exact same thing.

Marsha 27:46

I'm curious about the stories, and I and feel free to share or not to share, um, because there may be listeners who have a lot of stuff who are trying to find ways to let that stuff go and may have thought about journaling, may even journal, but in the detail you're describing, what type of story you've described the type of story, but can you share like a story? It didn't have to be a bad story or whatever you choose, but share a type of story and how much detail you went in with sharing that story to help someone maybe think that this is how I can get everything out and have it safe in another place.

SPEAKER_02 28:24

Yeah. So one of my the one that comes up the the fastest, and it's probably the one that sticks the hardest, is just um my first patient death. And so my first patient death was actually of while I was still a student, I was in fourth year and I was on an OB floor. And so it was my first C-section that I got into C. It was a scheduled

COVID Breaking Point And Story Writing

SPEAKER_02 28:46

C-section. She was just like a week overdue, I think. But when you're getting into writing the story, it's like, okay, you know, it was eight o'clock in the morning. It was the first thing that we went into, you know, going into the OR, trying to like close your eyes and saying, like, okay, it was where was I? So I was kind of like diagonal in the corner. I was a student, so they weren't gonna let me touch anything. So they put you at the head of the bed and and here's mom, and you know, describe mom. You know, she had red hair and it it flowed down and um, you know, she wasn't wearing glasses, and and this is kind of what we talked about, or you know, the temperature of the room. Like I wasn't used to being that cold when everybody else had an extra layer and nobody told me to wear an extra layer. I was freezing my buns off. And I I hate being cold. So that stuck. Um, you know, you think back to, you know, the blue of the color of the blue that was the drape that you know blocked mom from seeing what was going on and you know, who was in there? Well, my preceptor was in there and like two, at least two other nurses, and you know, the anaesthetist and the surgeon and probably another surgeon. Um, and just, you know, you remember the beeping and the dinging, and you know, sitting there and talking to her, and all of a sudden, like the dinging going off and and the anaesthetist yelling stuff over my head towards, you know, the surgeons, but I wasn't catching it because I didn't know what he was talking about. And so, you know, one minute the blood pressure's up, and the next minute the blood pressure's down and up and down and up and down, and you're like, well, what the heck's going on? And so while that chaos is happening and and you're starting to get that feeling of chaos going, here's mom. And so I'm I'm trying to do the best I can to talk to mom and and you know, distract her. And so she's like, you know, I I feel like I'm walking in the woods and I we have this cabin, and she's describing the cabin. I see God, and you're like, Pardon me. Um, and she's talking about seeing God. And and, you know, I knew that she was a woman of faith and that that was a big role with her in, you know, the 10 minutes prior that I'd met her, you know, she'd already kind of talked to about it. And like, okay. And so then, you know, the anaesthetist is yelling, and then she's getting more into like seeing God and and all these kinds of stories. And you're like, I I I don't know what to do with this. Like, I nobody's ever trained me how to talk to a patient like this or what's going on. So you just kind of do the best you can and you go, like, oh no, no, everything's gonna be fine. Like, I promise everything's gonna be fine, and it's not a problem. And so I remember, you know, they I remember them taking baby out. I didn't realize at the time that babe had to be resuscitated, but I was told that later. But babe cried. And so mom called out to babe and she said her name. And and I'm just like, oh my gosh, that's so lovely. And I kind of remember peeking over just to see what they were doing. And I remember them putting on the, you know, the white bandage that's like the knee bandage um across her abdomen. And then I hear a nestosis yelling, and then someone says, call code blue. Like, what? Like, you know, you hear code blue and you're like, I don't understand. So I kind of get pushed out of the way and and everything's happening so, so quickly. And then, you know, the drapes are being ripped down, and you're going, like, what, like, huh? Like, I don't understand. And and my preceptor's telling is the first on the chest, and she's telling me to call, you know, a code blue. And I'm like, how how do you call a code blue? Like, I'm a student, like, I don't understand. So, you know, call the code blue and and they get her back. Um, and so now she's intubated. We have to transfer her to the nearby sister um kind of heart specialty center. So, and I'm I feel like there was an actual tunnel that connected the two because they are quite close. And I remember going down this tunnel and you know, dark and grimy and just kind of not great, but you know, gray and a dark gray, and and going through that tunnel and dropping her off and coming back and, you know, okay, she's safe. We've on to the next, and babe's up to to Nick you and and you know, whatever else. And it's just going, well, okay, on with the day. And so I think like 12, one o'clock in the afternoon rolls around, they they gather us all in the nursing, um, the nursing room, and they go, Yeah, just want to let everybody know that unfortunately she's past. I'm like, whoa, whoa, whoa, whoa, whoa. What are you talking about? Past. Like, no, no, no, no. Like we dropped her off, she was breathing. I told her that everything was gonna be fine. Like, I promised her that everything was gonna be fine. And so my little mind just snapped and I kind of lost my marbles. And they're like, oh, we're we're gonna send you home. Like, yeah, yeah, like I can't. There's no way that I'm working, um, or even being a semblance of a person at this point. So, you know, that whole scenario of then going back into it. And I mean, I can still see that room perfectly. I can still see the angle of the stretcher perfectly. Um, I see her face less and less. Um, but you know, I've got her obit. So, so I do have a reference to it. It's just, you know, it was one of those moments where that stuck with me for, I mean, it still stuck with me, obviously. Um, and that's not going anywhere. But for the longest time, I felt like I needed to carry it for the family, like just to let them know that they didn't go through that alone. You know, here's this stranger who has this last memory of her and and carries it. So, you know, not realizing that that was the problem. Um, you know, writing that story down and getting it out, and then actually um to share it with the family. So being able to, you know, I kept in touch with the family, you know, dad got remarried. The girls are God, 18 and 19 now. Um, you know, watching them grow up has been one of those things that's been comforting um for the most part. Um, but giving that story to dad to say, A, here's here's her story, and then B, here's the rest of the book. Um, please go through it. If you want me to change anything, if you want me to take it out, if you want me to trash the whole book, I will trash the whole book. I don't care. But I need you to be okay with this. And dad read it and he said, you know what, there are things in here that I didn't know about. And I mean, I had written things for both dad and baby um the next day, because again, I was the last one to talk to her and I wanted them to know that this is what she was talking about. She was talking about God, and and she heard um babe take her first breath and she called out babe's name and and all this kind of stuff. So to to have dad still come back almost 18 years later and say, like, no, no, like you this needs to be out, like this, this is a great memory of her. And and you know, we're we're proud to stand behind you as you put this forward. It's just like, oh yeah, this is this this is more than just my story. It's it's hers too.

Marsha 36:00

And it's helped a family get through that. And like you said, the idea that you were there to witness her calling out her baby's name and share being able to share that story, something they would have never known at all. But having her call out that name and you being able to let the family know that, I'm sure brought a comfort to them as well. Because so many times when patients or family members learn about their family member passing away, it's always those, you know, sort of regrets like, oh, I wasn't in the hospital at the time. I wonder what was said, I wish I was there. Was she scared when she took her last breath or what was going on during that time? And I'm just happy that you have that, you have that outlet to actually share a story with the family and heartbreaking story, but heartwarming at the same time. And do you feel like getting that story down on paper has lightened your load of that story a little bit?

SPEAKER_02 37:02

Oh, a thousand percent. You know, it's it's not like I'm ever gonna forget it. It's not always like she's not just, you know, here up in the background, kind of could I cry about it in an instant? Sure, if I thought about it too hard. Um, but there was something so relieving and and just like the weight of I don't have to mentally carry this anymore because it's down on paper. It's it's down on paper, it's in a book. I I don't have to mentally carry this anymore. Um, not just for me, not just for the family, but like it's okay to kind of put that at arm's length versus like having it right on your chest.

Marsha 37:42

Yeah. Wonderful story. Thank you for sharing. And I see your book behind you and your journal book behind you as well. So tell us a little bit about the writings that you've done and how you've documented and the products that you have for nurses or helping them getting their stories out.

SPEAKER_02 38:01

Yeah. So nursing intuition, how to trust your gut, save your sanity and survive your career is my baby. Um, the ongoing joke is if I ever need a new therapist, you just give them this and you're like, so here's volume one. Why I am the way I am. We're gonna save like five grand. Don't worry about it, just read it. Um, so it's it's been so freeing to like get those stories out and to be able to talk about intuition without

The First Patient Death Story

SPEAKER_02 38:25

it being like woo-woo and and you know, oh, it's just something we talk about 3am, and it's just experience. Well, no, it's not just experience and and pattern recognition and all that. Like there's a lot of science behind it. There's, um, I think in the last nine months alone, there's been like 800 to 900 pieces of evidence-based, peer-reviewed backed science that um has backed the use of um nursing intuition. And it's more than just like it can start out like a hunch, but when you start following the hunches and then you're right and you get that feedback to be like, oh, I did call that right. Like that patient wasn't doing as well as they were, uh, that we thought they were, or there was more to that story that that they were too embarrassed to tell us that triage, or you know, there was a domestic violence piece that we weren't thinking about. Um, and that we we could have overlooked, but like thankfully, like my gut was saying that there was something way wrong with this this story, with this um, with how this injury was being um presented, that like I think there's more to it than that. Um, you know, just being able to teach people about using your intuition um has been so much fun. And being able to speak with Nurse Blake um at NurseCon was just life changing and you know, still fangirling hard over that one. Um, but so yeah, taking the book, teaching, um, the hundred shifts journal. Um You know, keeping track of your wins as you learn, um, putting in an IV for the first time that actually works, um, getting to advocate for somebody the first time, putting in a three-way catheter and having it work, being able to change a person in the bed, what you know, fully bed change in like one turn. Like those are the really small things that we forget mean so much in the beginning because at 17 years, they're just second nature. You're just going, you're just doing whatever without evening.

Marsha 40:30

And you don't remember. Yeah. And you don't remember your first time doing those things. Yeah. And you know what? I'm glad you brought that up. And I'm glad you brought up the stories that are what we would probably typically think as not stories. Because I think as seasoned nurses, and I consider myself a much babier nurse than some of the seasoned nurses who've been doing it for 30, 40 years plus. But I think it would be a good reminder for seasoned nurses to remember how it was when you were first hard out there. Yeah, when you were first learning on the floor and just helping new nurses get that learning back and joy back into why they went into nursing in the first place instead of the bullying and things like that. I think it's it probably is a good way to document those stories, but just the simple stories of your first IV and how that went and just going back to those times and remembering those things. So we'll put all of the information about your books and your journals in the show notes for everyone to take part. I do want to do a little bit of a switch and not wrap up just quite yet, but I kind of want to talk about the business of nursing. Yes. And what took you. How did you know how to publish a book? How did you know how to publish a journal? What was your thought process and going through all of this and saying these stories? Okay, I think I have something here. Now I just want to learn how to put it out in the world. And also you're speaking, speaking at, you know, nurse con and conferences. How do you start to make that transition from staff nursing to, okay, I think I have something that could be a business?

SPEAKER_02 42:09

Yeah. Trust yourself. Like it's it's a whole new skill. It's a whole new language. Oh my God, it's a whole new language. Um, but start small. Like, you know, God bless Chat GPT and being able to break down any task into a million different pieces. Um, when I first figured out that this was going to be a book, I was like, well, I think I need the validation from a traditional publisher. So was able to find a mentor and somebody who um could edit my book for me prior to me sending it out to um publishing houses. But she filled me in. She's like, oh, hey, this is how you figure out which publishing houses do which books, how to apply. The whole process of applying to traditional publishers is that every single different publisher wants the exact same thing in a slightly different way. So you can't just mass, you know, here's my application package and and just click email, click email, click copy, paste, copy, paste. That's not gonna work. You actually have to spend the time to like, oh, hey, you know, here find publishing and um, you know, small books publishing and all these other places. And so to get through that process was a lot, but they don't tell you that the publishing world is the slowest thing that I've ever experienced in my entire life. Um, not even joking. There was one publisher that said, apply to us. And so you're only sending samples of things, you know, you're sending a couple of chapters, you're sending your resume, you're sending, they all want to know, you know, your follower account and all this other BS kind of social stuff. And send us all that. And if we don't get back to you in a year, re-reapply. I'm like, Pardon me, a year. You want me, and they want exclusivity rights. So some of these publishers, you can only apply to one at a time. I am not waiting a year to apply to one publisher to then apply to no, absolutely not. That's ridiculous. Wow. Um, so went through that whole process and ended up actually getting a traditional publisher, which, you know, fun fact, to get published by a traditional publisher, you're more likely to get into Harvard. Um interesting.

Marsha 44:22

Readers out there.

SPEAKER_02 44:24

Readers out there, it is just it's a whole different world. But the the pro to going through a traditional publisher is you don't have to pay anything. You just get royalties. You only get 12 to 16% per book sold as royalties because they pay for all of the editing, the typesetting, the cover design, all those kind of things. So after getting accepted, I waited two years. We moved into the editing process that we were a couple months in. I was like, oh my God, my book's finally gonna get published. They gave me my rights back. They're like, you know what? We're actually gonna go back to physiotherapy books. Um, because again, you know, nursing intuition, it isn't a cut and dry memoir. It's not a DIY, it's it's not just uh medical how-to, like it's it's a couple of different things. So it's very hard to categorize, which made it very, very hard to pitch to publishers. So um, you know, figuring out that, oh, I've just gotten my rights back and going like, well, guess I'm gonna do it myself. So God bless readsy r-e-d-s-y.com. It is a book um haven. So you can write the whole thing on there. They've got access to a million different editors and typesetters and cover, like you could have the whole thing taken care of. Um, just be forewarned, it is going to cost you roughly six to 10K. And you'll more than likely not see that money back ever. So even when selling when publishing, even when some selling the book, the benefit of self-publishing is now I make about 60% royalties on Amazon and Burns and Noble and uh Indigo. But you know, selling one book at a time, it's likely not gonna happen. If you can get into bulk sales, though, bulk sales where is where you can actually then pitch your book to people who are going to buy a number of them at the same time.

Marsha 46:19

You give them universities, things like that.

SPEAKER_02 46:21

Universities, bookstores, um, gift shops, uh, hospital gift shops, um, all these places that you wouldn't think to send. Yeah, but you go, oh, you actually want a gift for nursing week? Here we go. At, you know, and so to have a deal that came my way uh at a conference last year where someone was like, Oh, for if you if we can make it for less than 10 bucks a book, I'll take 6,000 copies. You're like, Pardon me. Sure. Yeah, absolutely I can do that. Yeah, uh, not a problem, not a problem. Um, did that deal actually pan out? No, but it was like, oh, bulk sales are where I may actually make my money.

Marsha 47:01

But it taught you that. It taught if it taught you one thing, it taught you bulk sales is where to go.

SPEAKER_02 47:06

What? And then finding, you know, doing all the other business things, like finding printers and getting quotes and seeing, you know, what's gonna work where and shipping costs and uh then the tariffs, let's not even go there. And, you know, shipping across borders and and you know, all these different things. So it's been so as much as the loss sucks, and that one hurt because that was like half my my yearly wage and like one deal, um it it got me organized so that now I have all those numbers uh on hand if if something like that comes up again. And I still have that contact and they're still lovely. Um, it just things kind of fell apart at the last minute that way.

Marsha 47:49

Just curious. The process of actually knowing that, okay, this is gonna be a book and the actual book coming to be as a manuscript, how long was that process? Because I know sometimes I've heard well-known writers saying it took them five years to write this book, 10 years for this story to come out and actually become a manuscript. So, how long is that process for you?

SPEAKER_02 48:11

So I I am so hesitant to say because the actual writers of the world hate me. It took six weeks. Oh wow. You had a life. I but again, like that was me being at my absolute bottom. Um, like I was completely burnt out. I was super depressed. Um, my ADHD that I've never actually gotten a diagnosis for, but we're all pretty sure we're we're all pretty sure, um, was on fire with that manuscript. So, you know, once I had the stories, and the stories took a few weeks to kind of flesh out and then to actually like get teeth into them. Once I have figured out that, oh, the actual theme of the book is nursing intuition, and that is what's connecting all of these stories next to just nursing and me and the ER, the the intuition is the theme. So finding the theme, once I had the theme, I was like, holy shit, okay, well, that's cool. Um but again, that's August of 2020. I'm thinking the misinformation, disinformation was really starting to like kick up hard. And I said, I thought, honestly, if I put out this book now without references, I think I'm actually putting my license at risk. Um, I think I'm taking a really big risk with my license just to put this out as like a thought piece or a memoir. So doing the legwork of like, oh, let's get some references and let's do this and let's do that. Once I figure out that, oh, there's actually a ton of information on this, I was like, oh, let's let's go. And I was off and running with it. So, you know, it was, and I I don't remember writing a lot of the book, to be fair. I was up very, very early, you know, couldn't sleep at two, three, four in the morning sometimes. So I was up and early and writing. Um, at work, I was already thinking about like, well, how do I link the stories? Like that was always on my mind. Um, I would come home from work and I'd stay up late. And and all of a sudden, all this was just coming out of me. And I'm like, oh my gosh, this is all linking together. Yes, yes, yes, yes, yes. Um, so to be fair, it was six weeks, but it was also, as my mother loves to point out, it was like 13 years of trauma leading up to that. So those stories took 13 years to kind of collect and and put together. So the writing, yes, was was six weeks, but the the the getting their lessons was 13 years. Yeah.

Marsha 50:40

And you know what? Now that I'm thinking, you said six weeks. So it may have been a little quicker for you in that process too, because you already know the beginning and the end of the story. So you didn't have to creatively like no think of an ending that would satisfy a reader. You just told the story. Yeah.

SPEAKER_02 50:58

Absolutely. And really, if you're just regurgitating your own memories, that takes no effort whatsoever. Like the effort was actually just sitting in it to pull out the details and being able to work through it. That's what actually took the most

Sharing The Story With The Family

SPEAKER_02 51:12

out of me, was just to like, you know, okay, let's go into that story again. And like, oh, okay, I'm I'm here and oh no, that's a hard wall. I gotta pull out. And then, you know, then you're kind of wrecked for like a half an hour or an hour or so. You know, it's it's super emotionally labor intensive, whereas not necessarily physically um intensive. Right.

Marsha 51:35

One thing I've learned about the book publishing world, and I don't know if this is true for the entire publishing world, is that if you do get a traditional publishing gig, and I've worked with a book author before, I did a book launch party for uh someone I would consider a friend. Um you don't, they don't market for you. And so I'm curious, yeah, even though you may get that book publishing deal, you may find that they won't do any marketing and that's all up to you. That's all your money, that's all your costs. Yeah. So I'm curious about your book and how you got it out into the world. I know you're on TikTok and things like that. How did you do the marketing, knowing that these were your stories? And I'm not sure how, you know, uh social media famous you were before your book, but I'm not famous now. And so how did you just not how did you sort of get your book out there into the world?

SPEAKER_02 52:32

Um, I thought of, you know, and again, not knowing business, I'm like, oh, I think I'm just gonna sell these one at a time. So where are, you know, okay, at least my base is nurses. That's what I know. Um, and I know that this would probably be more appealing and more of use to nursing students and new nurses. Okay, we've niche down again. So then you're like, okay, well, where do all the the nurses hang out? To me, nursing conferences. So I'm like, okay, well, nursing conferences, like the official super regulated, you know, fancy dancy professional conferences. Hmm K, but like, not really. Whereas nurse Blake, oh, why, yes. That, you know, I've seen, I've seen his comedy show, I've seen his TikToks. Uh, he's got a huge following. I'm like, oh, that makes a lot of sense for theoretically getting a lot of press out to, um, or at least exposure out to new nurses. Like, that's a huge following. So I thought, okay, I will go to NurseCon and I will exhibit and I will sell my books and my journals and and we'll go that way. So that was phenomenal. Ended up um being right in the booth next to his business manager as they were selling like the nurse cruise. So her and I, we got chatting. Oh, location. Great location. So I was like, oh, this is perfect. So her and I got along, got along famously and we were chit-chatting. And she she actually has got like a marketing major behind her. So she's like, oh, if you, you know, put together like a gift giveaway package, get people to sign up and just buy the um because the book wasn't published at that time, but if you get them to buy like the e-cobo version, then that'll put you up on Amazon. Then you can get those screenshots of, you know, number one bestseller in your category. Holy crap, that's fantastic. So sure enough, within a day, hit number one bestseller status for the ebook uh in all three categories. So I was like, okay, this is clearly love her. We're gonna stick around with her. So when the chance came around, she had said, you know, we she'd sent me an email to say, hey, we're looking for new educators for the cruise. Why don't you apply? I said, Oh my God, yes, applied to be on the cruise, didn't get the cruise, went on the cruise, had a blast. Um, highly recommended. Um, but then as they were getting ready to go on the cruise, they were looking for educators for nurse camp. And nurse camp was more of a wellness holistic focus versus like the skills for work for focus. And so I'm like, oh, I got that wrapped up, like nobody's business. So here's four different classes on how to trust your gut, how to greet your patient, how to write your story, and then how to enter your villain era, which is really just putting you first. But people want to see that as villainous, sure, have at her. Um, so that, and again, that was like a year, and I still can't even believe that that happened. Happened. Yeah. Because like, I'm not my my kids every now and again, they're like, oh my god, mom's famous. I'm like, like making fun of me. I'm like, I'm not famous. Please don't make me famous. I don't want to be famous. Right. I don't want to leave bedside. Like, that's not the ultimate goal. The goal is to get nursing intuition out there and us talking about it while feeling supported by science. And then also to support the new grads transitioning into bedside because, like, man, she's a beast. Uh, we need more support services because clearly, with 30 to 60% of new graduate nurses leaving within the first two years, something's gotta give.

Marsha 56:06

That was Jin Johnson, ER nurse and author of Nursing Intuition: How to Trust Your Gut, Save Your Sanity, and Survive Your Career. And here's something that Jin loves when time permits.

SPEAKER_02 56:21

With the business getting up and running, I haven't done it as much, but I used to cross-ditch like hours a day. I love it. There's something just so relaxing about, you know, I have to just focus on the little X and the little X and the little X. And it helps to shut off the ADHD a lot because it's very repetitive. You can kind of zill out a little bit. Um, and, you know, it's it's crafty.

Marsha 56:50

Hey, thanks so much for listening to the show this

Nursing Intuition: Science And Practice

Marsha 56:52

week. Please make sure to rate and review this episode in your favorite podcast app. And don't forget to click the follow button so you won't miss an episode. This show was produced and edited by yours truly with administrative and research support from Liz Alexandry and Renan Silva. I'm Marcia Batti, and you've been listening to the Boston Earth Podcast.