17. Advocacy, Education, and Nurse-Led Innovation with Dr. Megan McDowell

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

In this episode, Marsha Battee speaks with Megan McDowell, DNP, MSN, RN-BC, CNE, about the unexpected turn that led her into critical care, the teaching moments that moved her toward nursing education, why nurses need better preparation to recognize and respond to human trafficking, and how an everyday clinical-management challenge became Track My Clinical.

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

Transcript

Live Show Shift On Substack

Marsha 0:00

Welcome to another episode of the Bossy Nurse Podcast. And we are doing something completely new to the show. We are now recording live episodes of the Bossy Nurse Podcast. We're doing so over on Substack. So if you have not joined Substack yet, if you've never heard of Substack or if you're curious about Substack, I encourage you to head on over to Substack.com and get your own account. It's sort of a writer's platform for anybody in the industry. You'll find lots of writers from all over telling their stories, telling wonderful stories. And now podcasting is a part of that platform as well. And I thought it would be fun to change up the sort of way we do the Boston Nurse Podcast and do some live episodes. So today we have a wonderful guest who's on the show. Her name is Dr. Megan McDowell, and we'll talk a lot about the work that she does, the advocacy work that she does, how she got into nursing. We'll talk about all of this on the show today. And I'm excited to bring her to the show. So, Megan, I want to welcome you to the show.

SPEAKER_01 1:12

Thank you so, so much, Marsha. I'm so happy to be here and to chat with you today. And yeah, so thank you for having me.

Marsha 1:21

Amazing. Great. So why don't you just give us like a little 30-second pitch on who Megan is and the work that she does and nursing?

Meet Dr. Megan McDowell

SPEAKER_01 1:32

Sure. So I'm Megan. I've been a nurse since 2003, fell in love kind of with nursing by accident, um, went into critical care and spent almost 18 years at bedside doing critical care and then transitioned into cardiology. And during that time, really found um my work as a nurse really sparked my interest in nursing education. So I taught first clinical and then classroom. I'm now an assistant professor at Brunell University here in Georgia. And through my doctoral work, I got involved with human trafficking. So I've been working with some great organizations here in Georgia and nationally, really putting forth um education for nurses about what is human trafficking and what can we do to help victims and survivors of traffic. And then last year, I also got into um a SAS business. So I started a software company based on the needs of nursing education and helping with clinical manage. So I wear a lot of hats, but I've really, you know, enjoyed being a nurse and all the different roles and just the opportunities. So it's been a really cool journey. And it's kind of, you know, neat to see. I don't really know where it's going to happen next, but that's one of the beauties about being a nurse.

Marsha 2:40

Oh, yeah. Very, yeah. I love being a nurse because there are so many things you can go into nursing. Um, you know, so many things that you can do. And I've done a lot of things in nursing, and I'm sure many nurses have that same story that there are so many things you can do with nursing. Um, so I do want to start sort of in the very beginning, um, before nursing. And um, where are you from originally? Where did you grew up? How was, you know, childlife for you? Where we're talking about that a little bit.

Growing Up With Dance And Doubt

SPEAKER_01 3:09

Sure. So I grew up in the Midwest, um, about a half an hour northwest of Chicago in the burbs, and um, youngest of three kids, you know, didn't got into high school and college with dance and I loved people, but really didn't know what I wanted to do with my life. And um was studying at our like local university at Northern Illinois and was studying dance and psychology and business and kind of floundering, not really knowing at 1819 what I wanted to do with my lives. And um, yeah, so that's kind of how that evolved. I don't know if you want me to go into like how I fell into nursing then.

Marsha 3:46

Well, yeah, before falling into nursing though, I'm curious about the dance. Uh, what was your uh, I guess, specialty in dance? I speak in everything in specialty terms now that we're nurses at this, but of course type of dance did you do?

SPEAKER_01 3:58

Um, I did jazz, tap ballet, lyrical point. Um, I was in a dance company and kind of toured usually locally. We did a couple national conventions and I really loved dance. So, but I think that also helped me as a nurse in terms of professionalism and being able to, you know, look and speak professionally and carry myself. And I think as a nurse educator, it's important because we're in front of people a lot and being able to, you know, still get scared a little bit with having to speak, especially if you've got, you know, a large I've been speaking now at conferences regarding my DMP project, but I think my training as a dance has really helped me in that. It's kind of crazy that all these years later. So Emily was it's funny. I was I was a cheerleader too. And I was too great. I was a base. So like it was my job not to let anybody hit the hit the ground. Yeah. So now as a nurse, you know, I I use that a lot in critical care where I would, you know, that skill to prevent patients from falling. So it's funny how these early, you know, moments in your life transition into your future profession. Right.

Marsha 5:03

Now, do you still dance?

SPEAKER_01 5:04

Do you still have the opportunity to I love to um I do Zumba here and there. So more just kind of dance parties in the kitchen with my kids now. Oh, okay.

Marsha 5:14

Well, that's always fun, I'm sure. Yeah. So so I I was reading a little bit about your

The ICU Unit Clerk Turning Point

Marsha 5:20

story, and um, we sort of have a similar story in terms of working in a hospital as a unit clerk before actually going into nursing. Yeah, when I was reading that, um, I saw that you were sort of during summertime asked to come in and do some unit secretary work on an ICU unit. And I was actually, um, although I was in nursing school, I was working as a unit clerk at the hospital that I ended up doing my first um, you know, nursing uh uh first year in nursing. Um, so tell us a little bit about how that happened, how you how you got asked to be a unit clerk. Not to be school. Yeah.

SPEAKER_01 6:01

Um, I was home on summer break, and that was still when I was studying, you know, psych and dance and business and not really knowing what to do. And I needed a summer job. And my mom was a risk manager at our local hospital and had heard that in our critical care unit, the unit secretary had a baby and was going to be out just for a short period of time. And they really, you know, didn't want to replace her, but needed someone kind of short-term to fill in. And she said, Would you be interested? And I thought about it and I said, Well, I'll try it. You know, it's what what do I have to lose? I need a job, you know, I'm poor and a college student and started in that job with no expectations and no realization that the impact that that would have on my life. Um, but I, you know, I told people, like, I had that front seat view of what the amazing nurses did every day in ICU. And there were nurses on that unit at that time that kind of saw that spark in me and that curiosity and kind of just that interest and helping people and saving lives. And I absolutely fell in love. Um, I just I realized how critical it was that nurses, you know, doing all the assessments, the interventions, the communication, the life-saving measures, where every day I was getting that front row seat and just being able to watch that with some incredible nurses. Um, so I ended that summer with going back to college saying this was what I was put on this earth to do. I'll do anything to do that and kind of figure out. And I'll be honest, I wasn't the greatest student. I feel like I really didn't have anything that like sparked that pressure or that passion in me. Um, I kind of just got by in my studies, you know, I was more with my friends and being social, and I loved that. So I struggled. Um, but I found, you know, in nursing education, there were some instructors that I had that were just so phenomenal. And I realized the more that I put into my studies, how that changed outcomes for patients, and that everything that I learned was immediately transferable at the bedside. So that really kind of changed my perspective, not like why do I have to learn this, but how much can I learn to improve myself as a nurse? And you really could see that, you know, the not only the ability to have the understanding classroom, the theories, but being able to apply that and just really, you know, understanding people, connecting people, having that empathy. And that really came naturally to me. I think just being a people person. Um, so I really was fortunate that I that lady had a baby that summer. I don't know that I'd be sitting here if she didn't. So thank you, whatever. Yeah, I think her name was Pam. So thank you, Pam, for having that baby.

Marsha 8:34

Yeah, isn't that amazing how one small shift in life can change your whole trajectory in life itself? And it wasn't even a shift that happened, well, not directly a ship that you made, but a ship that happened in someone else's life that actually um changed how yeah, changed how your trajectory was. And so I think I think that's very, very interesting. I can't think of the I'm trying to think of the name of the movie with Gwyneth Paltrow. I can't think of the name of the movie, but it'll come to me and I'll put it in the show notes. But it's it's something about, you know, you make one small decision and it changes the serendic kind of thing. Yeah. Yeah. So um I I do want to talk about your transition. So when you went back to school right after that experience in the ICU as a unit secretary, how was that transition for you when you went back to school? Did you find that you had to change a lot of your courses? I know you said you were studying psychology and business. Did you have to change a lot of what you were studying? And did you end up minoring in like a psychology or business or something to keep those credits? Just curious at how that happened.

Choosing An ADN To Focus

SPEAKER_01 9:44

It was challenging to be completely candid with you. Um, at the time, um, I was a social chair in my sorority. I was very, you know, involved in social life at the university. Um, I had met my boyfriend, who's now my husband. So I really decided at that time to be able to focus on nursing. I needed to leave the, you know, typical university and come home and go to a tech school and really focus on my studies because I kind of knew myself, I knew that I'd be distracted and that I probably wouldn't be successful had I stayed there. And I knew like at that point in my life, I really needed to like kind of hooker down. So I ended up um going to Harper College, which is a tech school, an ADN program. And I am so happy that I did. So Harper really set me up for success in terms of, I think I needed more of a clinical focused program. I'm very much a doer and a hands-on, you know, in terms of how do I like to learn things. And because I got so much more time in clinical to apply the theories, I really think that was, you know, integral to my success as a nurse and it helped tremendously. And there were some really great nursing instructors that I had there that I, you know, it was kind of cool later in my career when I came back as a nurse educator. I got to work alongside them at Harper. So that was amazing. Um, and really, you know, thank them for like being instrumental. And I I had had some educators up until that point in my life that just I think, you know, with our generation, a lot of us had ADD and probably undiagnosed. And um, I had a lot of struggles as a student. And I think a lot of educators kind of overlooked me. And there were definitely teachers that I had there that even though I struggled to learn, I did really well and I was gonna be a good nurse. So I think just pouring and just kind of building up my confidence and kind of um helping me, you know, through those struggles and giving me more time to apply the theory really helped.

Marsha 11:40

Oh, great, great. So in terms of all of the transition that you had going on at the time, did you feel that you were prepared in such a short period of time? I'm assuming it was a short period of time from the transition to graduating because it was an ADN program. How long was that transition?

SPEAKER_01 12:06

So I took probably about a year of prerequisites at the university prior to me. So I did it afterwards like living to tech school or something. So I went to the university and then decided, you know what, I'm I'm gonna go to live at home and be able to focus on my studies. So it did take me probably three years. So I spent six years getting an associate's degree as a nurse, which you know, but now as I'm a mom and I've got a college student, I I like to tell him, look, your pathway is not gonna be A to Z without all these little, you know, bumps along the way. The point is sticking with it, you know, and just, you know, learning that grit and that perseverance and just, you know, pushing yourself. So yeah, it took, I don't know if that's something I should have met readily. It took me six years to get my bachelor's degree, but I'm sitting here now. So I guess that's okay. But it definitely wasn't a traditional path in any way, shape, or form.

Marsha 13:02

Yeah, and I think it's important that you did point that out. Um, not intentionally probably, but I think it's important because there's a nurse out there or a nursing student out there who's listening to this and who's, you know, really struggling with the challenge of why is it taking me so long to get through this? Am I actually going to finish this because I'm on my third year, I'm on my fourth year because life happens in the background and I still have to do go to class and you know do a little schoolwork. Um, some some students may be mothers, some students may be in the midst of getting married, in the midst of getting divorced, several things. So, you know, it it it's okay that it can take some time to get through the coursework. Um, and I think it's gonna help somebody when they hear that so and help them keep going. So I think it's very good that you said that or talked about that. Um, so when you when you did, you know, finish the program, um, I think you went into that same unit, right? And how did that happen? Did you know that you wanted to go back into that unit, or did they kind of coax you when they found out you graduated, or what happened?

SPEAKER_01 14:11

So when I was getting towards the end of graduation at Harbor, um, we they had us start interviewing places, and I had fallen in love with critical

Returning To ICU And Preventing Burnout

SPEAKER_01 14:20

care. And everybody told me, you know, go into critical care as a new graduate, you know, you need to go to MedSurge, get some skills and that. And I was like, well, you know, I knew the providers, I knew the flow, I knew the nurses, at least the secretary side. You know, I obviously hadn't done the nursing side yet. Um, but I interviewed and um I really fell in love with PEDs too when I was doing my clinicals. So I was offered a night PQ position or a day adult ICU position back in that same critical care that kind of sparked my interest. And at the time, you know, a lot of the nurses that were working there when I fell in love with it were still there and they were, you know, willing to kind of bring me in under their wing. So I did. I took that, I took that position in the ICU and I never, and it was kind of great too. There was one of the nurses that I worked with, um, who was completing her, her name's Renee. She was completing her PhD and was working on, you know, burnout and ICU nurses and coping with, you know, dealing with the intricacies of being a critical care nurse, you know, life and death on a daily basis. And she, as part of that study, um brought me and some other nurses on that unit into that. And it was really like, it was so instrumental. We would meet weekly at her house and have breakfast, and we would just talk, you know, obviously HIPAA-sensitive, but about cases and really supporting each other through that and what that looks like. Because I think in nursing, we have a hard time. We're caring and caring and putting out, but a lot of us have a hard time caring for ourselves to be able to read color cut. So I think having that experience, my first year as a nurse, kind of set the groundwork for the rest of my career. So not only did I realize the importance as an ICU nurse, but as an educator for my students too, and really teach them that, you know, what does real self-care look like? And, you know, having the support of the people that I would go home and, you know, talk to my my Steve, my husband now, but or my mom about it. And my mom's a nurse and really understood, but having those peers with you and being able to debrief with them and not just once, but an ongoing. And that was really cool to be part of that. So I think that has really helped me throughout my career.

Marsha 16:24

And a lot of nurses don't have that. I mean, I would have loved to have the opportunity to have a senior nursery sit down with us outside of the unit and actually debrief and discuss uh, you know, what's happening on the unit and discussing burnout issues and things like that. And I don't even remember burnout being a thing when I was in nursing school. I remember being exhausted as a nurse and, you know, stressed as a first-year nurse and just all the things. Um, but I don't remember it being called burnout. And maybe it was because I wasn't tied into the whole nursing communities, you know, online and things like that. But I just remember being totally burned out, um, dreading going to work most days, um, not wanting to go to work, wanting to quit, you know, having those, you know, absolutely common thoughts probably among a many, many nurses. Um, but it's great that you have the support. And I think it's so key now, now that we have social media, um, you have LinkedIn, you have different platforms where nurses are now able to get the support online and actually have visibility into what other nurses are actually going through. I think it's so crucial that we now have those platforms and outlets for nurses. It would have been helpful if we had it back then. I know um, I can't even remember what platforms were online when I was in nursing school or first year nurse. I became a nurse in 2011. So I'm not sure what I can't remember which platforms. I know Facebook was out, but um I I just don't see I I didn't see the support that nurses probably have right now and the advocacy for yeah, self-care that we have now, which is which is great. Um, so in nursing, I know you were working in critical care. Um, and then you, from what I understand, you thought that, oh, maybe I should go become a, you know, get my nurse practitioner license or something like that, you know, go into that route. But then you made a different decision, which, you know, coming from critical care, um I know a lot of nurses in critical care usually go the route of, okay, nurse practitioner, because of this, the knowledge and skill that you have and the experience that you get working in those types of units. So, what made you think differently or make the decision to do differently?

Why She Picks Nursing Education

SPEAKER_01 18:49

Sure. So when I started grad school really was kind of thinking I just wanted to open more opportunities for myself as a nurse. And um, the first year of our graduate program, all of the nurse practitioners and the nurse educators were in the same group. And we kind of made it through that first year to decide what we wanted to do. Um, at that time, I was working at a hospital um in the Northwest suburbs, and we had just kind of evolved a rapid response team. So that was kind of a new concept then. And that was probably like early, like around 2010, 2009. So we're in there where we were creating it and we had protocols. And when I worked in the critical care, sometimes they would pull me into that rapid response role. And they had thought, you know, we had some cases on the units, whether it be MedSurge or Teleag, where um they wanted us to do kind of case studies for the safe staff nurses and educate them, like maybe certain things that they should look for. For example, if like a patient's going septic, what are some early indicators? And this is way before, you know, I mean, you know, the EHR was out, but before we had all those, you know, sepsis sniffers and uh AI to assist with that. So I part of that, I would go and do some classes for staff nurses about like what is sepsis, what does it look like, or maybe stroke, you know, talking about NIH stroke scale. And as I was doing that, a couple of the nurses said, you know, you have a really good way of explaining things in a simple way, but also really easy to understand and like apply it. And I got that feed medic a couple of times and I really enjoyed getting that feeling, like kind of teaching. I I always knew I loved patient care and critical care. We do some patient teaching, but a lot of times, you know, they're on a vent, I can teach their family something, but a lot of times if they're that sick. Um, but I really loved teaching and educating and just, you know, building that confidence in others that like I felt like I lacked early in my career and making things, these crazy complex concepts a little simpler and less scary and tangible. So I was about a year into my graduate program, and I decided this is right for me. I should do nursing ed. So I veered into that. Um, and then when I graduated from that program, they needed nurse educators, like clinical instructors, both at NIU, where I started, and HARPE. So I took both. So I took, so I went back to each of them, and it was kind of cool to be back at NIU in that role, um, just because I I started there, and then also at Harper, where I just had such a wonderful experience as a student, and then was able to, these people that I looked up to so much, I was able to be peers with them and teach alongside them. So that was just an amazing full circle moment. Um, and then yeah, so I've been teaching now since 2012, um, started about a decade, was in in the clinical environment and at CIN lab, which I love. And then now I've gotten more into the classroom aspect and doing um success coaching too. So coach students are kind of like me that maybe you're struggling a little bit with understanding because it's nursing school's hard. And a lot of times, you know, when they get to us, and depending on what their high school or their early college experiences look like, really not realizing the time commitment and really how challenging a nursing program is. So I think like that all of everything that's gotten me here is helped me in my educator. role, you know, kind of building up these students and, you know, helping them to study differently and helping them to see things in different ways.

Marsha 22:07

Yeah. So I did find some interesting.

The Moment Trafficking Became Real

Marsha 22:11

We've talked previously before we actually sat down to record this podcast. And I I have found it interesting the work that you did while you were in grad school with uh human trafficking. And um just curious about how that work came about and uh what are you doing with that work right now.

SPEAKER_01 22:30

Sure. So I actually got into um human trafficking and working in my advocacy role when I was doing um my DNP program. So that I started a few years ago and kind of thought that I would do my project. You know, obviously DNP projects were trying to change practice and using the evidence out there to make the clinical practice change. And with my background and critical care and cardiology, that was what I assumed that I would do my project in. But a few things happened where um it kind of shifted my focus to this problem. So around I don't know 2020 21 um the sound of freedom came out and it was about human trafficking and a lot of people saw that and I just remember thinking God that's so awful. I'm so happy it's not happening here in the States this was really kind of pre-Epstein where that wasn't huge. And um I moved to Georgia in 2020 and there were a lot of cases of trafficking that I kept hearing about not only you know nationally but here in my state of Georgia. And there's um a nurse educator that I really follow and like and respect. His name's Keith Risher, Keith RN. And he had had someone on his show speaking about human trafficking and she is a pioneer in some of the research that's being done around trafficking and nursing and what we can do. And really the gist of her study was that she wanted to know like with new nurses and nursing students how confident do they feel in their role and responding to a victim of trafficking and she interviewed almost 700 people and of those new nurses and nursing students only 5% said yeah I really feel confident in my role to be able to recognize respond and help you know a patient who might be involved with trafficking. So I listened to that and I was like well that's interesting. And then I kept hearing in the news in Georgia and I thought you know I really don't know much about this topic. It's happening here. And um one of the studies that I saw by Dr. McKinney Chisong um that she she's an ED physician at Cedar Sinai in New York and she said that up to 80 to 90% of survivors of trafficking had some point, some touch point with healthcare that they are coming and seeking care during their time of being trafficked. Yeah. And even though that's happening only 5% of us are really knowing about it. So I kind of thought about all my years in nursing ed and I thought I've never taught about this. I've never talked about this I don't really know anything about this. And then in my clinical practice I was um working in outpatient cardiology and a patient came in and something didn't add up. He was with someone that wouldn't leave him alone. He had a few of the red flags and risk factors and I couldn't I wasn't sure but I just knew in my bones that something was off with this patient and why was this person who was completely unrelated with him wouldn't leave him alone was talking for him the patient just seemed very meek. You know there were several things that now I realized he probably was being trafficked and I missed that opportunity. So all of that happened within a couple of months of each other and I kind of just got quiet and you know did like some a lot of thoughtfulness about it in prayer just kind of like what which path should I be taking here? And I felt like you need to be doing this, Megan. So that's kind of how I fell into trafficking and I really kind of jumped in, you know, feet first not really knowing anything about this topic and now I'm doing anything that I can to share it with nurses.

Marsha 25:58

Can you also talk about human trafficking in terms of it not just being about sex work or that type of um trafficking because I think when we hear human trafficking we automatically go to well some of us automatically go to the assumption that it has to involve some type of um you know sexual human trafficking when when that's not always the case. Because in the case that you're mentioning with the man who just couldn't appear to speak to himself um it didn't appear that the that was the

Sex And Labor Trafficking Basics

Marsha 26:31

case.

SPEAKER_01 26:31

Yeah so definitely so there's two kind of just so like I I like to talk like as an educator about like definition. So like in trafficking and really for it to be defined by the law there has to be an action a means and a purpose. So the action can be you know recruiting harboring maybe obtaining someone for the purpose of either sex or labor trafficking and using force fraud or coercion to keep them in that role. And with labor trafficking, you know, here in the States we do it definitely there are more people that are being sex trafficked here than labor trafficked. That said it's still a major issue you know some of the seeing 30 to 40% of the trafficking rates that are you know called in to the hotline involve labor trafficking. And we think that that could be maybe someone working um even worse it's in healthcare. It could be someone forced to do um housekeeping or you know depending on maybe it's a skilled worker, someone who's being forced to do any type of physical labor. Even we're seeing it in different hospitality industries. So it really can show up anywhere. So it's one thing I like to talk about is just our bias in terms of what do we think it looks like and what does it really look like because sometimes our bias can kind of hurt us, especially if we've seen those movies where we're like, it has to look like this to do where we know that trafficking happens in men and women. It happens from all the way from pediatrics all the way up to elderly. So it's not just you know what we, you know, a beater group, you know, a battered person that you would expect coming in and it certainly can be but I just I want people to almost have the the realization that anyone that you see in your practice could be. And that's something that we need to be screening for regularly.

Marsha 28:15

Yeah. Also I'm curious about that 5% of nurses who actually knew about it. And I'm not sure if this was part of the study at all. I'm a former forensic nurse. I used to work as a sexual assault nurse examiner um so um and used to have that certification. I don't do that work now but we were trained to this was part of our training to the term a forensic nurse um so we were trained in how to recognize the signs of human trafficking um I've actually had a few, a handful of instances where I came across what I suspected were human trafficking victims, you know, where you have um a partner who doesn't want to leave the room for a very intimate exam you know um just just various different instances where I've come across that. I'm curious if that 5% is there any research that would show that those are nurses who are actually trained as like forensic nurses because it would make sense if the 5% were such a it's could because it's such a small number if those nurses who actually knew how to identify it were maybe forensic nurses or had some kind of training in sure so that was Dr.

SPEAKER_01 29:30

Francine Bodoneri's study and that was of 700 she wanted to know nursing students and newly graduated. Newly graduated okay so that was her that was her sample. But that also told me as a nurse educator, you know, maybe we need to be touching on this more and not you know a 10 minute wide and one maybe in community health or behavioral health. But maybe this needs concept needs to be threaded throughout our curriculums where maybe we start it in an assessment course. It could be threaded in in maternal health or behavioral health we can do maybe a simulation in high acuity where you know maybe you have someone who's hypovolemic dehydrated because of forced labor, but also that person's being trafficked so you know kind of thinking it differently instead of just this little concept that needs to be touched on once that we really need our students to understand what does this look like and how to respond to them, you know, in a way that's trauma informed, that's survivor informed and really looking at what is, you know, what are we expecting for these survivors? Yeah. Anecdotally at where the hospital system where I did my project really didn't have much in terms of education or responses or protocols in place if someone came in with trafficking. And I did my project in the emergency room that tends to be the number one place where if victims are going to show up somewhere, that's I mean they absolutely absolutely can show up anywhere, but that's the number one place from where we know from our survivor studies. And one of the nurses had told me that a a patient came in and said, you know, I'm being trafficked I need help. And that's unusual because a lot of times they're not going to be that you know and they wanted to do the right thing. They involved security and they called 911 to get this patient some help. But what they didn't know that this patient was being forced to do criminal acts by their trafficker and had been told if you tell anybody or if you tell the police, you'll be deported, you'll be arrested, you'll be kicked out of the country and also we're going to come after you and your family. So when they did that and security showed up and that victim saw she bolted and that was just such a missed opportunity where it's you know there's going to be certain things that you know we we don't want to make assumptions for what they need. You know, maybe for that day they just need somewhere safe to be or a turkey sandwich, who knows? But you know, in terms of then getting help and getting them connected to resources, what does that look like? And you know obviously safety of staff nurses is paramount but also that might not be the best first you know thing that we do especially if they've been told you're going to get in trouble if you tell somebody.

Screening Tools And Safer Responses

Marsha 32:03

Yeah. And the first person that comes into the room is a police officer or security guard. And and it wasn't explained to them ahead of time hey I'm going to you know relay this information to security is it okay? Yeah. So just thinking about um I'm just thinking about rooming patients and you know in primary care or even the ER, those screening tools that we use sometimes I mean we have those screening tools where we ask about you know do you feel safe? Do you know if there's any work work currently being done with screening tools to actually add in more specific questions to address human trafficking because I just know that you know the questions of do you feel safe at home those kind of questions.

SPEAKER_01 32:50

But sure that just you know a lot of those aren't sufficient for patient for being trafficked. My project really focused on adult victims and I part of what I started was what is the best validated tool for screening for adult trafficking for both sex and labor trafficking. And what I realized is it it is important to screen people, but what is more important is to create the right environment so that when and if they're ready to disclose, then they'll come forward. So that said, um when I looked at all the tools that were available for adults um the RAF tool seemed to be wonderful. It's only four questions. It's easy to you know utilize in and then the quick you the the quick youth indicators tool granted I didn't my background's not pediatrics um but I found those two to be the best tools where it's just four questions. But I I preface that with you can ask the perfect question and they still aren't going to come forward. But you are creating yeah like really listening to them being empathetic not judging and these patients might come in you know especially if their trafficker is using you know maybe if they're addicted to drugs or something maybe they're using that to keep them in that vicious cycle. So when they present to us in the ED, we just see someone oh my gosh, they're strung out, they're drug seeking they're this and that not even thinking that maybe this could be what what their traffickers using to manipulate them to keep them in that cycle. So with that said I the RAF tool um and I'll link everything after this so that if your your listeners are interested um in just you know Dr. Greenbaum also came up with a tool she's based here in Georgia she's now retired and she's wonderful she's also a pioneer in pediatrics um where her tool is it's kind of similar to the quick you that's indicators tool but just asking those questions. But I think also it's important to just standardize you know asking people because one of my coworkers said and I get I feel embarrassed like what if I ask them about this and like they're not being trafficked and I don't want them to feel bad. It's uncomfortable but the more we kind of just normalize this right and get part of normal nursing care, then it doesn't have to be so I did do you know circling back to like the 5% in Francine study that she did I looked at that when I did my project too even though you know my project was not research based I did want to get that baseline data of the participants. So of the emergency room staff um that I had in mind my project I had from everywhere from paramedics, nursing assistants, MAs, nurses, physicians, nurse practitioners. So I got about 75% of the staff in that emergency room and found most of them had no formal education. Most of them had very limited knowledge. So I was seeing kind of that even though they're in the ER and they are experienced and they're seeing patients, most really had no formal education on this topic.

Marsha 35:43

Yeah. And I'm it's making me think now how would that topic actually be brought up in nursing school? Like what type of um I guess what what part of the curriculum would that even fall under you know I'm I'm sort of trying to imagine where that would fall under. Same with other topics there are other additional topics that are now in in our space that um need to be um talked about during nursing school and we just don't have the opportunity to be just because it's not normally been a part of the curriculum like innovation and nursing and things like that. Some nursing schools are progressive in doing these kind of things but um yeah so I I think this work is very important not because it's uh a former love and in it's probably despite the patient's experience it has been the best part of nursing um in my experience the best part of nursing that I've had come across as a um working as a nurse it's a fulfilling role in a way that you're helping one person and you get to work with one person at a time in that type of work. So I really enjoyed the work um regretted the patient circumstances of course but I really enjoyed the work um that was involved in it. So in terms of um moving from the you know the working with the advocacy and trafficking um and I know you you were saying you did that in your DNP program. So I'm thinking you know with track your track my clinical which is your SaaS product um did working um in your clinicals actually sort of bring about that idea of working towards that product?

Building Track My Clinical

SPEAKER_01 37:26

Sure. Yeah so kind of switching gears but um my husband kind of saw me not suffering but struggling through in terms of clinical management, scheduling, um getting everybody all the moving pieces on the same page and communicating with our clinical instructors, with our you know course coordinators, our clinical coordinators and getting everybody on the same page and looked at it with me and thought there's got to be a better way to do this. You know, we're and then I'm I'm always kind of thinking outside the box and how could we make how could we solve this problem in an easier way and it's also user friendly and you know really helps nurse educators get some time back. So we spent about a year talking to people just kind of gathering data. There are some software products out there now that do this um what we found is kind of their tech is a little bit outdated hadn't been updated in maybe 20 years and might have been focused more towards allied health and not nursing. So we created kind of from the ground up what would we want it to do? What would we want it to look like? How could we make it so that it's intuitive that I like pretty and colors that organized, you know, happy all that together. So we spent about a year building it, piloting it and have now taken it to market and it's been kind of a wild ride. So it's I'm learning things about tech and SaaS and you know in terms of you know SEO and getting in front of the right people and learning you know going to conferences for the first time where you know I was and asked to speak for trafficking and then was like well why don't we get a table there if I'm going to be there anyway. Yeah kind of having you know nurse educators see me wearing both hats and what that looks like. So yeah I kind of fell into this by accident but when we created it we're like well we should take this to market. It's helping me I think it would help others too. So it's been it's been a lot of fun. So what does the tool actually do?

Features That Simplify Clinical Management

SPEAKER_01 39:15

So it's called track my clinical and what it does is it really makes clinical management easier for not only nursing staff and faculty but for students. It does everything from clinical scheduling it uses um geofencing so that if a student is on site, they're able to log in and log out of their clinical and it really helps with in terms of professional professionalism and accountability. So a student has to be on site to be able to clock in and clock out kind of similar to what we do as nurses. That's how we get paid right um so kind of that's one part of it. It also makes easier everything clinical for the faculty because students are able to log what they do in clinical there, whether it be skills, um, they can fill out any type of formative or summative evaluations you could do your daily clinical assignments through it you could do your clinical evaluations tool through the product and super easy then for when our schools have accreditation standards where they need to pull all that reports in terms of hours in are your students meeting their objectives you know if they're maybe accredited by the AACN, you have to tie everything that we do clinically and in the CIN lab and in the lab back to the essentials. So we're able to build those reports and tie everything that the student does clinically back to whatever type of competency that the school uses. It's been a great way just for us all to be on the same page. My leadership likes it because they're able to have visibility across the entire program where's your where are your students at right now? So if anything major happens at the university any type of like an emergency where they need to know they can see in real time where are their students logged at, you know, and how long have they been there, they can really get that nice visibility with students too, they like it because they can track the hours where they've been what they've done and they can export from the tool too so if they want to use that as they're looking for employment or if they want to show you know if a clinical evaluator a clinical instructor gives them a really great eval, they have all that data right there. One issue that I faced was I we have you know a lot of clinical instructors and we use an LMS for our grade book and because of FERPA, which is kind of like HIPAA for students, I didn't necessarily want 10 different people in my grade book because there were students that they didn't need to necessarily be seeing their grades or have the opportunity to accidentally you know manipulate someone's. So with this um they're able we're able to export everything into the LMS and we're doing some cool stuff like in terms of AI and integrations with clinicals. So there's you know different platforms that we can connect with um and with the LMS too. So it's been exciting.

Marsha 41:50

So curious about the build of that do you have a whole team helping you build or is it you your husband sort of doing that build all by yourself and and I imagine that all of the features that you have now didn't come all at once like you built features. So curious about your team and then how did you start first initially and how did you build in features or what made you think to build in the additional features that you have.

SPEAKER_01 42:15

Sure.

Growing The Product Through Feedback

SPEAKER_01 42:16

So I am partnered with Steve so he was an army reservist that we met in college and was studying computer science at NIU and he's worked in software um software development as an architecture technologist an entrepreneur. So he's created some companies in the past I have um I've kind of been watching him interested intrigued over time but he was able to develop all this on his own and the cool thing with having in-house IT is that as we get feedback not only from different schools but we're able to make changes in real time almost like immediate which has been great. And it's been an evolution when we started the really the one feature that I had asked him to work on was clinical preceptorship. That's always a challenge for us. Our students typically in the last semester will get partnered with a nurse out in the wild if you will so their clinical instructor is not with them. They're paired with the nurse and they're going with the nurse on their schedule. And a lot of times we don't have that schedule until the last minute so it's always kind of a cluster of trying to get everybody together where are you at you know if there's a change. So we created it so that if there was a preceptorship like a non-traditional clinical course, the student's able to enter their own hours which is kind of you know none of the other products on the market do that. And another thing is that if their preceptor the nurse that they're paired with has to do an evaluation on that student, they can fill that out through our portal. And then if a clinical instructor needs to come visit so many times and fill out something, they can do that. So you have really nice visibility and where's my student at how are they doing clinically you know do they need anything is there you know getting that feedback in real time. So that's that's kind of how it started and now We've really kind of shifted towards listening to feedback. So we I try to follow like where is your pain? Where are your pain points? You know, what problems are you having? And it seems like with accreditation, you know, there's a lot of things that software now can change intuitively. We've used AI to partner. So again, those objectives, tying them to either the essentials of their AACN or tying them to program learning outcomes or course learning outcomes. So it just makes their life a lot easier.

Marsha 44:27

Yeah. Yeah, it seems like it. Yeah. Um, so in terms of who this product will be perfect for, um how do you approach an organization or a nursing school to um to get this product out of the world? I know you have some clients that you're already working with, but how did you go about it? And who, if if there is a nurse leader listening to today to this episode, who would be that nurse leader that you would reach out to?

SPEAKER_01 44:53

Sure.

Reaching Nursing Programs And Leaders

SPEAKER_01 44:54

So I think getting word of our company in front of schools has been really critical and also kind of challenging. You know, in all of my education and my years, I really didn't have any type of sales or marketing experience. I'm a nurse, I'm an educator. Yeah, I think I understand our industry deeply. Um, but I think we've had the best luck with going to conferences and speaking to people. We were at the AACN conference this spring. Um, unfortunately, I wanted to go to the OADN conference that's going to be happening this fall, but because they have a partnership with one of our competitors that does not allow anyone else in that industry to come. So I was not able to do that. Um, but kind of using Facebook, there's a lot of great nurse educator groups, both on LinkedIn and Facebook. Um, Keith Risher, who's Keith RN, runs Nurses Transforming Nursing Education. So that's, I think there's 20,000 nurse educators on that side in that platform. So it's been really helpful to me as an educator, not only to like put forth, you know, ideas with my own teaching, but also try to get our word out there in that way. Um, we've explored with you know different types of ads on fake Facebook, on LinkedIn, um, writing podcast or writing um blogs about it, and just really trying to talk to people and get our word, our name out there. Um, it's it's been slower than what I'd like, but um definitely would be useful for any nursing program, whether that's um LPN, ADN, BSN, even all the way up to graduate. Um, I noticed like in part of my DNP project, I had to clock my hours and used a very archaic way of doing so it could be, you know, can turn locations off. So if you know, maybe like for community health course, if your students are going to 50 different locations, you can turn location off. So they can so long their hours, but not have to be geofenced to a certain location.

Marsha 46:40

Okay. I was I was actually curious about that. Um, and how um if you've had any feedback about the geofencing um in from the students or from um, I guess nursing administration or the nursing infrastructure at some of these schools. So just was curious about that as well.

SPEAKER_01 46:58

No, no,

Geofencing Without Creepy Tracking

SPEAKER_01 46:59

we I mean we definitely we explored our options with how we wanted to track our students clinically. And we landed on geofencing because we felt like that was the most like friend student friendly in terms of, you know, not you know, I don't want to track these students when they're not in class. I just want to make sure that they're in the sim lab or that they're at the clinical site. So the way geofencing works is that we set a radius around where they're supposed to be for clinical, and that could be at the schools. Or we can even use it, use it for sim lab or lab. And you can set that radius at whatever you want. So if you had a student maybe that's not able to bring their phone, maybe if they're doing a maternity, you know, kind of rotation, we can set the radius around the parking lot so that they can log in and log out. Now, if the student leaves that geofence location, I have no idea where they are, nor do I want to, but I just want to know if they're able to, you know, if they're where they're supposed to be. So kind of teaching not only our faculty and staff, but our students what is geofencing, what does that mean? What does it not mean? Because I don't want to be followed. Yeah, yeah. Three kids and a dog. I'm looking for my children. I don't need to be chasing anybody else. Um, but just really kind of like explaining what does it mean and why are we doing it and really aligning it with professionalism and accountability has been helpful.

What’s Next For The Platform

SPEAKER_01 48:10

So, what's next for Atrect Like Clinical? I think just grow. Like we're really at the point where we're trying to grow our business and just really create great customer relationships. Um, we're creating, we're doing some new innovative things involving AI. So, you know, we're looking at when a student does, we used to call them clinical skills checkoffs. We try not to, a lot of us, you know, shifting now towards competency-based, we're calling it competency or skills checks or competency checks. Um, but using AI to be able to, a lot of us like to use it on paper instead of doing technology. So being able to maybe scan through our app the skills sheet so it's able to grab that data for that student clinically so that we don't have papers laying around. Um, but I think integrating and partnering with some organizations to help get our word, you know, help us help you, kind of Jerry Maguire thing. Like we're here, we're wanting to help my favorite movies, right? Get out there, like just and that's been honestly like I love people, but I'm I'm we're gonna be now looking at hiring some people to help us in terms of sales and maybe market for you know, in terms of outreach.

Marsha 49:19

So is it just you and your husband at this time? Yeah, wow. So that's a lot of work, yeah, to do on your own. Yeah. Um, and I commend you for that. I know. Um, I mean, especially your husband having those skills to actually build the platform, um, help you build the platform through the ideas that you've had and things like that. So uh what's your favorite? Curious, what's your favorite feature of your platform?

SPEAKER_01 49:44

I to me personally, I like the when you log in for the first time, you get kind of a monthly calendar and it's beautiful. It's different colors, so you can see where everybody's at, but just kind of having that organization and being able to know who, what, where, when, and in real time, so that we're able to share that with everybody. And that's made my life easy so much easier and our instructor's life easier and the students' life easier. So just having that ability to have that view is wonderful. Great. So it hasn't ruined our marriage yet. No, we'll I think we'll resign. Yeah. So definitely challenging because it's it'll be, you know, very early, very late at night, weekends. And I'm like, whoa, we need some boundaries around our working here. Seems like, but it's so far it's so good.

Marsha 50:36

Awesome. Well, I want to thank you so much for being on the show. All of the information that we talked about in the show, um, whether it's track my clinical, the advocacy work that um Megan is doing, also some of the resources that she put forth, we're going to put them in the show notes over at thebossynorse.com, also on Substack. And then you'll also be able to hear this episode or watch this episode on Substack, but you'll also be able to hear it in your favorite podcast app, and that's Apple Podcasts, Spotify, or wherever you get your episodes. So, Megan, I do have one final question for you before we wrap up.

Creator Mindset And Closing

Marsha 51:14

If you had to consider yourself as one of three things, which one would it be? And why? Um, would you call yourself a creator, innovator, or a risk taker?

SPEAKER_01 51:28

And I can pick one. I would say I think creator. I do. Even though there's, you know, innovation and what we're doing with track my clinical, I think the reason I came to that is because I like to be creative with how I approach teaching and how I reproach problems and thinking through different solutions. So I think that probably is the one that most resonates with me.

Marsha 51:54

That was Dr. Megan McDowell, advocate, educator, and nurse-led innovator. Hey, thank you so much for listening to the show this week. Don't forget to rate and review this episode in your favorite podcast app. And then don't forget to click the follow button. I'll see you on the next episode.