Nurse Burnout in the CHD Community Part 1

Anna Jaworski is joined by a panel of nurses to discuss a very important topic in this episode of "Heart to Heart with Anna." Deena Barber, Christy Sillman and, Roslyn Rivera share their experiences with Anna about nurse burnout, why nurses who serve the congenital heart defect (CHD) community are at risk, why people might be attracted to become a nurse in the CHD community, and exactly what nurse burnout looks like.

This program is the first of a two-part series investigating this important topic. Next week's program specifically deals with solutions to nurse burnout -- solutions that the CHD community can quickly and easily implement, as well as suggestions for hospitals, clinics, and organizations that employ nurses serving this special population.

Other Heart to Heart with Anna episodes mentioned in this episode include:

Deena Barber's programs -- The Natural Course of Congenital Heart Defects https://tinyurl.com/w36ywtf

A Nurse’s Perspective: Changes in Care over the last 30 Years: Part 1 and Part 2
https://tinyurl.com/wrmy5rs
https://tinyurl.com/us4ac2o

Christy Sillman's program -- Rethinking Transition Care for CHD Survivors
https://tinyurl.com/vcfr7ms

Roslyn Rivera's programs -- CHDs Around the Globe - Novick Cardiac Alliance
https://tinyurl.com/rv3rcll

A View From the Other Side of the Bed
https://tinyurl.com/w7cydol

Please take a moment to follow us on your preferred social media platforms:

Apple Podcasts (https://itunes.apple.com/us/podcast/heart-to-heart-with-anna/id1132261435?mt=2)

Facebook  (https://www.facebook.com/HearttoHeartwithAnna/)

YouTube  (https://www.youtube.com/channel/UCGPKwIU5M_YOxvtWepFR5Zw)

Instagram  (https://www.instagram.com/hugpodcastnetwork/)

If you enjoy this program and would like to be a Patron, please check out our Patreon page  (https://www.patreon.com/HeartToHeart)

Doctor Burnout in the Congenital Heart Defect Community
https://tinyurl.com/rgtgwvn

Transcript

Christy Sillman: 0:00

I've seen burnout when I worked in the pediatric ICU and I think that has to relate to the intensity, the degree of trauma that a lot of providers experience and I've seen nurses experience that trauma to the point where they have to leave the field of nursing because it's become too difficult.

Anna Jaworski: 0:23

Welcome to Heart to Heart with Anna. I am Anna Jaworski and the host of your program. I'm so happy you're here with us today. Our program today is a little bit different than other programs. Today we're featuring a panel of nurses from the congenital heart defect community. Earlier this season I had the pleasure of interviewing two doctors, Dr. Ami Bhatt and Dr. Bill Novick, about doctor burnout. During the interview, they were quick to say that not only do doctors experience burnout, but nurses, and other medical personnel and caregivers also experience burnout. In an effort to better understand how and why burnout might occur in the congenital heart defect(or CHD) community, I’ve invited 3 nurses to talk with me about this topic. I’d like for us to brainstorm ways we can address this topic and possibly come up with some suggestions for how we, as a member of the CHD community, can curb or prevent nurse burnout in our own medical communities. With me today are: Deena Barber who graduated from Kent State University with a Bachelor’s Degree in Nursing in 1983. For the last 3 decades she has worked in Akron, Ohio as a nurse at Akron Children's Hospital. Deena has become a nursing subject matter expert in adult congenital heart disease care. She has been working with adults with CHDs for the last 16 years and she has worked in the field of pediatric cardiology for 19 years. Many of you may remember Deena from the episode she was on entitled,“The Natural Course of Congenital Heart Disease,” or maybe you'll remember her from"A Nurse’s Perspective: Changes in Care over the last 30 Years: Part I” and“Part II” because we had so much to talk about! We had such a good time with those two episodes! Welcome back to“Heart to Heart with Anna,” Deena.

Deena Barber: 2:07

Thank you Anna. I'm very excited to be here. I think this is a really important topic and I look forward to discussing it with my colleagues.

Anna Jaworski: 2:13

Well, great! Yes. I also have with me today, Christy Sillman. She has a unique point of view as both an adult with multiple heart defects and as a nurse for adults with congenital heart defects or ACHDS. Christy was lost to care for 10 years and became a pediatric ICU nurse.She discovered ACHD cardiology while pregnant, and she went into heart failure following the birth of her son. Her experiences drove her to volunteer for the Adult Congenital Heart Association(or ACHA), Mended Little Hearts and the congenital heart walk in a quest to raise awareness of life-long care needs. For the past 6 years she has been the Nurse Coordinator for the Adult Congenital Heart Program at Stanford. Christy is a recent graduate of UCSF as an acute care nurse practitioner and was recently hired by the ACHA accredited program Sutter Sacramento ACHD program as a nurse practitioner. My loyal Listeners may remember Christy from Season 8 when she was on a show with Lena Morsch entitled“Rethinking Transition Care for CHD Survivors.” Welcome back to“Heart to Heart with Anna,” Christy!

Christy Sillman: 3:21

Thank you for having me on the show again, Anna, I'm really excited to talk about this topic.

Anna Jaworski: 3:28

Me, too. And to finish out the panel, I have Roslyn Rivera and she is an adult living with CHD whose experience as a patient in the hospital led her to become a pediatric cardiac intensive care nurse. She was diagnosed the day she was born with partial atrio-ventricular septal defect and underwent open-heart surgery at 3 years of age to repair this defect. At 10 years old, she had her 2nd open-heart surgery to replace her mitral valve with a mechanical valve. Roslyn currently works as an Outpatient Nurse Coordinator at UCLA Children’s Heart Center. She is a Pediatric and Fetal Cardiology Nurse and the Single Ventricle Home Monitoring Nurse for outpatient pediatric cardiology. She also participates in the Novick Cardiac Alliance, which is a non-profit organization. For them she is a PICU Nurse Coordinator. With a team of international medical professionals, she travels to developing countries to provide cardiac care and surgery for children. My loyal Listeners may remember Roslyn from Season 7 where she was on the program entitled,“Congenital Heart Defects Around the Globe: The Novick Cardiac Alliance.” So welcome back to“Heart to Heart with Anna,” Roslyn!

Roslyn Rivera: 4:39

Thanks Anna. I'm happy to be back.

Anna Jaworski: 4:41

This is so great. I love having all three of you on the show and it's especially exciting to me that all three of you have been on a program before and so my Listeners already know a little bit about you. I will be putting the links to your previous episodes in the Show Notes, so if anybody wants to listen to what you had to say before and get to know you a little bit better, they can do so really easily. So let's go ahead and get started. I'm going to start with you Deena, because I believe you're the most veteran nurse on the panel and I was really happy that you agreed to come on a program today because of all of your experience. Can you start by telling us what the warning signs are for nurse burnout and how somebody might recognize that a colleague or a member of their team has burnout?

Deena Barber: 5:25

Sure. I had to go back and do a little bit of research about this because there's a lot of differing opinions about that. I think one of the biggest things is that people begin to feel emotionally drained. It's really difficult for them to deal with the stresses of their job, the stresses of their family life. They feel overworked. They can feel very frustrated. They feel less productive when they're doing their work. Sometimes as it goes on, they can have a lot of physical symptoms and those can vary amongst people. They can be some depression and some negative emotions, and if it gets really bad, people sometimes just can't even begin to understand how they can get out of bed and bring themselves to go to work. Sometimes you can't even pinpoint what your own symptoms are. Sometimes you have to rely on a trusted colleague or a friend to say, you know,"Hey, things look pretty bad right now. Can you kind of share with me what's going on?" I think all of us are a little individualized and may experience burnout differently, but those seem to be some of the biggest symptoms that are reported.

Anna Jaworski: 6:25

Right, right. And that goes along exactly with what I've been reading about burnout, whether it's doctors, nurses, executives. I mean they all seem to have the same kinds of symptoms, which you just mentioned. You're right. I think sometimes you get so stuck in the muck that you can't even recognize in yourself that you're experiencing it, and sometimes it takes somebody a little bit outside of the situation to see that you're struggling.

Deena Barber: 6:52

I have to agree with that. Sometimes you just think, I don't know what's going on with me. And maybe you don't pinpoint that it's actually your job and the frustrations and the experience and the workload, and you don't realize that it's your job that's causing you all of these feelings.

Anna Jaworski: 7:05

And to be fair, maybe it's not just your job, it's the fact that your job is a really stressful job. But like you were saying earlier when you were describing some of the symptoms, we don't live just in our job. We have family obligations, we have different communities that we belong to and we can be affected by what's going on in those communities and I wonder if sometimes when something is stressful in one of our other communities, like if we have a family member who's going through a hard time, if then when you're having problems at work, it amplifies those problems.

Deena Barber: 7:39

It makes it even harder to adjust and harder to cope with even minor stresses if you have a sick family member or some financial issues, it's really hard to come to work and deal with the typical workload without having burnout symptoms at work as well as at home.

Anna Jaworski: 7:55

Right. I think one of the things about the nurses that I've noticed in the pediatric cardiology field, whether they're working with kids or whether they're working with adults, is that the people who I have seen who had been attracted to this field are extremely compassionate and they practically become members of our families and I think that can be stressful.

Deena Barber: 8:21

(soft chuckle) I have to agree with you. And the reason I chuckled just a little bit is that no, there's a code of ethics for nurses and for physicians and for nurse practitioners. And all of us have a code of ethics through our particular nursing board. And one of the things they tell you is'Mustn't become personal with family, mustn't cross that border, have to keep boundaries' and it goes on and on. And you know, frankly in my experience as a nurse and my experience as a patient, that's not somebody I want taking care of me. I don't want anybody taking care of me that's not compassionate and kind and going the extra mile and wants to become important in my life as far as knowing who I am and knowing where I work and knowing who my children are and knowing what my stressors are so that they can become an even better caretaker for me. So I think it's really interesting that the different boards and the different professional organizations will say,'Keep your distance and don't get close and make sure you have all these boundaries' when in reality we're all human beings. And I think we all need to have that engagement with our caretakers and our patients and I think that's one of the ways that we can start talking about avoiding burnout is what are those boundaries and what are those areas that touch you and that you can use to help your burnout.

Anna Jaworski: 9:33

I'm so glad you said that Deena, because one of the doctors, and I think it was Dr. Ami Bhatt, she talked about that and she talked about how the engagement that she had with her patients is part of what prevented burnout for her because she felt such a close bond with the patients; it was the interactions with patients and their families, that that's what kept her motivated. That's what helped to reduce the burnout for her, so I'm glad to hear that you feel that that's an important aspect of what you do as a nurse.

Deena Barber: 10:09

It's absolutely vital. It's what's kept me in the business for as many years as I've been in it so far,

Home2night4ever: 10:13

Music from Home. Tonight. Forever.(Available at iTunes, Amazon.com and Spotify) Home. Tonight. Forever by the Baby Blue Sound Collective, I think what I love so much about this CD is that some of the songs were inspired by the patients. Many listeners will understand many of the different songs and what they've been inspired by. Our new album will be available on iTunes, Amazon.com, Spotify. I love the fact that the proceeds from this CD are actually going to help those with congenital heart defects. Enjoy the music. Home. Tonight. Forever.

Disclaimer: 10:55

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The opinions expressed in the podcast are not those of Hearts Unite the Globe, but of the Hosts and Guests and are intended to spark discussion about issues pertaining to congenital heart disease or bereavement.

Rejoiner: 11:16

You are listening to Heart to Heart with Anna. If you have a question or comment that you would like addressed on our show, please send an email to Anna Jaworski at Anna@HearttoHeartwithAnna.com. That's Anna@HearttoHeartwithAnna.com. Now back to Heart to Heart with Anna.

Anna Jaworski: 11:35

Christy, what have you seen or experienced regarding nurse burnout?

Christy Sillman: 11:40

Thank you Anna. Personally, I've seen burnout when I worked in the pediatric ICU and I think that has to relate to the intensity, the degree of trauma that a lot of providers experience and I've seen nurses experience that trauma to the point where they have to leave the field of nursing because it's become too difficult. For me personally, it's not so much about nursing burnout as it is about maybe congenital heart disease burnout between my busy work being a hundred percent focused on ACHD care. I'm also on social media and I think I'm seen as a resource in the CHD community, which I see as a privilege and an honor. But almost daily I receive multiple messages from people I don't even know asking for my advice. And then I have many, many personal friends with CHD who will come to me as well for advice. And then of course my own CHD. So for me it can be difficult to balance all of that and sometimes get a break from CHD. So in that, the thing that usually gets neglected is my own healthcare. I usually put myself on the back burner, but I've come to realize that if I'm not well-nourished physically or well-rested mentally, then I'm not setting myself up for success to be a caregiver to the people I care about. And part of that complexity is that my work is a passion. I'm so grateful that none of what I do is just a job or just something that I feel like I have to do; it's something that I am driven and love to do. I literally put my whole heart into my work to the point where I commuted three-to-four hours each way to get to work at Stanford. That certainly contributed to any feelings of burnout I've experienced. I'm very excited about my new position, at Sutter Sacramento, which is 10 minutes from my home. Thank God. It's that sort of wellness and balance that I need to be the best care provider that I could be and I'm excited to see what, what will happen to my practice with this new rooted focus in my own personal wellness.

Anna Jaworski: 13:47

Well, I think that's beautiful. That's beautiful that you said,"I have to think about me if I'm going to help others." And I think that's true for any nurse, whether she has or he has a CHD or not. I think it's also brilliant that you realize it's not necessarily nursing that you're burning out on. It's the barrage of requests for information, requests for help, requests for support from other members of the CHD community. So maybe in creating your boundaries, you need to say,"I'm only going to accept questions from a certain time to a certain time on this day of the week. And if you don't hear from me, that's because I'm focusing on my wellness and my life aside from my CHD," because that's completely fair! To have to think about congenital heart defects every waking moment-- that's an awful lot. That's a huge burden!

Christy Sillman: 14:42

Right, right. So I've done that. I take social media breaks. If I get a direct message or a direct text from someone, if it's not urgent, I'll wait'til I have the bandwidth and the mental time to thoughtfully respond to that instead of sort of feeling beholden to instantly reply to people. I think this day and age we're so used to this expectation that people should instantly reply. And so setting those personal boundaries for myself of,'No, I'm with my family right now' or'I'm doing yoga right now to take care of myself' or whatever it is for my own mental wellbeing. And that's really changed everything.

Anna Jaworski: 15:17

Wow. I absolutely love that. Okay. Roslyn, I want to talk to you for a moment. Is the nurse burnout worse in something like a nonprofit organization where you're going into third-world countries where they may not even have all the resources they need versus the kind of hospital that you currently work for?

Roslyn Rivera: 15:35

Sure. So with the Novick Cardiac Alliance, you're right, it is us going to go work in developing countries and we definitely have limited resources. There are reasons that we're invited to go to these countries. It's because they don't have up-to-date supplies o r up-to-date protocols or even understanding of how to do different procedures and take care of these kids. So we're invited to go there to help bring all of those things to them so they can expand their own p rograms. But that being said, the availability of many medicines and supplies is often quite limited. We often w ill bring our own supplies from the U.S. Or from parts of Europe. Our team that comes from there w ill bring supplies, but oftentimes we have to work with what we have and therefore you have to be extremely adaptable to work in an environment that is really quite different than what you might be used to at home. Plus you're working with people that you may have never met before and you don't often speak the same language. So there i s

Anna Jaworski: 16:36

Wow!

Roslyn Rivera: 16:37

several other stressors that are there just as you're walking into the environment itself. Not to mention that we're actually going there to do heart surgery for babies and children and to take care of them. So it's stressful as it is. But doing this work in a third-world country is overall much riskier.

Anna Jaworski: 16:55

Yeah. Yeah. Oh, I can just imagine. So do you think that the nurses who are working for a nonprofit like that where it seems very extreme, not to mention you have any even said anything about safety. Some of the places that you have gone to are war-torn countries.

Roslyn Rivera: 17:14

Yes, definitely. So I've been to Iraq, I've been to Iran and Libya and just the travel there from where I live in the West Coast of the U. S.-- it takes over a day. It takes over 24 hours. So I get there; I'm already jet lagged and exhausted. And that plays into a role, sure of burnout itself because I'm already starting off tired. And then I go into these environments where they don't have everything that I'm used to having at my fingertips. I have to reuse things or not use a certain medicine because they don't have that type of medicine. So it's a lot of thinking outside the box. And what can you do with what you have? And most of our teams consist of volunteers. They're all international volunteers. So these medical professionals are actually choosing to spend their time-off to work in a much more stressful environment. So it's definitely not. Yeah, it's definitely not for everybody. We have had volunteers that have done one trip and said,"No, I can't do this. It's not for me. I don't have the ability to adapt to the situations. I'm So used to having everything I need at my fingertips" and that's totally fine. That's acceptable for them to feel that way. For a year, I traveled 16 weeks of the year, which was quite a lot for me emotionally and physically and it was exhausting and after that year I realized I can't continue to do this because I'm not sleeping well enough. I'm not taking care of my own health, and I knew I needed to take a step back. And that's happened with several of the volunteers that we've had who have taken a step back, done something for themselves for maybe six months or a year and have come back into the Novick Cardiac Alliance and will now be pursuing that as their career choice,

Anna Jaworski: 18:57

Which I love. I love the fact that there are people who have done this. It's extremely stressful, but from what I understand from the people I've talked to who have been involved, as stressful as it is, it's also extremely rewarding and for some of the people, it validates their decision to go into the medical field anyway. They don't have to spend quite as much time doing administrative work. It's much more hands-on with the patients and so there's that appeal, which I think maybe actually reduces some of the burnout for somebody in that field. Do you agree with that?

Roslyn Rivera: 19:34

Yes, absolutely. You mentioned not having to do some of the administrative work. There is definitely less red tape and less paperwork in working in these developing countries than working here, especially like in the U. S. where I was taught in nursing school'If you didn't chart it, it wasn't done.' But there's a little bit more leeway working in developing countries and that being said, it is extremely rewarding. I mentioned that we may not speak the same language, but there's something I learned pretty early on in trips that I've gone on is that the expression of gratitude is universal. A mom who's just saw their previously like really thin, not-able-to-eat baby, have heart surgery and get up and sit up now-- the way they look at us to say'thank you' is so heartwarming. That's the biggest reward really.

H2HwMichael: 20:22

"Texas Heart Institute were offering us a mechanical heart and he said,"No, Dad, I've had enough. Give it to someone who's worthy."""My father promised me a golden dress to twirl in. He held my hand and asked me where I wanted to go.""Whatever strife or conflict that we experienced in our long career together was always healed by humor." Heart to Heart with Michael... please join us every Thursday at noon Eastern as we talk with people from around the world who have experienced those most difficult moments.

HUG Store: 20:54

Hi, my name is Jamie Alcroft and I just published my new book, The Tin Man Diaries. It's an amazing story of my sudden change of heart as I went through a heart and liver transplant. I can think of no better way to read The Tin Man Diaries than to cuddle up in your favorite Hearts, Unite the Globe sweatshirt and your favorite hot beverage of course in your Hearts Unite the Globe mug, both of which are available at the HUG Podcast Network online store or visit heartsunitetheglobe.org.

HUG Message: 21:21

Heart to Heart with Anna is a presentation of Hearts Unite the Globe and is part of the HUG Podcast Network. Hearts Unite the Globe is a nonprofit organization devoted to providing resources to the congenital heart defect community to uplift, empower, and enrich the lives of our community members. If you would like access to free resources pertaining to the CHD community, please visit our website at wwwcongenitalheartdefects.com for information about CHD, the hospitals that treat children with CHD, summer camps for CHD survivors, and much, much more.

Anna Jaworski: 22:03

Christy and Deena, I'm going to ask both of you ladies to answer the next question for me. Do you feel that there are any personal qualities that attract medical professionals to the cardiology field, which might make them at-risk for burnout? And I know Deena, we already touched on this a little bit, but I'd like to be a little bit more specific to pediatric cardiology and I'll start with you Deena.

Deena Barber: 22:27

So I thought about that question a lot and I think one of the things that brings people to the congenital heart disease community is we're very interested in the heart to begin with. We find it fascinating; we enjoy that it is ever-changing. The patient with one particular type of heart defect is never going to be the same as the next patient with the same type of heart defect, even if it's a simple lesion. So I think we're fascinated with that. I think that we really enjoy the long-term patient followup that we know that we're going to have. If you're interested in pediatrics, you know that newborn through toddler/school age, all the way up to adulthood, if you're interested on the adult side, I think you're drawn to it because you see people at their most fragile and when they need you the most, and then you also get to see them in times of joy. You get to go to weddings, you get to see the babies after they're born, you get to see people graduate. And I think that's kind of unique in the congenital heart field. There's other specialties where you may have somewhat longterm relationships, but I think congenital heart disease, you know, it's from birth or wherever you meet the patient on their continuum and it goes on for literally decades. And I think there's a certain type of person that finds that very gratifying and very satisfying.

Anna Jaworski: 23:47

Wow. Wow. That's a lot of food for thought. I think that's really interesting. But I guess, you know, when you're a nursing student, I guess you see,'Oh, this is what pediatric cardiology is all about' and how it's different than say working with cancer patients or working with people in a regular clinic setting. Would you notice that even as a student studying pediatric cardiology?

Deena Barber: 24:14

I noticed as a student two things: that I wanted to be in pediatrics and that I liked cardiology, but I wasn't exposed to pediatric cardiology per se. And so I started my nursing career in adult cardiology and loved it, absolutely loved it, but wasn't crazy about my workplace at the time. So I switched over to a pediatric institution and then as the years went on, our program expanded and when our congenital heart disease program started in earnest in 2001 that's when I said,'Oh, now I could put the two things that I love the most together.' And that's when I started in congenital heart disease. And then a couple of years later they said,"Hey, you know, do you have any interest in adults?" I'm like,'I don't know if I do or not, but you know, let me give it a try.' And I have never looked back. I still get to see the babies. I'm still in the same clinic where little ones are. I get to see my patients' kids, but I've never looked back and I've done several different types of nursing and I just love it. It's just my passion, it's what I want to do for the rest of the time that I'm a nurse.

Anna Jaworski: 25:19

I love that. Okay. Christy, what would you feel are the personal qualities that attract medical professionals to the cardiology field that might make them at-risk? Because that's the one thing, Deena and I didn't talk about. Those lovely qualities also make you at-risk for burnout because you do care so much! That when you lose the patients, or when things go south, that it hurts your heart.

Christy Sillman: 25:42

Absolutely. I mean, I think you've touched on this when you talked about how there's this quality of compassion and empathy and this longitudinal relationship that you have with the patient that sets you up for true grief when something bad happens.

Anna Jaworski: 25:59

Right.

Christy Sillman: 25:59

And there's also a level of perfectionism that we see not just in cardiology, but in all of the medical field. I think that kind of tends to it and to kind of touch on what Deena was saying with what makes CHD so interesting is the heterogeneity of the field. There's not one defect or there's not one surgery. And especially in ACHD, there's a historical component to it of like, okay, you were born in this decade on this side of the country. So they were doing this type of surgical procedure. So that part of it, I think, is fascinating and what drew people to it, but also can sort of lead to burnout because there's a lot to know and there's a lot-- you never really know what's coming at you. And that is part of why I love it, but also part of what exhausts me is that I have to constantly assess,'Okay, who is this? What is their defect? What is their history? What is their socio-economic and family situation background? What is their emotional turmoil and baggage they're carrying with them?' But that's not the same for every patient. So you're having to adapt to each patient, which again, is what I love about it, but also is exhausting.

Anna Jaworski: 27:15

Wow, that's brilliant. No, that's so, so true. And it's a double-edged sword, isn't it ladies? It's what makes you perfect for working with this field of people. And what also puts you at-risk for burnout. Wow. Well Roslyn, how do you feel working with people with CHDs differs compared to other medical or allied health fields in terms of factors that contribute to nurse burnout?

Roslyn Rivera: 27:45

So I think it's already been said, there are just so many unknowns about CHD. Just from the simple fact that yeah, there are over 40 kinds of CHD and many children and adults have more than one. If you put, next to each other, two 10-year olds with tetralogy of Fallot, each one of them can have a completely different anatomy of their heart with the same diagnosis. So that being said, there's so many unknown things and it's even that much different than adult cardiology. Whereas in general, adult cardiology's kind of cookie cutter, they have this diagnosis, do this surgery, they're fine. But with congenital heart defects, you're born with a certain defect and you might have a procedure or surgery, but you will need to have followup care and you may need another surgery in the future either when you're as an older child or as an adult. And that being said, we still lose babies and children and adults with CHD and it's just difficult to accept that medicine doesn't have all the answers.

Anna Jaworski: 28:50

Oh, isn't that so true? That's so true. Yeah. Do you think that that makes it hard sometimes when you're working with technicians or when you're working with other doctors or surgeons that-- even though you guys are a great team together-- you don't have all the answers?

Roslyn Rivera: 29:08

Yes. That made me think of something. I received the call from a pharmacy because the cardiologist had prescribed a particular medication-- a beta blocker-- for one of our three-year-old patients and the pharmacist said,"How can this three-year old have a heart problem?" And it was shocking that that's the number one birth defect and still so many people in the medical fields don't really have the knowledge about it.

Anna Jaworski: 29:33

Yeah. Well I think it's because there's so much information and if you're a pharmacist, you cannot possibly know about every single medical condition out there and they may not have learned a whole lot about pediatric cardiology, don't you think?

Roslyn Rivera: 29:48

Yes, definitely. It is still, I think, just a small portion in medical school or in anatomy that's discussed. Sometimes pediatricians will even call us and say,"I've never seen a child with a CHD before and what do I do?"

Anna Jaworski: 30:03

Wow. Okay. As you can see, Friends, this topic is far too complicated to cover everything in one episode. I hope you'll tune in next week to hear the rest of the story. I want to thank my amazing guests and I hope they had as much fun with this program as I did.

Deena Barber: 30:27

Thank you!

Christy Sillman: 30:27

Thank you, Anna!

Roslyn Rivera: 30:27

Thanks, Anna!

: 30:27

That's it for this week's episode. Our episodes are archived on YouTube and Apple podcasts as well as I heart radio, Buzzsprout, Spreaker, Stitcher, just about any place where you hear podcasts you will find Heart to Heart with Anna. And if you did enjoy this week's episode, please consider becoming a Patron. Just go to www.patreon.com/hearttoheart and pledge a monthly, amount to support our program. We really do appreciate your support. We will have copious Show Notes with lots of different links to the previous episode that these wonderful guests were on so that you have even more great listening experiences. So thanks for listening today, my friends, and remember you are not alone.

Conclusion: 31:13

Thank you again for joining us this week. We hope you have been inspired and empowered to become an advocate for the congenital heart defect community. Heart to Heart with Anna, with your Host, Anna Jaworski, can be heard every Tuesday at 12 noon Eastern Time.