Primary Care Nurse Practitioner Roundtable: How Are We Doing After Covid?
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Show notes:
So many primary care nurse practitioners— new and experienced— are feeling overwhelmed right now.
Thinking: “Is it just me?” “Am I crazy?” “This is way worse than I thought.”
Feeling thrown in the deep end, still slogging and grinding after peak covid, wondering about their longevity in the profession…
I’ve been asking myself a lot — how do I keep an open heart and not barricade it away? Still allow myself joy, love, and connection to purpose? Whether at work, at home, in relationships…
Connection, community, and hope are what I keep coming back to.
For the last episode of 2023, I wanted to share something truly special with you that I hope will give you that sense of connection that you may need right now.
Recently, I spoke with two of my dear friends and NP colleagues, Kara and Heather, and the three of us talked about our shared experiences and challenges working together in the community health setting.
Listening to it pre-release, it made my NP colleague cry — she felt so seen and validated.
We talked about burnout, boundary setting, and the beautiful power of teamwork for primary care nurse practitioners.
Join us for a heart-to-heart chat that's raw, relatable, and peppered with a good dose of humor. Because, let's face it, sometimes laughter is the best medicine.
Whether you're a seasoned NP or just starting your journey, this episode is a virtual hug, a reminder that you're not alone.
I hope you find it uplifting, relatable, and a little humorous. 😉
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Hey there, welcome to the Real World NP podcast.
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I'm Liz Rohr, family nurse practitioner, educator and founder of Real World NP, an educational
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company for nurse practitioners in primary care.
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I'm on a mission to equip and guide new nurse practitioners so that they can feel
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confident, capable, and take the best care of their patients.
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If you're looking for clinical pearls and practice tips without the fluff, you're in
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the right place.
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Make sure you subscribe and leave a review so you won't miss an episode.
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Plus, you'll find links to all the episodes with extra goodies over at realworldnp.com
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slash podcast.
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Hey, so I have a really, really fun episode to share with you.
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So I was having a conversation with two of my really good friends, really good nurse
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practitioner friends.
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We all started at the same federally qualified health center together back in 2015, 2016.
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And I just thought it would be super fun.
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So I have this podcast, it's called That's Not How That Works.
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It's by Weez Duran.
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Weez is an amazing human.
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You should definitely check out her work if you are not familiar with it.
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But she has a podcast that talks about things like equity and liberation.
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But what she does is that it's herself and her colleague who also works in the equity
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space, and they come together and they have this podcast.
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And it's literally just them having conversations that are recorded and then it's shared
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as a podcast.
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And it's like it's so impactful as a listener.
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And yet for her, it's just it's just shop talk, basically.
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And so I just had that idea of like, oh, my gosh, that would just be so fun
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to be able to have recorded conversations of other nurse practitioners and myself.
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And especially because with so the two nurse practitioners are Kara and Heather,
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and they are both adult Jero nurse practitioners.
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Kara also is a women's health nurse practitioner.
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That's her other training of her degree.
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And yeah, we all started together.
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And so what my thought was is that we just I wanted to.
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Kara had the suggestion of coming on and sharing funny stories and are just
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like adding some sort of levity, because I just really feel like that's
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what's called for in this moment.
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And it went kind of all over the place, but I feel like it's a really special
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share what we really talked about.
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We definitely have some stories and a content warning.
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Depending on your level of comfort, we talk a little bit about patient
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stories with some not super gruesome details, but some some clinical
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details, and that include things like blood and stuff like that.
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So just so you know, that's like towards the end of the episode.
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And I start I say content warning before we start getting into that,
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if that's not your vibe.
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But yeah, so we kind of talked about like our experience together,
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being new grads together, what it was like, what insights and pearls that
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they have, especially because they have gone from we've all gone from brand
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new grads, you know, seven plus years ago into various leadership positions.
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So I have real world MP.
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Kara is a medical director.
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Heather is also medical director.
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She has a different role now, but it's just, I just, I just really
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want to share this conversation with you, whether you're a new grad or
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you are an experienced person in primary care, or if you're coming from
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a specialty back into primary care or into primary care for the first time,
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I think it's just really fun to have community and have levity because
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right now it's just things in the world feel a little bit intense
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and they have for a long time.
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So I just thought it would be super fun because I also feel like
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community is one of the things that I feel like is lacking, at least
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from my kind of experience of the profession, from my, where I've been
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in the, in the profession, right.
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And my experience in real life.
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And maybe that's not your experience in which case I'm so happy for you
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because community is so important and not being isolated is so important.
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So, yeah.
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So hopefully you enjoy this episode.
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I don't know.
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I just like, it's just kind of like, I am nosy and you may have
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heard this before, but I am super, super nosy.
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Um, it's kind of just like eavesdropping on like a
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really beautiful conversation.
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So, so yeah, I hope you enjoy it.
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So I wanted to add one of the things I'm trying to bring to the podcast
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this season and going forward is just a lot more humanity.
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Like I just want to have more authenticity, more humanity, more
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like real life, right?
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Because the whole point of this company is that it, you know, real world and P
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it's like the difference between grad school and the real world.
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But the other thing that's really evolving is that it's just important
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that we all just get to be regular people.
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And so I mentioned this in the recording, but a little bit spicier
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in real life, I think, than I let myself come through here.
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And so there is some language.
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If you have kiddles or little ones around you, just maybe
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putting on some earbuds, just knowing that that's going on.
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It's not too explicit, but I just want to give that disclaimer
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in case there's anybody around or you're listening in the clinic or something
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like that, but I really hope you enjoy this episode and I would
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adore to have them back.
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We'll see.
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We'll see what happens.
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But yeah, without further ado, here's the, here's the episode.
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And just to let you know, this episode is going to be
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wrapping up this season.
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We're going to take a brief holiday pause.
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And then in the new year, we have a whole bunch of other
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episodes to share, including a number of beautiful interviews.
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Some of that have already been recorded and some that
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are due to be recorded.
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So FYI, I've taken a little pause, but we'll be back real soon.
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So we were just saying before we started recording that we fucking
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miss each other, excuse my language.
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I might actually bleep that out on the real podcast.
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We'll see, use whatever language you want.
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It feels like it's appropriate for the new season.
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I mean, honestly with COVID, like life is weird, very weird.
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So it really is weird.
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And everyone's burnt out.
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Right.
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Yeah, pretty much.
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So yeah, what's going on?
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Like I just, there's so many places I want to go.
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And like, I don't know where to jump in.
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Cause like, I want to know what's going on right now, but like
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nobody listening is going to be listening to this, knows all
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of y'all and our story.
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So I don't know, maybe, maybe start with like, we, we worked together
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and we miss it a lot.
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Yes.
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Yes.
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And we worked together in FQHC.
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Yes.
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So back in 20, what year is that?
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2015?
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I think it was 2015.
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I started in 2015.
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2015.
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Yeah.
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That's when you started.
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And you were at Salem.
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Yeah.
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So I was, I was pre-setting in 2015 when you started in Gloucester.
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But I met you right when you started.
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And then I started the beginning of 2016.
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Oh my gosh.
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Oh, that's so right.
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I totally forgot about that.
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And Kara, when did you start?
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You started in 2015.
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Time is not real.
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A few months, a few months after me, so some time in 2016.
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I think it was 2016.
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Yes.
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Seven years.
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Seven years.
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Isn't that crazy?
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Oh my gosh.
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Um, and so we all worked in a federally qualified health center,
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which I don't know about y'all, but like for me, I was like on the
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hunt for a community health center.
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And I was just like, bam, like magical, amazing dream job.
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And it was something.
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Um, it was something.
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What are, well, I guess, so we all worked in FQC together.
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That was in 2015, 2016.
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And then I think we all kind of went different ways over
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the last couple of years.
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And so maybe, what are y'all doing right now?
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Maybe if y'all want to share, what kind of work do you do right now?
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You're, you're, what kind of nurse practitioner you are?
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What kind of work you do?
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You want to start Kara?
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I'll start.
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Yes.
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Okay.
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So 2016, I got to meet Liz Roar at a federally qualified health
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center, my first NP job.
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Oh my God, I might cry.
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I might cry.
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Sorry.
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I'm not trying to interrupt you, but I'm just like, I'm so
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emotional hearing about this.
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Well, what is amazing for me and feels like a full circle moment
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right now is that, so I've been at the same health center for seven
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years and my first NP job.
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And for people who are listening, I get to have my
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first NP job with Liz Roar.
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And I get to start as a brand new nurse practitioner at a health
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center and have a mentor there.
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Like that is absolutely amazing.
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Um, so I've been here for seven years and just a few months ago, I
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started as our director of clinical training.
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So this is that like full circle moment coming back.
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So the main role for me now is I'm a part, I'm at halftime
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PCP, and then the other halftime, I am going to figure out a way for us to
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standardize how we support new grads and people with less than two years
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experience.
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So talking with you today, yeah, right.
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Like, and everybody, like just to have the love can continue pouring out.
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Right.
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As everybody who joins the health center.
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And I said, okay, do you know Liz, do you have a world NP?
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And they're all like, yeah, yeah, I do that.
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And I'm like, I'm all like, trying to share resources and this is who they say is the
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same.
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I already do that person.
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Well, that's like really reassuring because I actually went to a
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conference.
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I don't know if I told y'all, but I went to, I went to a couple of
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different conferences and I had a table at one of them last year and
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people like, so what's this, what's this real world NP stuff?
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And I was like, oh, not that I like, I like needed to get thing, but I
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was just like, how can you not like, I just need all the people to know.
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I need all the people to know, but yeah, I feel like all the people I
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do know, yeah, it gets me so excited.
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I love it.
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Oh, I'm so happy, Kara.
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I'm just like, like we're all peers and yet like, I just have so much
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pride for, I mean, both of you, but like, oh my gosh, I'm just like, so
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proud of you.
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Like seeing from, oh, seeing where you get, this is just going to be
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like a love fest this whole time.
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Um, but I'm just so proud of you.
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Like it's so, so cool to see you where you are and like just taking
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on that boss role.
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Like it's like a, it's a big jump going from, you know, brand new
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clinician, experienced clinician, and then leading the people and having
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some tough talks and real talk and real world NP life.
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That's what I'm saying.
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I love that role for you, Kara.
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I think that's going to be awesome.
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I feel very excited.
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And right now we are in this super transition space and we have three
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new grads coming on board very soon, super excited in what an opportunity
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to, to get this right and to carry on what I got to learn from both of
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you and remembering what that felt like to start with other people who
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were new in practice and how I hope to like foster with them, to give
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them space where they can be together and actually build that into their
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schedules, right?
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Like if we can build in proper support, right?
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Like that would, that's the dream.
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I love that.
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Oh my God.
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So many chills.
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I love it so much.
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And I'm wondering, I think before, and again, you don't have to disclose
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any sort of personal things.
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This is on the internet.
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We'll be on the internet.
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I'm wondering about, I remember before, so since I left the health
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center that we worked at together, like we, there was a residency
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program that was in progress.
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Like, is that still going on?
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Is that part of it?
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Is it that this is separate?
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It's we moved away from that.
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And I think it, I think it's like, we need to create a
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culture of sustainability.
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And we had that program and it was lovely, but I don't think that we
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had the right amount of staff to do it well, right?
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Like we were asked, we were asking people to run that program who
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were doing a bajillion other things and didn't, which it is amazing.
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And they did a great job.
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And it was also really stressful.
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Like it wasn't well supported.
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So now I feel like we've moved away.
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Maybe, hopefully we can move back.
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Um, but a couple of our folks that are coming on new just went
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to our residency program, so it'll be nice to hear.
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Oh, I understand.
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So they went through a program and then now they're starting
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after their first job after a program.
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Yeah.
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So the other thing with the residency program was that we were
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no longer allowed to take students once.
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Oh, right.
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Cause Heather, you were there when the residency started.
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Cause I was not there at all at that time.
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Oh, that's really hard.
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We had a lot of employees that started as students, right?
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So like, I think that that sort of took away from us getting some
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of those new grads on board that we knew had the experience with
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our EMR and in community health.
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Um, cause there was a period of time we weren't even hiring new
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grads, it was just like through the residency program, or they
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had to have a certain amount of experience.
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And I think that was probably not the best direction to go in.
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So I think now I'm not, I'm not sure Gara, but I think maybe
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they'll be taking students again.
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Yes.
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We, we have three nurses at our health center who are all
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in NP school and that's an amazing count.
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Yeah.
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It is amazing because I get to start precepting someone in a
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couple of weeks who is our endocrine nurse.
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And then we have two other, like a nurse manager and somebody
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who is currently doing school-based self, like with us too.
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So we get to, we get to do their preceptor, which is lovely.
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Yeah.
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That is so exciting.
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And Heather, so you, you started around when we started
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and, um, yeah, what is, tell us about your experience.
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You're in a different, you're a different place right now, but
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I am.
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Yeah.
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So I'm also extremely proud of you.
300
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And I'm like, so, sorry, I'm not going to interrupt you.
301
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Go ahead.
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Go ahead.
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Each side initially, right?
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Like I started covering maternity leaves and I went to every site
305
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and as a new grad, you did that, right?
306
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You were like, yeah, yeah.
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Oh, I forgot about that.
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And then, um, so the FQHC that we worked at had three different sites.
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So, um, then, and then I got to move to the same side as you guys.
310
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And I was so excited.
311
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That was so great.
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Oh, I was so excited.
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I forgot that.
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I know it was like, we have another person, but I just want to keep her
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and all the new people.
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Do you remember Christina?
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Do you remember like the, like the, I'll say two Christina's, but
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not Christina's, but the Christina that started with me.
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Yeah.
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I haven't talked to her in a while.
321
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I'll have to chat with her, but yeah, that was just so fun.
322
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It was like a whole bunch of us.
323
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It was, I think it was all.
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I think it was us four with the main grads for a while until we had, and what
325
00:14:36.480 --> 00:14:37.280
Ryan and Ryan.
326
00:14:37.480 --> 00:14:38.120
Oh my God.
327
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I was just thinking of him.
328
00:14:41.420 --> 00:14:41.780
Yeah.
329
00:14:42.140 --> 00:14:43.240
Oh, so funny.
330
00:14:43.320 --> 00:14:44.340
I totally forgot about that.
331
00:14:44.560 --> 00:14:45.960
And we had a new grad physician.
332
00:14:46.180 --> 00:14:46.560
We had Dr.
333
00:14:46.720 --> 00:14:47.860
Dono too, right?
334
00:14:47.940 --> 00:14:50.740
Like we were, yes, she started the same day I did.
335
00:14:50.820 --> 00:14:54.220
It was, it was her right out of attending, uh, becoming an attending
336
00:14:54.220 --> 00:14:56.460
and then me and Christina and then the rest of the people.
337
00:14:56.600 --> 00:14:56.860
Yeah.
338
00:14:56.860 --> 00:14:59.460
So I think, I think Ryan started after you, right?
339
00:15:00.120 --> 00:15:00.600
Yeah.
340
00:15:01.100 --> 00:15:02.880
But we were just like all in it together.
341
00:15:03.200 --> 00:15:04.680
Like, let's do this.
342
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This is what we need.
343
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Like,
344
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and then you, so you came to our site and then, um, and like, you also
345
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became a boss lady.
346
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I mean, I don't know.
347
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And then right before I left, I became the medical director, but, um, the
348
00:15:25.960 --> 00:15:27.620
timing just wasn't it for me.
349
00:15:27.620 --> 00:15:35.160
So I had already started applying other places before I, um, was not before
350
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I was offered the role, but once I took it and then I started getting
351
00:15:39.480 --> 00:15:40.660
offers right after that.
352
00:15:41.100 --> 00:15:47.480
So, um, I ended up moving on mostly because I had my third baby and I
353
00:15:47.480 --> 00:15:50.140
just needed a better work life balance.
354
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It was like too much for me with renovating a home and trying to
355
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raise three little kids.
356
00:15:58.660 --> 00:16:04.800
So, um, yeah, I'm doing house calls now with a wonderful company.
357
00:16:05.080 --> 00:16:08.600
And I am so far enjoying it.
358
00:16:08.620 --> 00:16:11.300
I mean, the work work life balance is definitely there.
359
00:16:11.600 --> 00:16:13.080
It's a world of difference.
360
00:16:13.640 --> 00:16:17.940
So, yeah, that is still new to me.
361
00:16:18.000 --> 00:16:23.300
I'm still like, still learning the EMR and like in the figuring
362
00:16:23.300 --> 00:16:26.660
it out phase, but, um, yeah, I love that.
363
00:16:26.660 --> 00:16:27.940
What kind of things do you see?
364
00:16:29.040 --> 00:16:33.780
Well, like the average age of my patient is probably 90.
365
00:16:34.280 --> 00:16:34.680
Yeah.
366
00:16:35.840 --> 00:16:36.300
My goodness.
367
00:16:36.960 --> 00:16:42.000
I was going to say Jerry, Jerry, Jerry is like, wait, who said 90?
368
00:16:42.140 --> 00:16:42.520
I'm sorry.
369
00:16:42.960 --> 00:16:43.960
I just processed that.
370
00:16:46.760 --> 00:16:47.740
That's amazing.
371
00:16:47.800 --> 00:16:50.460
So I do miss, I do miss adults though.
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00:16:50.460 --> 00:16:58.280
Like, I feel like we had two, at least two solid years of like 80%
373
00:16:58.280 --> 00:17:00.840
of our visits being like adult mental health.
374
00:17:00.980 --> 00:17:03.640
Oh my gosh, since COVID, you mean?
375
00:17:03.960 --> 00:17:04.359
Yeah.
376
00:17:04.579 --> 00:17:09.619
And it was, you know, like exhausting, but also rewarding.
377
00:17:09.619 --> 00:17:13.400
And also like, you just learned it very well.
378
00:17:14.319 --> 00:17:15.359
You mean mental health?
379
00:17:15.380 --> 00:17:17.520
I started to know that space very well.
380
00:17:17.819 --> 00:17:18.800
Yeah, mental health.
381
00:17:18.800 --> 00:17:22.140
And, um, yeah, not so much Jerry.
382
00:17:22.599 --> 00:17:26.380
So here I am relearning all things geriatrics.
383
00:17:26.780 --> 00:17:27.440
I love it.
384
00:17:27.440 --> 00:17:29.860
Well, I just remember, I think when we were around when we first started, or
385
00:17:29.860 --> 00:17:32.840
maybe like during those years, I feel like I was like, what was
386
00:17:32.840 --> 00:17:35.100
you, what would your like ideal patient situation be?
387
00:17:35.160 --> 00:17:39.080
And you were like, like, like a sniff or an LTCH or sorry,
388
00:17:39.980 --> 00:17:41.000
long-term acute care.
389
00:17:41.120 --> 00:17:41.520
I was like,
390
00:17:46.980 --> 00:17:48.380
that sounds terrible.
391
00:17:51.280 --> 00:17:53.000
Yeah, no, I loved it.
392
00:17:53.180 --> 00:17:55.740
And now it's like a lot of hospital follow-ups.
393
00:17:55.940 --> 00:17:59.240
Um, so we're like seeing the patients in their home because they're
394
00:18:00.040 --> 00:18:01.120
getting into the office.
395
00:18:01.660 --> 00:18:02.580
Um, I love that.
396
00:18:03.480 --> 00:18:06.880
What kind of stuff are they following up for like pneumonia or.
397
00:18:08.860 --> 00:18:10.480
All they went to the hospital for.
398
00:18:10.860 --> 00:18:10.880
Yeah.
399
00:18:11.500 --> 00:18:12.400
So yeah, pneumonia is false.
400
00:18:12.460 --> 00:18:14.040
CHF, exacerbation.
401
00:18:15.860 --> 00:18:16.340
Yeah.
402
00:18:17.060 --> 00:18:21.920
Oh, I'm so glad there are people who are all super complicated because you
403
00:18:21.920 --> 00:18:26.020
know, they're 90, so by then you have a world of chronic diseases.
404
00:18:26.260 --> 00:18:26.700
Yeah.
405
00:18:26.760 --> 00:18:30.880
Um, but I don't know.
406
00:18:31.040 --> 00:18:33.120
I, I'm enjoying it so far.
407
00:18:33.280 --> 00:18:34.380
So hopefully it continues.
408
00:18:34.900 --> 00:18:35.780
That's awesome.
409
00:18:36.740 --> 00:18:37.980
I love that.
410
00:18:38.780 --> 00:18:39.540
Oh my gosh.
411
00:18:39.660 --> 00:18:42.540
So I guess I'm, we're just kind of going off the cuff here.
412
00:18:42.580 --> 00:18:44.600
I guess the thing that's coming to me that I'm wondering about.
413
00:18:44.600 --> 00:18:49.640
So like, obviously like I really miss working with y'all and, um, um, I'm
414
00:18:49.640 --> 00:18:50.860
wondering what it was like for you.
415
00:18:50.880 --> 00:18:51.020
Yeah.
416
00:18:51.020 --> 00:18:54.420
Like since the pandemic and I don't know, I mean, I think so I've
417
00:18:54.420 --> 00:18:56.920
made a couple of episodes already for this podcast season.
418
00:18:57.180 --> 00:18:58.500
I can't remember when this one's going to come out.
419
00:18:58.500 --> 00:19:02.300
If it's before the new year after, but, um, talking about, I just
420
00:19:02.300 --> 00:19:03.780
feel like things have really changed.
421
00:19:03.980 --> 00:19:06.340
And like when I started real world NP, I was just like, yeah, like
422
00:19:06.340 --> 00:19:08.460
this is like, this is how the profession is going.
423
00:19:08.760 --> 00:19:10.980
And it just like, it just felt so different.
424
00:19:10.980 --> 00:19:13.520
And I just feel like COVID hit and I just, I feel, I don't know.
425
00:19:13.520 --> 00:19:15.380
I'm feeling a little disoriented still.
426
00:19:15.720 --> 00:19:18.200
Like, I just feel like, I don't know.
427
00:19:18.240 --> 00:19:19.460
What has it been like for you?
428
00:19:19.620 --> 00:19:22.440
Cause so before we started recording, it was kind of just like, well, I mean,
429
00:19:22.440 --> 00:19:24.840
maybe at the beginning of the recording, you said that Heather, everyone's
430
00:19:24.840 --> 00:19:28.100
kind of burnt out, but, um, yeah, what's going on?
431
00:19:28.160 --> 00:19:31.460
What, what has it been like for you and where, what was it?
432
00:19:31.460 --> 00:19:32.380
What has it been like?
433
00:19:32.540 --> 00:19:33.800
Where are you at now?
434
00:19:34.180 --> 00:19:37.460
I think we've all talked a lot about burnout and reevaluation.
435
00:19:38.320 --> 00:19:40.620
And I don't know, what do you want to share?
436
00:19:40.720 --> 00:19:42.660
What do you want to share with the people thinking about the new grads,
437
00:19:42.660 --> 00:19:45.220
Kara, you've gotten all those new people come in and.
438
00:19:45.320 --> 00:19:45.820
Yes.
439
00:19:46.240 --> 00:19:46.540
Yeah.
440
00:19:46.780 --> 00:19:53.200
I feel like, especially for new grads, when I feel like labs is a huge thing.
441
00:19:53.220 --> 00:19:59.100
When you're a new grad, it was for me and COVID, I remember COVID like,
442
00:19:59.800 --> 00:20:04.020
and like the first month in our CMO called each one of us individually
443
00:20:04.020 --> 00:20:09.300
to give us like a pep talk and to like, get us ready for like pandemic
444
00:20:09.300 --> 00:20:10.660
mode and it was teaching us.
445
00:20:10.660 --> 00:20:14.260
Sorry, not to give it specific names, but the one, the CMO that we all had
446
00:20:14.260 --> 00:20:15.560
that is now not there anymore.
447
00:20:15.860 --> 00:20:16.460
Oh my God.
448
00:20:16.840 --> 00:20:17.680
That was really sweet.
449
00:20:18.200 --> 00:20:18.220
Yeah.
450
00:20:18.220 --> 00:20:18.860
I loved it.
451
00:20:18.880 --> 00:20:23.760
Like it was, it was a very supportive conversation and it was asked.
452
00:20:24.060 --> 00:20:24.220
Yeah.
453
00:20:24.220 --> 00:20:27.820
And it was asking, okay, like it was the height of things and we were,
454
00:20:28.080 --> 00:20:31.380
we shut down, we went to full telehealth and he was like, what are you
455
00:20:31.380 --> 00:20:33.060
going to send someone to the health center for?
456
00:20:33.560 --> 00:20:37.120
And the correct answer there was nothing, right?
457
00:20:37.120 --> 00:20:41.280
Cause you are weighing the risk of somebody getting COVID and potentially dying.
458
00:20:41.900 --> 00:20:41.960
Right.
459
00:20:42.320 --> 00:20:45.800
And so what a beautiful, like what a teaching moment of also realizing
460
00:20:45.800 --> 00:20:50.400
what is important and to remind yourself, like, I am ordering something
461
00:20:50.400 --> 00:20:54.160
that is going to impact our decision and it's going to impact someone's life.
462
00:20:54.340 --> 00:20:58.000
Cause I feel like for me, especially, I didn't know really what to
463
00:20:58.000 --> 00:21:00.700
order in the beginning, or I was going to do a CBC for everybody and
464
00:21:00.700 --> 00:21:03.920
I was going to do a CBC with diff for everybody and why not a TSH?
465
00:21:04.180 --> 00:21:05.520
And then, Hey, let's do that.
466
00:21:05.840 --> 00:21:05.940
Right.
467
00:21:06.120 --> 00:21:06.360
Totally.
468
00:21:06.420 --> 00:21:06.700
No.
469
00:21:06.700 --> 00:21:08.020
Throw it a dip.
470
00:21:09.920 --> 00:21:10.920
Dip it.
471
00:21:12.380 --> 00:21:16.400
So I feel like, like COVID has done so many things, but that's something
472
00:21:16.400 --> 00:21:22.080
that it was for me really helpful at re-centering on like what's most
473
00:21:22.080 --> 00:21:24.960
important is what you're here with the patient for, right?
474
00:21:24.960 --> 00:21:27.440
And you're, you're following guidelines and doing the screenings.
475
00:21:27.620 --> 00:21:27.880
Yes.
476
00:21:28.080 --> 00:21:31.800
But we're not looking for things that, that aren't there, right.
477
00:21:31.800 --> 00:21:37.440
And helping to go back to standards of care and also like, cool for me
478
00:21:37.440 --> 00:21:40.200
was beautiful, like calling people at their homes, right?
479
00:21:40.260 --> 00:21:42.100
I know, I feel like that's such your speed.
480
00:21:42.440 --> 00:21:43.940
Like it just, it's so cool.
481
00:21:45.860 --> 00:21:49.440
Like hearing you Heather, like doing house calls, like I had
482
00:21:49.440 --> 00:21:51.080
not had that experience before.
483
00:21:51.080 --> 00:21:54.020
And I have so many people where I get to care for their whole family.
484
00:21:54.040 --> 00:21:57.720
So I was calling people and I was hearing multiple patients in the
485
00:21:57.720 --> 00:22:00.480
background and it was so cool.
486
00:22:00.480 --> 00:22:04.760
And like, it really made me like, I feel like for, for many of us, right.
487
00:22:04.820 --> 00:22:08.720
It's, it was disorienting and life is fricking disorienting in general.
488
00:22:09.200 --> 00:22:13.900
And also brought me back to the mindfulness of what am I, what am I
489
00:22:13.900 --> 00:22:19.240
here for and I'm here for, for connection and it helped me get to do
490
00:22:19.240 --> 00:22:21.800
that and also think about what matters and what matters is like,
491
00:22:21.840 --> 00:22:25.200
Hey, you're here for somebody else and you're facilitating health.
492
00:22:26.180 --> 00:22:29.820
And so to me, it feels good, but it's hard for me to know
493
00:22:29.820 --> 00:22:32.680
disorientation is because I got kids, right.
494
00:22:32.720 --> 00:22:34.020
I'm going to start a new job.
495
00:22:36.540 --> 00:22:36.980
Word, right.
496
00:22:37.100 --> 00:22:41.320
Maybe it's that, you know, or like, you know, there's just like genocide.
497
00:22:41.520 --> 00:22:41.680
Right.
498
00:22:41.740 --> 00:22:42.680
There's that too.
499
00:22:42.920 --> 00:22:43.220
Right.
500
00:22:43.620 --> 00:22:47.000
Like, like there's so many coming at you from every angle.
501
00:22:47.200 --> 00:22:47.680
Jesus.
502
00:22:47.960 --> 00:22:48.200
Right.
503
00:22:48.680 --> 00:22:51.700
But like, Jesus, like, I don't know.
504
00:22:51.860 --> 00:22:52.060
Right.
505
00:22:52.700 --> 00:22:59.560
So I think being an NP, like you be yourself and you be
506
00:22:59.560 --> 00:23:00.940
yourself with other people.
507
00:23:01.260 --> 00:23:05.260
And I feel like that is the most healing is giving space for
508
00:23:05.260 --> 00:23:07.780
people to be themselves and COVID.
509
00:23:07.940 --> 00:23:10.080
You got to be there for people when it was like a really
510
00:23:10.080 --> 00:23:11.420
vulnerable, scary time.
511
00:23:12.080 --> 00:23:16.540
And that was such a great teacher for trauma informed care.
512
00:23:17.120 --> 00:23:19.280
And yeah, how to show up for people.
513
00:23:19.440 --> 00:23:19.920
Yeah.
514
00:23:21.120 --> 00:23:22.340
Carrie, you need a podcast.
515
00:23:22.760 --> 00:23:23.240
I mean,
516
00:23:29.560 --> 00:23:31.160
I went a lot of places there.
517
00:23:32.700 --> 00:23:36.560
I'm clear, but main thing is like, we want to be ourselves.
518
00:23:36.580 --> 00:23:39.460
And I feel like for me, especially when I first started, like, I didn't
519
00:23:39.460 --> 00:23:43.700
really know how to be myself because like y'all had like experience
520
00:23:43.700 --> 00:23:45.200
like in like nursing too.
521
00:23:45.300 --> 00:23:48.240
And that wasn't, I had experiences like a health, a health counselor
522
00:23:48.240 --> 00:23:49.460
at a school based self center.
523
00:23:49.860 --> 00:23:53.020
So like, I love my sexual health experience and that's where I came
524
00:23:53.020 --> 00:23:57.760
from, but I didn't have that like bedside nursing or like even like
525
00:23:57.760 --> 00:23:58.480
head surge stuff.
526
00:23:58.920 --> 00:24:03.880
So I felt like major imposter syndrome of like, okay, you went to the
527
00:24:03.880 --> 00:24:06.500
school, but you have not really done this.
528
00:24:07.920 --> 00:24:08.640
So, right.
529
00:24:08.980 --> 00:24:11.460
But that people just want you to be there and to listen.
530
00:24:11.540 --> 00:24:12.940
And then you look the things up.
531
00:24:13.420 --> 00:24:13.880
It's all good.
532
00:24:13.880 --> 00:24:14.420
It's so true.
533
00:24:14.520 --> 00:24:17.320
And I want to just be clear too, that like, when I, I remember
534
00:24:17.320 --> 00:24:20.200
cause wait, Heather, I'm totally blanking.
535
00:24:20.460 --> 00:24:23.600
What, were you master's entry or were you, did you work on the floor?
536
00:24:23.940 --> 00:24:24.420
You were master's entry.
537
00:24:24.580 --> 00:24:27.080
No, but yeah, I worked because my program was part time.
538
00:24:27.080 --> 00:24:27.800
So I worked.
539
00:24:27.940 --> 00:24:28.600
Oh, I see.
540
00:24:28.740 --> 00:24:29.140
I see.
541
00:24:29.500 --> 00:24:30.340
During my program.
542
00:24:30.500 --> 00:24:33.160
Well, I was going to say, I just feel like both you, like I just,
543
00:24:33.280 --> 00:24:36.800
just to really validate for you, but also for other new grads out there.
544
00:24:36.900 --> 00:24:38.660
I was in nurse for about six years.
545
00:24:39.480 --> 00:24:41.800
And like, I feel like there was something that I, the, the
546
00:24:41.800 --> 00:24:46.200
thing that I felt really happy with, having had that experience was
547
00:24:46.200 --> 00:24:50.620
that I had, I think the challenge that I think that a lot of new
548
00:24:50.620 --> 00:24:53.960
grads have, especially like if you haven't been in the hospital
549
00:24:53.960 --> 00:24:58.280
setting before is like seeing the acuity and, and recognizing and like
550
00:24:58.280 --> 00:25:01.780
having that kind of like visceral kind of like, Oh, that person's sick.
551
00:25:01.780 --> 00:25:04.740
Like you can look at them and be like sick, even if you don't know what it is.
552
00:25:04.760 --> 00:25:07.940
And so I felt like for me, that really helped me coming in.
553
00:25:08.180 --> 00:25:10.940
But honestly, I was just so impressed with both of you.
554
00:25:11.040 --> 00:25:14.000
I was like, I was like my, I'm not, again, I'm just such a crier.
555
00:25:14.040 --> 00:25:16.660
I'm going to try not to cry, but I was just so impressed with both of you.
556
00:25:16.660 --> 00:25:20.360
Like how much you knew and how good you were.
557
00:25:20.380 --> 00:25:23.220
And I was just like, wow, they're like amazing.
558
00:25:23.220 --> 00:25:27.060
And I feel like it makes me so angry when people just like hate on like
559
00:25:27.060 --> 00:25:30.300
master's entry versus traditional entry, like whatever, like there are some
560
00:25:30.300 --> 00:25:33.440
challenges that I feel like I had a lot of empathy and compassion for you both.
561
00:25:33.480 --> 00:25:36.820
Cause I felt like I would have had a much harder time if I didn't have that
562
00:25:36.820 --> 00:25:39.460
experience, but you know, just like, just glue.
563
00:25:41.400 --> 00:25:42.380
One time, Kara.
564
00:25:42.480 --> 00:25:43.160
I mean, I remember one time.
565
00:25:43.160 --> 00:25:44.200
Did we have a choice though?
566
00:25:44.420 --> 00:25:44.720
What?
567
00:25:45.180 --> 00:25:46.340
Did we have a choice?
568
00:25:48.780 --> 00:25:49.700
It's so true.
569
00:25:49.960 --> 00:25:50.500
It's so true.
570
00:25:50.640 --> 00:25:53.020
Well, yeah, Heather, what do you, what do you want to, what do you
571
00:25:53.020 --> 00:25:54.300
want to chime in for the new grads?
572
00:25:54.840 --> 00:25:57.140
I totally agree with like the labs.
573
00:25:57.980 --> 00:25:59.660
So go for something.
574
00:26:00.180 --> 00:26:03.020
And, and a lot of times it's like your own insecurity, like I
575
00:26:03.020 --> 00:26:03.900
don't want to miss something.
576
00:26:03.900 --> 00:26:08.100
So I'm just going to check everything, but you're not necessarily
577
00:26:08.100 --> 00:26:09.700
helping the patient out by doing that.
578
00:26:10.120 --> 00:26:16.600
And I think just listening to what they want and need and kind of
579
00:26:16.600 --> 00:26:21.280
going in that direction, instead of sort of hearing your own dialogue
580
00:26:21.280 --> 00:26:25.140
and saying, okay, I just have to make sure it's none of these 20 things.
581
00:26:26.960 --> 00:26:30.800
Because likely it's not so hard though.
582
00:26:30.900 --> 00:26:34.140
The other thing is the followup.
583
00:26:34.460 --> 00:26:38.320
So that was one thing like I was working with one of my providers
584
00:26:38.320 --> 00:26:44.820
with a lot was just follow up, follow up in two weeks.
585
00:26:45.340 --> 00:26:48.800
If you need to like check on something else, follow up in one month,
586
00:26:48.800 --> 00:26:50.140
follow up next week.
587
00:26:50.240 --> 00:26:53.400
If you feel like it's urgent, but it doesn't need to be addressed today.
588
00:26:53.800 --> 00:26:58.240
Like, you don't have to address everything in that one visit.
589
00:26:58.780 --> 00:26:59.840
That's so hard.
590
00:26:59.920 --> 00:27:02.440
It can become so overwhelming for the provider.
591
00:27:02.540 --> 00:27:06.560
If you're like trying to touch on everything they say, and you want to
592
00:27:06.560 --> 00:27:08.040
make sure you get everything right.
593
00:27:09.700 --> 00:27:12.060
Prioritizing like, what do we need to do today?
594
00:27:12.080 --> 00:27:14.100
And what can we revisit next week?
595
00:27:15.440 --> 00:27:15.920
Yeah.
596
00:27:16.160 --> 00:27:19.240
And that perspective gives me that perspective.
597
00:27:19.340 --> 00:27:20.360
It can be really tough too.
598
00:27:20.360 --> 00:27:22.880
Cause like, I remember being like, yeah, should I write down
599
00:27:22.880 --> 00:27:24.980
that like toe tingling problem?
600
00:27:27.680 --> 00:27:30.600
Like we're going to, like, I think it's okay, but should I add it to
601
00:27:30.600 --> 00:27:32.080
my problem list of like 27?
602
00:27:35.520 --> 00:27:38.040
What if it's really serious in six months?
603
00:27:38.040 --> 00:27:40.380
It's like, okay, well, it's gonna, it's gonna keep getting worse.
604
00:27:41.340 --> 00:27:41.780
Okay.
605
00:27:41.780 --> 00:27:42.660
It's okay.
606
00:27:43.280 --> 00:27:44.420
Oh, I love that.
607
00:27:44.420 --> 00:27:47.480
It feels to me like things are really different.
608
00:27:47.540 --> 00:27:50.540
And it's funny because I'm trying to like talk like myself and I swear a
609
00:27:50.540 --> 00:27:53.600
lot more in person than I do in the podcast and I'm like catching myself.
610
00:27:54.260 --> 00:27:57.480
Um, but, uh, yeah, just like things are so different.
611
00:27:57.480 --> 00:28:00.440
So you've, you feel like things like, I guess before it was kind of this,
612
00:28:00.480 --> 00:28:03.660
at least for me, I was like, You know, hustle grind.
613
00:28:03.780 --> 00:28:04.940
Here's the way that medicine is.
614
00:28:04.940 --> 00:28:05.560
Here we go.
615
00:28:05.600 --> 00:28:08.120
And it just feels to me, especially with real world NPA, like
616
00:28:08.120 --> 00:28:11.420
Justin is like an example, like I would share, we would do these Friday wins.
617
00:28:11.420 --> 00:28:14.620
I haven't been on social media as much lately list this whole year, actually,
618
00:28:14.660 --> 00:28:19.280
but we would just do this thing about sharing wins inspired by another company
619
00:28:19.280 --> 00:28:22.240
that did something similar, but people would share things that are really
620
00:28:22.240 --> 00:28:25.480
concrete about like, Oh, like I passed my boards, I got a job and people
621
00:28:25.480 --> 00:28:26.500
still share that, which is great.
622
00:28:26.700 --> 00:28:30.440
But I think the shares that I'm noticing that makes me so happy is
623
00:28:30.440 --> 00:28:33.740
like those self honoring choices of like, I love to talk so workplace.
624
00:28:33.880 --> 00:28:37.060
I have more things to do, but I decided to be done for the day.
625
00:28:37.060 --> 00:28:38.940
Cause it's Friday night and I want to chill.
626
00:28:39.320 --> 00:28:41.400
So yeah, what do you, what do you, does that strike
627
00:28:41.400 --> 00:28:44.260
you as like, that's what's happening out there in the real world?
628
00:28:44.280 --> 00:28:46.300
Like in what you've seen and what you've experienced.
629
00:28:46.300 --> 00:28:47.660
Like, I don't know.
630
00:28:47.700 --> 00:28:52.200
Like, like we had, we had those gifts of like gifts of COVID as
631
00:28:52.200 --> 00:28:56.550
much as it's been terrible, but like, yeah, what showed us like
632
00:28:57.240 --> 00:29:01.560
work life balance, although there was like no work life balance during
633
00:29:01.560 --> 00:29:06.340
COVID, I think it, it showed us what it was like to be home with your
634
00:29:06.340 --> 00:29:13.380
family more and that working from home is possible in, you know, in
635
00:29:13.380 --> 00:29:14.820
healthcare in general.
636
00:29:16.060 --> 00:29:20.480
Um, when we went back, we still had a telehealth day, right?
637
00:29:20.580 --> 00:29:24.500
So like when we went back after COVID, we still had a telehealth day.
638
00:29:24.500 --> 00:29:30.360
We still had a remote day and, um, me personally, after my first
639
00:29:30.360 --> 00:29:33.640
kid, I had to cut my hours back because I was like, there's no
640
00:29:33.640 --> 00:29:38.640
way I can sustain like working this many hours, seeing this many
641
00:29:38.640 --> 00:29:40.820
patients and raising a family.
642
00:29:41.200 --> 00:29:46.420
And then from there, I think it was during COVID that, um, we got
643
00:29:46.420 --> 00:29:50.220
promoted to associate medical director, right?
644
00:29:50.300 --> 00:29:53.680
And so that gives you a little more admin time and a little more
645
00:29:53.680 --> 00:29:56.460
balance between patient care and admin time.
646
00:29:56.860 --> 00:30:02.500
And it just helps with burnout so much, like whether it's cutting
647
00:30:02.500 --> 00:30:09.160
back hours or throwing in some telehealth or finding a way to get
648
00:30:09.160 --> 00:30:13.800
more admin time, taking on projects, like anything like that can
649
00:30:13.800 --> 00:30:18.200
help to prevent burnout, at least for me, it did.
650
00:30:18.340 --> 00:30:22.420
And I think it does for the most part across the board because
651
00:30:23.200 --> 00:30:28.460
patient facing care and seeing patients is like really, really
652
00:30:28.460 --> 00:30:32.260
where I find burnout and it's like the most important role,
653
00:30:32.260 --> 00:30:32.680
right?
654
00:30:32.740 --> 00:30:37.240
But if you're doing it, you're seeing 16 patients a day, five days
655
00:30:37.240 --> 00:30:41.980
a week, like you just, you can't.
656
00:30:42.720 --> 00:30:43.060
Yeah.
657
00:30:43.060 --> 00:30:45.280
And also like, depending on like, and then, and then more
658
00:30:45.280 --> 00:30:47.580
complications you add to, cause I definitely like talk to people
659
00:30:47.580 --> 00:30:50.400
in the community and it's like, it's such a wild range of what
660
00:30:50.400 --> 00:30:53.980
people are seeing, whether it's like 16 a day, 20 a day.
661
00:30:54.100 --> 00:30:55.920
I mean, there's 30 people a day.
662
00:30:59.320 --> 00:31:00.660
I mean, I really hope that that's going down.
663
00:31:00.740 --> 00:31:02.160
I don't, it's all anecdotal, right?
664
00:31:02.160 --> 00:31:05.200
Like I don't have any actual stats, but it's, yeah, it's.
665
00:31:06.800 --> 00:31:07.260
But yeah.
666
00:31:07.320 --> 00:31:08.760
And like, what were you going to say, Kara?
667
00:31:09.240 --> 00:31:12.400
I think, well, here when you talk, Heather, like we went
668
00:31:13.060 --> 00:31:17.680
through this like crucial, like point at the health center
669
00:31:17.680 --> 00:31:21.920
where I think it was like 15 people who left and we are
670
00:31:21.920 --> 00:31:23.000
not a big health center.
671
00:31:23.000 --> 00:31:26.300
Hold on, 15 providers or all staff or?
672
00:31:26.640 --> 00:31:28.320
Yes, mainly MPs.
673
00:31:28.400 --> 00:31:30.360
And it was, it was awful.
674
00:31:30.360 --> 00:31:37.060
And I, it makes me sad that we didn't make the changes for
675
00:31:37.060 --> 00:31:41.000
sustainability before, because those were lovely people.
676
00:31:43.340 --> 00:31:48.080
And that did kind of force the organization to deal with it.
677
00:31:48.820 --> 00:31:50.980
And I think they would have any ways, right?
678
00:31:50.980 --> 00:31:53.140
But that left, that puts you in a position where you
679
00:31:53.140 --> 00:31:54.820
can't see patients, right?
680
00:31:54.900 --> 00:31:56.740
Like there's not people to do that.
681
00:31:56.880 --> 00:31:57.080
Right.
682
00:31:57.080 --> 00:32:00.480
And we really were able to shift.
683
00:32:00.700 --> 00:32:03.540
Like we were doing on call, but that was part of the contract
684
00:32:03.540 --> 00:32:05.560
and you weren't necessarily getting paid for that.
685
00:32:05.600 --> 00:32:08.760
You were doing Saturdays was part of the contract, not getting paid.
686
00:32:09.460 --> 00:32:14.740
It was like, kind of like, you weren't having to tell a health day.
687
00:32:14.880 --> 00:32:18.800
Like it was kind of, it was all like being shifted and we didn't
688
00:32:18.800 --> 00:32:20.120
have like the resources we needed.
689
00:32:20.380 --> 00:32:24.520
So people left and then we changed how we paid people.
690
00:32:24.900 --> 00:32:26.640
And now we pay well.
691
00:32:27.080 --> 00:32:29.340
I was going to say, what are some of the sustainable changes?
692
00:32:29.460 --> 00:32:31.560
Cause I think that's, I think it's really helpful for people to hear
693
00:32:31.560 --> 00:32:34.660
because I don't think people are doing this as often now, hopefully,
694
00:32:34.700 --> 00:32:37.500
but people have this feeling of obligation that they need to stay
695
00:32:37.500 --> 00:32:40.660
in toxic workplaces, not saying that where you were, where we
696
00:32:40.660 --> 00:32:44.760
worked was a toxic place, but yeah, I think it's really
697
00:32:44.760 --> 00:32:45.800
helpful for people to hear that.
698
00:32:45.800 --> 00:32:48.520
It may have been for like periods of time.
699
00:32:48.640 --> 00:32:48.880
Yeah.
700
00:32:49.000 --> 00:32:51.880
There were some periods of time, but yeah.
701
00:32:51.940 --> 00:32:54.120
Like when people leave, like that's going to help the
702
00:32:54.120 --> 00:32:57.000
organization shift, like you staying in a toxic workplace does
703
00:32:57.000 --> 00:32:59.640
not help things change necessarily, but yeah, go ahead, go ahead.
704
00:32:59.960 --> 00:33:00.420
Totally.
705
00:33:00.560 --> 00:33:00.860
Yeah.
706
00:33:01.280 --> 00:33:04.880
So we started to make like small changes, you know, but it wasn't
707
00:33:04.880 --> 00:33:08.440
quite fast enough, which I think is the hard part of institutions.
708
00:33:10.720 --> 00:33:15.760
And we hired two remote on-call people who do on-call as their
709
00:33:15.760 --> 00:33:20.280
main job and we took away Saturdays and that was extra pay.
710
00:33:20.440 --> 00:33:22.300
So no more Saturdays, no more on-call.
711
00:33:22.420 --> 00:33:26.460
And if you do them, you get paid and yeah.
712
00:33:26.460 --> 00:33:27.580
We pivoted.
713
00:33:28.940 --> 00:33:30.680
Companies already took away call.
714
00:33:30.820 --> 00:33:33.740
So that was like a big thing that had people leaving.
715
00:33:34.420 --> 00:33:35.320
Was the on-call schedule?
716
00:33:35.660 --> 00:33:36.080
Yeah.
717
00:33:36.320 --> 00:33:38.940
I mean, you could find places that were outsourcing call.
718
00:33:40.040 --> 00:33:46.260
So, um, that was a, that was a big thing for some people was not having to do call.
719
00:33:46.720 --> 00:33:47.820
I mean, that makes a big difference.
720
00:33:47.840 --> 00:33:51.080
Was it, was it an organ that was at a contracted company or was
721
00:33:51.080 --> 00:33:53.680
it in-house employees that did the call?
722
00:33:54.160 --> 00:33:54.700
In-house.
723
00:33:54.980 --> 00:33:55.300
In-house.
724
00:33:55.340 --> 00:33:55.780
That's interesting.
725
00:33:55.780 --> 00:33:59.540
And I just wanted to offer that other organizations were contracted out.
726
00:34:00.740 --> 00:34:01.020
Oh, okay.
727
00:34:01.020 --> 00:34:03.960
So it's, it was an on-call like group.
728
00:34:04.200 --> 00:34:04.300
Okay.
729
00:34:04.300 --> 00:34:07.640
Cause I was going to say, so the thing that, um, I just love talking about
730
00:34:07.640 --> 00:34:10.300
that, cause I think it's nice for people to know, cause so many new
731
00:34:10.300 --> 00:34:12.280
grads are in this like isolated position where they don't even know
732
00:34:12.280 --> 00:34:13.739
it's available, like all they have.
733
00:34:13.900 --> 00:34:17.139
And I, I bet you felt the same way of like when you entered an
734
00:34:17.139 --> 00:34:20.000
organization or like, oh, this is just how things are, but hopefully
735
00:34:20.000 --> 00:34:21.400
like fingers crossed things are changing.
736
00:34:21.580 --> 00:34:24.040
But, um, the last health center that I worked at, that was not
737
00:34:24.040 --> 00:34:25.380
where you, we all worked at.
738
00:34:26.159 --> 00:34:30.780
Um, they had a company that had a call service that went through a nursing
739
00:34:31.719 --> 00:34:35.080
triage first, and then they had all these protocols and then they got to you.
740
00:34:35.080 --> 00:34:39.159
And so we still had on call, but it was like, mind blowing.
741
00:34:39.340 --> 00:34:43.320
Like I had somebody with a, with an INR or something that was super high.
742
00:34:44.280 --> 00:34:45.699
Um, and, uh, was it an INR?
743
00:34:45.760 --> 00:34:47.639
I can't remember, but it was, it was some sort of, I think I had
744
00:34:47.639 --> 00:34:51.179
to do some war for an adjustment and, um, it was just like, here's
745
00:34:51.179 --> 00:34:52.139
the thing, here's the thing here.
746
00:34:52.179 --> 00:34:54.440
All the questions that you would have asked me, it was just like, bam,
747
00:34:54.440 --> 00:34:55.420
like presented for me.
748
00:34:55.440 --> 00:34:57.760
And I was like, wow, this is amazing.
749
00:34:57.840 --> 00:35:00.240
I just had to do, she's like, here's, and then here's the suggestion of,
750
00:35:00.340 --> 00:35:01.460
do you want to do this or this or this or this?
751
00:35:01.460 --> 00:35:03.880
And I was like, oh, I just, yes.
752
00:35:05.520 --> 00:35:06.840
I'm going to go back to sleep now.
753
00:35:07.280 --> 00:35:07.340
Bye.
754
00:35:07.600 --> 00:35:11.000
To new grads that you can make change.
755
00:35:11.180 --> 00:35:14.260
You can leave if change is not being made.
756
00:35:14.640 --> 00:35:15.000
Yeah.
757
00:35:15.340 --> 00:35:22.180
Um, but you can also push and, you know, keep advocating and eventually
758
00:35:22.180 --> 00:35:29.500
maybe slowly, but, um, there was a lot of change in the past few years that
759
00:35:29.500 --> 00:35:33.080
ended up being positive change and it did take people leaving and it did
760
00:35:33.080 --> 00:35:39.260
take us voicing a lot of opinions, but, um, changes were ultimately made
761
00:35:39.260 --> 00:35:42.700
and for the better, and I think in the long run for the company,
762
00:35:42.900 --> 00:35:44.480
they will be able to retain.
763
00:35:44.800 --> 00:35:45.240
Yeah.
764
00:35:45.700 --> 00:35:46.140
Yeah.
765
00:35:46.420 --> 00:35:46.740
Yeah.
766
00:35:46.740 --> 00:35:49.180
So it definitely sounds like there's like a both ends there of like you
767
00:35:49.180 --> 00:35:53.340
had to, you know, if you feel fully resourced and capable of staying
768
00:35:54.240 --> 00:35:57.720
beautiful and you don't have to stay, you're not abandoning anybody.
769
00:35:57.900 --> 00:35:59.300
Like there will always be providers.
770
00:35:59.400 --> 00:36:00.440
There will always be patients.
771
00:36:01.040 --> 00:36:05.400
What are some of the changes that you felt like, um, you've been happy
772
00:36:05.400 --> 00:36:08.100
about, um, Heather in the last couple of years, like, what do you feel
773
00:36:08.100 --> 00:36:09.380
like some are some of those changes?
774
00:36:09.380 --> 00:36:13.360
I think that people would love to know kind of like what was going on
775
00:36:13.360 --> 00:36:17.400
and, and maybe like what you advocated for and how you advocated for it.
776
00:36:18.120 --> 00:36:20.180
If you feel like sharing one of the big ones.
777
00:36:20.240 --> 00:36:20.540
Yeah.
778
00:36:20.700 --> 00:36:25.760
So we got to the point where we were like having to tell people that
779
00:36:25.760 --> 00:36:30.160
everyone at, at the end of their call week wants to quit.
780
00:36:30.640 --> 00:36:31.900
Like that's how people are feeling.
781
00:36:31.980 --> 00:36:37.000
People were calling out on their last day of call or the day after call.
782
00:36:37.600 --> 00:36:44.440
We had to like present it, like just very real to our leadership that
783
00:36:44.440 --> 00:36:48.240
we don't, our employees shouldn't feel like they have to call out.
784
00:36:48.280 --> 00:36:49.640
They shouldn't have to take a sick day.
785
00:36:49.660 --> 00:36:54.300
They shouldn't have to request a vacation day, the day after their
786
00:36:54.300 --> 00:36:57.900
call week, because they are so burnt out from being on call.
787
00:36:58.300 --> 00:37:01.880
And so they trialed a few different things, right?
788
00:37:01.900 --> 00:37:05.820
Like they were doing, maybe you don't have clinic the week
789
00:37:05.820 --> 00:37:10.520
you're on call and then they gave us the Monday after call off.
790
00:37:10.520 --> 00:37:15.760
And so they trialed a few things and some of it was just not
791
00:37:15.760 --> 00:37:17.160
sustainable financially.
792
00:37:18.120 --> 00:37:25.340
And, um, eventually we came to, or, you know, leadership came to this
793
00:37:25.340 --> 00:37:32.140
plan where they hired two people to rotate colleagues and, um, it's
794
00:37:32.140 --> 00:37:37.200
a huge change to not have to take that on as a primary care provider.
795
00:37:37.200 --> 00:37:40.780
I mean, like just, if you just like, look at it on paper, it's like,
796
00:37:40.840 --> 00:37:45.080
okay, you're supposed to function all day long, making really important,
797
00:37:45.520 --> 00:37:48.180
challenging decisions and holding so much.
798
00:37:48.220 --> 00:37:50.660
And then you're supposed to go home and have a life and answer
799
00:37:50.660 --> 00:37:52.060
more questions all night long.
800
00:37:54.580 --> 00:37:59.960
One thing COVID did was like change what call was because we had
801
00:37:59.960 --> 00:38:04.660
access, patients had access by phone 24 seven to the clinic.
802
00:38:04.660 --> 00:38:10.400
And we had people doing telehealth on Saturdays and Sundays and late nights
803
00:38:10.400 --> 00:38:16.000
more frequently, so patients were calling us 24 seven, like you would
804
00:38:16.000 --> 00:38:21.500
get over, I think a hundred calls in a week on a week on call that was
805
00:38:21.500 --> 00:38:33.940
through COVID because it was just high anxiety, anything came up, they
806
00:38:33.940 --> 00:38:35.000
pre-COVID.
807
00:38:36.120 --> 00:38:37.960
It was never like nine calls this weekend.
808
00:38:37.960 --> 00:38:39.920
It was like 25.
809
00:38:41.800 --> 00:38:42.240
Wow.
810
00:38:43.520 --> 00:38:43.960
Wow.
811
00:38:44.640 --> 00:38:45.700
That's so much.
812
00:38:47.400 --> 00:38:51.960
Here you say data, like Liz, like whenever I talk to anyone in
813
00:38:51.960 --> 00:38:54.800
leadership, right, that's the question they come back to, like
814
00:38:54.800 --> 00:38:55.860
tell me, show me the data, right?
815
00:38:55.860 --> 00:38:59.600
Cause I'm happy to show you all my emotions and to relay all my
816
00:38:59.600 --> 00:39:02.100
emotions for how the other people feel, right?
817
00:39:02.100 --> 00:39:03.480
I can access that.
818
00:39:04.000 --> 00:39:07.100
I've learned now to show the data, exactly what Heather said, right?
819
00:39:07.120 --> 00:39:10.160
You look at the number of call-ups that happened the day after the
820
00:39:10.160 --> 00:39:14.240
number of people that are planning days off, you look at the data
821
00:39:14.240 --> 00:39:15.900
for how many calls you get.
822
00:39:17.120 --> 00:39:21.600
And we also made a shift and moved away from 15 minute visits.
823
00:39:21.660 --> 00:39:23.140
And that was, that's huge.
824
00:39:23.760 --> 00:39:30.660
We now do 20, 30s, 30s is just physicals or when somebody is
825
00:39:30.660 --> 00:39:33.460
requesting that time when someone needs the time, which is really nice.
826
00:39:33.480 --> 00:39:36.180
Um, that is huge.
827
00:39:36.600 --> 00:39:41.080
And it's also helpful to ask your organization, like what is the bottom line?
828
00:39:41.380 --> 00:39:44.120
What is your goal for a PCP to see a day?
829
00:39:44.120 --> 00:39:46.280
And also what is the minimum, right?
830
00:39:46.340 --> 00:39:48.920
Like what are we needing to support the health center?
831
00:39:49.080 --> 00:39:52.120
Um, I was surprised to learn that about our organization that
832
00:39:52.120 --> 00:39:54.640
is not nearly as high as I thought it was.
833
00:39:54.780 --> 00:39:55.820
The bare minimum, you mean?
834
00:39:56.140 --> 00:39:56.420
Oh yeah.
835
00:39:56.460 --> 00:39:58.940
The bare minimum is like 12 and an eight hour shift.
836
00:40:00.500 --> 00:40:02.820
Like, so knowledge is power, right?
837
00:40:03.320 --> 00:40:04.460
So cliche, right?
838
00:40:04.500 --> 00:40:07.540
But knowing that and being able to make your decisions, it does not mean
839
00:40:07.540 --> 00:40:08.860
you can't just schedule 12 patients.
840
00:40:08.880 --> 00:40:12.500
You have to schedule more to allow for the things that shift.
841
00:40:13.500 --> 00:40:20.100
But knowing those things and knowing also what, what makes people happy at
842
00:40:20.100 --> 00:40:22.820
their job, you want people to be happy.
843
00:40:23.060 --> 00:40:25.820
Um, and that is crucial, right?
844
00:40:25.820 --> 00:40:28.040
People leave because you're doing too much.
845
00:40:28.080 --> 00:40:30.780
That is very, very consistent across the board.
846
00:40:30.780 --> 00:40:33.500
So us making that shift is huge.
847
00:40:33.620 --> 00:40:36.800
I got to interview someone yesterday and she just came from seeing 22
848
00:40:36.800 --> 00:40:38.240
patients at a community health center.
849
00:40:38.240 --> 00:40:41.680
And I got to say with confidence that you will not do that here.
850
00:40:42.060 --> 00:40:44.660
Um, we are not going back to 15 minute visits.
851
00:40:44.660 --> 00:40:46.380
Like that has not happening.
852
00:40:46.720 --> 00:40:49.440
And so I feel like we are in an excellent place
853
00:40:49.440 --> 00:40:51.020
for sustainability to build.
854
00:40:51.240 --> 00:40:52.280
I'm feeling hopeful.
855
00:40:52.280 --> 00:40:55.100
Like we are, we have a lot of work to still do, right?
856
00:40:55.260 --> 00:40:58.680
But not having 15 minute visits anymore is huge.
857
00:40:58.680 --> 00:41:02.320
Not expecting people to see 20 patients is huge.
858
00:41:03.520 --> 00:41:05.120
Um, so an increasing salaries.
859
00:41:07.000 --> 00:41:12.120
Other thing that like we had people leaving places, they didn't
860
00:41:12.120 --> 00:41:18.440
necessarily even want to work, but they could just make 100% more money.
861
00:41:18.900 --> 00:41:21.500
For them financially and their family.
862
00:41:21.720 --> 00:41:22.540
It made sense.
863
00:41:23.520 --> 00:41:26.820
We had like a good handful of people do that.
864
00:41:27.640 --> 00:41:32.360
Oh, they all went to the same place because they knew that they knew
865
00:41:32.360 --> 00:41:34.860
what they could make and it's so true.
866
00:41:34.980 --> 00:41:35.460
It's so true.
867
00:41:35.540 --> 00:41:37.260
We lost, um, my last health center.
868
00:41:37.520 --> 00:41:44.160
We lost, um, this is more other staff, but we, we, I remember one shift.
869
00:41:44.380 --> 00:41:50.440
We had one medical assistant for five providers because, um, they all went
870
00:41:50.440 --> 00:41:54.500
to this one facility that made several dollars more an hour to do way less
871
00:41:54.500 --> 00:41:56.160
work, not a federally qualified health center.
872
00:41:56.160 --> 00:41:57.020
It was a big hospital.
873
00:41:57.240 --> 00:42:00.700
They had to do a lot less and they worked really, really, really hard.
874
00:42:01.200 --> 00:42:02.540
Um, so yeah, that is, it's really important.
875
00:42:02.540 --> 00:42:04.800
I love that you say that, um, care about the data.
876
00:42:05.000 --> 00:42:08.020
It's like, I think that, um, I think it's so, I might just
877
00:42:08.020 --> 00:42:11.280
remember being a new grad and not knowing any of this of how healthcare
878
00:42:11.280 --> 00:42:14.040
works and the business of primary care, I have, I made a couple
879
00:42:14.040 --> 00:42:16.300
episodes for the channel about it and I think it's on the podcast.
880
00:42:16.500 --> 00:42:19.540
So I can link, I'll share those with the people when they're listening,
881
00:42:19.720 --> 00:42:24.300
but, um, it's, it's so helpful to know those pieces and like, I
882
00:42:24.300 --> 00:42:28.080
think like another takeaway for whether you're a new grad, new grads or
883
00:42:28.080 --> 00:42:31.780
people coming into practice is like, what is your criteria of satisfaction?
884
00:42:32.300 --> 00:42:35.980
Um, like what are you independent of this clinic setting or whatever
885
00:42:35.980 --> 00:42:38.240
clinic setting, like what are the things that you need to make you
886
00:42:38.240 --> 00:42:38.780
happy, right?
887
00:42:38.980 --> 00:42:41.080
Because for some people they don't mind call.
888
00:42:41.140 --> 00:42:44.560
So some people they don't mind, you know, like whatever the things are
889
00:42:44.560 --> 00:42:46.220
in it, is it, is it about the money?
890
00:42:46.320 --> 00:42:49.000
Because obviously we need to pay our bills and we need to have the
891
00:42:49.000 --> 00:42:50.360
life, you know, that we want to have.
892
00:42:50.860 --> 00:42:53.020
And it may not always be the money.
893
00:42:53.020 --> 00:42:54.660
It could be the money and it could be stuff.
894
00:42:54.760 --> 00:42:55.840
It could be, do you know what I mean?
895
00:42:56.080 --> 00:42:59.080
Like, I just love, I love hearing you share about all of those
896
00:42:59.080 --> 00:43:00.940
different pieces that are available.
897
00:43:04.040 --> 00:43:04.620
Oh my gosh.
898
00:43:04.680 --> 00:43:06.080
I could talk to y'all forever.
899
00:43:07.300 --> 00:43:10.880
And I mean, I, we can talk about this separately, but I'd
900
00:43:10.880 --> 00:43:11.940
love to have you come back.
901
00:43:14.160 --> 00:43:16.560
Just round table chats for the people.
902
00:43:17.940 --> 00:43:18.300
Thank you.
903
00:43:18.560 --> 00:43:20.120
So go ahead.
904
00:43:20.760 --> 00:43:22.220
Any funny patients?
905
00:43:22.320 --> 00:43:22.920
Yeah, do I guess.
906
00:43:22.920 --> 00:43:24.180
Yeah, we have to, we have a few more minutes.
907
00:43:24.220 --> 00:43:27.620
So yeah, just like some funny stuff, like any favorite story I've tried.
908
00:43:27.700 --> 00:43:31.100
So I'm trying to think of stories and all of mine are like kind
909
00:43:31.100 --> 00:43:32.540
of traumatizing, but it's like tragic.
910
00:43:32.820 --> 00:43:33.660
You know what I mean?
911
00:43:34.120 --> 00:43:35.240
I think y'all were there.
912
00:43:35.240 --> 00:43:38.880
I mean, I think, you know, my stories of like, yeah, there was,
913
00:43:38.900 --> 00:43:41.260
there was, yeah, there's a lot happened in that clinic.
914
00:43:41.340 --> 00:43:45.140
It was a wild place, especially like, I don't know.
915
00:43:45.280 --> 00:43:48.200
I mean, y'all did trainings at other clinics, but I went to another
916
00:43:48.200 --> 00:43:50.920
clinic and I was like, they are not as sick.
917
00:43:51.400 --> 00:43:52.300
It is wild.
918
00:43:52.300 --> 00:43:57.380
It was, wow, like they're like 20 to 50 healthy, recently immigrated,
919
00:43:57.480 --> 00:43:58.700
have a lot of mental health and trauma.
920
00:43:58.740 --> 00:44:03.280
Like that's, but I I'm comfortable in that space, but like not like,
921
00:44:03.360 --> 00:44:06.920
Hey, I'm sending you to the hospital because you're well, content
922
00:44:06.920 --> 00:44:10.760
warning, you're, you're, you know, blackened toe is sticking out
923
00:44:10.760 --> 00:44:14.900
of your foot on a Saturday urgent care, you know, like, or like
924
00:44:14.900 --> 00:44:20.920
bone rather, but yeah, so sorry, sorry, these are like the tragic
925
00:44:20.920 --> 00:44:22.400
how many stories that I can think of.
926
00:44:22.500 --> 00:44:24.040
And I was like, yeah, I remember that.
927
00:44:24.520 --> 00:44:27.060
I mean, yeah, I wish, oh my God, you know, who I should bring on.
928
00:44:27.480 --> 00:44:31.680
I feel like, I feel like I should bring Melissa on all three of us.
929
00:44:31.760 --> 00:44:33.880
Plus Melissa, like stories.
930
00:44:34.140 --> 00:44:37.340
She's such a character and she was the nurse that worked with us.
931
00:44:37.780 --> 00:44:40.320
But yeah, funny stories, any funny stories, any light stories.
932
00:44:40.420 --> 00:44:43.000
I think we, we wrote like 10 minutes and I think I got to let you all go.
933
00:44:43.740 --> 00:44:49.580
But I think any recent things or new grad things or I don't know if
934
00:44:49.580 --> 00:44:55.360
the world's ready for my gruesome, your gruesome toe, the gruesome toe
935
00:44:55.360 --> 00:44:57.820
and train that was left in from the hospitalization.
936
00:44:58.940 --> 00:45:00.320
No, I don't even know what that is.
937
00:45:02.100 --> 00:45:03.580
I love you and leave.
938
00:45:08.960 --> 00:45:10.380
Were you going to say a story, Heather?
939
00:45:10.820 --> 00:45:13.360
No, I'm trying to like think back, but I was hoping you guys would
940
00:45:13.360 --> 00:45:15.380
have some that would like jog my memory.
941
00:45:15.780 --> 00:45:16.740
Well, do you all remember that?
942
00:45:16.740 --> 00:45:17.580
Remember that gentleman?
943
00:45:17.660 --> 00:45:17.880
I'm sorry.
944
00:45:17.900 --> 00:45:18.740
Do you have a story Kara?
945
00:45:19.200 --> 00:45:21.080
Cause I can, I could just riff, but
946
00:45:21.080 --> 00:45:28.260
I mean, like last week sent someone to the hospital, which never do lightly.
947
00:45:29.340 --> 00:45:35.020
His potassium was 2.5 and having some EKG changes.
948
00:45:35.680 --> 00:45:39.800
He's drinking a whole lot, which is likely what's causing the low potassium.
949
00:45:40.520 --> 00:45:44.980
And we just had this lovely moment where he's like, and
950
00:45:44.980 --> 00:45:46.180
we speak in Spanish together.
951
00:45:46.240 --> 00:45:50.000
He's kind of like, thank you for sending me and I hate you.
952
00:45:51.800 --> 00:45:52.280
Right.
953
00:45:52.920 --> 00:45:54.400
Like, which I so appreciated.
954
00:45:54.920 --> 00:45:57.660
Like just, just leaving it like that.
955
00:45:57.760 --> 00:45:58.040
Right.
956
00:45:58.400 --> 00:46:02.180
Like, I feel like you've got such a great rapport with all of your
957
00:46:02.180 --> 00:46:04.680
patients, Kara, they just like adore you.
958
00:46:04.880 --> 00:46:05.560
It's amazing.
959
00:46:05.560 --> 00:46:08.500
Cause I got to inherit them from somebody else who they adored.
960
00:46:09.240 --> 00:46:11.280
So I got to maintain the adoring.
961
00:46:11.700 --> 00:46:12.120
Right.
962
00:46:12.400 --> 00:46:15.400
You were the perfect person to take over that panel.
963
00:46:15.860 --> 00:46:21.060
I, I was well, speaking of that person that I got to take over the
964
00:46:21.060 --> 00:46:22.840
patient for my first time.
965
00:46:23.080 --> 00:46:24.620
That was last month.
966
00:46:25.380 --> 00:46:29.240
Um, and this patient knew it was going down, knew that was happening.
967
00:46:29.240 --> 00:46:32.820
Cause we kind of like, we set our boundaries and for years, we've kind
968
00:46:32.820 --> 00:46:34.640
of just kept pushing them to the side.
969
00:46:34.920 --> 00:46:37.520
And this time we're like, no, we need to do this and we're
970
00:46:37.520 --> 00:46:38.600
going to have a talk about it.
971
00:46:38.980 --> 00:46:39.920
She knew it was happening.
972
00:46:39.920 --> 00:46:42.540
And when I walked into the room, she had a very large cross
973
00:46:42.540 --> 00:46:44.460
that she had on the exam table.
974
00:46:44.500 --> 00:46:45.540
Do I know this person?
975
00:46:45.740 --> 00:46:48.420
Is this something I think I, I think I can see her in my mind.
976
00:46:48.420 --> 00:46:48.740
Yes.
977
00:46:48.740 --> 00:46:49.880
I'm pretty sure I can see her.
978
00:46:50.180 --> 00:46:50.280
Yep.
979
00:46:51.460 --> 00:46:58.880
I had it like cross on the table, ready to kind of like, like just give me the word.
980
00:46:59.040 --> 00:46:59.480
Right.
981
00:46:59.480 --> 00:47:03.040
And as I'm saying, like, like, yes, this is happening.
982
00:47:03.200 --> 00:47:03.420
Right.
983
00:47:03.580 --> 00:47:06.440
We, we're going to find another primary care for you.
984
00:47:06.520 --> 00:47:08.640
Hold up the cross, like to my face.
985
00:47:09.620 --> 00:47:09.640
Right.
986
00:47:11.240 --> 00:47:13.360
Like hopefully not in a threatening way.
987
00:47:14.160 --> 00:47:16.620
Wanted to spread some curse or something, right.
988
00:47:17.260 --> 00:47:19.380
And this is probably not a fabulous, funny story.
989
00:47:19.420 --> 00:47:20.900
So we can maybe take this one out.
990
00:47:21.060 --> 00:47:22.660
Um, right.
991
00:47:22.920 --> 00:47:26.660
But like having to tell somebody like, Oh, no, no, not today.
992
00:47:26.760 --> 00:47:27.020
Nope.
993
00:47:27.100 --> 00:47:27.300
Nope.
994
00:47:27.400 --> 00:47:29.800
I'm going to put that down and we're going to bring it back.
995
00:47:33.600 --> 00:47:36.580
You know, that's the thing I feel like about healthcare humor is that like
996
00:47:36.580 --> 00:47:40.120
there's the, the, the tragic comedy is like the, it's that thing.
997
00:47:40.160 --> 00:47:42.540
It's like, if you don't laugh, you're like, how can you handle something
998
00:47:42.540 --> 00:47:45.080
like that, like a cross being held up to your face, being like.
999
00:47:46.740 --> 00:47:51.400
I can share what, what brought me to healthcare was teen based care.
1000
00:47:52.260 --> 00:47:53.540
And it's always stayed with me.
1001
00:47:53.680 --> 00:47:58.220
I got to call somebody with their negative, like SDI screening results
1002
00:47:58.220 --> 00:48:02.020
and they're on the phone and they scream, I'm a beast.
1003
00:48:11.160 --> 00:48:11.840
Oh my God.
1004
00:48:11.960 --> 00:48:13.520
I love that so much.
1005
00:48:13.520 --> 00:48:15.580
I was like, that's what we want.
1006
00:48:16.360 --> 00:48:19.040
Sexual health is one of my favorite topics.
1007
00:48:19.100 --> 00:48:21.380
Cause it's just gets to be so fun.
1008
00:48:21.600 --> 00:48:23.700
I mean, I know it's not comfortable for everybody, but like, you know,
1009
00:48:23.760 --> 00:48:25.600
you and I, Kara, I love that.
1010
00:48:25.600 --> 00:48:26.220
Love that stuff.
1011
00:48:26.340 --> 00:48:30.160
It's just, it just adds so much levity to some really heavy stuff.
1012
00:48:31.140 --> 00:48:31.440
Sometimes.
1013
00:48:32.980 --> 00:48:34.220
Does that jog any memories for you?
1014
00:48:34.340 --> 00:48:34.600
Sorry, go ahead.
1015
00:48:34.700 --> 00:48:36.900
Well, I suggested funny stories, right?
1016
00:48:36.900 --> 00:48:39.880
And then I realized I don't have really any funny stories.
1017
00:48:40.040 --> 00:48:41.420
So I made a mistake.
1018
00:48:41.420 --> 00:48:44.800
Um, I have a fun time, right?
1019
00:48:45.780 --> 00:48:50.500
And it's like funny when we're talking about these stories that are not funny.
1020
00:48:50.560 --> 00:48:50.980
Yes.
1021
00:48:51.160 --> 00:48:53.420
Like some of these are like scary.
1022
00:48:56.580 --> 00:49:02.120
I remember like someone coming at me, literally like calling me the C word
1023
00:49:02.120 --> 00:49:04.160
and telling me they're going to punch me in the face.
1024
00:49:05.160 --> 00:49:11.020
And like, I don't even remember who had to step in, but like we know
1025
00:49:11.020 --> 00:49:14.300
the patient well and we sort of expect it, right?
1026
00:49:15.260 --> 00:49:18.760
Like, you know, this is going to happen and it can be scary.
1027
00:49:19.400 --> 00:49:22.340
And a week later, it can be something we're sort of laughing at.
1028
00:49:22.640 --> 00:49:30.400
So we've had some, I think like someone threw a cane at someone
1029
00:49:30.400 --> 00:49:38.540
and no one got hurt, but when you get to know these patients, it's
1030
00:49:38.540 --> 00:49:40.560
like, you know, this is what's going to come of it.
1031
00:49:40.560 --> 00:49:45.740
So as long as you're prepared, it can be a little entertaining after the
1032
00:49:45.740 --> 00:49:49.600
fact, as long as everyone comes out unscathed.
1033
00:49:49.600 --> 00:49:50.820
It's so true.
1034
00:49:52.520 --> 00:49:53.040
Oh my gosh.
1035
00:49:53.220 --> 00:49:59.000
I feel like like the funny stories are more like trauma bonding.
1036
00:50:02.320 --> 00:50:03.300
I don't remember.
1037
00:50:03.500 --> 00:50:06.640
I'm not going to name any names, but there was a, there was a patient
1038
00:50:06.640 --> 00:50:11.620
who had really severe diabetes, ended up having heart failure.
1039
00:50:12.260 --> 00:50:18.540
Um, real talker, real talker, uh, was like, not obsessed with me,
1040
00:50:18.540 --> 00:50:21.200
but like, he was like, I feel like he and I had the rapport.
1041
00:50:21.300 --> 00:50:22.540
This was like at the very beginning.
1042
00:50:22.660 --> 00:50:23.660
I don't know if y'all remember this.
1043
00:50:24.040 --> 00:50:24.400
Yeah.
1044
00:50:24.580 --> 00:50:25.760
Um, I wish I could help you.
1045
00:50:25.900 --> 00:50:28.100
Definitely some people who were obsessed with you.
1046
00:50:28.180 --> 00:50:29.280
Big fans, big fans.
1047
00:50:29.500 --> 00:50:29.640
Yes.
1048
00:50:30.140 --> 00:50:32.460
This gentleman, it was like, you couldn't get a word in edgewise,
1049
00:50:32.540 --> 00:50:35.100
but like we graduated to the point where it was like, cause it felt
1050
00:50:35.100 --> 00:50:37.800
like he just like straight up talked for like 45 minutes.
1051
00:50:37.820 --> 00:50:41.460
And I would be like, um, uh, can I, well, you know, but that anyway,
1052
00:50:41.520 --> 00:50:43.500
but one time this must've been a set.
1053
00:50:43.640 --> 00:50:46.560
I feel like this maybe it was a Saturday, but our, I think the
1054
00:50:46.560 --> 00:50:50.560
person's who's panel you inherited was still there, um, Kara and,
1055
00:50:50.700 --> 00:50:52.760
um, that we all worked with that.
1056
00:50:52.940 --> 00:50:54.100
I called mom accidentally.
1057
00:50:58.840 --> 00:51:02.040
She inherited all of us or like acquired all of us.
1058
00:51:05.100 --> 00:51:08.060
And she, of course, is like the amazing gem of a human.
1059
00:51:08.240 --> 00:51:10.720
It was just like, yeah, no, I'm not your mom.
1060
00:51:11.840 --> 00:51:15.640
But I remember one time, uh, one time I was, I was, I, this was
1061
00:51:15.640 --> 00:51:18.500
when I was a newer grad and I was still like a little bit nervous and
1062
00:51:18.500 --> 00:51:22.880
I went into the room and, uh, and he was basically like, um, yeah.
1063
00:51:22.880 --> 00:51:24.420
So I like stubbed my toe walking.
1064
00:51:24.640 --> 00:51:26.740
So the place that we worked, like had a lot of cobblestone streets
1065
00:51:26.740 --> 00:51:29.840
and was like, you know, I stubbed my toe on the cobblestones and
1066
00:51:29.840 --> 00:51:30.820
like, I think it's okay.
1067
00:51:30.860 --> 00:51:33.260
Like it's, you know, it's like not a big deal, but I just, I'd
1068
00:51:33.260 --> 00:51:34.160
love for you to just take a look at it.
1069
00:51:34.160 --> 00:51:36.940
It was like a doorknob question, like at the end of the, and like,
1070
00:51:37.120 --> 00:51:39.860
we were talking about so many things and I don't know, maybe I intended
1071
00:51:39.860 --> 00:51:41.140
to do a foot exam anyway, whatever.
1072
00:51:41.240 --> 00:51:47.220
But he, um, took off his shoes and his socks and the smell
1073
00:51:47.220 --> 00:51:49.220
filled the entire, um, health center.
1074
00:51:49.820 --> 00:51:52.620
Um, and I was like, Oh, give me a second.
1075
00:51:52.660 --> 00:51:56.880
Um, because it was basically like, um, Oh my God, bone infection,
1076
00:51:57.060 --> 00:52:00.600
osteomyelitis, like it was like almost like near like no, no
1077
00:52:00.600 --> 00:52:02.460
chance it couldn't have been that, but I was a new grad and I
1078
00:52:02.460 --> 00:52:04.660
never seen like new diagnosis of osteomyelitis.
1079
00:52:05.100 --> 00:52:07.260
And so I like walked down the hall and I got her
1080
00:52:09.340 --> 00:52:11.300
cause I'm not really sure what I should do.
1081
00:52:11.560 --> 00:52:13.240
Like thinking about antibiotics.
1082
00:52:15.960 --> 00:52:16.600
So much.
1083
00:52:16.840 --> 00:52:17.920
Well, we're going to take a second.
1084
00:52:18.000 --> 00:52:19.560
We're going to step out and we walked out and she's like,
1085
00:52:19.560 --> 00:52:20.800
you need to send him to the hospital.
1086
00:52:20.820 --> 00:52:22.000
And I was like, Oh, okay.
1087
00:52:22.040 --> 00:52:22.320
Okay.
1088
00:52:23.140 --> 00:52:25.760
I was so nervous cause I was a new grad and I was just like,
1089
00:52:25.780 --> 00:52:27.680
do I send them to the hospital for IV antibiotics?
1090
00:52:27.820 --> 00:52:28.520
Can we get away with it?
1091
00:52:28.740 --> 00:52:31.120
And now that I've experienced, I'm like, Oh, duh.
1092
00:52:31.120 --> 00:52:34.200
Like, of course someone with like heart failure, complicated
1093
00:52:34.200 --> 00:52:37.360
diabetes and renal impairment, like he ended up having an
1094
00:52:37.360 --> 00:52:37.840
amputation.
1095
00:52:37.900 --> 00:52:41.880
He had it, I've, you know, like a smash in his kidney
1096
00:52:41.880 --> 00:52:43.840
function because he had to have all that treatment done.
1097
00:52:43.980 --> 00:52:45.020
But like, I don't know.
1098
00:52:45.080 --> 00:52:47.040
I think, I mean, it's like, again, like that's like not
1099
00:52:47.040 --> 00:52:49.040
funny that that happened to that person, but like the
1100
00:52:49.040 --> 00:52:51.160
humor is in the, like.
1101
00:52:51.300 --> 00:52:55.700
Asking mom to take a look and be sure you should do
1102
00:52:55.700 --> 00:52:57.460
with that.
1103
00:52:57.460 --> 00:52:58.920
I mean, she's such a mom though, right?
1104
00:52:58.980 --> 00:53:00.180
Did y'all ever call her mom?
1105
00:53:00.580 --> 00:53:00.980
I did.
1106
00:53:00.980 --> 00:53:01.740
Am I the only one?
1107
00:53:02.520 --> 00:53:03.980
Definitely never did I'm like,
1108
00:53:06.220 --> 00:53:07.800
she's definitely mom-like.
1109
00:53:07.960 --> 00:53:09.980
It was like that teacher moment, you know, when you go
1110
00:53:09.980 --> 00:53:11.940
to school as a kid and then you're like, you call your
1111
00:53:11.940 --> 00:53:13.660
mom, you call your teacher mom.
1112
00:53:14.000 --> 00:53:14.520
It was one of those.
1113
00:53:14.640 --> 00:53:15.980
It was charming, but yeah.
1114
00:53:16.500 --> 00:53:20.440
I did have to remove a tampon that was in for at
1115
00:53:20.440 --> 00:53:23.600
least, at least a week, I think, when I was like
1116
00:53:23.600 --> 00:53:24.980
seven months pregnant.
1117
00:53:25.300 --> 00:53:29.960
Oh, I remember like just having to run out of the
1118
00:53:29.960 --> 00:53:30.680
room immediately.
1119
00:53:30.900 --> 00:53:34.620
So I wouldn't throw up, but like, it's like, okay, I
1120
00:53:34.620 --> 00:53:36.080
got this, I'm going to do this.
1121
00:53:36.100 --> 00:53:38.000
And then I have to leave the room immediately.
1122
00:53:38.620 --> 00:53:41.420
And I don't remember, like, if I, I don't think
1123
00:53:41.420 --> 00:53:45.120
I did throw up in that, but I have a very vivid
1124
00:53:45.120 --> 00:53:48.020
memory of like, this was not good.
1125
00:53:48.400 --> 00:53:50.680
This was not going to end well for me.
1126
00:53:51.400 --> 00:53:51.880
Oh my God.
1127
00:53:52.060 --> 00:53:53.400
I actually, so that first time that I had that
1128
00:53:53.400 --> 00:53:55.180
happen, I was with Melissa, the nurse that we
1129
00:53:55.180 --> 00:53:57.000
worked with and I must've been an urgent care
1130
00:53:57.000 --> 00:53:58.660
day, cause I think it was just her and I.
1131
00:53:59.540 --> 00:54:00.180
But yeah.
1132
00:54:00.340 --> 00:54:01.520
So like, I hadn't done that before.
1133
00:54:01.580 --> 00:54:02.660
And I was like, Oh, I think that's what's
1134
00:54:02.660 --> 00:54:02.780
happening.
1135
00:54:02.800 --> 00:54:04.800
And she was like, you need to take that out
1136
00:54:05.120 --> 00:54:05.440
immediately.
1137
00:54:05.740 --> 00:54:07.680
Like in it's like, what is that the procedure
1138
00:54:07.680 --> 00:54:09.660
you kind of like use the, the forceps and
1139
00:54:09.660 --> 00:54:11.040
then you kind of pull and then you put it
1140
00:54:11.040 --> 00:54:11.900
in the gloves immediately.
1141
00:54:11.900 --> 00:54:12.800
And then you put it in the trash.
1142
00:54:12.900 --> 00:54:14.960
She like took the trash and ran.
1143
00:54:16.300 --> 00:54:16.420
Yeah.
1144
00:54:19.040 --> 00:54:20.440
The patient was so mortified.
1145
00:54:20.560 --> 00:54:22.000
And I was just like, I was, I felt, I was
1146
00:54:22.000 --> 00:54:23.520
like trying my best to like have her feel
1147
00:54:23.520 --> 00:54:23.760
comfortable.
1148
00:54:23.840 --> 00:54:26.700
Cause like how mortifying, you know, but yeah.
1149
00:54:27.440 --> 00:54:30.340
I remember your face Liz, like, so I got to
1150
00:54:30.340 --> 00:54:32.880
do my IUD training with Liz.
1151
00:54:34.360 --> 00:54:37.480
Um, and after I got trained, then I had
1152
00:54:37.480 --> 00:54:39.520
to do a couple where I had you come in to
1153
00:54:39.520 --> 00:54:41.060
just make sure, Hey, I got this.
1154
00:54:41.440 --> 00:54:43.140
I remember going down the hall and it
1155
00:54:43.140 --> 00:54:46.680
was somebody who is 18 for like their
1156
00:54:46.680 --> 00:54:47.000
IUD.
1157
00:54:47.260 --> 00:54:49.000
And I remember looking at you and you
1158
00:54:49.000 --> 00:54:50.780
like made this face, like, this is not
1159
00:54:50.780 --> 00:54:52.100
going to really be so quick.
1160
00:54:52.120 --> 00:54:53.820
Cause I was just like two seconds, come on
1161
00:54:53.820 --> 00:54:56.680
in, watch me do this, um, cross it off.
1162
00:54:56.680 --> 00:54:58.580
And your face was like, okay.
1163
00:55:01.960 --> 00:55:03.140
And I was like, what do you mean?
1164
00:55:03.220 --> 00:55:04.060
It's going to be fine.
1165
00:55:06.620 --> 00:55:08.400
It was, but I remember your face in
1166
00:55:08.400 --> 00:55:10.900
that moment being like, hmm, I don't
1167
00:55:10.900 --> 00:55:12.340
know if she really.
1168
00:55:15.420 --> 00:55:16.500
Oh my God.
1169
00:55:16.760 --> 00:55:18.400
And so many, um, I, I was thinking
1170
00:55:18.400 --> 00:55:19.620
of you, Kara, cause then my last
1171
00:55:19.620 --> 00:55:22.900
clinic, um, I did, uh, so Karen, I
1172
00:55:22.900 --> 00:55:24.500
did a bunch of, um, women's health
1173
00:55:24.500 --> 00:55:26.520
procedure, a gynecological contraceptive
1174
00:55:26.520 --> 00:55:26.940
procedures.
1175
00:55:26.940 --> 00:55:29.340
And, um, yeah, I just remember so
1176
00:55:29.340 --> 00:55:31.580
many, um, next one on removals, we
1177
00:55:31.580 --> 00:55:33.860
would tag team of like, I can't get
1178
00:55:33.860 --> 00:55:34.200
it.
1179
00:55:34.300 --> 00:55:35.160
I can't get it.
1180
00:55:35.260 --> 00:55:36.820
We didn't have Lida came with Epi.
1181
00:55:37.040 --> 00:55:38.260
Like I remember coming back from
1182
00:55:38.260 --> 00:55:39.660
maternity or something, and it
1183
00:55:39.660 --> 00:55:40.500
was like a shortage.
1184
00:55:40.540 --> 00:55:41.860
And so we had to do next, but on
1185
00:55:41.860 --> 00:55:43.200
removals without Epi.
1186
00:55:43.380 --> 00:55:43.540
Yeah.
1187
00:55:44.040 --> 00:55:45.160
And it was just a gut.
1188
00:55:45.600 --> 00:55:47.680
So much, so much, so much blood.
1189
00:55:48.220 --> 00:55:49.280
This is egregious.
1190
00:55:49.360 --> 00:55:51.280
This is really, really unnecessary.
1191
00:55:51.420 --> 00:55:52.680
I remember like getting, I was
1192
00:55:52.680 --> 00:55:53.880
happy that we both were doing that
1193
00:55:53.880 --> 00:55:54.920
together because I'm like, we're
1194
00:55:54.920 --> 00:55:55.300
doing this.
1195
00:55:55.320 --> 00:55:56.060
We're not going to make someone
1196
00:55:56.060 --> 00:55:59.700
come back for this, but a lot of
1197
00:55:59.700 --> 00:56:04.680
fluids, so much gauze, much
1198
00:56:04.680 --> 00:56:05.040
gauze.
1199
00:56:05.180 --> 00:56:06.940
My, my, my, my second clinic that
1200
00:56:06.940 --> 00:56:08.820
I just worked at, they didn't use
1201
00:56:08.820 --> 00:56:09.220
Epi.
1202
00:56:09.260 --> 00:56:10.400
They didn't use Lida with Epi.
1203
00:56:10.500 --> 00:56:12.200
I was like, how have you ever
1204
00:56:12.200 --> 00:56:13.960
removed an explodon without that?
1205
00:56:14.440 --> 00:56:15.300
It was wild.
1206
00:56:15.720 --> 00:56:16.620
I w it was like a very
1207
00:56:16.620 --> 00:56:17.940
novel to introduce, but.
1208
00:56:18.400 --> 00:56:18.820
Okay.
1209
00:56:18.880 --> 00:56:19.300
Oh my God.
1210
00:56:19.420 --> 00:56:20.560
Maybe I'll try again now that I
1211
00:56:20.560 --> 00:56:21.860
have more experience, but back
1212
00:56:21.860 --> 00:56:22.800
then I was like, whoa.
1213
00:56:23.060 --> 00:56:24.140
No, no, no.
1214
00:56:24.140 --> 00:56:24.460
Thank you.
1215
00:56:24.500 --> 00:56:24.960
No, no, no.
1216
00:56:25.060 --> 00:56:26.040
I was like, we're going to
1217
00:56:26.040 --> 00:56:27.160
We have Epi.
1218
00:56:27.220 --> 00:56:28.480
Why would we not use that?
1219
00:56:29.000 --> 00:56:29.360
Yes.
1220
00:56:29.740 --> 00:56:30.360
Oh my gosh.
1221
00:56:30.520 --> 00:56:32.100
This has me really wanting to
1222
00:56:32.100 --> 00:56:33.560
work at the same clinic again.
1223
00:56:33.920 --> 00:56:35.780
Like I just, oh my gosh.
1224
00:56:36.600 --> 00:56:37.320
So fun.
1225
00:56:38.680 --> 00:56:40.860
Oh, I, I, I, I, again, I
1226
00:56:40.860 --> 00:56:42.320
I could keep you here all day.
1227
00:56:42.520 --> 00:56:43.780
Um, do you have any other
1228
00:56:43.780 --> 00:56:44.820
anecdotes you want to share?
1229
00:56:44.920 --> 00:56:45.980
Should we wrap up and maybe
1230
00:56:45.980 --> 00:56:48.040
like, I just, I mean, I could
1231
00:56:48.040 --> 00:56:49.440
do this, I could do this all
1232
00:56:49.440 --> 00:56:50.020
the time.
1233
00:56:50.380 --> 00:56:50.720
I don't know.
1234
00:56:50.760 --> 00:56:51.760
Any other, any thoughts, any
1235
00:56:51.760 --> 00:56:53.520
parting thoughts for now to be
1236
00:56:53.520 --> 00:56:56.240
continued again, new grads.
1237
00:56:56.240 --> 00:56:57.740
Like I think the main people,
1238
00:56:57.980 --> 00:56:58.900
from what I understand the main
1239
00:56:58.900 --> 00:57:01.320
people, it seems all across the
1240
00:57:01.320 --> 00:57:02.360
board, but we're really like new
1241
00:57:02.360 --> 00:57:03.460
grads, people entering primary
1242
00:57:03.460 --> 00:57:05.540
care from the other thing is
1243
00:57:05.540 --> 00:57:07.600
like, no, what you don't know
1244
00:57:07.600 --> 00:57:09.580
and ask for help.
1245
00:57:10.520 --> 00:57:11.500
I don't feel bad about it.
1246
00:57:11.540 --> 00:57:12.400
I mean, it's hard not to
1247
00:57:12.400 --> 00:57:13.260
feel bad about it.
1248
00:57:13.300 --> 00:57:13.660
Yeah.
1249
00:57:14.580 --> 00:57:15.760
Everyone, you know, everyone
1250
00:57:15.760 --> 00:57:17.060
you're working with, it's
1251
00:57:17.060 --> 00:57:18.620
probably potentially going to
1252
00:57:18.620 --> 00:57:20.200
follow up with that patient or
1253
00:57:20.200 --> 00:57:21.460
maybe see them in the future.
1254
00:57:21.500 --> 00:57:23.000
Like, don't feel bad about
1255
00:57:23.000 --> 00:57:24.140
asking for help.
1256
00:57:25.440 --> 00:57:27.260
And if you feel like you don't
1257
00:57:27.260 --> 00:57:29.800
know something, you know, either
1258
00:57:29.800 --> 00:57:33.860
look it up the longer way or ask
1259
00:57:33.860 --> 00:57:35.880
for help or follow up with the
1260
00:57:35.880 --> 00:57:37.440
patient, like short-term follow
1261
00:57:37.440 --> 00:57:39.020
up, if you're not a hundred
1262
00:57:39.020 --> 00:57:39.720
percent sure.
1263
00:57:42.060 --> 00:57:43.260
And that zoomed out
1264
00:57:43.260 --> 00:57:44.920
perspective too is so hard to,
1265
00:57:44.940 --> 00:57:45.760
at least for me, it was so
1266
00:57:45.760 --> 00:57:46.400
hard to have.
1267
00:57:47.420 --> 00:57:49.300
But it's like, take a, take a
1268
00:57:49.300 --> 00:57:50.740
beat and it's like, okay, if
1269
00:57:50.740 --> 00:57:51.880
you don't get the monofilament
1270
00:57:51.880 --> 00:57:52.920
test done today for this
1271
00:57:52.920 --> 00:57:56.500
diabetes, it's probably okay to
1272
00:57:56.500 --> 00:57:58.060
do it in three weeks.
1273
00:57:59.060 --> 00:58:00.980
The things I like don't do now
1274
00:58:00.980 --> 00:58:02.520
that would have terrified me
1275
00:58:02.520 --> 00:58:03.900
before, right?
1276
00:58:04.080 --> 00:58:04.900
The things that I'm just like,
1277
00:58:05.000 --> 00:58:05.540
people will ask them, I'm
1278
00:58:05.540 --> 00:58:06.220
like, no, no, no, no, it's
1279
00:58:06.220 --> 00:58:06.340
okay.
1280
00:58:08.480 --> 00:58:09.820
It's not a priority.
1281
00:58:10.100 --> 00:58:10.280
Sorry.
1282
00:58:10.600 --> 00:58:11.060
Yeah.
1283
00:58:11.360 --> 00:58:12.580
I went for a lot of walks,
1284
00:58:12.600 --> 00:58:14.040
like the first month, especially
1285
00:58:14.040 --> 00:58:15.260
in practice, because I just
1286
00:58:15.260 --> 00:58:16.960
had, I wasn't expecting the
1287
00:58:16.960 --> 00:58:18.800
mental exhaustion for myself.
1288
00:58:20.100 --> 00:58:22.180
So like, like as you enter, if
1289
00:58:22.180 --> 00:58:23.440
that was, if that's something
1290
00:58:23.440 --> 00:58:25.460
right for me, like just making
1291
00:58:25.460 --> 00:58:26.660
space where I kind of like
1292
00:58:26.660 --> 00:58:27.960
shut down everything else where
1293
00:58:27.960 --> 00:58:28.980
I didn't like over plan
1294
00:58:28.980 --> 00:58:30.340
things, but just getting to
1295
00:58:30.340 --> 00:58:32.060
like be outside after, like
1296
00:58:32.060 --> 00:58:33.180
seeing patients was helpful
1297
00:58:33.180 --> 00:58:33.620
for me.
1298
00:58:34.940 --> 00:58:36.020
Cause even just a new job
1299
00:58:36.020 --> 00:58:36.800
can be exhausting.
1300
00:58:36.960 --> 00:58:38.080
Even if you've been in this
1301
00:58:38.080 --> 00:58:39.220
game for a long time, you
1302
00:58:39.220 --> 00:58:41.000
know, like it's just like,
1303
00:58:41.080 --> 00:58:42.140
there's so much to listen
1304
00:58:42.140 --> 00:58:42.180
to.
1305
00:58:42.660 --> 00:58:43.100
Yeah.
1306
00:58:44.940 --> 00:58:45.760
You, what'd you say?
1307
00:58:46.120 --> 00:58:46.380
Oh, yeah.
1308
00:58:46.840 --> 00:58:48.580
But I totally felt that about
1309
00:58:48.580 --> 00:58:49.060
the exhaustion.
1310
00:58:49.120 --> 00:58:50.520
Like I remember in grad school.
1311
00:58:50.940 --> 00:58:52.140
Um, and again, like everyone's
1312
00:58:52.140 --> 00:58:53.680
like everyone's coping and
1313
00:58:53.680 --> 00:58:54.540
physical abilities are
1314
00:58:54.540 --> 00:58:54.840
different.
1315
00:58:54.900 --> 00:58:56.380
And, and I feel like for me,
1316
00:58:56.380 --> 00:58:57.940
like we would, we would go
1317
00:58:57.940 --> 00:58:59.220
to class like all day.
1318
00:58:59.320 --> 00:59:00.520
My brain would be like
1319
00:59:00.520 --> 00:59:01.800
throbbing, trying to remember
1320
00:59:01.800 --> 00:59:02.080
things.
1321
00:59:02.080 --> 00:59:03.500
And then I would get on the
1322
00:59:03.500 --> 00:59:04.760
treadmill and I'd be like,
1323
00:59:04.780 --> 00:59:05.660
wow, I feel so much
1324
00:59:05.660 --> 00:59:05.900
better.
1325
00:59:05.900 --> 00:59:06.940
Like something I was like, I
1326
00:59:06.940 --> 00:59:07.520
don't know what
1327
00:59:07.520 --> 00:59:08.380
physiologically is happening,
1328
00:59:08.380 --> 00:59:09.040
but I feel like I've just
1329
00:59:09.040 --> 00:59:10.060
like drained all the lactic
1330
00:59:10.060 --> 00:59:11.020
acid out of my brain or
1331
00:59:11.020 --> 00:59:11.240
something.
1332
00:59:11.260 --> 00:59:11.900
I don't know if that's
1333
00:59:11.900 --> 00:59:12.500
actually accurate.
1334
00:59:12.540 --> 00:59:13.420
Don't quote me on that.
1335
00:59:14.720 --> 00:59:16.200
But yeah, sort of like
1336
00:59:16.200 --> 00:59:18.340
ECP is like, or just an
1337
00:59:18.340 --> 00:59:20.000
NP, especially in primary care.
1338
00:59:20.220 --> 00:59:21.700
Like the questions don't stop.
1339
00:59:21.720 --> 00:59:23.740
You get home and the
1340
00:59:23.740 --> 00:59:25.360
family member calls you or
1341
00:59:25.360 --> 00:59:28.320
a friend calls you or
1342
00:59:28.320 --> 00:59:30.500
totally sick or yeah.
1343
00:59:30.900 --> 00:59:32.700
I feel like it comes at all
1344
00:59:32.700 --> 00:59:34.500
angles, all those medical
1345
00:59:35.120 --> 00:59:35.640
questions.
1346
00:59:36.920 --> 00:59:37.800
It's so true.
1347
00:59:38.060 --> 00:59:39.240
Well, thank you so much.
1348
00:59:39.260 --> 00:59:40.800
This is amazing.
1349
00:59:40.800 --> 00:59:42.940
And I love you both so dearly
1350
00:59:42.940 --> 00:59:44.400
and I'm so grateful to
1351
00:59:44.400 --> 00:59:45.440
share your
1352
00:59:49.720 --> 00:59:51.340
Thank you for having us, Liz.
1353
00:59:51.340 --> 00:59:52.480
This was lovely.
1354
00:59:53.200 --> 00:59:53.560
Thank you.
1355
00:59:53.640 --> 00:59:54.660
It's so good to see your
1356
00:59:54.660 --> 00:59:55.500
faces and chat.
1357
00:59:58.200 --> 00:59:59.840
That's our episode for today.
1358
01:00:00.000 --> 01:00:01.320
Thank you so much for
1359
01:00:01.320 --> 01:00:01.760
listening.
1360
01:00:02.020 --> 01:00:03.500
Make sure you subscribe,
1361
01:00:03.760 --> 01:00:05.340
leave a review and tell all
1362
01:00:05.340 --> 01:00:07.260
your NP friends so together
1363
01:00:07.260 --> 01:00:08.760
we can help as many nurse
1364
01:00:08.760 --> 01:00:10.160
practitioners as possible,
1365
01:00:10.240 --> 01:00:11.460
give the best care to
1366
01:00:11.460 --> 01:00:12.120
their patients.
1367
01:00:12.420 --> 01:00:13.680
If you haven't gotten your
1368
01:00:13.680 --> 01:00:14.760
copy of the Ultimate
1369
01:00:14.760 --> 01:00:16.140
Resource Guide for the new
1370
01:00:16.140 --> 01:00:17.620
NP, head over to
1371
01:00:17.620 --> 01:00:19.260
1372
01:00:19.260 --> 01:00:20.120
slash guide.
1373
01:00:20.520 --> 01:00:21.860
You'll get these episodes
1374
01:00:21.860 --> 01:00:22.680
sent straight to your
1375
01:00:22.680 --> 01:00:24.240
inbox every week with
1376
01:00:24.240 --> 01:00:25.620
notes from me, patient
1377
01:00:25.620 --> 01:00:27.220
stories and extra bonuses
1378
01:00:27.220 --> 01:00:28.320
I really just don't
1379
01:00:28.320 --> 01:00:29.360
share anywhere else.
1380
01:00:29.800 --> 01:00:30.760
Thank you so much again
1381
01:00:30.760 --> 01:00:31.320
for listening.
1382
01:00:31.540 --> 01:00:32.720
Take care and talk soon.
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