HeartBeats Episode 19: Nurses Wear Scrubs Not Capes

Host:

Welcome, I'm Cathy Murtagh-Schaffer and, I'm your host for this episode of heartbeats. This podcast is brought to you by Shipley Cardiothoracic Center, an educational series dedicated to providing our patients and the community with information and education about our cardiothoracic surgery program, Lee Health and matters affecting your health. Today is a very special broadcast to celebrate nurses month. As our guests, we have some very special nurses present that are integral to the function of Shipley Cardiothoracic, as well as the operating room and our open heart intensive care unit. We have Emily Ambrose, Mikaela Smith, and Tracey Perry, to talk about the joys of nursing. Welcome everyone, I can't tell you how happy I am to be able to do this podcast with you all. One of the things that I'm very aware of is how much nurses have played a role in my career nurses over the years have helped me to become the Physician Assistant that I am today. I'm sure I would've survived without the ever-present watchful eye of the nurses that I've worked with, and for that, I'm incredibly grateful. So can we start by having you introduce yourselves and tell us how long you've been a nurse and where do you work at Lee. Tracey?

Tracey Perry:

Yeah, certainly. My name is Tracy Perry. I work right now at Health Park CVOR, which is the cardiovascular wing of the OR Health Park on the third floor. I've been a nurse for over 16 years.

Emily Ambrose:

Hi, I am Emily Ambrose. I have been a nurse for almost five years. This August will be my little anniversary and I started my career on SPCU, which is our step-down unit for our open-heart surgeries. I have recently made the transition over to the open heart ICU to kind of just gain a better knowledge of what happens behind those scenes.

Mikaela Smith:

Hi, my name is Mikaela Smith. I've been a nurse for 15 years and I am the transcatheter valve therapies coordinator here at Shipley.

Host:

I didn't know. You'd been a nurse that long.

So I'm curious, Mikaela, why did you become a nurse?

Mikaela Smith:

Oh, well, It wasn't for the commonly heard reason, I want to help people. I do want to help people, but, actually, when I was in high school I had no idea what I wanted to do when I finished school. So, I had a cousin that was a massage therapist and I went that route right from high school. I did that for a while and I felt like there had to be the next logical step, you know, and I didn't know what that even looked like. Someone said to me, how about a nurse and without any knowledge or direction or goal, really in mind I just looked into nursing school. It was the best decision I ever made.

Host:

And you're a great nurse, no question.

Host:

Em. why did you become a nurse?

Emily Ambrose:

So it's funny that you say the whole, cause in high school I was the same way. We were literally sitting in ninth grade and everyone's talking about, I want to do this, I want to do that, and I was like, I do not know what I want to do. So a couple of people were like, you know, you should be a nurse, and I was like, why? I was like medical has never crossed my brain. I was like, no way, I'm not a medical person. And then they were like, you know, you just, you care so much about others, you really good at taking care of people. I was like the mom of the group and kind of ever since then, I just started looking into that career path. I started with like, you know, taking anatomy and physiology and I was really interested in it, I liked it, it clicked in my brain. And you know, like you said, it was just the best decision you could ever make, because nurses have a very unique job role in that you need to have a level of critical thinking, like equivalent to, not like what the doctors do, but you need to have that mentation of like, how do you, what does your patient need and how are you going to get them that, you know, even if you can't provide whatever they need, like, what is it that you need to get them? And who do you need to contact? And I love using my brain in that way.

Host:

There's definitely a lot of critical thinking involved in nursing care. There's no question about it.

Tracey, what's your story?

Tracey Perry:

Well, I'm going to piggyback on the rest of them. I also had not planned on being a nurse. My mom was a tech at the nursing home, so I knew I liked something medical, but, my route was quite different. I actually, my first degree is in psychology, and I realized it'd be four or five years to go back and get a master's or Ph.D. So, it was just one of those things that at Creighton University, in Omaha, Nebraska, they actually had an accelerated nursing program and you literally had to have a degree in something else, and it was for people that wanted to go back and be nursing as their second career. So I went back and I literally spent a year, didn't work, and went through the program. I became a nurse through their accelerator program. So that's an option for some people to look at it as a second career as those are those accelerated programs out there.

Host:

Yeah, that's a great opportunity actually, to be able to step out of one degree and find your path into another occupation.

So what's special about what you do, Tracey?

Tracey Perry:

Here, I'd say there's a specialty in that I became an OR intern. My background was ICU for a while and I've always wanted to get to the operating room, but it's very hard. They actually said that a lot of people would have to pretty much retire to do that. So I've been looking at intern programs a long time and the first hospital system I looked at, they really wanted to hire from within and I had moved here from North Carolina. Luckily I got accepted to Lee Health's intern program and what I think is very exciting is in the system, they're the only ones that actually do hearts. And so I feel like it's a very specialized field that in a system as big as Lee, we're the campus that does the open heart surgeries yet.

Host:

And you're right, we are the only spot where open-heart surgery is being done here in Southwest Florida, at least in Lee county. That does make you guys incredibly special.

Tracey Perry:

So that was kind of a motivation for me.

Host:

Emily, what about you? What makes, what makes, what you do special?

Emily Ambrose:

I think a lot of people, when they first think about nurses, they think like, oh, it's the most trusted profession, we care about others, we're good at taking care of people. But, kind of like what I was saying before, I think what a lot of people don't realize is the level of critical thinking and autonomy that has to happen. And especially in this patient population, you need to be on top of it because your patient can tank very quickly. Being astute to that and knowledgeable of that and knowing either how to prevent it, fix it, manage it, you know, like I love that part of this job, and that's what kind of fuels my fire, that learning, that engagement. You know, seeing them start from being so sick and then kind of looking like they got hit by a truck and then watching them get better, you know, and being a part of that, I feel like is what's very special about this.

Host:

Mikaela, Your turn.

Mikaela Smith:

I think everything about nursing is special. Like Emily has said, the amount of mental engagement, the critical thinking, you know, putting all the pieces together, and having this clinical picture that you have to work with advantage all day long, that is special. But the most special thing about nursing to me is just how rewarding it is. I mean, most days I feel really good about what I do and how I affect people.

Host:

And I do want to call you out and that you started with the TAVR program and have built that program along with our surgeons here at Shipley into a very robust program. We did, how many TAVRs now recently, what number did we hit?

Mikaela Smith:

We just passed 1500.

Host:

Wow. Congratulations. That's amazing. Congratulations to you too

Emily Ambrose:

Watching them go from when we first started doing TAVRs, having to stay in the ICU, they're there two, three, four days, you know, to moving on to, okay they come to us straight from PACU and it was okay they got a minimum of three-day stay, and then to now it's, okay you can have your surgery, you do well, you go home the next day. Like that's incredible in just the very short amount of time we've been doing them.

Mikaela:

So we've transitioned over the years to a minimalist approach. Having these patients had to have invasive lines, stay several days afterward, go to the ICU and they were actually intubated with the breathing tube and now they are under conscious sedation and they're going home the next day for the most part.

Host:

That's amazing.

Emily Ambrose:

And I can tell you from the patient's perspective, they're super pumped about that. Cause they're like, you know, they just like being able to take a surgery that was a cutdown to, a go home the next day. Like that's just incredible in medicine in general.

Host:

And Tracey, and I'm sure you've seen huge differences up in the OR as far as the TAVRs are concerned.

Do you guys have a patient story that stands out in your head, one where you felt like you really made a connection with a patient?

Tracey Perry:

Piggybacking on what she kind of said in terms of everything about nursing is special. One of the stories that stick with me and it was a North Carolina, but we had taken care of a patient. And the reason the story probably sticks out with me its years ago where ARDs was really big. It was also where a lot of people that didn't even take the flu shot, that particular year, even the young people that usually don't get vaccinates and maybe this is the year I should. So we took care of a patient, but back to technology and equipment, at that time there was a RotoProne bed and we got into it. It flips you prone. So a lot of times where it takes six to eight nurses to flip your prone, there's a RotoProne bed that will actually prone you. And all of us got in strapped ourselves in and kind of thought, you know, we'll never use this. It would come to the facility and we would try it out and kind of educate on it. Well, this was the first patient that our hospital, CMC union, North Carolina actually put on this, on the actual bed. Cause she was that sick. And I talked to her before she got sick. I really built a relationship with her. And then she got sick and really decompensated, and there was a lot of things that were, at their time still I wouldn't say experimental, but they still didn't know. So we were using a lot of technology, we saved her life, but I think it's not just the patient, it's their family. I remember the patient and how she talked about her kids, but what I remember more is how the family would come in, but they still had to take on their life. So we literally would have a little side table and stool set up for their kids because they'd come in and be doing their homework in the corner and they would come in and stay for hours, but they still had to have their homework. So that story sticks with me because it showed when we did have to use technology, the rotoprone bed, how sick she was. We didn't think she would make it. She made it. And I still, to this day, stay in contact. I probably look at their post once a year just to see how the family is doing. And that just really sticks with me because it was one of those situations where we all prayed, we hope, but we didn't think that was going to be the one. And when she walked out of there, it was just something else stuck with us, something to celebrate for sure about you.

Host:

How about you, Em?

Emily Ambrose:

There's a lot. It's a crazy patient population, but, there was a woman I'll use her first name. Obviously, I can't use her last, but her name was Sheila and she was not my patient. I was walking down the hallway and part of my routine is to just look in rooms, make sure no one's doing anything funky or sketchy that I got to stop them. So I'm walking by a room and she looks like she's in normal clothes. She's like seizing and the cardiac chair. And I was like, hello, are you okay? I go in there, I'm shaking her. I'm like, hello, hello, are you okay? She's not responding, and I'm like, where is like, who's has this patient! And so, she finally comes to, and I'm like, hi, do you know what just happened? And she's like, no. And I'm like, screaming for help the whole time, and it's like one of those moments where you're like, am i alone? It was probably only a few seconds, and Monica came in and I'm like, what did she just do on the monitor? And she's like, what are you talking about? And I was like, her, what did she do on the monitor? And she's like, she's not on the monitor, she's going home. I was like well she's not now, so I get her hooked up. She's in complete heart block, she was a TAVR patient and she had done perfect EKG were perfect, everything was great, the husband was picking up the car, they'd already got their discharge instructions and I was just like, what in the french toast just happen? I had to call downstairs and like, can you tell the guy in the white SUV to come back? She ended up getting a pacemaker, but she had no recollection of what had happened. We ended up becoming pen pals for a little bit, cause she was like, you saved my life, I never would've known. She just kind of felt flushed. She thought maybe she'd like fall asleep and woken up and just was kind of disoriented. So, you know, just the constant vigilance and just being aware of your surroundings and what's going on and it was a simple fix, you know, here's your pacemaker, you go home the next day.

Host:

Nobody would have known that if you walk by that room.

Emily Ambrose:

no, she was in the isle room, so she was like tucked. It was just one of those crazy things. And like I said, she wasn't even my patient. I didn't have her post-op either. I went and I visited her. We chatted, you know, she did great. So it was just, you know, like one of those, when you save a life, like that's what it's all about.

Host:

See God puts angels in the right place. No question about it.

How about you Mikaela?

Mikaela Smith:

Well, the most profound story that I have actually does not have a happy ending. So I guess I won't go there since he's, lady's telling happy stories, but, I think the most recent good story that I have is a young-minded gentleman that was living up in the Port Charlotte area. He had a bad mitral valve. He's actually the father of a friend of mine, and she called me up one day and said, he's ready to throw in the towel. He feels like he's facing death and this is a man who otherwise takes care of his own pool, his own house, he goes golfing, things like that. The local providers, wherever he was, didn't seem to be offering him any solutions or any hope or anything like that. They just, he felt resigned to dying for mitral valve. So I called up Dr. Mapala and I said, here's this situation, this guy needs our help. And we worked relentlessly over the weekend to get him transferred down here, get him admitted to the hospital to tune him up. I think Dr. Hummel was actually going on vacation that week. So this was on a Saturday/Sunday. So we ended up giving him a mitral clip that Thursday. And he's now back to playing golf, and I mean, he was bedridden for a period of time. He feels like he has a new lease on life. You know, it makes a difference when you already know someone, but he's definitely a grateful patient.

Host:

It's nice when you can actually see the benefits of good work, but yes, for sure.

Who has a funny story to tell?

Group:

They're all so inappropriate. How inappropriate can we get?

Tracey Perry:

I'll think of a funny now so its not as bad (haha) . They always say, nurses have a certain sense of humor and it's, there's no doubt it's a coping mechanism. It's definitely a coping mechanism so please bear with us. This story has actually changed my practice just little bit. Because I go to pre-op, when we come in early, I go to pre-op, I meet the family and I try to get in touch with them and meet them and really kind of form: We have so little time with patients in the OR, but I get to know them for that very brief moment of time. And so I went and met the family and then I come back once they've been sedated and get ready to take them away to the operating room. And obviously, I always say in my bubbly voice hugs and kisses, everyone and state of Florida, a lot of people from different places and they have different backgrounds and some people are probably than others. And the dad kissed me

Host:

No kidding (laughter)

Tracey Perry:

Because I said, hugs and kisses to everyone. So now I'll say hugs and kisses to each other. So I just had to kind of laugh, and it was funny because I was leaning right by them and I said, hugs and kisses everyone.

Host:

And you got kissed.

Tracey Perry:

Yeah, a small little kiss (laughter). So I just think that's funny. So now when i say that I kind of say, you know, would you like to give them a hug before we weld them off?

Mikaela,

You may have to come back to me. There are, I think every day something funny happens. But the truth is that most of the time it's inappropriate. (laughter)

Emily Ambrose:

One hundred percent, like the first story that popped in my head I can't talk about here. I cannot. No, it's I mean then you, cause obviously again, it's the morbid sense of humor. So your first story is your worst story, right? Either way, any question. Mine, I had to text my friend and I'm like, Hey, you know, I'm going to be on this podcast. What's a story I can tell that's not bad. And she reminded me of a guy that we had that was, he had very provocative tattoos from his neck to his ankles. It was all women in various positioning. Yes. Poses. That's a good word. And he said, every time he and his wife got in a fight, he would go and get another tattoo, and that was why he had so many, but the first, and I was like, I don't know that that was very productive. But the first tattoo I saw, the first time I meet this guy because the whole unit's talking about it, you know, they're like this guy, don't freak out when you go in there. Cause I'm front back everywhere. And his call light goes off, I go in there, I walk into a bent over naked man with this tattoo on his back of this woman in this position, and I was like, what are you doing? What is happening? And he was trying to pick up something off the floor, but I was just like, hi, so nice to meet you, sir. He was the nicest, like most cordial guy on planet earth, and he was so sweet and so polite, and I was just like, this is what you did to piss your wife off? He was like, well, it wasn't always the best decision, and she came in and she was like, yeah, but I mean they were just like the cutest couple and you know, they're just obviously fun in their younger days.

Mikaela Smith:

I don't want our listeners to think that we laugh at our patients' misfortunes. But like Emily said, during introductions, humor is a coping mechanism, and stories are either not appropriate for a podcast.

Host:

Well, I think the old saying if I didn't laugh, I would cry. Probably applies.

Emily Ambrose:

Yeah, and 9 times out of 10, the family's laughing with you because everyone knows their own crazy.

Host:

That's true, that's typically true.

Mikaela, what's the hardest thing you've ever had to do?

Mikaela Smith:

I suppose the hardest thing I've ever had to do would be to grieve with the family. Not that I'm not available for that or don't want to, but it's not easy. Finding the right words, the right..

Host:

The words never seem right, do they?

Mikaela Smith:

No, they don't, they never seem like they're enough.

Host:

How about you, Em?

Emily Ambrose:

Well, I think along with that, you have to build a rapport very quickly with your patients. You know, and it's in a matter of a 12-hour shift, you can know a lot about their personal life, their medical status, and you are now invested and involved in their recovery and their whole situation. So yeah. , you are taking care of this person and the family's looking at you and the docs are looking at you and everyone's kind of eyes on you to manage what's happening, and if that outcome isn't great or the outlook, isn't great, you do, you grieve that with them. And it's hard, I have bawled my eyes out with family and patients and just cause you know, they take a little piece of you and those are always the ones you remember and it's hard. I think to add onto that, like advocating for your patients can also be really hard when no one's listening. And you're like, no, I need someone in here now I need this now. Like, and you've got to be that secretary and you're calling this doc and that doc and here and there and the family and this, and you know, it's just, you're their advocate and you're their support.

Mikaela Smith:

You're everything; They're so vulnerable, and they're so desperate at times and you are it. You are their eyes and ears

Emily Ambrose:

Their dictionary, for what's going on.

Host:

About you Tracey?

Tracey Perry:

So I thought of this in two different scenarios, the hardest thing always surrounds death obviously. And I'll take myself in two different categories. One is in the OR and a situation came up where in the middle of the night and I had a dissection aneurysm, I had to tell a family member that patient probably would not make it. And that was new for me because obviously the doctor can't leave and tell them because they're still operating. I had to go out to Health Park's atrium and tell them that. And so I'm glad I discussed it with another person because I was always used to my background that once you talk to a family member, there was someone else around or, whether it was other people you were working at, but this is a quiet OR where there is no one else and there was no other cases. And I had this family member in the atrium and I said, once I tell them this, I feel like I just can't leave them alone, but that I can't, I have to go back to the room. Luckily I discussed that with someone else, my feeling, I had another circulator with me and she said, call the house supervisor. And sometimes in that moment, you just need to know to reach out and talk to someone else because just by her saying, well call house supervisor. I was still able to go out there and make that very important, have that very important conversation. But then I had the house supervisor sit with them because my biggest thing is you can't, and when I say it's three o'clock in the morning, no one else is around with that loved one, and I had to leave them. So I called the house supervisor and that just was a very hard thing to do even as I was walking out because I said, I need to give them comfort, but I knew the limitations of me also getting back into the room and talking to them so that stuck with me and that's something else I will do. The other thing concerning death was in a different state, one of the hardest things was to do was I had to pronounce death and every state's different but states I had worked at the doctor's always did it, but in North Carolina, you actually have where you can have an order with two nurses could pronounce death. I just remember doing that for the first time, and it takes two nurses you have to follow a protocol, the families all sitting around watching you, you listened to the lungs, you listen for the absence of breath sounds obviously for a full 60 seconds and you have to do all these things and the family's just looking at you and then you look up and tell them they're gone. I just remember thinking that was so new for me because in other states I've worked, that was not part of something that I to do. And so I bring that with nursing and different states and different practices that just stuck in my mind. And then obviously, unfortunately, I became more comfortable, but I just remember the first time I ever had to do that.

Host:

Of course, we remember a lot of our first for sure.

Em, for you, I'm curious. How did you cope during COVID? Schoolwork, isolation?

Emily Ambrose:

I had Emerson smack in the beginning of like when we were doing the shutdown. So when we had just finished, or well implementing like no visitors in the hospital, like, you know, and it was all quiet and weird. I actually went into labor at work. The benefits of having OB at your hospital (laughter) Well, she was two and a half weeks early, so that wasn't, it wasn't bad. She came, I was standing in an office and all of a sudden I was like, wait a second. My water broke. Okay. I was charged that day. I had to like.... oh my God, but everyone was excited, but anyways; So during the smack down or shut down of COVID, this societal smack down, I was home with the baby. So it was so strange to me in that I was very much, I want my whole family their when I have the baby and to come visit me, you could have one to two visitors. It was your permanent. So it was just me and my hubby the whole time. And then when we got home, you know, obviously everyone's like, I want to come see the baby and I'm like umm....... So that was really hard limiting, cause you also need a lot of help in the beginning. So you're like, did you shower before you come over? Did you not go out today? If you're going to watch her, can you quarantine? You know, like it was just, and it was hard because in the beginning, our families were, you know, "oh, we're young, we're good". Like it's, we don't know everything we know now and so people were going out a lot still. I was like, with my dad, I was like, "stay home dang it!". Because he is a cardiac patient and he anyways, stressful parents, you have to parent your parents, man. So, that part was hard, not being able to go freely to the grocery store. Every time we came home, we showered and changed and then went and had the baby. And you know, that was all hard. But fortunately, I didn't have to work during the worst of it’s my first day back, we were still gowned up like full PPE. And then the next day I walked in and they're like- oh, we're not doing that anymore, and I was like, what? And they're like, yeah, the rules change a lot. And I was like, okay.

Host:

That's been the hard part of all of this COVID, I think for everybody is that the rules have been flexing and fluxing for the entire year and one day to the next you're not sure exactly what it is we're doing

Emily Ambrose:

And you're learning on a day by day bases.

Host:

You're learning constantly. There's always, this whole thing has been an evolutionary process for sure.

Mikaela, how about you in the COVID?

Mikaela Smith:

Oh, COVID in the beginning I did spend some time working from home, and I think it's a great option for a lot of people. For me, it was not, I did not find myself being very productive. Being trapped between the same four walls all day every day, all night every night, it was overwhelming. And I think still we haven't realized the full effects of the stress of COVID. I'm curious to see what kind of study will be out there several years from now that just illustrate how stressful and the impact of that. But anyway, I just, I tried to normalize all the aspects of my life that I could. Come to work, be productive, maintain interaction safely with my peers and my friends and I read they would come over and we would have like a little driveway, sit down, everyone brings their lawn chairs, separate six feet apart, sitting in a circle and talk and play games. The worst part for me, I think is just how unmotivating it was. You want to go out and do things and the more you can't, the less you have any desire to do them. It's just, it's very strange.

Host:

2020 was a lost year. I feel like nothing really got done. We survived. But as I always quote from this book that I read, station 11, surviving is insufficient. We want to have lives, we want to connect, we are human beings, we need that activity we need activities that are relevant to our lives. Em, what you're talking about, getting your family to come and how hard that was.

Host:

Tracey, what about you? How did COVID affect your working life or your home life?

Tracey Perry:

Well, I was fortunate or unfortunate, I did not get any days off. The CVOR cardiovascular was considered essential, and so they were still doing operations. However, I decided or was asked to redeploy. So I redeployed to a separate area, it was actually a transfer center or the COVID hotline. It was very different because I had some telemarketing experience in the past and I thought there would be this big room where I was taking calls from people in the community come to find out- it was quite funny- The calls were all from employees and that was not what I expected, but it was because employee health was so overwhelmed during that period that I was taking calls from employees. And back to what she said was how it changed every day. I literally was even just to be more prepared for that first call, I would spend time on my own time just reading through some of the changes every day, because it was also helping me. But so as soon as I sat down there would be calls and calls all day, it had everything to do with quarantines, traveling, what should I do, time off returning paperwork. It was very interesting how stressed employees were that I was getting so many calls from our own people in different areas. The other thing that happened during that time was I was, the death calls also came all through the hotline. So anytime there was a death in the facility, it had to be to report it to the department of health. So they would call her line and I would call the department of health. There were some days that they would call me and I'd be like, yeah I already got a call on that patient, and they would be like, no this is a different patient. There were certain times in a 12, because I did 12 hours, which I normally do eight to 10. There were certain times that I was like, what is going on in that unit? And I just would feel for them because I, myself was not working on the front lines, but I was receiving all the calls of the deaths that happened. So it was very stressful because I had to keep track and sometimes I had to put people on hold because you there would be another call waiting and you'd have to get all the information, and one particular day it was of course with HIPAA, I would never repeat it, but a call came through of someone I knew. And so that was something that I was just quietly kind of thought through and that's you recognize names after a while you recognize the nurses or the floors and so there were days that then I would report them to the department of health and call the doctors and there were so many that I was, unfortunately, would stack a couple of them up and called the doctor with three of them at a time, and call the department health with four or five. And so that became stressful because we're such a big facility and when those calls came in, I just would sit and be like, these are patients that are dying..

Host:

And just to clarify, you're getting calls from all five hospitals?

Tracey Perry:

Anything through Lee Health came to our line because then they would give me the information because obviously, you're too busy on the floor, and I report to the doctor, whoever the infectious disease doctor was on there was three of them that worked at our facility and that I would have called the department of health with them information.

Host:

Yeah, that definitely sounds stressful.

Tracey Perry:

Yeah, that was a little bit, I didn't know what I was getting in with the COVID hotline. So I'll just leave it at that.

Host:

So I'm curious in your opinion, has COVID impacted your nursing practice?

Emily Ambrose:

That's a hefty question. I don't think it's necessarily changed the way I practice. I think it's changed, I don't know how to answer. I was a leader on the unit, so I watch all of my new hires coming in and you have that normal honeymoon phase of nursing and then they walk into this pandemic and granted, our floor is very fortunate, limited COVID patients, but they walk into like suboptimal conditions; None of us are operating at what we want to be, what we need to be in everything that's happening and you're having to flex and be flexible. As an experienced nurse, you know, you have a little better ability to do that. When you're a new nurse and you're walking in and you already need to be flexible, adaptable, moveable, changeable, like everything right now while learning how to be a nurse, I just feel for them. I've just seen how it has changed the culture of units and the culture of nursing because you feel very powerless at times to make the impact that you either know you can make or that you've always wanted to make and you're not being given that opportunity. And I feel like that's the impact I've seen. I look at everyone, like the teams on my floor, other floors, other units the OR down here, it's the volume is still there and you're just, you know, you're just trying to keep up. You talk about the mental health stress of it all, you talk about how there's no more after a tough day at work, you going out and hanging out with people., The decompression that you needed, isn't always available and isn't always there without the constant added stress of going out in public and what are people thinking and doing, and seeing and coughing and you know, it's a normal, this, the normal cold or whatever, but you're just, you don't get that decompression. You don't get it at home. You don't get it if you go out, you don't get it. Coming to work was my stress reliever. I'd be like, I'm gonna use my brain, I'm going to bang some stuff out, make some impacts, do some things, go home, feel good about it. And lately, it's just been like, okay, well I survived today and I'll go survive when I get home and it's hard.

Host:

How about you Mikaela?

Mikaela Smith:

I'm going to say no that COVID did not affect the day-to-day operations or function of my job or how I function in my role. You know, we continued to see patients in clinic, although it was less, I mean typically we would see 15 to 16 patients every day in clinic and we went down to maybe 10. So if anything, it was a little more manageable from that perspective, but as far as the way that I practice or the things that I do or the way that I take care of my patients that is not impacted at all.

Tracey Perry:

I guess the biggest thing is because it's such a fluid situation I think it impacted them just in terms of keeping up the skills that I have. I obviously redeployed to other areas and was doing something different, but even during that time, I said, I will keep up skills because you never know when you might need to redeploy to a different area. So, it really made me think about skills I needed to keep up. The silver lining, it's hard to even think there'd be a silver lining in anything so negative, but I guess the thing is the appreciation of family, teachers, nurses, essential workers, and even on the environment of us just not being out as much.

Host:

I think for me, the silver lining has been the incredible increase in innovation that we've seen within the hospital. I think for nurses, for me, it's just been absolutely amazing and awesome to watch how you all have been able to convert from doing one thing that you specialize in to all of a sudden, now you're taking care of COVID patients and it requires a tremendous amount of skill, thought, compassion, critical thinking, and self-protection on top of it all. I just have to give kudos to all of those nurses who participated in and volunteered to do those things. And then to all the nurses who filled in for those nurses who were isolated on those units. I just think it's been amazing to watch how we as a system, especially nurses came together and made this place run despite all of what was going on around us. The other thing that I always go back to is while telehealth was a concept that we were talking about and kind of slowly getting into it was COVID that brought that particular aspects of technology to life. We did 79,000 telehealth calls last year, once COVID started. And I can still remember there was a big disagreement about whether or not every unit should even have their own iPad in order to do telehealth on the units and now it's not even a question. So I think there have been some silver linings to COVID for whatever that means, but it certainly has been an adventure to say the least.

Host:

So what would you, I'll say to people who want to enter the nursing profession today? What should they be prepared for? And is it a career you recommend? Tracey?

Tracey Perry:

It's still a career that I recommend. You saw the strength of people. I always say you could see the worst or best in someone during stress and that you really saw people push themselves to the limit, being able to do it. What I recommend for new people is maybe shadow, interview, get your niche because sometimes when you're unhappy, it might just be there's so much nursing has to offer; It might just be a different area you need to work in and so really research it because there's so many different levels, school nursing, nursing business, telehealth, I mean kids, adults, there's just so many. And so I just tell people to research because there's a lot of opportunities out there.

Mikaela Smith:

I second everything Tracey said. Nursing is a very, very incredibly rewarding career and there are so many different things that you can do within nursing. I mean, you can be a legal nurse consultant, you could be in the device world, pharmaceutical companies, all the different specialties, different age brackets there is a place for a nurse.

Host:

It doesn't necessarily mean you need to work in a hospital.

Mikaela Smith:

That's right. I think people that are considering going into nursing that's their first thought is, I'm going to take care of people in the hospital. How does that look? And the truth is there are so many avenues in nursing.

Emily Ambrose:

I one hundred percent agree. I tell people like, even if you start out somewhere and after a couple of years you kind of get tired, I'm like explore something different. We, the millennials and the gen Z's are so different from the baby boomers. The baby boomers, you got hired on that unit and you stayed on that unit until you retired because there were safety and security in it and our generations are more, they want to explore, they want to advance, they want to learn, you know, we have constantly been bombarded with technology and education since a very young age. So you explore those avenues and I feel for them in that everyone in nursing school right now is doing virtual clinicals because to lose that..like, that was where when I went to nursing school, I was like I'm going to do peds or I'm going to do NICU. I got to my peds rotation and I was like, absolutely not. No, no, no thank you. And then I was like, mom/baby, I’ll for sure do mom/baby. I got there, loved it, and then I got to SPCU as my last rotation and I was like, dang, this is some cool stuff. I never thought about working with geriatrics. And now I'm like, well, they're some of the most resilient people on this planet. Just explore your avenues, like Tracey said, shadow somebody, ask someone, call the hospital, they do stuff like that. So just explore everywhere you can, research. You will know because you'll get excited about what you're researching and if you're not excited about it or you don't want to learn the next part of it, then don't go there and don't go because someone told you you'd be good at that, like go with what you feel good about.

Host:

Any last words from anybody?

Tracey Perry:

Seems cliché, but you know, there are a lot of heroes out there and I think we finally saw that. We were people's families and he had to hold them, last dying breath, I just, it's unfortunate that something had to happen to get the recognition. The biggest thing is we don't do it for the recognition, but you get into because you really love people and want to see them do well. And you go over and beyond. A lot of times we were people's families.

Host:

I agree, there were many when nobody was allowed in the hospital except for patients and staff, and those patients sat there, by themselves.

Mikaela Smith:

And you know, on the recognition note, don't go into nursing, if you don't or if you think it's going to be this glamorous career and sometimes it is, but do it because you want to, and you have a passion for that. I mean, there's been a lot of light shed on the nursing career in this past year. I do think a lot of people find that appealing, but that's not, that's not a good enough reason to go into nursing.

Emily Ambrose:

Yeah. There's a level of maturity you gain when you come here. Especially, as in like a newer nurse, early twenties, you know, that's like when I started and there's a lot of growing up too, there's a lot compartmentalizing what's happening and what's going on and you know, like Mikaela said, if you don't have a passion for it, you will want to quit like month one because it's not just the task and it's not just the emotional stuff, it's not just the procedures. It's all of it and you got to do it every time when you come into work, you got to bring it and it's evident when you don't.

Mikaela Smith:

You cannot be sloppy or lazy or cynical and uncaring.

Host:

Well, I would say that COVID has definitely shed the light on a group of superheroes, but being a superhero is not easy. It requires tremendous dedication and it requires tremendous abilities to live outside of yourself and for that, I can say, I am incredibly proud to call you my colleagues.

Group:

Thank you.

Host:

So I just want to thank all of you for being here today and to say thank you on behalf of Shipley Cardiothoracic Center for the incredible work that you do, you are truly angels of mercy until next time. I'm Cathy Murtagh-Schaffer, and this has been HeartBeats, Shipley Cardiothoracic Centers podcast, dedicated to bringing research innovation and education to our patients and the community.