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A lot of mental health care still runs on a quiet assumption: name the disorder, match the protocol, move on. When we do that, we can end up calling something “treatment-resistant depression” when the real driver is developmental trauma, chronic stress, or attachment wounds that never had a chance to heal. That gap is where our conversation with Dr. Jordan Madden, a PMHNP from Wisconsin, gets especially real and especially useful.
Jordan walks us through his long path from CNA work in a nursing home to geriatric psychiatry, Mayo Clinic experience, and eventually building a private practice in his hometown. Along the way, he wrestles with the limits of a strictly biomedical model even while seeing the benefits of interventional psychiatry like IV ketamine, Spravato (esketamine), and TMS. We explore how trauma-informed care and whole-person case formulation can change what we think we’re treating, not just how we treat it.
We also dig into parts-based trauma work and Developmental Needs Meeting Strategy (DNMS), an ego state therapy that focuses on unmet childhood needs and the “wounded parts” that can get stuck in the past. Jordan shares simple ways to explain triggers, disproportionate reactions, and nervous system responses using concepts like polyvagal theory, plus practical guidance for PMHNPs who want to start integrating trauma principles without pretending they’re doing specialty trauma therapy.
To close, we tackle a big question: if you had $1 million to change psychiatry, what would you fund? Jordan’s answer centers on softening our approach, slowing down, building real relationships, and reducing burnout while staying socially aware and deeply human. If you care about trauma-informed psychiatry, complex PTSD, and care that fits actual lives, subscribe, share the episode, and leave us a review so more clinicians can find it.
Let’s Connect
Dr Dan Wesemann
Email: daniel-wesemann@uiowa.edu
Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner
LinkedIn: www.linkedin.com/in/daniel-wesemann
Dr Kate Melino
Email: Katerina.Melino@ucsf.edu
Dr Sean Convoy
Email: sc585@duke.edu
Dr Melissa Chapman
Email: mchapman@pdastats.com
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رونوشت 🔗
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Welcome back, everybody, to a new episode of Peplau's Ghost.
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This is another one I'm really excited to get to know.
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Dr.
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Jordan Madden is here, and he is a PMHNP from Wisconsin.
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And we connected online, and he was generous enough to not just put it into a spam and actually reply.
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So I'm interested and excited to get to know Dr.
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Madden here and really kind of get to know his experience, what kind of brings him to the field, and then also really talk about, or all I think, hopefully excited, and people listening are excited about the upcoming conference Beyond the Script coming up in mid-October.
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Is that right, Jordan?
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Yep.
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Yep.
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Yep.
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October 14th through 17th in Orlando.
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Orlando, yes.
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Enjoy it.
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So perfect time to go down there.
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Maybe people are getting a little bit cooler and so enjoy some nice uh Florida weather at that time.
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So so again, thank you, Jordan.
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And again, as always, I'm joined with my esteemed colleagues, Dr.
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Kate Molino.
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I'm gonna call you Catherine.
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I don't know why.
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And Dr.
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Melissa Chapman-Hayes.
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So thank you.
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Appreciate you guys being here.
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So, Jordan, I always like to kind of maybe start off with just, you know, let's take a trip back in time.
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Let's talk a little bit about what brings you to this point in your life.
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How did you become a PMHNP?
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How did you get interested in doing psychotherapy and all these kind of experiences and such?
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Feel free to share some personal experiences, professional, whatever has kind of guided you to this point.
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And again, say thanks for being here on the podcast.
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Yeah.
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Well, thanks for having me.
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It's nice to meet you all.
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I'm really excited to be here.
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This is my first time being on a podcast.
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So I don't know if that's an honor, but I'm we're thrilled to have you be the first.
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So yeah.
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Yeah, yeah.
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Well, I appreciate you having me.
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So yeah, so my story of how I am where I am today is kind of a long and winding one.
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I'll try and keep it simple.
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But so right now I have my own private practice.
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I've been operating for about two years now.
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And what's kind of cool about my practice is I opened it up in the hometown that I grew up in.
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So really nice to be tied to the community in that way and be able to sort of serve the community that I grew up in, in a sense.
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But so essentially, I think you know, where I ended up today is maybe a similar experience to what a lot of us have encountered in our lives and being drawn to this field, largely due to like our own personal experiences.
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And so I think that kind of serves as an underpinning in a sense.
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But to be a little bit more literal of how I got here, I knew kind of from a young age that I wanted to work in healthcare.
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I knew that I wanted to be a leader on the healthcare team.
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And so in high school, Gray's Anatomy was still kind of like in its prime.
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And so at that time, I was like, I want to be a neurosurgeon.
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Like, I let's go big, you know, shoot for the stars.
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And so I decided to get my CNA license, started working as a nursing assistant at one of the nursing homes in my hometown in high school, after school on the weekends, summers, things of that nature.
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And I found that in doing that work with people, I actually really enjoyed being able to slow down and get that hands-on experience and just spend time with my residents in the nursing home.
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And I just sort of naturally gravitated towards working more with my residents that had cognitive impairments and dementia.
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I don't know why, but I really enjoyed working with them.
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And I think maybe being able to provide some comfort and what can be a very disorienting experience and just sort of like some of the like lighthearted and silliness nature that can come along with that.
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Like, you know, you you have to take things with a grain of salt.
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It's it's hard work, but when you can connect with them, you know, it's just so cool, you know, when their face lights up when you walk in the room and you establish that relationship with them.
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And so through that experience, I shifted into nursing.
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I want to do nursing, I think.
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Keeping in mind I still want to be a leader on the healthcare team.
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And I I knew kind of going into my undergrad program that nurse practitioner was the ultimate goal.
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And so I kept that in mind throughout my undergrad career.
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I went to UW Madison and was involved in research and different learning experiences to kind of pave that path a little bit, knowing that I wanted to go to graduate school pretty quickly.
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And so while I was at UW, I initially was really focused on geriatric health, was in a geriatric research lab focused on Alzheimer's and dementia, and kind of shifted into more of the psych realm.
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I figured out I don't want to be like a med surge nurse.
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I don't want to work in the ICU.
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I really want to do more of like the psych nursing aspect of things.
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And so through that, my program at UW Madison is really good about pairing students to their interests.
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And so my capstone clinical course was on a geriatric psychiatry unit, which I would say is a pretty unique experience for an undergrad nursing student.
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I also completed an internship with the Veterans Affairs Hospital in Madison the summer between my junior and senior year.
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And I was able to be placed on their inpatient adult psych unit and in their community living center, which was like hospice, transitional care, more of that older adult population.
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My first job out of nursing school blended kind of like the medical aspects of nursing and psychiatry really well.
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I was working at Mayo Clinic in Rochester on their medical and geriatric psychiatry unit.
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So acute medical plus acute psych need and then geriatric psychiatry.
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And our unit was the ECT unit.
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So great experience.
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Decided to pursue my psych NP.
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I went to the University of Minnesota where I got my doctorate of nursing practice.
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And in that process, I kind of got opened up to the world of trauma and trauma-informed care.
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I read the book The Deepest Well by Nadine Burke Harris, which is all about the ACE study and Dr.
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Palletti's work.
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And I my mind was just like blown.
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I was like, what?
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How did I not know this?
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And so that was kind of a shock for me in a sense.
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And I think, you know, kind of sometimes in the inpatient psychiatry world, we can get pulled into this place of like stigma, right?
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And like not really understanding like what is really happening beneath the surface.
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And so, you know, it's been a long and winding process in a sense to get to where I am now.
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But I did my my DNP project on implementing trauma-informed care education and kind of delved into that a little bit.
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Did some general outpatient psychiatry work after grad school just to get my foundation, and then pivoted into interventional psychiatry.
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So a clinic opened up nearby where I got to learn about IV ketamine, spravato, TMS.
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And ultimately at the time, this role was positioned as a quote unquote like treatment-resistant depression clinic.
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And in that experience, I learned so much, moving from just like this very like rigid kind of algorithmic place of nursing of like, you know, pair this intervention to this disorder to now, like, how can we apply things like IV ketamine or spravato or TMS more broadly?
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But something just didn't click for me there.
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Something just didn't feel right.
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I I was, you know, treating or quote unquote treating these people that had treatment-resistant depression.
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But what I found is that so many of these people didn't really fit like the classic major depressive disorder criteria that's needed for, you know, prior authorizations for insurance for spravato and TMS.
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And, you know, some people did fabulous with these treatments.
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We saw really great results, and other people like seemingly nothing.
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And I was just like, what the heck?
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This doesn't feel right.
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Well, where I'm at now, I realized this was a very like biomedical model.
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And you know, what we refer to as treatment-resistant depression is so much more than that.
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It's oftentimes very deeply steeped in trauma and environmental factors and background and development.
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And so I always knew I wanted my own practice, decided to open that up.
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We just passed two years and things are going wonderful.
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From the get-go of my nursing psychiatric nursing practice, I knew that I wanted to sharpen up some of my therapy skills.
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So kind of early on, I was getting into trainings regarding like supportive psychotherapy.
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Debbie Granick, who I'm sure you know, has the 20-minute like therapy and med management visit course, like I did that early on, and then kind of hodgepodge together a bunch of different PESI trainings and self-teaching DBT skills and things of that nature.
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So I just knew how I could sit with my patients and what to say and offer more than just, you know, here's some Zoloft, see you in four weeks.
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Bye.
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And so I kind of chuckle now, reflecting back on it.
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But when I was growing my practice, right, and I had all these openings, I was getting a lot of people that were reaching out for therapy.
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And I kept saying to people, well, why don't you come in?
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We'll do an initial evaluation, we'll hear a little bit about what's been going on.
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And, you know, I'm pretty skilled in doing like standard therapy, developing coping skills, talking through issues, processing these things, but I don't do trauma therapy.
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And it was always such a weird thing to say, but it was true.
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I was like, you know, I don't know how to work with like really like deep and ingrained trauma in this therapy like type role.
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And I stumbled upon Tracy Powell's fellowship program last fall, so fall of 2025.
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And I emailed her and I said, Hey, I'm guessing you don't have any openings in your cohort that's starting next month, no big deal.
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Put me on your email list.
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I'm interested in a future program.
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And she said, Well, actually, we just had somebody drop out, so there is a spot.
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And I was like, Okay, I guess this is destined to be.
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I was a little bit nervous, but I'm like, let's go for it.
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And it was such an incredible experience.
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I learned so much about the neurobiology of trauma and nervous system regulation and polyvagal theory.
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And then a big part of this training is the developmental needs meeting strategy, which I'm sure we'll get into a little bit more later.
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But this fellowship, it was a six-month training with a you know, a weekend long experiential where we all got together, was just really transformative to my practice and how I view my patients and understanding the wounds beneath the symptoms.
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And in the last like nine months here, my clinical practice has just shifted abundantly.
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And I've stumbled into a couple of other trainings that I'm working on right now, trauma model therapy by Dr.
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Colin Ross.
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And then I just recently completed ketamine-assisted psychotherapy training.
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So I'm really excited to work on integrating a lot of these things into my practice.
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Um, so that was a long monologue.
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No, no, that's this this is great.
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No, thank you.
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I mean, that's uh yeah, I'm gonna go back to where you started, kind of that idea that you you went you were going big as far as a neurosurgeon.
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You you I I think you went bigger, you know, as a PMHMP.
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I mean, this is this is lifelong learning at its best, and and I think it's just remarkable.
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So really kudos to you and uh and then kind of finding your way and then just keep trying to refine it.
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So thank you.
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Uh Kate, I'll turn it over to you.
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I was gonna echo what Dan said.
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Jordan, thank you for walking us through that.
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I think it's so wonderful.
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You know, our our co-host Sean talks about people who are journeymen or journey people who have this long and winding road toward their careers.
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And I always think it's fascinating to see, you know, where people have gone and where their road has taken them.
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And I also really appreciate how you spoke about how your practice really grew out of geriatrics, which I think is like kind of an undersold subspecialty.
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But honestly, I'm I am biased because I work in geriatric psychiatry also, but uh, like you said, the complexity of medical and psychiatric and often social and familial, you know, that's such a great grounding in terms of learning to hold complexity with patients.
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And then what you've done with the trauma piece is adding yet another dimension to that.
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So yeah, this is incredible.
00:12:36.720 --> 00:12:47.120
We we were talking before we started taping a little bit about your education at the University of Minnesota and uh working with Mark Peterson, who we've had on the podcast as well.
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So we wanted to ask you a little bit about your program there.
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And, you know, obviously this podcast is called Paplau's Ghost.
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So we were curious about how your education or experiences have shaped your understanding of Paplau's model and how has that laid the foundation for this really complex work that you're doing now?
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Yeah, thank you.
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Yeah, so I attended the University of Minnesota, and I may be a little bit biased, but I think it's an incredible program.
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I really like that that the U of M's program one is a hybrid model, so it's very focused on in-person connection with our colleagues and staff in the greater community while also doing that kind of individualized learning as well.
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And the the faculty at the U of M is top tier, really.
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So when I started the program, I was Dr.
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Mary Koss, was the program director for the DNP Psych and P program.
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And Barb Peterson was kind of like her right-hand woman, if you will.
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And there were some other wonderful faculty as well.
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And Dr.
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Koss retired right along with my graduation.
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So I've maintained in close contact with Dr.
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Peterson over the last several years, and also I'm close with a lot of the current faculty there.
00:14:00.240 --> 00:14:09.519
And so, what's so great about the U of M's curriculum and their approach to the PMHNP role is the whole person care model.
00:14:09.759 --> 00:14:26.720
You can read all about it on their website, but they're very focused on holistic care and not holistic care and kind of what we maybe think is like, you know, very woo-woo, like spiritual energy type work, but more so let's recognize the individual as a part of their larger experience, right?
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And all of the different factors that go into their mental health and their well-being.
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So their physical health, their background, social determinants of health, all of these different things.
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And so they taught us to be really curious about thinking about the whole person.
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And I really appreciated that because I think that sometimes our medical models can be so reductionistic of like, here's the issue, here's the disease, let's focus on this, but we neglect so much more of the clinical picture.
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And so they they incorporate elements of psychotherapy and just this sort of relational approach from the get-go in the PMH and P program there, which I really appreciated.
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It really holds on to the humanness that I think, you know, Pepau's models really and her, you know, what she demonstrated for us kind of encapsulates in a sense of like this relationship that we have with our patients.
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And so, you know, tying that into some of the trauma work that I do, I mean, complex PTSD is kind of my niche that I've identified in a sense.
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And relational work is kind of the hallmark of this, you know, these corrective healing experiences.
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And so we really need to be able to see our patients as people, right?
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Not just our patient or like, you know, our 11 a.m., but you know, this is an individual who has a whole life of experience and a whole context that influences, you know, the the 30 minutes or the 60 minutes that we get with them once in a while.
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And it's important for us to be really mindful of all those things.
00:16:02.320 --> 00:16:06.720
Yeah, I I think you I think we just need to be careful because the first episode is evidence-based woo-hoo.
00:16:06.799 --> 00:16:08.480
That's our that's a trademark for the podcast.
00:16:08.639 --> 00:16:09.360
No, just kidding.
00:16:09.440 --> 00:16:09.679
Yeah.
00:16:09.840 --> 00:16:11.519
Um just kidding.
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No, that's great.
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I mean, it's it's a great term, right?
00:16:13.919 --> 00:16:15.440
I mean, it just is so perfect.
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So, but yeah.
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I can get woo-woo.
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I mean, I told you I just did academy and assisted psychotherapy experience.
00:16:20.559 --> 00:16:21.679
So I'll love it.
00:16:22.240 --> 00:16:22.639
I love it.
00:16:22.960 --> 00:16:23.759
All right, Melissa.
00:16:24.879 --> 00:16:25.279
Thank you.
00:16:25.440 --> 00:16:34.879
I'm gonna go back, Jordan, to you mentioned the Beyond the Script conference that's coming up next month, and your ongoing collaborative work with Tracy Powell.
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And we know your work with Tracy extends well beyond the conference.
00:16:41.279 --> 00:16:45.279
So, how has working alongside her influenced your personal practice?
00:16:45.519 --> 00:16:53.360
And how do both of your clinical lenses complement each other when navigating complex trauma and interpersonal dynamics?
00:16:54.159 --> 00:16:58.879
Yeah, so it's been an absolute honor and pleasure to work alongside Tracy.
00:16:59.120 --> 00:17:13.839
And yeah, I just really can't underscore how pivotal the work that she is doing with Psych NPs is to, you know, our profession, but also personally in my cohort, there I think was seven of us, if I remember.
00:17:14.000 --> 00:17:27.039
And I mean, that journey was not just like clinical and psychoeducational, it was a personal journey as well for many of us, where we, you know, would spend time talking about our own stuff that we've experienced throughout life.
00:17:27.359 --> 00:17:47.279
And Tracy has such a gift for being able to convey things in a way that the clinical, kind of like typical psych NP mind can wrap themselves around and like, you know, here's the science behind it, here's kind of the nuts and bolts of it, you know, focusing on that evidence base in a sense.
00:17:47.519 --> 00:18:05.119
But she also does a great job of kind of pushing us beyond that and to be curious and question, you know, what are the things that, you know, maybe there isn't as clear-cut answers for, but how can we be open about that and see the impact and the change that it has on our patients?
00:18:05.440 --> 00:18:13.839
And so, you know, I myself, as I think a lot of nurses are, you know, are can be a little bit more rigid, right?
00:18:14.000 --> 00:18:22.160
We want our standing orders, we want the order set, we want to know exactly how to do the procedure, the intervention, um, especially early on.
00:18:22.240 --> 00:18:28.400
And, you know, some of that is how we're trained as nurses, some of that is our own stuff that comes up, right?
00:18:28.559 --> 00:18:42.799
And so that's something that I like really struggled with when I initially got into the developmental needs meeting strategy training, because some of this was a little bit more abstract and a little bit more difficult for me to wrap my head around.
00:18:43.039 --> 00:18:54.960
And Tracy was patient with me and she did a great job of like meeting me where I was at and respecting kind of that, like, yep, this is how nurses think, like, this is some of your own stuff coming up.
00:18:55.200 --> 00:19:00.720
And also, like, let's let's just create a little bit of a bit more openness for opportunity here.
00:19:01.039 --> 00:19:21.680
And I think that that has the potential to have such a larger impact on on our our field as nurses and as psych NPs to to get to a place of more openness and and compassion and less rigidity and not trying to fit patients into a one size fits all boxes.
00:19:22.480 --> 00:19:24.640
It kind of reminds me of that famous quote.
00:19:24.720 --> 00:19:28.400
I think it was Kurt Lewin who was like, There's nothing as practical as a good theory.
00:19:28.640 --> 00:19:39.680
But what you I I live I love working at the intersection of theory and practice, and I think what you described just it's a beautiful description of that dance and interplay between theory and practice.
00:19:39.759 --> 00:19:40.400
So thank you.
00:19:40.799 --> 00:19:41.839
Yeah, thank you.
00:19:42.240 --> 00:19:43.359
Yeah, that's awesome.
00:19:43.599 --> 00:19:46.960
I mean, let's maybe let's the next let's keep going with that.
00:19:47.039 --> 00:19:50.079
I think, you know, let's talk a little more about you kind of brought up this.
00:19:50.319 --> 00:19:57.839
I you work with Tracy Powell, and I think the training in that developmental needs meeting strategy, DM DNMS.
00:19:58.240 --> 00:20:03.440
It's an ego state, it's an ego state therapy focused on the unmet needs of the wounded child parts.
00:20:03.519 --> 00:20:08.480
And so how do you, and again, maybe this is an unfair question, but just how do you conceptualize that?
00:20:08.559 --> 00:20:19.200
How do you maybe the better question is how do you bring parts of that theory and those concepts into each session that you kind of have with patients and and and how does that integrate into the work that you do?
00:20:19.599 --> 00:20:22.640
Yeah, well, I'll bold the word you said parts, right?
00:20:22.960 --> 00:20:23.519
Right, right, yeah.
00:20:24.799 --> 00:20:26.319
Encapsulate a whole theory in like two senses.
00:20:26.400 --> 00:20:26.880
Yeah, try it.
00:20:26.960 --> 00:20:27.680
No, yeah, sorry.
00:20:28.000 --> 00:20:29.279
Uh no, you're good.
00:20:29.599 --> 00:20:37.680
So yeah, so the you know, the easiest way to kind of conceptualize this is that DNMS is an ego state-based therapy.
00:20:37.839 --> 00:20:41.920
And so what most of us are familiar with is internal family systems, IFS.
00:20:42.000 --> 00:20:51.759
And so I would say that this is kind of parallel to IFS in a sense and in some of its principles, but it it has much different frameworks and the ways that we apply it.
00:20:51.920 --> 00:20:59.599
And so Shirley Jean Schmidt was the, I believe she's an LMF, LMFT, she's a therapist who developed this model.
00:20:59.680 --> 00:21:06.400
And on her website, she actually has a very nice table comparing IFS and DNMS side by side.
00:21:06.480 --> 00:21:09.200
So I would encourage you all to read that when you have a chance.
00:21:09.440 --> 00:21:16.640
But so developmental needs meeting strategy is really focused, like you said, on meeting the unmet needs that we have in childhood.
00:21:16.799 --> 00:21:20.079
And so it's important to differentiate.
00:21:20.240 --> 00:21:31.920
You know, we have shock traumas, our capital T traumas, if you will, abuse assault, life-threatening events, which can be addressed with memory reconsolidation, like EMDR, for example.
00:21:32.160 --> 00:21:38.480
And then we have our attachment or our emotional wounds, maybe our little T traumas, if you will.
00:21:38.720 --> 00:21:44.559
In the DNMS framework, we think about it as you know, the good things that should have happened to you that didn't happen to you.
00:21:44.880 --> 00:21:59.680
So maybe having a lot of inconsistency in the household growing up, having a caregiver that's not really attuned to your needs, having people in your life that invalidate you, critique you, speak poorly to you, having an absent caregiver.
00:22:00.640 --> 00:22:10.400
And what this really focuses on too is recognizing that it's not meant to be the blame game, you know, that our parents did us wrong and things of that nature.
00:22:10.640 --> 00:22:17.279
We really focus on the generational patterns that happen here and we understand, you know, why did things happen the way that they did?
00:22:17.440 --> 00:22:23.839
You know, maybe our caregivers didn't have the tools that they needed to show up in the way that we needed as individuals.
00:22:23.920 --> 00:22:26.079
And as a result, some of these wounds happened.
00:22:26.319 --> 00:22:36.000
And so when I explain this to patients, I talk about this idea that we are all made up of very many different parts of ourselves that kind of make up our whole being.
00:22:36.319 --> 00:22:49.119
And in childhood, if we're exposed to a lot of these attachment wounds or these emotional wounds, as these parts of ourselves or our psyche are developing, they can kind of get stunted or stuck in the past.
00:22:49.279 --> 00:22:59.359
And so then what happens in the present moment is that me as a man in my 30s, you know, maybe experiences what we would say is a trigger.
00:22:59.519 --> 00:23:05.200
And I have this huge reaction that seems really out of context or out of proportion to the situation.
00:23:05.440 --> 00:23:10.799
And it's like, whoa, that was not characteristic of, you know, a man in his 30s.
00:23:11.039 --> 00:23:15.440
This instead seems like a really like angry and vengeful 14-year-old.
00:23:15.599 --> 00:23:24.160
And so what this theory says is that, you know, this 14-year-old part is being triggered and is reacting and sort of like taking over in a sense.
00:23:24.400 --> 00:23:36.160
And so maybe an example of this would be like you're at work and you get an email from your boss, or you get that, you know, Teams meeting invite for an hour from now, and you're like, what is this?
00:23:36.319 --> 00:23:43.519
And you start panicking, you've got that pit in your stomach, you're freaking out, and it's like it's probably nothing, but what if?
00:23:43.759 --> 00:23:55.839
And that what if is maybe a wound from your past that is actually replaying this as you know, an authority figure being very angry or mean at you in a sense.
00:23:56.079 --> 00:24:17.839
And so with DNMS, what we want to do is we do a lot of deep inner work to provide these corrective experiences for these wounded parts so they can heal and get unstuck from the past so we can become more integrated and live life in the driver's seat as you know, a man in his mid-30s that's competent and capable to handle these things and has the power to do so.
00:24:18.559 --> 00:24:19.200
Awesome.
00:24:19.440 --> 00:24:20.559
Yeah, I'm thinking too.
00:24:20.640 --> 00:24:25.359
I'm like, so if you like what you're hearing, if you're listening right now, please make sure you attend the beyond the script.
00:24:25.519 --> 00:24:27.920
I'm sure uh we're just talking about that you're presenting there.
00:24:28.000 --> 00:24:31.839
So and this might be like a teaser of what you're gonna be presenting here in a few weeks.
00:24:32.240 --> 00:24:32.720
So that's great.
00:24:33.039 --> 00:24:33.599
Kate.
00:24:35.039 --> 00:24:36.799
This is very this is so great, Jordan.
00:24:37.039 --> 00:24:44.480
And and so, you know, I want to ask you obviously you've done a lot of additional training and really dove deeply into this.
00:24:44.960 --> 00:25:01.200
But for PMHMPs listening out there who you know haven't done this training but are really interested in what you have to say and maybe want to integrate some of this into their practice, what guidance would you offer them in terms in terms of how to weave some of these principles into their everyday clinical work?
00:25:01.759 --> 00:25:03.599
Yeah, I would say get curious.
00:25:03.759 --> 00:25:07.839
First of all, get curious about your patients and and how they're showing up, right?
00:25:08.400 --> 00:25:14.640
What we see on the surface is very rarely the actual issue that's at hand here.
00:25:15.039 --> 00:25:22.880
And so, kind of a segue in a sense to one of these other trainings that I am working on, trauma model therapy.
00:25:23.119 --> 00:25:24.559
I sort of stumbled into this.
00:25:24.720 --> 00:25:32.799
I connected with one of the people that runs that program on LinkedIn and was messaging her, and she was like, hey, we're trying to roll this out to Psych NPs.
00:25:32.960 --> 00:25:35.440
Like, do you want to be a beta tester and like give us feedback?
00:25:35.519 --> 00:25:37.920
And I was like, sure, sounds good.
00:25:38.160 --> 00:25:44.160
And so I this year I became the first level one trauma model therapy trained psych NP.
00:25:44.559 --> 00:25:50.559
And so I actually think trauma model therapy is a really great introduction that is a little bit more accessible.
00:25:50.880 --> 00:25:52.720
Tracy's program is incredible.
00:25:52.799 --> 00:25:55.920
Like, if you ever have the opportunity, I would highly recommend it.
00:25:56.079 --> 00:25:58.319
But it's only offered, I think, once a year.
00:25:58.480 --> 00:26:03.200
It's it's a very large commitment, you know, and but also it's really deep work.
00:26:03.519 --> 00:26:14.559
But trauma model therapy introduces some of these concepts in a little bit easier to digest way that can be really helpful for psych NPs, I think.
00:26:14.799 --> 00:26:24.720
They have several different principles, and off the top of my head, two of them that stand out to me that I that I bring up with my patients all the time is one, the problem is not the problem.
00:26:25.119 --> 00:26:36.720
So the person that comes in with anxiety or lack of motivation or who's self-harming or abusing substances, like that itself is not the problem.
00:26:36.960 --> 00:26:39.759
The problem is what's actually driving this behavior.
00:26:39.839 --> 00:26:51.200
So let's focus on what's the behavior at hand, whether it or sorry, what's the underlying issue at hand, work with that, and we're gonna see the quote unquote problem get better.
00:26:51.519 --> 00:27:00.160
The other principle that I incorporate all the time, and people are just like, wow, that makes so much sense, is the idea of attachment to the perpetrator.
00:27:00.319 --> 00:27:10.000
So, especially in developmental trauma, children, you know, us as humans, as biological beings, our main drive in life is survival.
00:27:10.240 --> 00:27:13.680
As children, we rely on our caretakers for survival.
00:27:13.920 --> 00:27:22.720
And so this can become very confusing, especially when you have a caretaker that is abusive, neglectful, hostile, whatever it may be.
00:27:22.880 --> 00:27:26.559
Because as a child, I need to attach to this individual for survival.
00:27:26.640 --> 00:27:27.839
They're my lifeline.
00:27:28.000 --> 00:27:33.359
But at the same time, they're hurting me, you know, whether physically or metaphorically speaking.
00:27:33.440 --> 00:27:38.079
And so it creates this like internal push-pull distance within the child.
00:27:38.160 --> 00:27:50.400
And this is where we can see this is kind of like, you know, underpinnings for dissociative disorders and whatnot, but trauma as a whole of like, how do I relate to this person and keep myself safe at the same time?
00:27:50.640 --> 00:27:57.839
And it just creates so many different relational patterns and like how we see ourselves, how we connect to others, the world around us.
00:27:58.079 --> 00:28:06.960
And so I think that, you know, if you're looking for practical things, like check out trauma model therapy, message me on LinkedIn, I can get you a discount to do the training.
00:28:07.200 --> 00:28:08.319
But just be curious.
00:28:08.480 --> 00:28:16.960
Start start asking these questions and spend some time reading about attachment and developmental wounds and trauma.
00:28:17.200 --> 00:28:19.119
And the rest will all come out.
00:28:19.200 --> 00:28:22.880
But compassion and curiosity, I think, are the two biggest things we can do.
00:28:24.480 --> 00:28:25.279
C and Z.
00:28:25.440 --> 00:28:26.720
Compassion and curiosity.
00:28:26.880 --> 00:28:27.359
I love it.
00:28:27.519 --> 00:28:27.680
Yeah.
00:28:28.079 --> 00:28:36.960
It's, you know, it's it's making me think I was not too long ago listening to Mel Brooks's uh autobiography and his kind of early life was talking about just say yes to everything.
00:28:37.119 --> 00:28:38.960
You know, just be just be hungry for everything.
00:28:39.039 --> 00:28:48.559
And that's kind of the message I'm getting from you is just when you see something that needs fixing or or you need to kind of dig more into it, say yes to it and see where that kind of takes you.
00:28:48.799 --> 00:28:50.160
So that's great.
00:28:50.400 --> 00:28:51.680
We're kind of getting close on time.
00:28:51.759 --> 00:28:56.960
So we at this point of the podcast, we are going to introduce our previous guest, Dr.
00:28:57.039 --> 00:29:00.319
Pedro Morante, who has a question for you.
00:29:00.480 --> 00:29:02.160
Now we are not hallucinating here.
00:29:02.240 --> 00:29:03.440
This wasn't done by AI.
00:29:03.839 --> 00:29:06.480
You may hear a different name, but that was that's okay.
00:29:06.559 --> 00:29:09.279
But we'd still love to hear your perspective on this question.
00:29:09.359 --> 00:29:10.319
So let's have Dr.
00:29:10.480 --> 00:29:12.720
Morante give that perspective.
00:29:14.079 --> 00:29:15.119
Hi, Dr.
00:29:15.279 --> 00:29:15.920
Sylvia.
00:29:16.000 --> 00:29:24.559
If you're gonna be given like a one million dollars, how will you shape or change the psychiatry practice right now?
00:29:25.519 --> 00:29:26.799
Yeah, it's concussion.
00:29:26.960 --> 00:29:27.759
Let's see what you think, Jordan.
00:29:27.920 --> 00:29:29.359
What are you gonna do with a million bucks?
00:29:29.759 --> 00:29:32.079
Oh wow, that's that's a big one.
00:29:34.559 --> 00:29:36.079
I'll keep receipts, so just keep going.
00:29:36.480 --> 00:29:39.519
Yeah, yeah, you keep a running tally for me.
00:29:41.519 --> 00:29:50.559
I think what I would do is invest in some way that we could.
00:29:56.640 --> 00:30:05.920
I think what I would do is try and invest in some way that we could soften our approach in psychiatry.
00:30:06.160 --> 00:30:25.599
And by this I mean really focusing on ways that we can show up for our patients in a way that is non-judgmental, that is social justice informed, and is empathetic to the the human suffering that we all experience.
00:30:25.759 --> 00:30:35.039
I think that it's really easy for us to get wrapped up in, you know, our day-to-day and our jobs, and let's, you know, move people through the line.
00:30:35.200 --> 00:30:39.599
And it just poor care is what results.
00:30:39.839 --> 00:30:52.960
And so I would invest in a way that we could we could slow down, we could be curious, and we could actually have good relationships with our patients in a way that uh doesn't put us at expense for burnout.
00:30:53.119 --> 00:31:01.039
And and I think in a way, you know, being able to slow down and actually have more of those human connections could help with some of that too.
00:31:01.359 --> 00:31:10.720
To be able to just see the person in front of me and have that therapeutic relationship and rapport can be so much more than than a prescription ever is.
00:31:11.119 --> 00:31:26.400
And so I don't think a million dollars is quite enough, but maybe it could fund some sort of pilot intervention to get some additional funding and as to how we can, yeah, yeah, just get back to the roots of of humanity a little bit more inside.
00:31:27.599 --> 00:31:28.240
Yeah, I love it.
00:31:28.319 --> 00:31:34.640
I I think it's um, and I may be misquoting, but I think it's it was Gandhi who said that we uh we vote with every dollar that we spend.
00:31:34.799 --> 00:31:35.680
So I like the idea.
00:31:35.759 --> 00:31:36.079
You're right.
00:31:36.160 --> 00:31:41.599
It probably takes more than a million dollars to do that, but uh that million dollars is going towards that direction, and that's what you care about.
00:31:41.680 --> 00:31:42.640
And so thank you, Dr.
00:31:42.720 --> 00:31:43.039
Jordan.
00:31:43.200 --> 00:31:45.839
Man, very much appreciate you sharing your perspective.
00:31:45.920 --> 00:31:51.440
This has been wonderful for me, and I hope though for the listeners too, feel free to share, like, comment, and subscribe.
00:31:51.680 --> 00:31:56.720
We'd love to hear from you and as listeners, would love to kind of see what we want to hear next.
00:31:56.799 --> 00:31:58.799
So look forward to a new episode coming out.
00:31:59.039 --> 00:31:59.759
Happy Last Go.
00:32:00.000 --> 00:32:01.680
Thank you so much, and we'll see you next time.