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Hi everyone, welcome to another episode of Tattoos and Telehealth.
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I'm Nicole Baldwin, Board Certified Nurse Practitioner, and this is my good friend and colleague, Kelly White, also board certified nurse practitioner.
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And today, in honor of 9-11, can you believe it's been 25 years?
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A long time.
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A long time.
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It doesn't feel like it though, because most of us can remember, especially us, we're dating ourselves, but there's so many of us that can still remember where we were, what we were doing, 100%, what was happening when the very first tower was struck.
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Oh, 100%.
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I can.
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Absolutely, I can.
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And I mean I was in Florida at the time, and I remember people that I was working with had family in New York and the panic.
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It's just um devastating.
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And I remember when year 19 hit of 19 years, I remember some of the first children that were the moms that were pregnant going into the fire academy.
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There was like several of them that they had turned 18, had graduated, had gone through the fire academy.
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And I thought just that was such a special, yeah, a special, special time for them.
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You know, they didn't get to meet their dad.
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Yeah.
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But that they're carrying that on.
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And then now I feel like it's just been a blink, and now we're at 25 years.
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Yes.
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That's kind of where Nicole and I want to spend some time today, mostly because I think there's a lot of things that happened between then and now, not just these big events.
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We've had 9-11, we've had COVID, but we've had a lot of little things happen in between there.
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These are just the big things that we can talk about in healthcare that kind of stand out for us.
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But I really want to bring forward and shine some light on first responders, healthcare workers, those that come out in times of trauma, whether that's Red Cross or the National Guard or people that are on standby at all times.
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You know, there's this stigma around first responders and healthcare workers because we are culturally conditioned to be the strong caregivers.
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And that makes us sometimes less likely to reach out for help.
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If we need help ourselves, we are much less likely to reach out in those times.
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We don't seek mental healthcare as a standard part of our routine.
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It's not a part of our conversations on a daily basis.
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We normalize that.
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We internalize it.
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We normalize it.
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It's similar to physical conditioning.
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When you have people that are in the military, they physically condition themselves to be ready for combat.
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Healthcare workers and frontline workers and first responders, that's part of our conditioning.
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We that's our mental conditioning to be ready.
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You see terrible things, you see horrible things that people should never have to lay their eyes on.
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We pack it away, we store it, and we move on.
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And I think that that's one of the things that sometimes people, especially in healthcare and first responders, we don't think about.
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We're culturally conditioned to move that to the back, right?
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That's part of who we are.
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And I think that there's some cumulative effect there.
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There's some cumulative burnout, especially when you think about that daily exposure, that cumulative effect, that secondary trauma and what that turns into.
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So we have this, we have this full culmination of where it goes.
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And then we have secondary trauma that comes in the form of whether it's sleep disruption, shift work, high-stakes decision making that can compound into this physical and emotional exhaustion.
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I have spoken to nurses, frontline workers, firefighters, or attire EMTs.
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They reach a point, Nicole, where it physically hurts their bodies to get out of bed and go to work, to step a foot back on the bus, to put a foot back on the steps of the fire truck, because it's their body's visceral response to what they've been through.
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Yeah, for sure.
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I think fire and police constantly, specifically on 9-11, the the police and the fire, you're seeing body parts, and you cannot, and nor do you have time to deal with it or even comprehend fully what you're seeing before you move on to the next thing.
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And that's how EMS and the police work.
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They are going from a crash where people were thrown and are deceased, or maybe they're doing CPR and maybe the patients live, maybe they don't, and then they're getting called to a completely different scenario that very well could be equally devastating, and they still haven't had a minute to even think about what just happened.
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So there's no processing time
Load full transcript
because the last thing we want to do when we get home is think about how our of all the things and all of the decisions, life-sustaining, life-changing decisions that we had to make.
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And then, especially on 9-11, being in such a mass casualty and such an acute situation, just going from body to body to body to body to body, and the things that you're seeing, you can never unsee those things.
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You just cannot unsee those things.
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And I think it's devastating to the families of those because I feel like for police, and I can say because there's police in my family, that if they went and got help, that's offered to them.
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They would be seen as weak, and so they won't.
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Yeah.
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Yeah, absolutely.
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And I'm quoting.
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So oh, I can't reach out to so and so who does post-traumatic counseling.
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They offer that.
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Yeah.
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But will they go?
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I hope they do, but I will tell you, in most cases, they do not because it makes them look weak.
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Yep.
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And then you have that occupational stress carrying over into the domestic life, carrying over into their home.
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And that will look often like emotional withdrawal from their family, or they become hypervigilant.
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So you have one of two scenarios.
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They become this recluse, withdrawn, won't participate in family functions, won't discuss, won't, they just become this person that nobody recognizes anymore.
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Or they become this hyper-vigilant person at home where they are just like constantly keyed up and they can't get their body out of that state.
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And that's not any way to live on either direction.
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And so it just becomes this lose-lose situation from them.
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And so we have this situation where no one wins.
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But again, it's because we have, as first responders, as healthcare workers, we have been trained to do this.
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It's part of our conditioning, it's part of our emotional conditioning.
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And that's that cumulative effect.
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And so I think that thinking about today, remembering 9-11, remembering that cumulative effect of very catastrophic, very acute events that culminated and led up to that.
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I also want to take a moment to recognize just the citizens, the everyday people that were impacted by that.
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So many people were shoved into a first responder role.
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People that had never been in healthcare, never been in a first responder situation, never had to do that.
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That instinct kicked in.
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We saw people that had no clue, had no idea, or had never been involved in first responders.
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They just jumped in and started helping because that's what we do, right?
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We rally, we come together, we do those things.
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And then we started seeing the effects of what that looked like for them, especially for them, because they'd never had to deal with that before.
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And so we started seeing that secondary trauma manifest itself in the average person.
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So think about what that looked like for someone who had never been exposed to something like that, who had never had to see something like that.
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And so I think that those are big things to think about.
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And so I really want to hit home with first just in this the season that we're in, this political environment that we're in, and this time of unrest in our society, for everyone to just step back and take a moment to consider not only what today represents.
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If you're listening to this today, it's September 11th, it's 9-11, Patriot Day, if that resonates with you, but just to have some grace for each other, right?
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Just to have a moment to just stop and just love your neighbor, to just realize that we're all going through something.
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We've all gone through some type of tragedy or acute trauma or a cumulative effect of something, right?
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That's happened in our life.
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For an hour.
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For a long time after, not an hour, for a long time after, weeks and maybe a month.
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People were so nice because we were all going through the same trauma.
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Yeah.
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Yeah.
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This world looked very different.
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It looked very, very different.
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It looked very, very different.
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But I will never forget watching them, even on TV, carrying out the Catholic priest.
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Nobody's can can forget that.
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Carrying him out.
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No.
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And I'm glad that they put things like that on TV because that's real life.
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And when they handicote stuff, it gives us a false perception of what's really going on and knowledge is everything, right?
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Knowledge is everything.
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But I think you hit it.
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I think it's super important to acknowledge not just the, of course, the first responders.
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They're top on the list.
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Police, fire, EMT, hospitals, but also those people that are just going through it.
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That are just going through it and having to live through it when maybe they have signed up for that.
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Yeah, exactly.
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I think that we're talking about these things compounding into just this physical and emotional exhaustion.
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I want to lay out for everyone, specifically talking to our healthcare workers, our first responders, our people that are there daily, but to anyone, there's some pretty significant signs of compassion fatigue.
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Nicole and I have had this beat into our heads as first responders, but it is always good to talk about them.
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Compassion fatigue is something that you have to watch for in yourself, in your colleagues, and those around you.
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And it's okay to talk about compassion fatigue with your loved ones and let them know, hey, this is something that I think I'm going through, or maybe the people that are around me are going through.
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But the one thing that I think is really key to notice is if you see someone or maybe you're starting to experience some emotional detachment, maybe even some cynicism, you're not quite as bothered, that's a problem.
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We can in turn put that in a box and set it aside in the moment.
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But if you're numb to it, that's a problem.
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Chronic irritability, insomnia is a huge one.
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That's oftentimes the first thing that shows up.
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People start losing sleep and they're just like, I'm not sleeping well, I can't function, then they get numb and then they get very cynical, and that's a problem.
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Or if you start having some unhealthy coping mechanisms.
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I've given my story before.
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I've told Nicole this when I left in-person care.
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I had gotten to the point where it was at the height of COVID, things were just rough.
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I had spent some time in the ICU, I had gotten sick, I had gotten so tired of stacking body after body after body.
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I was, I was self-medicating and I was drinking and it was a problem.
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That's self-medicating, guys.
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That is an unhealthy coping mechanism, but that's what was happening.
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And it wasn't until I stepped back and I was like, whoa, I can't do this.
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I can't keep doing this.
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And so those are some red flags.
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But I want everyone to understand that there is, there are peer support programs out there.
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There is power in those peer support programs.
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Even if, like Nicole said, oftentimes there's this stigma against reaching out to those.
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Man, sit down and have a meal with a friend and just tell them what's going on.
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You it doesn't necessarily have to be with a pastor or a psychiatrist or a psychologist or anything like that.
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Just tell someone how you're feeling and get the conversation started.
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Then it feels like a safe environment.
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You can go from that to even something so much as a structured, peer-led situation.
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There's all kinds of things out there.
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And then that goes on to cognitive behavioral therapy.
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There's EMDR, there's trauma-informed somatic techniques.
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There's a lot of stuff out there.
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And so I really want people to understand that getting help doesn't have to be going and sitting on someone's couch and pouring your heart out.
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It doesn't have to be that way.
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It can be just from moving from that cynical, numb feeling to just telling someone how you feel, truly.
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That is true.
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That is true.
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And if you don't have anyone, the 988 Lifeline is available.
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You can call, text, you can chat.
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They're Spanish speaking.
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They have, if you go on their website, 988lifeline.org, there's a deaf and hard hearing area that you can go to.
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But the 988, it's a suicide hotline, but it's and crisis lifeline.
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And so whether you're facing mental challenges, struggles, emotional distress, alcohol or drug use or concerns, or just need someone to talk to, they have counselors there that are waiting for you to call so that you're not alone.
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Because a lot of people isolate themselves and they are alone, or maybe they don't want to talk about it with someone that they know because of whatever stigma.
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But the 988 Lifeline, it's free.
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You can talk to a counselor right there.
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And so I hope anyone that's struggling, take advantage of that.
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Take advantage of that.
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They're there.
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And it was created for a reason because absolutely.
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Absolutely.
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All right, guys.
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So as we close up today, I just want to first and foremost thank anyone and everyone that is a first responder, a healthcare worker, a frontline worker.
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Maybe you are a volunteer for the Red Cross.
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Maybe you are someone who just shows up when they need extra waters.
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God bless you.
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If you are just that person that says, you know what, I can't do anything, but I can say a prayer.
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Thank you.
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It doesn't matter who you are.
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If you stop and take five minutes, maybe prayer isn't your thing, but you can stop and just give a moment of silence.
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Thank you.
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You are needed.
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Everyone, we are all there for each other.
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Whether that's just stopping for a moment and just saying, you are valuable, you are worthy, that is enough.
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And I just want everyone to understand and hear that you are enough.
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And days like today remind us that we are not in this alone.
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And when times like 9 11 happen, gosh, we can rally together like no other.
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Yep, that's true.
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So everyone out there, stay safe and God bless the USA.
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Amen.