Fullstendig transkripsjon av Nursing Intuition & Learning to Trust Your Gut as a Nurse with Jennifer Johnson BScN, RN

00:02:30.000 --> 00:02:34.639 That realization ultimately inspired her to write her book, Nursing Intuition. 00:02:35.039 --> 00:02:50.479 In today's conversation, we dive into what nursing intuition really is, how it differs from clinical judgment, why experienced nurses often recognize subtle changes before the monitors do, and how new nurses can begin developing this skill from the very start of their careers. 00:02:50.719 --> 00:03:03.360 We also talk about Jennifer's own nursing story, overcoming workplace bullying, finding her love for emergency nursing, and why learning to trust yourself may be one of the most important skills you'll ever develop as a nurse. 00:03:03.599 --> 00:03:21.520 Whether you're a nursing student, a new grad, or an experienced nurse who's ever had that quiet feeling that something's not quite right, I think you'll walk away from this episode with a whole new appreciation for the incredible blend of science, experience, and intuition that makes nursing such a remarkable profession. 00:03:21.919 --> 00:03:25.599 Okay, let's jump into today's conversation with Jen Johnson. 00:03:26.000 --> 00:03:30.879 I'd like to welcome Jennifer Johnson to the Life After Nursing School podcast. 00:03:31.039 --> 00:03:32.800 I'm so excited to have you, Jen. 00:03:32.960 --> 00:03:35.360 I've been a follower for actually quite some time now. 00:03:38.879 --> 00:03:46.240 It's like the weirdest most complimentary thing ever, where you're just like, nobody follows, like nobody listens. 00:03:46.400 --> 00:03:50.479 Nobody, I'm just shooting this out into the internet superspace to be like, meh. 00:03:51.120 --> 00:03:52.080 It's so true. 00:03:52.240 --> 00:03:54.319 You don't realize the impact that you have on the other end. 00:03:54.400 --> 00:03:56.319 And you know, you just go with your daily life. 00:03:56.479 --> 00:04:02.800 I've had a previous coworker even message me a couple of times in the last month being like, hey, I shared your page with a nursing student. 00:04:02.879 --> 00:04:04.400 Oh, I referred another girl to you. 00:04:04.479 --> 00:04:05.840 And I'm like, that's so nice. 00:04:06.400 --> 00:04:07.280 Like it's the best. 00:04:07.759 --> 00:04:08.080 Yeah. 00:04:08.240 --> 00:04:09.039 I just, I don't know. 00:04:09.120 --> 00:04:13.599 I don't think people realize the impact that has on the person actually creating the content and putting stuff out there. 00:04:13.840 --> 00:04:14.240 Absolutely. 00:04:14.400 --> 00:04:14.560 Right. 00:04:14.800 --> 00:04:17.759 And of course, because you're just like constantly putting you out there. 00:04:17.839 --> 00:04:20.000 You're like, hope I don't get fired this week. 00:04:20.240 --> 00:04:21.759 Hope I don't say something stupid. 00:04:22.079 --> 00:04:23.519 You're like, is anybody out there? 00:04:23.680 --> 00:04:25.920 Like I feel like that Adele song, like, hello. 00:04:26.560 --> 00:04:26.800 Hello. 00:04:27.120 --> 00:04:28.480 Is anyone anyone? 00:04:30.319 -->

00:04:39.360 Um, but Jen, can you please like share a little bit about yourself and what your life looked like after nursing school and what led you to write the book about? 00:04:40.879 --> 00:04:41.360 Yeah. 00:04:41.600 --> 00:04:44.160 So everything, you know, fell into nursing. 00:04:44.319 --> 00:04:48.800 It was never kind of a thought process, ended up just kind of falling into it. 00:04:49.040 --> 00:04:52.399 When I graduated, I was then dating my now husband. 00:04:52.480 --> 00:05:02.240 And so he's like, hey, there's there's an opening at this teeny tiny little rural hospital, one RN for merge, one RN with two LVNs or RPNs on the floor. 00:05:02.480 --> 00:05:03.600 You know, have that. 00:05:03.759 --> 00:05:05.519 And I'm like, sure. 00:05:05.839 --> 00:05:08.160 So, you know, you got to play house. 00:05:08.480 --> 00:05:09.839 There was a job opening. 00:05:10.079 --> 00:05:12.639 It seemed like it was, you know, made in heaven. 00:05:12.879 --> 00:05:17.920 Um, the worst bullying experience of my entire life and career. 00:05:18.160 --> 00:05:22.000 Yeah, kind of like five years of the joys of that. 00:05:22.399 --> 00:05:27.360 Fast forward where we get married, and I'm like, haha, I can't stay here anymore. 00:05:27.519 --> 00:05:30.800 We are not even joking, literally living next door to your mother. 00:05:30.959 --> 00:05:34.079 So we're gonna have to draw some clear boundaries. 00:05:34.240 --> 00:05:39.759 I'm gonna we're gonna have to pop off here because this is only gonna get worse once the kids come. 00:05:39.920 --> 00:05:40.240 Yeah. 00:05:40.560 --> 00:05:52.800 So moved down south, finally got to go into a much larger center, stroke center, and got to meet the most fun people, some of whom I actually just volunteered at my kids' camp last week. 00:05:52.879 --> 00:05:58.480 And I got to re-hit up my buddy, who he and I were working together with these 300 kids. 00:05:58.720 --> 00:06:07.839 And it was just like no time had passed, even though it's probably been, you know, we've done it yearly for the last three years, but before that, like we kind of lost touch for about 10 years. 00:06:08.079 --> 00:06:16.560 So, you know, just getting back into it and and actually finding the love of nursing and like, okay, these are my people and and this is what's going on. 00:06:16.720 --> 00:06:30.480 And in a really big emerge, which, you know, if you're an undiagnosed ADHD or a diagnosed ADHDer, you tend to fall into a merge that's just kind of what calls to a the chaos calls, and we go, yes. 00:06:31.279 --> 00:06:37.120 So ended up back in a merge, and just things were going really well. 00:06:37.360 --> 00:06:42.480 Ended up being my husband was headhunted by another hospital system about an hour up the road. 00:06:42.560 --> 00:06:44.240 So we're like, sure, let's move. 00:06:44.480 --> 00:06:50.319 Had a few years jumping from the pediatric hospital and then to the like did a year there. 00:06:50.399 --> 00:06:54.160

I was like, this is cool, but it's the same six things over and over and over again. 00:06:54.319 --> 00:07:00.879 And as much as I love dealing with parents when it's like one every 50 people, I can't do it when it's all parents. 00:07:01.040 --> 00:07:02.240 So I'm gonna, I'm gonna bounce. 00:07:02.399 --> 00:07:03.680 I'm gonna go back to adults. 00:07:03.759 --> 00:07:04.639 I miss them. 00:07:04.959 --> 00:07:10.800 So went to the trauma center, kind of stuck around there, and then needed a full-time line. 00:07:11.120 --> 00:07:25.759 You know, the kids were born and they're starting to grow up, and I'm like, okay, we need some structure and ended up falling into my job now, um, which is an emergency department, which is like a little sister or little brother of kind of the the larger healthcare system. 00:07:26.079 --> 00:07:31.199 So a little bit rural, but we've got a CT, we've now got RTs 24-7, God bless. 00:07:31.519 --> 00:07:51.839 And then COVID hit, and it was just chaos, as per anybody who was even remotely paying attention during that time, whether you were bedside, in hospital, in home, clinics, management, like nobody came away unscathed. 00:07:52.079 --> 00:08:04.560 And so up in Canada, there were a group of uh lawyers that had come forward and and with the best intentions, were like, we'd love to do everybody's, you know, all these frontline responders their wills for free. 00:08:04.800 --> 00:08:10.480 And at the time, unfortunately, all we heard was you're not gonna make it. 00:08:10.879 --> 00:08:18.879 So, you know, it really, if I was already kind of circling the train a little bit, that just last little kick over the edge. 00:08:19.199 --> 00:08:31.920 And it got me thinking, my kids were four and five when COVID hit, you know, if I I'm choosing to continue to go into work, if I die, how do I explain to them why I continue to choose to go to work? 00:08:32.080 --> 00:08:38.159 And so, you know, had a couple of nice stories, and you're writing down the nice little stories and it's cute and everything. 00:08:38.320 --> 00:08:45.600 And because I was so sleep deprived and so out of my mind, the trauma, there was no more blockade for the trauma. 00:08:45.679 --> 00:08:48.480 So it just came flying through. 00:08:48.799 --> 00:09:03.279 And after writing years worth of the little stories that we turn into two-minute nuggets for everybody else at 3 a.m., I've now gone into detail with it and gone back and said, like, okay, what's the theme here? 00:09:03.440 --> 00:09:11.200 And so Llewellyn, who's a metaphysical publisher out in the out in the States, they were having online book fairs and I kept meaning to catch them and I kept missing them. 00:09:11.279 --> 00:09:12.799 And I was just like, what the heck's going on? 00:09:13.039 --> 00:09:17.919 The one that I caught, the author was talking about her book, Intuition at Work. 00:09:18.080 --> 00:09:19.919 And I'm like, Intuition at work. 00:09:20.080 --> 00:09:22.320 I'm like, there I use my intuition all the time at work. 00:09:22.480 --> 00:09:27.519 And it was just this like snap moment of, oh my god, that's it. 00:09:27.679 --> 00:09:28.240 That's the theme. 00:09:28.320 --> 00:09:39.759 So go back and sure enough, every single story had some element of intuition, whether I knew whether I was trusting my gut, whether I wasn't, did was I believed, was I not? 00:09:39.919 --> 00:09:40.799 Did anything happen? 00:09:40.960 --> 00:09:43.120 Did did something not great happen? 00:09:43.360 --> 00:09:45.519 And going, like, okay, here we are. 00:09:45.840 --> 00:09:48.080 I've I've cranked out this book in like six weeks. 00:09:48.240 --> 00:09:50.080 I'm like, this is insane. 00:09:50.240 --> 00:09:53.440 I don't, and to be fair, I don't remember writing the book. 00:09:53.759 --> 00:09:57.039 I think I've blocked it out mentally and physically. 00:09:57.200 --> 00:10:02.240 I remember getting up really, really early, like a three, four o'clock in the morning to like continue to write. 00:10:02.399 --> 00:10:06.799 I remember staying up super late, but it just all spilled out. 00:10:07.120 --> 00:10:12.399 And you're looking at, you're like, okay, this idea of intuition and nursing, we all talk about it at 3 a.m. 00:10:12.639 --> 00:10:17.200 That gut feeling, the docs can call it Spidey Sense, and that's 100% acceptable. 00:10:17.679 --> 00:10:23.840 We we call it just a gut feeling, and we're like, and the depending on the doc, sometimes it's like, oh, well, you know, what do you mean? 00:10:24.000 --> 00:10:25.440 Where's your where's your evidence? 00:10:25.519 --> 00:10:26.480 And and all this kind of stuff. 00:10:26.559 --> 00:10:34.559 So I thought, okay, if I put this out there without any science behind it, I think I actually would be risking my license a little bit. 00:10:35.200 --> 00:10:47.840 And the university prepared nurse is is dying to throw in some references, and I'm going, okay, maybe there's one or two within the last five to ten years, and that'll be enough, kind of thing. 00:10:48.559 --> 00:10:54.080 There were like 800 studies on specifically intuition in nursing. 00:10:54.320 --> 00:10:58.960 Wow, it was unbelievable the amount of science. 00:10:59.039 --> 00:11:02.159 And I'm sitting there going, like, you're joking. 00:11:02.320 --> 00:11:15.440 I'm reading study after study and and going, like, okay, the the science is here, and we've all been taught if the science is there, it doesn't matter how you feel about it, you teach it because the science is backing it. 00:11:15.600 --> 00:11:23.120 And I'm like, okay, well, guess if somebody's gonna be the one to kind of you know say something, it might as well be me. 00:11:23.360 --> 00:11:27.039 And so I wrote the book on intuition and nursing. 00:11:27.360 --> 00:11:28.240 Oh my gosh. 00:11:28.399 --> 00:11:31.679 Just a little quick little round of applause for you because that's amazing. 00:11:31.840 --> 00:11:38.080 Wait, there's so

many things in your story though that I need to touch upon before we jump into intuition, which I cannot wait to talk about. 00:11:38.240 --> 00:11:38.559 Okay. 00:11:39.440 --> 00:11:43.360 First, backing up to the initial five years of bullying. 00:11:43.440 --> 00:11:48.720 Like I'm so hung up on that because now this is like you were a new grad, right? 00:11:48.960 --> 00:11:53.279 Also, what I want to point out too is that you said, okay, you had those five years of being bullied. 00:11:53.600 --> 00:11:58.159 You also then sort of lived lived next to your mother-in-law who like maybe it was too close. 00:11:58.320 --> 00:11:59.360 You needed to set boundaries. 00:11:59.600 --> 00:12:06.960 Sounded like you set boundaries, and then you literally like went to a place you loved and moved and were happier. 00:12:07.039 --> 00:12:12.639 And I love that because I think it's so scary to set boundaries, especially with the people we love the most, right? 00:12:12.720 --> 00:12:16.080 Our family, like, hey, we're like a little too close to you. 00:12:16.240 --> 00:12:16.879 You know what I mean? 00:12:16.960 --> 00:12:19.200 Like it's like cool. 00:12:19.440 --> 00:12:20.960 Yeah, that's really hard to do. 00:12:21.039 --> 00:12:25.360 But I just want to highlight here for anyone that's like knows they need to set a boundary, but they're not. 00:12:25.679 --> 00:12:36.320 If you just it's hard, that uncomfortable thing, you may literally be like Jen and end up in a place that you love to work, end up with a great relationship with your whoever it is that you need to set that boundary with. 00:12:36.480 --> 00:12:42.000 And it will just propel you forward in the right direction, even if initially it sets you back a little bit, right? 00:12:42.159 --> 00:12:44.720 It's hard having it's so hard. 00:12:45.039 --> 00:12:47.039 And sometimes they're not reciprocated. 00:12:48.320 --> 00:12:51.279 Or they take a minute to understand why they might feel hurt. 00:12:51.519 --> 00:12:54.799 We go through all the conflict resolution and whatnot, right? 00:12:54.879 --> 00:12:56.240 All of the conversations. 00:12:56.720 --> 00:13:03.360 It's a whole thing where it's like, you know, hey, put a helmet on the kid when they're on the ATV or their bikes. 00:13:03.519 --> 00:13:05.279 And she's going, Well, what do you mean? 00:13:05.360 --> 00:13:06.639 Like, I would never hurt the children. 00:13:06.720 --> 00:13:08.639 And I'm like, I'm an ER nurse. 00:13:08.720 --> 00:13:10.639 Your son used to be a paramedic. 00:13:11.200 --> 00:13:14.559 Real medical help is two hours away from here. 00:13:14.799 --> 00:13:24.080 Real medical help, like the hospital that I work with, you know, there's no vent, there's no RT, there's no CT, there's no MRI, there's there's no PEDs really. 00:13:24.879 --> 00:13:28.720 Real medical, true medical help is two hours away. 00:13:28.960 --> 00:13:32.240 But wait, tell me about those five years of bullying. 00:13:32.320 --> 00:13:33.279 Like, what did that look like? 00:13:33.440 --> 00:13:34.480 Was it undermining? 00:13:34.639 --> 00:13:35.440 Was it legit? 00:13:35.519 --> 00:13:37.919 Like, I don't know, did they come after you? 00:13:38.080 --> 00:13:40.879 Was it a nurses eat nurses kind of a situation? 00:13:41.519 --> 00:13:42.480 Of course it was. 00:13:42.720 --> 00:13:47.840 Of course it was, because they warn you in school, hey, just so you know, nurses eat their young. 00:13:48.000 --> 00:13:51.519 And at the time you're kind of going, like, okay, this is a standard practice. 00:13:51.679 --> 00:13:52.799 I need to be aware of it. 00:13:52.960 --> 00:13:56.320 They don't say though whether it's acceptable or not acceptable. 00:13:56.480 --> 00:13:56.799 Totally. 00:13:56.960 --> 00:14:02.159 They just say, hey, this is what's gonna happen, or this is more likely what's going to happen. 00:14:02.320 --> 00:14:02.879 So great. 00:14:02.960 --> 00:14:04.000 I kind of saw it coming. 00:14:04.080 --> 00:14:20.480 I saw it for what it was, very much undermining, very much giving me heavy assignments, even though we have a union up here that regulates you can't go from a night shift within 24 hours to a day shift because she was the like mid-manager, nobody could really figure out what she did in a day. 00:14:20.639 --> 00:14:25.360 She was like 65, she did, you know, did whatever she wanted. 00:14:25.519 --> 00:14:28.240 And you know, the one day we had like sat down. 00:14:28.320 --> 00:14:42.000 And I think so, in a town of like less than 5,000 people over the span of 20, 25 years, she had pushed out like 15 RNs in a town that small out of the hospital system, which the hospital system was dying. 00:14:42.240 --> 00:14:45.039 So everybody knew that this was what happened. 00:14:45.200 --> 00:14:52.879 It was very well known, you know, especially with the hospital and a town that small, and everybody knows everybody's deal, everybody's business. 00:14:53.039 --> 00:14:58.720 You really can't afford to push people out when you have a very small school of people around that are could be your applicants, right? 00:14:58.799 --> 00:15:00.639 Like you you really can't percent. 00:15:01.039 --> 00:15:14.000 There were only eight full-time lines, there were five or six part-time lines, there were maybe five or six other full-time nursing jobs within the town. 00:15:14.559 --> 00:15:16.399 Virtual nursing was not a thing. 00:15:16.559 --> 00:15:20.399 There wasn't a lot of Zoom communications or anything like that. 00:15:20.480 --> 00:15:27.440 Like there, it was really just bedside and public health, and and maybe an awk health job here and there, but like that was it. 00:15:27.600 --> 00:15:30.960 And you know, working at Hydro and being the awk health nurse at Hydro. 00:15:31.440 --> 00:15:33.279 So it's like, what? 00:15:34.320 --> 00:15:50.720 And again, like she comes in, she's scheduling me all these double backs where I'm like nights today, nights today,

nights today, nights today, you know, every single scheduling me every single weekend because I'm part-time and doing whatever she wants, even though we've got a union, nothing was ever done. 00:15:50.799 --> 00:15:55.919 And so it got to the point where the day where I got to quit, so it had been five years. 00:15:56.080 --> 00:16:00.240 I had already gotten a job, southern Ontario from Northern Ontario. 00:16:00.639 --> 00:16:09.200 And we've been waiting three months because we needed two full-time incomes to be able to move from north to south because the you know it's so costly down here. 00:16:09.679 --> 00:16:13.679 And so my husband calls me, he goes, Hey, I got that job. 00:16:13.919 --> 00:16:15.759 And I said, We can move. 00:16:16.000 --> 00:16:16.960 He goes, Yes, we can move. 00:16:17.039 --> 00:16:17.840 I'm like, oh my God. 00:16:17.919 --> 00:16:27.919 I remember, and again, phone on the wall, like crumpling down onto the floor in the kitchen with the long cord, and just like, oh my god, I get to quit. 00:16:28.080 --> 00:16:30.559 And then like, ha, I get to quit. 00:16:30.799 --> 00:16:31.840 So went. 00:16:34.480 --> 00:16:52.879 So went up, got the exact same outfit that I interviewed in, exact same heels, exact same like little, you know, white dressy, you know, suitsy thing, walked in, and thank God it wasn't like winter time because I would have froze, but like go in there and go see the chief nursing officer. 00:16:52.960 --> 00:16:55.519 And he's been, you know, a tool to me this whole time. 00:16:55.600 --> 00:16:57.440 And I'm like, do not be unprofessional. 00:16:57.600 --> 00:16:59.360 You're still you're not burning a bridge. 00:16:59.600 --> 00:17:01.679 You getting out is you winning. 00:17:01.919 --> 00:17:04.160 So just cut it off as it is. 00:17:04.240 --> 00:17:04.880 And you know what? 00:17:04.960 --> 00:17:07.200 You know, oh, thank you so much for this opportunity. 00:17:07.359 --> 00:17:08.720 I've learned a lot. 00:17:08.960 --> 00:17:12.240 I'm continuing in emergency medicine, and this is where I've gotten my start. 00:17:12.319 --> 00:17:20.160 And I wouldn't have known about that unless I'd come here and trying to find the positive, like buried in all the negative. 00:17:20.319 --> 00:17:24.960 And then a little, I walked myself up to the floor and I'm like, where is she? 00:17:25.119 --> 00:17:26.960 Because she's working Monday or Friday. 00:17:27.680 --> 00:17:28.319 Seven to three. 00:17:28.400 --> 00:17:29.440 I'm like, where is she? 00:17:29.599 --> 00:17:32.319 And so, and everybody's looking at me because I'm dressed up. 00:17:32.400 --> 00:17:33.359 They're like, What's happening? 00:17:33.440 --> 00:17:36.400 I'm like, the tables have turned. 00:17:36.880 --> 00:17:38.000 The tables have turned. 00:17:38.079 --> 00:17:39.119 I'm so free. 00:17:39.359 --> 00:17:47.039 And you know, not that I'm still bitter 18 years, 18 years in, recounting this tale. 00:17:47.200 --> 00:17:49.599 And so I'm

like looking around and was like, Oh, where is she? 00:17:49.680 --> 00:17:50.720 I'm like, where is she? 00:17:50.799 --> 00:17:51.599 Let's go. 00:17:51.839 --> 00:17:53.039 And she comes around the corner. 00:17:53.200 --> 00:17:55.759 I'm like, oh hey, I got something to tell you. 00:17:55.839 --> 00:17:57.039 She's like, You quit. 00:17:57.200 --> 00:17:58.240 I know already, bye. 00:17:58.480 --> 00:18:00.640 And like she's got an Irish accent and off she goes. 00:18:00.720 --> 00:18:04.640 I'm like, I'm like, da-da-da, gonna walk myself. 00:18:04.960 --> 00:18:12.400 And her last act, I gave a month's worth of notice just to be again super appropriate, super professional. 00:18:12.720 --> 00:18:18.480 Because again, it it's gonna take them a long time to fill this spot because she's always known all the other nurses. 00:18:18.799 --> 00:18:27.759 So I do my two weeks and then I go in for the last two weeks, and as a last act, she has wiped out all of my shifts for the last two weeks. 00:18:27.920 --> 00:18:28.960 I'm like, you know what? 00:18:29.279 --> 00:18:30.799 You think that's gonna bug me? 00:18:31.680 --> 00:18:32.240 Done. 00:18:32.640 --> 00:18:35.039 Yeah, thank you so much for my time back now. 00:18:35.359 --> 00:18:35.759 See you. 00:18:36.079 --> 00:18:39.519 Got no goodbye party, got no goodbye gifts. 00:18:39.599 --> 00:18:41.200 It was five years that I was there. 00:18:41.279 --> 00:18:43.839 Wow, got nobody sent a card. 00:18:44.000 --> 00:18:47.039 No, I'm like, I see it for what it is. 00:18:47.200 --> 00:18:47.759 That's okay. 00:18:47.839 --> 00:18:49.279 It was a learning experience, awful. 00:18:49.759 --> 00:18:52.559 Totally, totally bigger, brighter things. 00:18:52.799 --> 00:18:56.240 The toxic work culture totally exists in healthcare. 00:18:56.319 --> 00:19:04.880 And it is amazing when you go from one toxic, even if it's a you one unit in the hospital and you go to another unit that's not toxic, it's like night and day. 00:19:05.200 --> 00:19:09.680 And really the people you work with can make or break just if you love the job or not. 00:19:09.839 --> 00:19:18.240 Like it could be your specialty that you want, but if the people around you are terrible humans, you're gonna you're gonna probably hate your job, right? 00:19:18.319 --> 00:19:25.119 Like and and if you find a sweet spot line, I mean, I could be doing any sort of nursing. 00:19:25.279 --> 00:19:27.839 Does emergency nursing really work for me? 00:19:28.000 --> 00:19:28.240 Yes. 00:19:28.319 --> 00:19:34.400 The quick turnarounds, the in and out, the problem solving, the solving a puzzle, you know, the adrenaline. 00:19:34.480 --> 00:19:36.240 Yes, it fits me to a T. 00:19:36.559 --> 00:19:42.319 However, if you were to stick me on med surge with my line that I've got currently, happy as a clam. 00:19:42.559 --> 00:19:44.400 Be like, yeah, right. 00:19:44.799 --> 00:19:45.119 Doesn't matter. 00:19:46.079 --> 00:19:47.279 I so agree with that. 00:19:47.359 --> 00:19:48.799 Oh my gosh, it totally resonates. 00:19:48.880 --> 00:19:54.799 And I think sometimes we get things a little backwards, like we're we're chasing the specialty, or I guess you call in Canada the line. 00:19:54.880 --> 00:19:55.519 Is that what you call it? 00:19:55.599 --> 00:19:58.480 Like a so a line is just like your line mates. 00:19:58.559 --> 00:20:06.720 So, you know, we have you know, two days, two nights, five off, or you're on a continental, but if you're full-time, you're typically on the same line. 00:20:06.960 --> 00:20:08.720 So you end up with the same people. 00:20:08.960 --> 00:20:16.720 There'll be a little bit of part-time people kind of flitting in and out, but for the majority, you're kind of stuck with those linemates because they don't shuffle them up. 00:20:16.880 --> 00:20:23.039 Thankfully, our boss is actually pretty awesome, and she tries to flip the lines every year or so, which is so nice. 00:20:23.200 --> 00:20:25.759 Cause then you're like, Oh, my body, I haven't seen my body in a year. 00:20:26.000 --> 00:20:27.519 Like, yes, now we're on the same line. 00:20:27.759 --> 00:20:28.160 Perfect. 00:20:28.319 --> 00:20:33.680 But yeah, specialties, ER, PACU, oncology, all the things. 00:20:34.000 --> 00:20:36.240 And even the whole nurses eat their young, you're right. 00:20:36.319 --> 00:20:41.920 It's sort of like, hey, buckle up, this happens when really why are we shining a light on it and making it okay? 00:20:42.160 --> 00:20:51.279 And I will say, I'm sure almost any nursing student you talk to nowadays, they feel it just from being a student, you know, and and I see it as a clinical instructor. 00:20:51.440 --> 00:20:53.759 I walk in there and the staff aren't happy to see me either. 00:20:53.920 --> 00:20:59.200 They don't they think, you know, and I'm not I try to be helpful, but at the same time, it's like I get it. 00:20:59.279 --> 00:21:00.720 I'm not one of you guys. 00:21:00.880 --> 00:21:02.640 I can't do everything that you are doing. 00:21:02.720 --> 00:21:05.759 I don't even work at the hospitals that I bring students into. 00:21:06.079 --> 00:21:11.119 So yeah, yeah, it there is definitely something there, and I hate it. 00:21:11.200 --> 00:21:11.839 I really hate it. 00:21:12.000 --> 00:21:15.039 I wish we were more of a supportive workforce. 00:21:15.119 --> 00:21:18.960 And I I think I want to think we're getting there, but I don't know. 00:21:19.759 --> 00:21:25.039 The new generations are not putting up with it at all, which I am so for. 00:21:25.279 --> 00:21:25.519 Yeah. 00:21:25.759 --> 00:21:31.519 A buddy of mine was complaining, we've got this newer grad who's now doing our haze chairs. 00:21:31.599 --> 00:21:41.759 So kind of like middle acuity is gonna need an RN scope and are just a little bit too sick for like the quick in and out RAS, but they usually will take. 00:21:41.839 --> 00:21:46.880 So the nurse that we had for the last like year, she would take

eight to eleven patients. 00:21:47.039 --> 00:21:48.000 She was phenomenal. 00:21:48.160 --> 00:21:50.400 She killed herself, like she she rocked it. 00:21:50.480 --> 00:21:51.920 She was an absolute rock star. 00:21:52.160 --> 00:21:53.839 And so now we've got this newer nurse. 00:21:53.920 --> 00:21:55.759 She caps herself at five. 00:21:56.079 --> 00:21:59.680 And she's not upset about that's she's not upset about and 00:22:00.160 --> 00:22:04.559 And so my buddies kind of texting me and he's she's like, you know, like I can't believe she's only take taking five. 00:22:04.640 --> 00:22:07.920 I'm like, hold on now, turn the script around. 00:22:08.240 --> 00:22:10.079 She knows to cap herself. 00:22:10.480 --> 00:22:15.039 And we're mad because she actually's doing it and she's actually doing it. 00:22:15.279 --> 00:22:20.319 The thing that we all want to do, we all want to cap, we all want to run like crazy. 00:22:20.480 --> 00:22:26.640 And yet we're getting mad at her for actually, again, setting the boundary and like saying, no, no, no, five is max. 00:22:26.720 --> 00:22:28.960 And once one goes, I can get another one in. 00:22:29.119 --> 00:22:35.119 If one all of a sudden they're being admitted, we can move them to a different area or like a chair freeze up. 00:22:35.359 --> 00:22:39.759 Absolutely, I will happily take another person, but no, I'm gonna cap five. 00:22:40.000 --> 00:22:42.240 Whereas the rest of us are running around like maniacs. 00:22:42.319 --> 00:22:45.039 I'm like, Yeah, and then burnt out and not wrong, guys. 00:22:45.200 --> 00:22:46.480 Like she's not wrong. 00:22:46.799 --> 00:22:47.440 I agree with you. 00:22:47.519 --> 00:22:52.640 I know Gen Z, there is a lot of evidence that shows that they are so driven by work life balance. 00:22:52.720 --> 00:23:04.319 And they aren't driven really by money, like the rest of us have been, you know, where they're like, no, I want a job that fits my life, that supports me, not living a life that supports my job, right? 00:23:04.400 --> 00:23:05.359 Or only working. 00:23:05.519 --> 00:23:07.759 And I think we can all learn from that. 00:23:07.839 --> 00:23:09.119 And I hope we can embrace that. 00:23:09.200 --> 00:23:14.799 And I love that you sort of stuck up for that new nurse because hello, she's like doing the Lord's work. 00:23:14.880 --> 00:23:16.480 We need to get on board with this. 00:23:16.640 --> 00:23:18.799 She's setting boundaries and eMERGE. 00:23:18.960 --> 00:23:20.079 Who would have thought? 00:23:20.480 --> 00:23:21.440 I love that. 00:23:21.680 --> 00:23:22.000 Okay. 00:23:22.160 --> 00:23:24.319 I want to obviously talk all things intuition. 00:23:24.400 --> 00:23:32.480 And just for reference for those listening, Jen's book is called Nursing Intuition: How to Trust Your Gut, Save Your Sanity, and Survive Your Career. 00:23:32.640 --> 00:23:33.839 And it's on Amazon, right? 00:23:34.319 --> 00:23:35.680 Burns and Noble Indigo. 00:23:36.240 --> 00:23:37.759 Oh, it's a Burns and Noble? 00:23:38.000 --> 00:23:38.559 Oh, yeah. 00:23:40.079 --> 00:23:44.640 I love nursing intuition because it's something we hear about, like you said, we talk about all the time. 00:23:44.880 --> 00:23:47.200 Yet it's kind of hard to define. 00:23:47.519 --> 00:23:53.680 So I don't know, maybe for newer nurses or people that are like, I don't know really what nursing intuition is. 00:23:53.920 --> 00:24:00.799 Can you sort of give us a definition or just explain to us a little bit about what nursing intuition is when we're talking about it? 00:24:01.119 --> 00:24:02.000 Absolutely. 00:24:02.240 --> 00:24:05.039 So again, nursing's predominantly female. 00:24:05.359 --> 00:24:11.359 We as females trust our guts implicitly and have been since at least age 12. 00:24:11.680 --> 00:24:14.799 You see a guy at the bar, immediate no. 00:24:15.119 --> 00:24:18.960 Have never talked to him, don't know who he is, just looking at him. 00:24:19.119 --> 00:24:22.480 The again, the Gen Z, the vibe is wrong, the vibe is off. 00:24:22.799 --> 00:24:25.440 There's something there, hard no. 00:24:25.759 --> 00:24:30.160 And you get that intuition, you get that idea, and you're like, nope, cut off. 00:24:30.480 --> 00:24:34.559 I don't, I've never talked to him, could care less, but there's just something there. 00:24:34.720 --> 00:24:35.839 And we trust it. 00:24:36.079 --> 00:24:39.519 There's somebody walking behind us, you're like, oh, my hair's on the back, your neck go up. 00:24:39.599 --> 00:24:41.680 You're like, I'm gonna cross the road. 00:24:42.000 --> 00:24:45.759 This is all in relation to your survival. 00:24:46.000 --> 00:24:49.599 So self-survival, we're always in self-survival mode as females. 00:24:49.759 --> 00:25:06.400 Again, I can't speak to the males, but as a female, you're constantly watching your peripherals, you're always on guard, especially critical care scenarios where people kind of get extra violent, get really good at sussing people out, and being like, you're gonna be a problem later. 00:25:06.640 --> 00:25:17.599 If I don't put a lid on this now, you are gonna spin and you're gonna get angry and you may get violent, or something's gonna blow up in my face, I'm gonna chart my behind off. 00:25:17.759 --> 00:25:27.920 And just make sure that if this is right in court, we have a whole lot of notes as to what precipitated because you know that something's coming down the pipe, so you can feel it. 00:25:28.400 --> 00:25:32.079 So to take that into nursing, it's another skill. 00:25:32.240 --> 00:25:34.319 It takes time, it takes effort. 00:25:34.559 --> 00:25:39.119 The way that I kind of figured out I was even doing this, I was playing a game at triage. 00:25:39.440 --> 00:25:47.680 I thought, you know, I'm 12 hours at triage, I've gone from seeing one to five patients in 12 hours to 120. 00:25:48.160 --> 00:25:53.920 And being that sorting system, you've got five minutes, that's all you've got at

triage, and on to the next. 00:25:54.400 --> 00:25:59.920 So, you know, you you kind of see people sitting there, and in order to keep myself engaged, it was like, okay, let me see. 00:26:00.079 --> 00:26:01.279 Do I think they're sick? 00:26:01.599 --> 00:26:05.119 Just by looking at them without talking to them, maybe, maybe not. 00:26:05.200 --> 00:26:05.759 I don't know. 00:26:05.920 --> 00:26:10.400 Um, then they come in, you get more of the story, you're like, oh, bells are going off. 00:26:10.559 --> 00:26:15.920 I'm starting to ask questions that maybe I don't typically ask, and they're out of my mouth before I realize. 00:26:16.160 --> 00:26:18.960 And in a merge, thankfully, most people answer the questions. 00:26:19.039 --> 00:26:24.640 They may or may not be truthful or to the full extent of the truth, but people answer the questions. 00:26:24.720 --> 00:26:27.680 So you're like, hey, how long is this one going on for? 00:26:27.839 --> 00:26:30.000 And all of a sudden you're going down a different path. 00:26:30.160 --> 00:26:31.680 And an idea pops into your head. 00:26:31.839 --> 00:26:35.519 Oh, I need to make sure that it's chest pain, but it's also into their back. 00:26:35.680 --> 00:26:38.000 It's maybe a little bit like tight. 00:26:38.240 --> 00:26:40.160 I need to make sure it's not triple A. 00:26:40.400 --> 00:26:42.000 I need to make sure, you know, what about the rip? 00:26:42.240 --> 00:26:43.920 Do you have any ripping or tearing sensations? 00:26:44.079 --> 00:26:47.200 Do you have any like unilateral BP differences? 00:26:47.359 --> 00:26:50.000 And then you again thought I was just good at my job. 00:26:50.160 --> 00:26:53.920 So then you play in the game and you're kind of getting, okay, this one's really sick. 00:26:54.000 --> 00:26:57.440 Well, I want to kind of follow their progress through the ER and what happens at the end. 00:26:57.519 --> 00:27:04.400 And so, oh yeah, you were bang on that person decided to punt out at in, you know, six hours in, and you're like, okay, perfect. 00:27:04.480 --> 00:27:05.920 I made the right call on that one. 00:27:06.079 --> 00:27:08.319 Well, now let's make it one step further. 00:27:08.559 --> 00:27:10.400 Maybe let's guess what they're coming in with. 00:27:10.559 --> 00:27:11.839 Okay, oh, is it abdominal? 00:27:11.920 --> 00:27:12.480 Is it chest? 00:27:12.559 --> 00:27:13.200 Is it back? 00:27:13.359 --> 00:27:14.480 Is it head? 00:27:14.799 --> 00:27:15.920 Just guessing. 00:27:16.079 --> 00:27:17.839 Okay, somebody's clutching your their chest. 00:27:18.000 --> 00:27:18.559 That's a problem. 00:27:18.720 --> 00:27:21.359 You come on in here, and we're gonna get that sorted out. 00:27:21.519 --> 00:27:22.880 Pretty self-explanatory. 00:27:23.119 --> 00:27:26.799 But somebody holding their abdomen, you're like, I wonder, is it constipation? 00:27:26.960 --> 00:27:29.359 Is it, you know, appendicitis? 00:27:29.440 --> 00:27:30.559 Is it dimeticulus? 00:27:30.720 --> 00:27:37.200 Like, and again, just goofing off, just trying to keep myself engaged for that full 12 hours. 00:27:37.680 --> 00:27:42.799 And the more often I would guess, the more often I was right. 00:27:42.960 --> 00:27:47.759 And then that validated me to be like, oh, I really did recognize that that person was sick. 00:27:48.000 --> 00:27:51.920 And I called it, and sure enough, yeah, they proved to be sick later. 00:27:52.160 --> 00:27:54.400 So that validation was like super helpful. 00:27:54.559 --> 00:28:04.400 And then when it came time when I wasn't at triage and I had my five to whatever patients that emerge, and you go, oh, this person's colors off. 00:28:04.799 --> 00:28:09.680 As in, like, they're kind of gray, they're kind of getting a little green, a little yellow. 00:28:09.839 --> 00:28:11.759 Okay, something's something's changing. 00:28:11.839 --> 00:28:12.640 Now they're sweating. 00:28:12.720 --> 00:28:13.599 You're like, uh oh. 00:28:14.079 --> 00:28:16.240 You know, the vitals may be fine. 00:28:16.720 --> 00:28:19.599 Sure, in that moment, they will be fine. 00:28:19.839 --> 00:28:24.240 They may not be fine 10, 15, 30 minutes an hour, you know, an hour from now. 00:28:25.359 --> 00:28:30.799 So, you know, then being able to go to my docs and be like, hey, I've got Mrs. 00:28:30.960 --> 00:28:32.640 So-and-so in bed three. 00:28:32.799 --> 00:28:44.079 All of a sudden, like she really was fine before, but now, you know, her, you know, vitals again are okay, but now there's been a change, there's been a change in meditation, there's been a change in how she's breathing. 00:28:44.240 --> 00:28:46.000 All of a sudden her sats are dipping. 00:28:46.160 --> 00:28:52.000 You know, I feel like we're missing something, or I feel like we're something's coming down the pipe, something's brewing. 00:28:52.240 --> 00:28:54.640 Can you just come and see this patient again? 00:28:55.200 --> 00:29:00.319 Good doc will stop everything and be like, yes, and go and see your patient. 00:29:00.400 --> 00:29:04.000 And this is the again, the benefit of remerge having physicians 24-7. 00:29:04.880 --> 00:29:11.039 But am I going to my physician being like, oh my God, my intuition is saying um that you need to come and see? 00:29:11.680 --> 00:29:13.200 No, absolutely not. 00:29:13.359 --> 00:29:14.880 The people at work still make fun of me. 00:29:14.960 --> 00:29:16.079 They're like, Is it your intuition? 00:29:16.160 --> 00:29:17.119 I'm like, shut it. 00:29:19.680 --> 00:29:21.119 They laugh, but it works. 00:29:21.359 --> 00:29:31.039 But if you say to your physician, or if you don't, if you're not quite comfortable going to a physician, you want to kind of run it by your charge nurse or another coworker, you're like, I just want to run this by you. 00:29:31.119 --> 00:29:31.920 You know, it's 3 a.m. 00:29:32.160 --> 00:29:33.039 I'm having a brain for it. 00:29:33.119 --> 00:29:34.960 I just want to see what you think. 00:29:35.279 -->

00:29:37.839 And maybe they get the same vibe, maybe not. 00:29:38.079 --> 00:29:42.240 But if you push for it and go talk to your physician, worse comes to worse. 00:29:42.319 --> 00:29:45.119 You say that you're advocating for your patient. 00:29:45.680 --> 00:29:46.319 Use that word. 00:29:46.480 --> 00:29:59.200 That word stops people because they know that if I'm then gonna chart, MD notified, advocated for patient, MD aware, no new orders received. 00:29:59.519 --> 00:30:00.880 They know how that looks. 00:30:01.039 --> 00:30:04.960 They know that I'm real mad if your name is actually spoke with Dr. 00:30:05.039 --> 00:30:09.359 Fernandez and like no new orders received. 00:30:09.519 --> 00:30:12.000 You know, they they know that I'm mad at that point. 00:30:12.079 --> 00:30:13.359 And I'm like, that's fine. 00:30:13.519 --> 00:30:15.039 I've done my due diligence. 00:30:15.119 --> 00:30:21.519 I will continue to be on top of this patient and do vitals more often than not, and and really keep an eye on them. 00:30:21.839 --> 00:30:26.480 But trust me, six hours from now, it's not gonna be good. 00:30:26.640 --> 00:30:28.319 And then we're gonna be playing catch up. 00:30:28.559 --> 00:30:33.359 When I told you six hours prior, look it, something's changed. 00:30:33.599 --> 00:30:35.839 I love a few things that you said about intuition. 00:30:36.160 --> 00:30:42.319 First, I want to verify with you that we can pretty confidently say everyone has intuition. 00:30:42.480 --> 00:30:46.640 Of course, we can speak more to the females because that's you know what we are in our experience. 00:30:46.799 --> 00:30:47.519 That's all we know. 00:30:47.759 --> 00:30:47.920 Right. 00:30:48.079 --> 00:30:48.720 It's all we know. 00:30:48.799 --> 00:30:57.279 So whether you're a nurse or not, whatever you do in life, we all have that intuition because that is part of sort of our fiber flight, our survival response. 00:30:57.519 --> 00:30:57.839 Okay. 00:30:58.160 --> 00:31:09.519 And then I love that you actually kind of highlighted that intuition can be used for not just, oh, I have a bad feeling this patient is gonna die or this patient is, you know, gonna decompensate. 00:31:09.759 --> 00:31:12.640 You can also have intuition like, oh, this patient's okay. 00:31:12.799 --> 00:31:13.279 They're fine. 00:31:13.519 --> 00:31:14.960 My intuition is okay. 00:31:15.200 --> 00:31:21.920 Yeah, or this patient, I think we're going to have some type of bad social interaction. 00:31:22.079 --> 00:31:28.480 They are going to get very angry or combative or something, like I'm getting these feeling or these vibes, right? 00:31:28.640 --> 00:31:31.839 That something isn't right from even a social standpoint. 00:31:32.079 --> 00:31:32.480 Absolutely. 00:31:32.640 --> 00:31:55.039 And again, like nobody is more peripherally safety aware than somebody where you know, people are walking through the department at all hours in all different states of coping or not coping, or drug use or alcohol use or or whatever else, you know, these aren't your typical patients that make it up to the floor or the or their family members. 00:31:55.279 --> 00:32:00.160 Sometimes it is the family members that you're just like, oh, this is not gonna go well. 00:32:00.400 --> 00:32:02.640 You know, yeah, I totally agree with that. 00:32:02.799 --> 00:32:09.039 I also love how you share your triage example for testing your intuition. 00:32:09.200 --> 00:32:19.039 So just if people aren't in emergency care, there's uh typically a triage nurse assigned to that role for the shift, and they basically take the intake of the patient. 00:32:19.119 --> 00:32:23.680 They're checking in, they're telling us chief complaint, we're going through all kinds of different questions. 00:32:23.920 --> 00:32:27.920 I know in the states we use ESI levels, emergency severity index. 00:32:28.400 --> 00:32:29.200 We do CTAS. 00:32:29.359 --> 00:32:32.240 It's the same, it's the same system, it's just a different name. 00:32:32.400 --> 00:32:35.039 We got we got real fancy with the Canadian triage acute. 00:32:36.880 --> 00:32:47.119 It's it's funny too because I think back, I know most of my bedside career was in the ERs in the ER for seven years as a bedside nurse and then did some management stuff. 00:32:47.279 --> 00:32:52.240 But oh, I know, don't even go, I don't want to go there. 00:32:52.559 --> 00:32:57.680 But you can tell, like, really, who is intuitive triage nurse and who isn't? 00:32:57.759 --> 00:33:03.119 Because I know there's one nurse, not gonna say names, who would be like, hey, I'm giving you a belly pain. 00:33:03.200 --> 00:33:05.200 They're fine, they're stable, blah, blah, blah. 00:33:05.359 --> 00:33:08.960 And then I would go in there and be like, oh, dude, this woman's circling the drain. 00:33:09.039 --> 00:33:10.640 Like this is she is not good. 00:33:11.200 --> 00:33:11.440 Right. 00:33:11.599 --> 00:33:22.079 And I feel like we can be taught all the ways to do assessment skills and and gathering data and this and that, but we really don't talk about the nursing intuition. 00:33:22.240 --> 00:33:24.160 And I remember I loved triage. 00:33:24.559 --> 00:33:26.160 That is like, to me, it was like such a fun role. 00:33:26.240 --> 00:33:30.960 And again, I think so, like, yeah, ER nursing was definitely my jam. 00:33:31.200 --> 00:33:39.279 But I remember this, I remember this couple walked in the door and they're wearing their winter jackets and they're holding this baby, and all I can see is the baby's arm. 00:33:39.440 --> 00:33:43.599 And I just see the arm like moving like this, and I'm like, is that baby having a seizure? 00:33:43.680 --> 00:33:45.119 And it's like all the way down. 00:33:45.200 --> 00:33:50.160 And the parents are like, do, do, do, do, like walking in, like, they're yeah, like, oh, we just figured we'd stop by. 00:33:50.480 --> 00:33:50.880 They don't know. 00:33:51.200 --> 00:33:51.359 Yes. 00:33:51.519 -->

00:33:52.720 I'm like, they don't know. 00:33:52.880 --> 00:33:53.119 Right. 00:33:53.279 --> 00:33:53.759 They don't know. 00:33:53.920 --> 00:33:58.319 And I immediately, like, I just like kind of watched them walk in, and that arm looked a little funny to me. 00:33:58.400 --> 00:33:59.839 And I was like, something is not right here. 00:34:00.000 --> 00:34:02.559 And I like immediately I grab the baby from them. 00:34:02.640 --> 00:34:05.440 I don't even triage them in the triage room because you know, they're gonna know. 00:34:05.839 --> 00:34:06.720 So you're grab and go. 00:34:06.960 --> 00:34:08.480 Yes, sprinting back. 00:34:08.559 --> 00:34:10.079 And the parents were like, What's going on? 00:34:10.159 --> 00:34:10.800 Where you what's going on? 00:34:10.880 --> 00:34:11.519 You just took my baby. 00:34:11.840 --> 00:34:15.360 They were like confused because they don't have that nursing intuition. 00:34:15.519 --> 00:34:20.800 And I just I feel like I would love to capture data on like, okay, you're the triage nurse. 00:34:20.960 --> 00:34:25.119 How accurate were you on the scale, you know, of your ESI or whatever you use? 00:34:25.360 --> 00:34:29.840 And if you were accurate along, you know, as your patient progressed, you can do you can do a study. 00:34:30.000 --> 00:34:31.440 You can do a study, no problem. 00:34:31.760 --> 00:34:32.000 Right. 00:34:32.079 --> 00:34:39.840 Because I feel like we get to a part, I know in the ER that I worked at, you had to kind of be there for at least a year or two before they made you like a specific triage nurse, and then you had to take a course. 00:34:39.920 --> 00:34:40.960 And that was great. 00:34:41.199 --> 00:34:45.840 But I would just love to know, you know, because maybe that's something the nurse would take that feedback. 00:34:46.000 --> 00:34:50.320 That's something I need to work on, or I need to lean into my intuition, or what are they doing that I'm not doing. 00:34:50.639 --> 00:34:59.039 And also we'd get better care if you have a very intuitive nurse with experience, of course, you know, in triage, the right patients are going to get the right care at the right time. 00:34:59.280 --> 00:35:02.719 So I absolutely love that that was your experience with intuition. 00:35:02.960 --> 00:35:09.920 And I love talking about how if we know something's going on with the patient, how we approach the provider. 00:35:10.159 --> 00:35:18.559 Because I will say, when I was first a nurse, I definitely would have the intuitive feeling, but I'd also be like, I don't know what's happening, but I feel like this patient's not doing well. 00:35:18.719 --> 00:35:24.559 And really, my intuition was helped me more so with those patients that were actively circling the toilet. 00:35:24.719 --> 00:35:28.719 I didn't have as much of the intuition with like, oh, you know, this person's playing me. 00:35:28.880 --> 00:35:34.639 They're just drug seeking or this, like I didn't have that yet, but I just yeah,

that came later. 00:35:34.880 --> 00:35:35.679 That came later. 00:35:35.840 --> 00:35:36.079 Right. 00:35:36.639 --> 00:35:41.280 But I feel like at least initially, I was like, wow, that patient looks terrible. 00:35:41.440 --> 00:35:42.400 I don't know what to do. 00:35:42.559 --> 00:35:52.000 And and I think it was really hard to trust that feeling because I'm like, I have three minutes of experience, and here I am knowing something bad's gonna happen. 00:35:52.239 --> 00:36:01.039 So I guess my question for you is how do we strengthen that feeling and how do we articulate that or how do we escalate? 00:36:01.119 --> 00:36:03.199 If we're like, okay, I know something's wrong with my patient. 00:36:03.360 --> 00:36:04.800 What do you think the steps would be? 00:36:05.119 --> 00:36:06.000 Sorry, I want to add in. 00:36:06.159 --> 00:36:10.480 I love that you have certain verbiage that you feel like works, like advocating, right? 00:36:10.800 --> 00:36:11.519 Advocating. 00:36:12.079 --> 00:36:12.719 Advocating. 00:36:12.960 --> 00:36:16.000 Listen, I'm just covering all my bases. 00:36:16.239 --> 00:36:20.000 I'm just making sure I's are dotted, T's are crossed. 00:36:20.239 --> 00:36:23.360 I'm just making sure that we're not missing anything. 00:36:23.599 --> 00:36:26.320 I'm just not sure we've got the whole story. 00:36:26.559 --> 00:36:26.960 Yes. 00:36:27.119 --> 00:36:34.159 And you're just like, okay, you know, like because in Emerge, if you get 5% of what's going on, great day. 00:36:34.480 --> 00:36:39.039 Because you need to operate on the fact that you are missing 95% of the story. 00:36:39.199 --> 00:36:41.760 You haven't got that patient's whole life story in front of you. 00:36:41.840 --> 00:36:45.199 You haven't got their last six months of medical data in front of you. 00:36:45.440 --> 00:36:47.280 They barely know which medications they take. 00:36:47.440 --> 00:36:49.519 Oh, the little white pill for hypertension. 00:36:50.000 --> 00:36:51.119 Great, which one? 00:36:51.280 --> 00:36:52.400 There's like 16. 00:36:52.719 --> 00:36:54.480 Like, please, you know. 00:36:54.960 --> 00:36:56.719 Oh, I don't know who my family doctor is. 00:36:56.800 --> 00:36:58.239 Oh, I don't know when I saw them last. 00:36:58.320 --> 00:37:00.400 Oh, I don't know when my last menstrual period was. 00:37:00.559 --> 00:37:05.599 I don't know how much I drank or when I drank last, or I don't know how many stairs I fell down. 00:37:05.760 --> 00:37:07.519 That changes everything. 00:37:07.760 --> 00:37:10.800 So you have to operate on like worst case scenario. 00:37:11.039 --> 00:37:18.000 Because again, I would rather be wrong and be safe than be like, oh, a little cavalier and be like, ah, it's nothing. 00:37:18.079 --> 00:37:21.440 And then all of a sudden it's like, oh, oh, that was a bad call. 00:37:21.519 --> 00:37:25.760 And now I'm in, now I'm in court, you know, nine months later trying to defend my actions. 00:37:26.000 --> 00:37:26.159

Yeah. 00:37:26.639 --> 00:37:27.840 Not going to go well. 00:37:28.079 --> 00:37:28.400 Yeah. 00:37:28.800 --> 00:37:47.599 So there's actually a study, granted, it was done in 2008, but they found that so a nurse who's just, you know, kind of starting to trust their intuition, they think that something's wrong, they call the provider, provider comes in, they have one look over the patient, they do not change anything and they go, you know what, things are actually okay. 00:37:48.159 --> 00:37:59.199 Studies say that the patient experience and the patient's like plan of care and trajectory actually improves with no interventions, but just one more physician touch point. 00:37:59.679 --> 00:38:04.159 So you can be wrong and still improve your patient outcome. 00:38:04.400 --> 00:38:05.360 Oh, I love that. 00:38:05.679 --> 00:38:07.039 Do not be afraid to be wrong. 00:38:07.280 --> 00:38:08.239 Involve in wrong. 00:38:08.480 --> 00:38:12.320 And it's a little easier in emergency medicine, which we talked about because the providers are right there. 00:38:12.400 --> 00:38:14.880 You literally can go tap them on the shoulder and say, come over here. 00:38:15.360 --> 00:38:23.679 Where my first year of nursing, I was on a surgical floor, and I remember this one patient, okay, that was she was circling the drain. 00:38:23.920 --> 00:38:30.480 And I, of course, was working nights, and she was assigned to the scariest surgeon known to man. 00:38:30.639 --> 00:38:35.280 And this female surgeon would eat you alive, yet was an incredible surgeon. 00:38:35.360 --> 00:38:35.519 Okay. 00:38:35.599 --> 00:38:38.639 So had the respect for her, scared shitless of her. 00:38:38.719 --> 00:38:39.039 Okay. 00:38:39.280 --> 00:38:40.719 So I knew she was about to be well. 00:38:40.960 --> 00:38:41.760 And I was panicking. 00:38:42.000 --> 00:38:45.360 I remember I went to my peers and I said, This patient is really sick. 00:38:45.440 --> 00:38:47.280 And my peers are kind of like, Well, what do you think's going on? 00:38:47.360 --> 00:38:48.239 And I'm like, Well, I don't know. 00:38:48.400 --> 00:38:57.440 And I'm giving them the data that I could at least, the tangible data, because it's hard to say, my gut's telling me, you know, so I was like, Well, you know, these are the vitals. 00:38:57.519 --> 00:38:58.719 And they're like, Oh, they're not that bad. 00:38:58.800 --> 00:39:01.280 And I'm like, well, but you know, she's really working to breathe. 00:39:01.360 --> 00:39:06.480 She's the, you know, the like, I tried to paint the clinical picture as best I could to support my feeling. 00:39:06.800 --> 00:39:09.920 So I remember they were like, okay, yeah, maybe something's going on. 00:39:10.079 --> 00:39:13.760 But they're like, you know, I wouldn't call that surgeon with just that. 00:39:13.840 --> 00:39:14.719 And I'm like, oh, yeah. 00:39:14.880 --> 00:39:19.280 So then I remember I got the resource nurse, the overnight resource nurse who had critical care background. 00:39:19.360 --> 00:39:20.159 Here I am, a new grad. 00:39:20.320 --> 00:39:21.280 And I'm like, oh, thank you. 00:39:21.440 --> 00:39:23.360 You know, we let her leave the room. 00:39:23.440 --> 00:39:24.719 Yeah, the poor resource nurse. 00:39:24.880 --> 00:39:27.119 She's just like, oh gosh, Caroline's on tonight. 00:39:27.760 --> 00:39:30.320 So she comes in and she's like, oh my gosh, this patient is so sick. 00:39:30.400 --> 00:39:33.199 Even the resource nurse was like, I don't know if we should call that surgeon. 00:39:33.280 --> 00:39:34.239 It's three in the morning. 00:39:34.320 --> 00:39:37.760 And I'm like, yeah, but like the uh she starts blowing the drain. 00:39:38.159 --> 00:39:41.360 Finally, it becomes, I'm in that room all night long. 00:39:41.519 --> 00:39:43.280 Finally, it is change of shift. 00:39:43.360 --> 00:39:44.480 Well, a little bit before that. 00:39:44.559 --> 00:39:46.400 The surgeon comes in and rounds at like 6 a.m. 00:39:46.559 --> 00:39:47.280 And she comes in. 00:39:47.440 --> 00:39:50.880 She is like ripped shit mad at how sick her patient is. 00:39:51.119 --> 00:39:58.000 And of course, I'm like, well, I should have called her, but everyone scared me and basically was like, I wouldn't call her. 00:39:58.159 --> 00:40:06.480 What I also should have done back now, and I hope if this is a new grad listening or feel like they've been in this position or could find themselves in this position, is why didn't I just call a code? 00:40:06.639 --> 00:40:08.400 Why didn't I call an RRT? 00:40:08.639 --> 00:40:12.079 I think I was so scared of making this a thing that it wasn't. 00:40:12.159 --> 00:40:13.199 Like I was, I don't know. 00:40:13.360 --> 00:40:18.320 I didn't truly trust my intuition enough to call the surgeon and say, hey, your patient is sucking wind right now. 00:40:18.400 --> 00:40:18.960 You need to do something. 00:40:19.119 --> 00:40:19.840 What do you want me to do? 00:40:20.000 --> 00:40:23.199 They should not be on my surgical unit and I have three minutes of experience. 00:40:23.280 --> 00:40:25.280 I shouldn't even be taking care of her, you know? 00:40:25.440 --> 00:40:26.159 But I didn't. 00:40:26.239 --> 00:40:27.119 I was too scared to do that. 00:40:27.199 --> 00:40:32.480 So instead, I got all these other people to confirm that yes, she's sick, but also they were like, I don't know if you should call. 00:40:32.719 --> 00:40:33.440 So I don't know. 00:40:33.679 --> 00:40:40.159 End of that situation, I was I looking back, I'm like, I should have called an RRT or and or I should have called the darn surgeon. 00:40:40.320 --> 00:40:41.360 Like, this is their job. 00:40:41.440 --> 00:40:42.159 This is their patient. 00:40:42.480 --> 00:40:42.719 You know? 00:40:42.800 --> 00:40:43.599 So 100%. 00:40:44.000 --> 00:40:44.159 Yeah. 00:40:44.239 --> 00:40:47.360 And I think as a new grad, it's so hard to trust that feeling. 00:40:47.519 --> 00:41:05.360 But I feel like with what you

were saying about knowing only 5% of the story, I think really starting with asking questions, gathering any other evidence that can support the way you're feeling, so that you can then appropriately advocate for your patient and articulate, like, hey, something is going on, especially when you're when the doctor's not right there. 00:41:05.599 --> 00:41:09.360 Truly, you have carried that now for how long. 00:41:10.559 --> 00:41:11.760 It haunts me. 00:41:12.079 --> 00:41:20.000 So would you rather have been wrong and it haunts you, or God forbid, poor outcome, patient dies? 00:41:20.400 --> 00:41:22.000 You're gonna carry that patient with you. 00:41:22.239 --> 00:41:26.800 We already have enough patients to that we you know mentally carry with us for our careers. 00:41:27.039 --> 00:41:30.480 And again, most of them start out when we're young and we're afraid to call. 00:41:30.719 --> 00:41:35.199 But now that I'm you know 41 and could give a shit. 00:41:35.360 --> 00:41:35.519 Yeah. 00:41:35.760 --> 00:41:36.639 It's like, you know what? 00:41:36.800 --> 00:41:38.079 You want to chew me out? 00:41:38.400 --> 00:41:38.880 Sure. 00:41:39.360 --> 00:41:40.480 I know I'm right. 00:41:40.719 --> 00:41:43.440 And I and even if I'm wrong, fine. 00:41:43.679 --> 00:41:46.079 I'm not carrying this patient on my conscience. 00:41:46.159 --> 00:41:47.599 I'm not doing it anymore. 00:41:47.920 --> 00:41:49.679 You want to talk about work-life balance? 00:41:49.840 --> 00:41:58.559 I would rather be wrong and have them do better without doing without changing a thing and have you be notified, and then it's off me. 00:41:59.039 --> 00:42:15.360 Like I looking back, I would rather remember that this surgeon chewed me out in the middle of the night on the phone, but yet the patient was then transferred to where they should have been, getting the care they should have gotten, than me being too scared to wake up that surgeon in the middle of the night. 00:42:15.760 --> 00:42:16.559 You know, I don't know. 00:42:16.639 --> 00:42:18.880 So I just feel like we need to normalize that too. 00:42:19.039 --> 00:42:24.000 Definitely calling RRTs, even if we even if we're like, ah, there's just something not right, who cares? 00:42:24.239 --> 00:42:29.360 If you've got access to resource teams, holy crap, utilize them. 00:42:29.760 --> 00:42:55.039 I keep, I keep my in my perfect nursing world, there would be one extra critical care nurse to pair up with the primary nurse who called to help them understand what's gone on, reaffirm that yes, you did the right thing, a little bit of education as to the critical scenario, and then help them tee up the rest of their patients who've probably been left to their own devices for anywhere from five minutes to two hours. 00:42:55.280 --> 00:42:56.480 Yeah, that's so true. 00:42:56.719 --> 00:43:00.320 So the people who start out on med surge could be coming down to critical care. 00:43:00.400 --> 00:43:04.400 So why not utilize

this moment because that you give them knowledge? 00:43:04.559 --> 00:43:04.960 Guess what? 00:43:05.039 --> 00:43:05.679 At 3 a.m. 00:43:05.920 --> 00:43:14.000 the next time their buddies going through the exact same thing, the nurse that you've now taught goes, Oh, this is what my patient did three months ago. 00:43:14.239 --> 00:43:19.679 And they said it was this process and that process, but I really benefited from calling the R team. 00:43:19.760 --> 00:43:21.039 So, like, why not? 00:43:21.199 --> 00:43:21.760 Why not? 00:43:22.000 --> 00:43:22.639 Why not? 00:43:22.880 --> 00:43:27.760 Yeah, I think I almost think I didn't even think of it in the moment because I was so green, you know? 00:43:28.480 --> 00:43:31.039 One, you never know, like what's acceptable. 00:43:31.199 --> 00:43:31.760 What can I do? 00:43:31.840 --> 00:43:32.559 What can I can't? 00:43:33.119 --> 00:43:35.360 And I love imposter syndrome too. 00:43:35.440 --> 00:43:37.679 You're kind of like, who am I to call an RT? 00:43:37.760 --> 00:43:40.719 Like, who am I to, you know, and it's like you need to do it. 00:43:41.039 --> 00:43:44.880 Put on, put on those big girl panties and be like, you know what? 00:43:45.119 --> 00:43:46.239 We're doing it. 00:43:46.559 --> 00:43:59.679 Because if you can take your own ego out of the mix and be like, I am doing this for my patient, do you know how much easier all of this gets when you're finally pushed to the point of hold. 00:44:00.079 --> 00:44:04.480 Holy crap, I need help now that your ego has left the building. 00:44:04.559 --> 00:44:06.079 Now it's all about the patient. 00:44:06.239 --> 00:44:06.960 Let's go. 00:44:07.199 --> 00:44:08.000 I'm mad. 00:44:08.239 --> 00:44:10.159 And for me, I get mad. 00:44:10.400 --> 00:44:12.000 And then stuff gets done. 00:44:13.039 --> 00:44:14.960 So like that works. 00:44:15.519 --> 00:44:19.920 But I mean, even calling the doc and be like, Oh my god, I'm so sorry for waking you up. 00:44:20.159 --> 00:44:21.599 I don't even say that anymore. 00:44:23.119 --> 00:44:25.280 This is an expectation of your job. 00:44:25.599 --> 00:44:27.119 Am I sorry that it's 3 a.m.? 00:44:27.360 --> 00:44:28.639 Sure, I'm sorry that it's 3 a.m. 00:44:28.880 --> 00:44:36.800 But I'm not sorry that I'm calling because this is my job to tell you because you are not here, this person's starting to crumple. 00:44:36.960 --> 00:44:38.079 You need to come. 00:44:38.400 --> 00:44:38.639 Yeah. 00:44:38.800 --> 00:44:43.119 And I think with intuition, you have initially that gut feeling. 00:44:43.280 --> 00:44:49.440 And then I think it's like you said, sort of like your ego or your logical side starts being like, well, no, no, no, hold on. 00:44:49.599 --> 00:44:52.719 You know, and then it looks for signs to tell you that everything's okay. 00:44:52.800 --> 00:44:53.920 Because that just is right. 00:44:54.000 --> 00:44:54.880 We want to stay safe. 00:44:54.960 --> 00:44:56.079 We want to stay comfortable. 00:44:56.320 --> 00:44:57.679 So then you get confused. 00:44:57.760 --> 00:45:00.159 You're like, well, a part of me is like, something's not right here. 00:45:00.239 --> 00:45:02.559 And the other part of me is like, you have no evidence of that. 00:45:02.719 --> 00:45:06.239 Or like, or showing you evidence of like things are okay. 00:45:06.559 --> 00:45:12.000 It's like this internal battle that you're like, oh, do I trust this little piece of me that's like something's not right? 00:45:12.239 --> 00:45:16.239 Or do I go with the tangible evidence that shows things are stable? 00:45:16.480 --> 00:45:17.119 It's tough. 00:45:17.440 --> 00:45:18.960 So another fun study. 00:45:19.119 --> 00:45:19.440 Yeah. 00:45:19.679 --> 00:45:31.840 Critical care nurses are more apt to not only utilize their intuition but trust it and then make decisions off of it for the simple fact of they don't have the time to second guess. 00:45:32.800 --> 00:45:33.280 Amen. 00:45:33.440 --> 00:45:35.519 So then we're using it more. 00:45:35.760 --> 00:45:37.440 We get validated more. 00:45:37.599 --> 00:45:40.559 And then we go, oh, that feeling meant that something was off. 00:45:40.719 --> 00:45:42.239 That means that I need to do something. 00:45:42.400 --> 00:45:44.559 Now we understand that feeling. 00:45:44.639 --> 00:45:51.519 Now we understand how that works within our workflow to be like, why am I all of a sudden like I've got this heaviness in my gut? 00:45:51.599 --> 00:45:55.760 And like I just I look at this patient, I'm like, uh, not great. 00:45:56.000 --> 00:45:57.360 I'm not deciding that. 00:45:57.440 --> 00:46:02.239 That's just my body going like not it's things aren't going to go well, not good. 00:46:02.639 --> 00:46:09.199 So can you still monitor for a period of time to see if okay, yes, uh, maybe I'm just being oversensitive. 00:46:09.280 --> 00:46:09.920 I don't know. 00:46:10.079 --> 00:46:12.000 I'm tired, it's three in the morning. 00:46:12.159 --> 00:46:13.360 Let me just keep an eye on it. 00:46:13.440 --> 00:46:14.960 And so keep track of the vitals. 00:46:15.039 --> 00:46:29.199 Do vitals more often, eyeball your patient more often, do an assessment more often because again, the more data you have to back you, the more the physician's gonna listen if they really want to truly go on to the tangent of like just data only. 00:46:29.360 --> 00:46:37.360 So they're now starting to call nursing intuition like nurse worry and using that as an indicator of patient deterioration. 00:46:37.760 --> 00:46:47.920 So again, same feeling, same baseline understanding, but trying to find the verbiage that works best to have us be believed. 00:46:48.159 --> 00:46:48.400 Yeah. 00:46:48.480 --> 00:46:51.039 And it sounds like intuition is just like a muscle. 00:46:51.199 --> 00:46:56.239 The more you exercise it, the more reps you put in, the stronger it gets, the more confident you get. 00:46:56.480 --> 00:47:00.559 And then you can be like, yeah, I am

quite certain this is not gonna go well for this patient. 00:47:00.639 --> 00:47:06.960 And then you can call and advocate so much more effectively just because of your own conviction, you know, of trusting that skill. 00:47:07.280 --> 00:47:14.239 And I think that's why there's sort of this myth that like seasoned nurses have intuition and new grads don't or they haven't developed it yet. 00:47:14.480 --> 00:47:22.800 But that is partly true because you might have it as a new grad, but like my example, I didn't even know how to use it to my advantage. 00:47:22.960 --> 00:47:27.760 I didn't even know how to let it guide me and to go get more evidence and to come up with a story. 00:47:27.920 --> 00:47:31.599 And I think I love that you highlighted you can go in and do more vitals. 00:47:31.679 --> 00:47:37.440 You can go in and assess, even though you work might say, oh, in your 12-hour shift, it's one full head-to-toe assessment. 00:47:37.599 --> 00:47:40.000 You can go in and do 10 of them if you want. 00:47:40.159 --> 00:47:47.280 It doesn't absolutely nobody is going to fault you for doing more vitals and more assessments, not one person. 00:47:47.599 --> 00:47:47.920 No. 00:47:48.239 --> 00:47:51.119 And I think a big thing too that helped me as a new nurse. 00:47:51.199 --> 00:47:55.440 I I just clearly, you know, Jen, I have such a special place in my heart for new grads and new nurses. 00:47:57.280 --> 00:47:57.760 Yeah, right. 00:47:57.840 --> 00:48:02.400 They're just they're a sweet population and they're just trying to get into our profession and spread their wings. 00:48:02.480 --> 00:48:04.880 And I think it's such a huge learning curve. 00:48:04.960 --> 00:48:12.159 But when it comes to intuition, if you feel like something's not right, I know looking back, I a lot of times would tell my like charge nurse. 00:48:12.239 --> 00:48:16.079 It's like I wouldn't go straight to the doctor, but I'd be like, hey, something's not right in that room. 00:48:16.239 --> 00:48:23.119 I would pull them in, you know, because we will, we will definitely usually help each other out, you know, more so than maybe a physician. 00:48:23.440 --> 00:48:32.639 But that would also just help me feel validated, like, oh yeah, you know, this doesn't look good, or let's come back in here in an hour, or let's come up with this other plan. 00:48:32.960 --> 00:48:36.159 I felt better too because I'm like, okay, we're doing something about it. 00:48:36.320 --> 00:48:40.079 I'm not just ignoring a bad feeling and hoping everything works out. 00:48:40.400 --> 00:48:46.559 I now have a colleague that I trust that is experienced that is telling me, yeah, you're right, you're on to something. 00:48:46.719 --> 00:48:47.760 Let's look at these lab values. 00:48:47.840 --> 00:48:49.760 Let's look, you know, and it was like a learning moment. 00:48:49.920 --> 00:48:56.960 So I feel like you're a new grad nurse, you've had a gut feeling, or you're worried you're gonna have one at some point, because you will go use your coworkers. 00:48:57.039 --> 00:48:59.519 Let me tell you, they're like the best people to learn from. 00:48:59.840 --> 00:49:00.159 Yeah. 00:49:00.400 --> 00:49:03.440 Find that one nurse who loves to teach. 00:49:03.599 --> 00:49:10.400 You know, if you're scared of your charge nurse because they're burnt out, they're they're nitpicky, they're awful, it's toxic. 00:49:10.559 --> 00:49:11.519 I get it. 00:49:11.760 --> 00:49:12.880 You can go around. 00:49:13.039 --> 00:49:17.840 And again, being on the other end of the age spectrum, you get real comfortable. 00:49:18.079 --> 00:49:19.119 You want to bitch me out? 00:49:19.440 --> 00:49:20.239 Have adder. 00:49:20.480 --> 00:49:21.840 Like I can care less. 00:49:22.159 --> 00:49:24.960 I'm sorry, again, I'm just advocating for my patient. 00:49:25.039 --> 00:49:25.920 You're the charge nurse. 00:49:26.079 --> 00:49:31.199 I'm telling you that my patient's not doing well because you also need to be aware, right? 00:49:31.280 --> 00:49:31.440 Yeah. 00:49:31.599 --> 00:49:46.239 So if you have a concern about your patient, please bring it to the charge nurse because there's nothing worse than being the charge nurse, thinking that everything's all fine and dandy, and then you know, the resource team comes down, or all of a sudden there's a code blue in the back, and you're like, What was happening? 00:49:46.400 --> 00:49:48.480 Like, what do you mean you didn't reach out to me? 00:49:48.639 --> 00:49:49.519 I could have helped. 00:49:49.679 --> 00:49:51.119 We could have dealt with this sooner. 00:49:51.280 --> 00:49:56.320 And, you know, you want to use it as a learning experience and not shame them or blame them or anything. 00:49:56.400 --> 00:50:07.039 Because again, it's a weird, weird career, and there are so many avenues and tips and tricks, and every floor is different, let alone every hospital. 00:50:07.119 --> 00:50:13.679 And it is really hard, and you just need to be so kind to yourself because it's hard. 00:50:14.400 --> 00:50:15.679 Adulting is hard. 00:50:16.079 --> 00:50:16.639 So true. 00:50:16.800 --> 00:50:17.760 It's so true. 00:50:18.079 --> 00:50:30.400 And a profession that is so heavily influenced by evidence-based practice and data, it is hard to then be like, oh, my gut is telling me, you know, and it's like, well, people are specific about that. 00:50:30.800 --> 00:50:44.800 But what I think I appreciate in your story too, of how you came to write your book, it sounds like you spent a lot of time putting pen to paper, just like it almost, I mean, I don't know if it was like a journaling or just more of a creative writing flow. 00:50:45.119 --> 00:50:49.840 And then you looked back and you realized intuition played a key part in all of your stories. 00:50:50.159 --> 00:50:57.440 Do you feel like that would help if there were a situation where maybe you or if you're like, I want to strengthen that intuition muscle of mine?

00:50:58.239 --> 00:51:00.800 I feel like there is a power in reflecting, right? 00:51:00.880 --> 00:51:02.719 And being like, so much. 00:51:03.039 --> 00:51:03.599 So so much. 00:51:03.840 --> 00:51:09.599 I even remember when I was a new grad, I or when I was new to the ER, so I had a year of experience, then I went to the ER. 00:51:09.920 --> 00:51:14.880 My preceptor is so badass, and she looks like she always looks like she's doing nothing, and yet she's doing everything. 00:51:15.039 --> 00:51:15.599 Like, how? 00:51:16.000 --> 00:51:16.239 You know? 00:51:16.400 --> 00:51:20.960 And she would go into my patient's room, you know, we would be assigned together, but she'd let me go in and do everything. 00:51:21.039 --> 00:51:23.119 And then she'd come in and she'd be like, oof, they don't look good. 00:51:23.199 --> 00:51:23.840 And I'm like, what? 00:51:23.920 --> 00:51:24.480 What do you mean? 00:51:24.719 --> 00:51:28.239 And I would be like, I didn't even pick up on that they didn't look good. 00:51:28.400 --> 00:51:33.679 But she was so good about literally like walking into the door, just being like, Hey, I'm Amy, blah, blah, blah. 00:51:33.840 --> 00:51:38.480 And then she would be like, and then she'd come out being like, oof, that guy, he's slick. 00:51:38.639 --> 00:51:39.440 I'm like, he is? 00:51:39.760 --> 00:51:40.960 And I'd be like, what do you mean? 00:51:41.119 --> 00:51:41.760 And then I would run. 00:51:42.239 --> 00:51:48.639 Again, like, if you haven't seen this, it is a ton of experiences that you've never had access to. 00:51:48.719 --> 00:51:48.960 Yes. 00:51:49.119 --> 00:51:51.760 You've never seen somebody who's been highlighter yellow. 00:51:52.000 --> 00:51:58.000 You've never seen somebody who's gone from like pale to gray to green. 00:51:58.239 --> 00:52:00.639 Like you haven't seen that progress yet. 00:52:00.800 --> 00:52:05.360 So you know, at pale, you're like, ugh, I'm already, I'm already kind of keyed up because they're pale. 00:52:05.519 --> 00:52:09.280 So but are they pale because they can't breathe or their sats crap? 00:52:09.599 --> 00:52:11.679 Are they pale because they've got no hemoglobins? 00:52:11.840 --> 00:52:13.280 What is happening and what's the reason? 00:52:13.440 --> 00:52:14.800 And again, guess. 00:52:15.039 --> 00:52:16.159 It's okay to guess. 00:52:16.320 --> 00:52:23.519 You can play a game with yourself to just oh totally like, oh, and again, we're kind of notorious in the eMERGE for playing games, right? 00:52:23.760 --> 00:52:26.079 Because again, just trying to keep yourself into it. 00:52:26.159 --> 00:52:29.519 And so it's like, okay, what do you think that patient's hemoglobin is gonna be? 00:52:29.679 --> 00:52:30.639 Well, it looks like six. 00:52:30.719 --> 00:52:31.119 I don't know. 00:52:31.199 --> 00:52:32.400 Like it just looks awful. 00:52:32.480 --> 00:52:34.159 Like they look like they're see-through. 00:52:34.239 --> 00:52:35.119 I don't understand. 00:52:35.360 --> 00:52:47.760 And so then again, you're just goofing off, and you know that it's not actually gonna be six, but like you're like, oh, like it's something crazy, and then all of a sudden you're like, oh, it was it was six? 00:52:48.800 --> 00:53:12.800 Okay, holy crap, I I was right, and then you get that validation, and then write it down, write it down because honestly, you know, when I think about it in 18 years of year nursing, I can't even guesstimate the number of people that I've touched, I can't guesstimate the number of bodies I've wrapped, I can't even guesstimate the number of like family members that I've cried with over the years. 00:53:12.880 --> 00:53:22.719 Like, I wish I had something to kind of refer back to, and especially on those like awful days where you're like, I'm not learning fast enough, this isn't happening, this maybe this isn't for me. 00:53:22.800 --> 00:53:23.920 I'm screwing this up. 00:53:24.079 --> 00:53:27.920 You can go back into your own experiences and be like, no, no, no, no, no. 00:53:28.079 --> 00:53:30.079 I am learning, I am growing. 00:53:30.239 --> 00:53:37.920 It's just not what I thought it would look like because my expectations were sky high because nursing school said my this is what I was gonna do. 00:53:38.159 --> 00:53:44.000 And unfortunately, nursing school and what happens at the bedside are two very different things. 00:53:44.320 --> 00:53:44.960 Absolutely. 00:53:45.119 --> 00:53:49.199 And I love that you say write it down because I think that also helps with confidence. 00:53:49.360 --> 00:54:07.280 And they say that in general, like you should almost have like this note on your notes app that's like wins, and it's just like things that you've accomplished so that when you're feeling like down on yourself or you're not feeling confident or you're battling imposter syndrome, you open that notes section and you read all the things that you've accomplished and you're like, oh yeah, like I have done things. 00:54:07.519 --> 00:54:26.719 And I think if you can actually start a little log of like things you were like clinically right about, you might then be like, hey, I know more than I think I know, and I'm actually good at what I do, and I now have more confidence to now lean on that intuitive bustle and advocate appropriately. 00:54:26.800 --> 00:54:29.039 And I think that's a really great way to do that. 00:54:29.199 --> 00:54:30.320 And I I never thought of that. 00:54:30.480 --> 00:54:31.599 I think that's wonderful. 00:54:31.920 --> 00:54:33.840 Can I do a shameless plug? 00:54:34.400 --> 00:54:36.880 Please, that's what this is about. 00:54:37.039 --> 00:54:37.519 Oh my gosh. 00:54:37.840 --> 00:54:39.119 We're plugging all our nurses. 00:54:39.679 --> 00:54:40.960 The plug in the nurses. 00:54:41.119 --> 00:54:54.000 So in speaking, after writing the book and speaking, yeah, ran into new graduate nurses in well, actually first semester of first year, and you know,

just three hours of me just gibber jabbering about all my stories. 00:54:54.320 --> 00:54:58.400 And all of their questions were like, Well, how do I manage work-life balance? 00:54:58.480 --> 00:54:59.760 How do I mitigate grief? 00:54:59.920 --> 00:55:02.079 How do I, you know, advocate for my patients? 00:55:02.239 --> 00:55:07.199 All these things that they were like looking that they were already aware of in like moment one of nursing school. 00:55:07.280 --> 00:55:09.679 I'm like, I don't think I've ever asked myself these questions. 00:55:09.840 --> 00:55:12.880 So, like, uh let me let me come up with something. 00:55:13.039 --> 00:55:22.639 So I created a journal that it's shift summaries, so like your top priorities and like skills checks, shift what went well, what didn't go so well. 00:55:22.800 --> 00:55:23.840 Did you drink some water? 00:55:24.000 --> 00:55:25.360 How many steps did you do? 00:55:25.679 --> 00:55:31.760 Med questions for when you get home, and things to look up when you get home because nobody's more keen to learn than a new grad nurse. 00:55:31.920 --> 00:55:35.679 So I've created a study because I'm trying to figure out why all these nurses are leaving. 00:55:35.760 --> 00:55:41.679 So 30 to 60 percent of nurses, new nurses, leave nursing entirely within the first two years, which is insane. 00:55:42.159 --> 00:55:45.920 And trying to get a handle on why everybody is going. 00:55:46.480 --> 00:55:49.840 And so right now I've got a study going on, it's completely free. 00:55:49.920 --> 00:55:50.960 I will send you out a journal. 00:55:51.119 --> 00:56:02.960 If you've got less than two years experience or you're about to graduate, I need participants, I need your data, I need your opinions as to how we who've already been there can help change things. 00:56:03.119 --> 00:56:13.280 And so trying to get hospitals on board with like maybe you know, bringing this in for orientations and stuff like this, because we all love our apps, but like that's one more thing. 00:56:13.440 --> 00:56:15.119 We already shouldn't be on our phones at work. 00:56:15.679 --> 00:56:18.639 This way, quick jot down, run away. 00:56:18.719 --> 00:56:24.960 And then when you get home, you've had time to decompress and cry and you know have a glass of wine. 00:56:25.039 --> 00:56:29.840 And then the next day you're like, okay, what was that medication that I was like thinking about again? 00:56:30.079 --> 00:56:33.599 You can go back, it's no longer a missed learning opportunity. 00:56:33.840 --> 00:56:34.960 Now you have that information. 00:56:35.039 --> 00:56:37.920 Then now this also turns into a reference guide for you. 00:56:38.079 --> 00:56:38.320 Yeah. 00:56:38.480 --> 00:56:46.800 And you can kind of keep track of all of your wins so that when you have that knockdown drag out day, you can go back in and go, I am learning, I am growing. 00:56:47.039 --> 00:56:59.199 Yeah, I think there's a lot of power to putting pen to paper, like literally, not just typing on my phone or whatever, but actually getting out a journal, a paper, whatever, and writing down how you feel. 00:56:59.360 --> 00:57:01.039 There's no one there checking your grammar. 00:57:01.119 --> 00:57:03.440 There's no, you know, you can be so brutally honest. 00:57:03.840 --> 00:57:10.480 And I think it just you at least I know for me, and I haven't gotten into a great journaling practice, but when I am really stressed, I will journal. 00:57:10.559 --> 00:57:11.760 Or there's something I'm not sure about. 00:57:12.000 --> 00:57:14.000 When I need clarity, I will journal. 00:57:14.239 --> 00:57:17.679 And I always end the journal entry feeling lighter. 00:57:17.840 --> 00:57:27.280 Even if it's like a five-minute journaling session, I just feel like I mentally could transfer that energy out of my body and I can, yes, and I can't. 00:57:27.440 --> 00:57:28.719 Or just move on. 00:57:28.960 --> 00:57:38.320 There's actually a nurse acronym for identifying the emotion, what was happening around, and just jot form two seconds to just quickie get it down and walk away. 00:57:38.480 --> 00:57:48.320 Because again, um let me grab my coffee and it's you know midnight, and I've I've gotten into my cozy pajamas and I'm I'm hauled up with my favorite pen and my like great. 00:57:48.480 --> 00:57:49.920 We all would love to do that. 00:57:50.159 --> 00:57:51.360 It is not reality. 00:57:51.679 --> 00:58:13.280 So the more you can just like quick jot and come back to it, to be fair, personally, that was the biggest learning was being able to come back to it and reliving those moments and going like, oh, I didn't realize that I had actually stored away all those details as much as I had until because I was so used to condensing the story into two minutes. 00:58:13.440 --> 00:58:17.920 So going back in and being like, no, the room was actually really cold that day. 00:58:18.000 --> 00:58:18.800 It was 2 a.m. 00:58:19.039 --> 00:58:28.239 I remember some of the nurses who were there, and and I remember what happened when this happened, and walking yourself through it also was like hella healing. 00:58:28.480 --> 00:58:36.079 Cried my eyes out, had to come in and out of multiple stories multiple times because I kind of was like, Oh, yeah, I have a hit of wall, I can't do it anymore. 00:58:36.239 --> 00:58:37.599 And I gotta pull out. 00:58:37.840 --> 00:58:38.719 You can pull out. 00:58:38.800 --> 00:58:41.039 Nobody's saying that you have to do it all in one day. 00:58:41.360 --> 00:58:45.039 Like, there's no, there's again, nobody checking you. 00:58:45.199 --> 00:58:48.000 This is just for your own growth and healing. 00:58:48.079 --> 00:58:55.920 And there's actually so much data surrounding physically writing and getting it out on paper, which is why everyone's like, is this gonna be an app? 00:58:56.000 --> 00:58:57.760 I'm like, I can't with the apps. 00:58:57.920 --> 00:59:02.400 Like, hey, it's like I mean, maybe it's

like$30,000 for the friggin' app. 00:59:02.480 --> 00:59:04.719 I'm like, uh, no, I don't have that kind of money. 00:59:04.960 --> 00:59:06.480 Sorry, not happening. 00:59:06.800 --> 00:59:09.679 And you know, this is available on Amazon and all this kind of stuff. 00:59:09.760 --> 00:59:17.360 But like, if people would love to reach out, like I am always, always looking for more people to bring into the study and like I will have a mail you free stuff. 00:59:17.519 --> 00:59:18.000 Absolutely. 00:59:18.320 --> 00:59:19.280 Yeah, absolutely. 00:59:19.440 --> 00:59:20.559 Okay, I love that so much. 00:59:20.639 --> 00:59:22.480 I feel like this is a good way to segue. 00:59:22.639 --> 00:59:26.000 How can listeners connect with you, learn more about you? 00:59:26.159 --> 00:59:27.440 Where can they find you? 00:59:27.760 --> 00:59:32.480 Yeah, so TikTok and Instagram is at ernurse.genj-en-n. 00:59:33.039 --> 00:59:47.679 My email jenj-e-n at nursegen.ca, and my website's nursegen.ca2n and LinkedIn, honestly, I am like live and well on LinkedIn probably every moment that I possibly can be. 00:59:47.840 --> 00:59:50.960 I think it's Jennifer Johnson B S C N R N. 00:59:51.280 --> 00:59:54.079 And that's only because there's like a million Jennifer Johnsons. 00:59:54.719 --> 01:00:01.280 Should've kept my maiden name, but you know, if you find Nurse Jen, it will take you everywhere or TikTok or Instagram. 01:00:01.440 --> 01:00:03.440 Okay, I have my final question for you, Jen. 01:00:04.000 --> 01:00:10.320 If you could go back to New Grad Nurse Jen, tell yourself and why. 01:00:13.440 --> 01:00:15.840 Oh I know it's a loaded question. 01:00:16.480 --> 01:00:17.760 Such a loaded question. 01:00:18.000 --> 01:00:20.880 She's not worth the tears that you cried. 01:00:22.000 --> 01:00:33.119 She is not worth, you know, now hating a town because of her environment, because of one person. 01:00:33.280 --> 01:00:42.639 However, always trying to look for the silver lining, had she not been so awful, I would not have been as motivated to leave. 01:00:43.440 --> 01:00:46.400 And I wouldn't have met all these wonderful people. 01:00:46.559 --> 01:00:50.639 I probably would have wasted a way in that town, I would have been miserable. 01:00:50.960 --> 01:01:02.400 She, as awful as she was, a, I know that I can live through that now, not without its pitfalls and its medications, and a heavy, heavy dependence on wine. 01:01:02.719 --> 01:01:05.840 But, you know, I was able to live through that. 01:01:06.000 --> 01:01:07.199 I got through it. 01:01:07.440 --> 01:01:11.119 And I then wrote a book because guess who's in the book? 01:01:11.519 --> 01:01:22.639 There's nothing greater than, you know, taking that trauma, repurposing it to, you know, if anybody else can feel better about what they're going through from my pain. 01:01:22.800 --> 01:01:22.880 Yeah. 01:01:23.199 --> 01:01:23.679 Perfect. 01:01:23.840 --> 01:01:30.320 And really, if I ever needed a new therapist, because God bless, you always need at least one on, you need one therapist and then one on backup. 01:01:30.480 --> 01:01:35.519 You just I hand them the book and be like, so this is volume one of why I am the way I am. 01:01:36.000 --> 01:01:38.400 We're gonna save each other a lot of time. 01:01:38.559 --> 01:01:43.679 It's pretty entertaining, it's pretty easy to read, but like you need to know what you're getting into. 01:01:44.159 --> 01:01:44.960 Yeah, here you go. 01:01:45.039 --> 01:01:45.920 Here's some pre-work. 01:01:46.079 --> 01:01:46.559 Here you go. 01:01:46.719 --> 01:01:47.119 Yes. 01:01:47.920 --> 01:01:50.960 Well, Jen, thank you so much for joining me today. 01:01:51.119 --> 01:01:57.280 I truly believe that you've given our listeners permission to trust the most powerful tool, which is actually themselves. 01:01:57.599 --> 01:02:05.920 And thank you for bringing awareness not only to how intuition plays in nursing, but just reminding us that both nursing is science and an art, right? 01:02:06.079 --> 01:02:07.119 Not just one or the other. 01:02:07.360 --> 01:02:12.719 We're honestly so fortunate to have you in our profession and to have your voice help leading our profession. 01:02:12.800 --> 01:02:14.880 So don't make me cry. 01:02:15.119 --> 01:02:17.519 Oh my god, don't do it. 01:02:18.000 --> 01:02:20.159 Hey, no, I will. 01:02:22.000 --> 01:02:25.360 Well, that's it for today's episode of Life After Nursing School. 01:02:25.519 --> 01:02:30.880 I hope you feel more confident and ready to tackle the challenges that come with starting your nursing career. 01:02:31.039 --> 01:02:37.840 Remember, the first year or two might not be easy, but with the right mindset, you can overcome anything. 01:02:38.000 --> 01:02:44.719 If you found value in today's episode, I'd love for you to hit that subscribe button so you never miss a future episode. 01:02:44.960 --> 01:02:48.880 Also, please consider leaving a review on your favorite podcast platform. 01:02:49.039 --> 01:02:52.079 It helps so much in reaching other new nurses like you. 01:02:52.239 --> 01:02:55.519 Thanks for listening, and remember, you've got this. 01:02:55.760 --> 01:02:57.920 Take care and see you next time.