From Primary Care To Psychiatric Nursing Leadership with Dr Elizabeth Hopfenspirger

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We are the comment told the beat of old every beat every breath we commit from night just to take break cover at the top of those on the tone performance to be the flock is best the machines for press it's crazy what has to come for the proof filling in a spot notice what we do.
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We are nurses, but the most everybody to another episode of Peplau's Ghost.
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Super excited to have this next guest.
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I've been hanging around with her for a while and meeting her at conferences.
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And uh I'm just really looking forward to this conversation just to get to know her a little bit more.
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As we all know, it just, you know, we don't have those opportunities to get to hang out with people and just kind of find out what makes them tick.
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So I am super thrilled to uh welcome Dr.
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Elizabeth Hopfensberger, which again apologized for the mispronouncing if that is incorrect.
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Is that right, Elizabeth?
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It was spot on.
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Spot on, Dan.
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Yeah.
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She's gold star for me.
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I can feel it.
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That's great.
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So so thank you again for being here.
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And thank you to Dr.
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Sean Convoy and Dr.
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Melissa Chapman-Hayes, my other co-hosts here for the podcast.
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So let's get to it.
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I'm I'm always it's kind of my pleasure to really get to know and ask kind of the history question here, get to, you know, what got you to this place?
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You know, I know you're the program director for the PMH MP program, University of Minnesota.
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You have a lot of experience in as an NP, you know, FNP to psych.
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So you really kind of weave those things together.
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But, you know, what brought you to this place, you know, as a nurse?
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You know, what kind of brought you to an NP world and then eventually here to as a psych mental health nurse practitioner?
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Podcast.
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I am a longtime fan.
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My students are longtime listeners.
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And we sent her our very first psych-specific course on Hildegard Peflow and her interpersonal relations theory.
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So this is a dream come true.
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I love the question you asked me of how I got where I am.
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And I really love the fact that I am a dual-board certified family nurse practitioner and psychiatric nurse practitioner, that I bring both lenses to it.
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I actually did not practice solo as a family nurse practitioner.
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I was in the master's program at St.
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Louis University for family nurse practitioner.
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And about a month before graduation, I decided I have to do psych.
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I just have to.
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All through my rotations, my clinical rotations as a family nurse practitioner.
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I was in many different settings with family practice physicians.
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And I saw just a huge gap in being able to help the patients with anything related to mental health.
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Even just nervousness or health anxiety or follow-up.
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I was following some pretty great providers, but they just didn't address the mental health needs.
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And then the patient would pull me aside afterward and say, Can you help me?
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And I'd be writing down notes in the hallway, running in between patients.
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So ultimately, I decided, with the advice of the advisor from St.
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Louis University, she said, You have to graduate.
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You can't switch one month out from graduation.
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You have to go on.
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So I went back to my alma mater, the University of Minnesota for my DNP for psych mental health.
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And it is exactly where I needed to be all along.
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And I look back to as a kid, I was always interested in what makes people, what makes people tick and embracing diversity and asking all kinds of questions or being able to befriend the new kid or the person who just went through something traumatic.
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And I've just always been curious about people's stories and forming that therapeutic relationship.
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So when I look back in hindsight, it was just there all along.
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And it's the most natural fit to practice in this world.
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And then a couple of years ago, I made my way into academia.
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So it's been a really interesting path that I've just kind of followed the cookie crumbs in front of me or the breadcrumbs through the forest, and it's led me here.
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That's so great.
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I love it.
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I mean, I think of, you know, yeah, I have some similar experiences.
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Even, you know, when I was getting my RN, I remember going on a cardiovascular floor, and there was a patient who was, you know, very clearly depressed.
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And I wanted to spend all my time with that patient.
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And my preceptor was like, you're spending too much time with that patient, and really was kind of discouraging of just kind of getting to know this person and just uh listening to their story.
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So I knew probably cardiovascular was not my calling, but psych was just kind of more of that fit.
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And so you would you mind kind of continuing your story a little bit?
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You mentioned you, you know, you you've been in practice and you know found your way to psych, but I think there's there is this, you know, obviously there is a shortage in academia of, you know, people going into academia and and things like that.
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So you mind sharing a little bit about what what made you switch there, going from practice to academia?
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Oh, that's great.
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Great question because that's a really big shift.
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I've been practicing for 12 years in the outpatient setting, and I had always created what I always say are really challenging uphill battles for myself, where I would purposefully seek out positions that didn't exist and create them for myself.
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So embedded within a primary care setting that has never had a mental health provider, embedded within specialty care settings.
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And they, I mean, from top to bottom didn't know what to do with me.
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So I actually took that as an advantage of oh, I get to create exactly what I want, how I want it to look.
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But that in itself, I was practicing solo for most of my career, was very stressful.
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And I am I'm all in, I'm very thorough.
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I was trained in a way where where I document very, very fastidiously.
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I'm actually an expert witness and peer review for legal cases.
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I'm involved in a case in Arizona right now, so I'm very fastidious about my work.
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And then for my patients, I have a plan A, B, and C.
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And as you can imagine, that is that's a lot.
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So I decided I I wanted a better work-life balance.
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I know that's I mean who, if anyone can figure that out, they're gonna be, but one of the big things for me was my one of my daughters, when she was entering sixth grade, had a very traumatic health issue where she was diagnosed with Guillain Beret, and we nurses know what that what that look what that's like.
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And she was heading into sixth grade.
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And during that time, I just really had a deep look inside of what do I want my work-life balance to look like and my family, and the importance of all that, and how can I fill my own cup while still doing the amazing work that I'm doing.
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And around that time was when one of my mentors, Barb, Dr.
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Barb Peterson, whom you know very well, Dan, um, reached out and and it had been in the works, but it became very serious at that time that I was going to make that transition back to my alma mater to teach as Barb wanted to retire.
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So I thought, you know, this could give me more work-life balance.
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I can inspire the next generation of psych NPs, which I loved precepting and teaching and peerleading along the way.
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And I thought that would just be a better fit for my life moving forward.
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That's perfect.
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Yeah, that's awesome.
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I'll be a little timely in the podcast and just make a small joke that I'm hoping that your expert witness is not a part of uh Lindsay Clancy's case.
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And and I mean, that's the whole thing, right?
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Everybody's talking about it.
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It's so hot.
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Can't stop.
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And my specialty is perinatal mental health.
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Oh, there you go.
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There you go.
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Very first specialty.
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So I am not an expert witness in that.
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I'm very thankful.
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I mean, I I have a lot to say about it for sure, but no, that is not the case.
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That's great.
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I'm gonna turn it over to Sean.
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Thanks.
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Hey Elizabeth, so I uh I I I recently read a quote that uh was sur surfaced in my mind when you were talking about your students.
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And I'm gonna ask you another question also about your students in a second, but I'm gonna share this quote with you and then ask you to kind of respond to it through the lens of being both a psych nurse practitioner, but also a psych nurse practitioner faculty member, okay?
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And the quote is as follows In academics, the lesson precedes the test, but in clinical practice, the test commonly precedes the lesson.
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Can you uh process this and kind of speak to it?
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I'm like, that's so good.
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Okay, I know as we're all of us nurse, all we nurses know that coming out of our BSN program, we're like, okay, the real learning actually happens on the job.
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Sean, this is a great question.
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I know all of us went through RN, got our BSN.
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We would always hear from faculty and preceptors even actually learn what you need to know.
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And I remember being frustrated about that of, well, can't you prepare me for that?
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And really, you can't prepare for real world experiences very well.
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And in the role of faculty, I'm working to change that.
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So interestingly enough, I'm I'm in today is my last day of teaching my brand new summer course, craft from scratch from my brain and life experiences.
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It's complex mental health with complex comorbidities.
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And so I'm using case-based learning for my students based on my patient examples, obviously HIPAA-compliant identifying information, but I specialized in incredibly complex patients with multiple comorbidities.
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I mean, and my my students even said, How in the world did you even do this?
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Because I wrote them 11 pages, one of them was.
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And so I'm trying to really immerse them within real-world life experiences, and then we talk it through, we hash it out to to show what it would be like when you're dropped right in the deep end instead of having first time when they're there.
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I want it to be in a pre-immersive experience in our courses.
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So I think the quote that you gave is spot on, but how can we flip that as educators to help them feel prepared, especially in those really complex situations?
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And then we use that time class to talk through what would you do, what medications might you prescribe, or what approach would you do, and no answers are bad answers, but then we really see it through all the way to the all-have consensus.
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That's wonderful.
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I that's that's thank you very much for that.
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I uh I was also really excited for those of you who weren't listening before Dan turned this on.
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It was kind of cool because Elizabeth noted that she not every school across the country right now actually has a standalone psychotherapy course.
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So I am super grateful to say that the University of Minnesota is leading from the front in that regard.
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So Elizabeth, I'm actually going to speak to your students right now and say, I would love for you guys to kind of blow up the podcast message boards and identify some memorable things that you learned about Hildegar Peplow and Dr.
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Elizabeth's course.
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So Elizabeth, can you just can give us a quick, you know, elevator speech about what this that psychotherapy course is like?
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Well, Sean, we have we do have a standalone psycho, but we also sprinkle psychotherapy throughout very intentionally.
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So, for example, this course that I taught each module or each week was centered on a very specific intent complex mental health with complex comorbidity.
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And then the students in each case had to say which psychotherapeutic approach they would take and give a very detailed rationale.
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And so it was very different, for example, for personnel mental health education.
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And that is sprinkled throughout many of our courses.
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The course I was speaking about, where we talk about Hildegard Peplow, is our very first about pooping before us, pooping path.
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And our standalone course is different.
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It's in the fall, and my colleague, Dr.
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Elena Geiger Simpson, is teaching that psychotherapy, and she has just created this new course for fall centered around decolonizing a book.
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So interested to see what that will look like.
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So it seems where we have a lot of psycho integrative plan and then a thank you very much.
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I'll pass it to Melissa.
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Thank you, Elizabeth.
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I love hearing about case study examples, especially from your real real world practice and getting that as a sort of bridge between learning in the classroom and preparing them for the real world.
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So thank you for that.
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Um, my question's going to flip a little bit to I'm gonna say this word very slowly, psychoneuroendocrinology.
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I am the non-nurse, so I just want to make sure I pronounce that and I can't do it fast.
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Thank you.
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Your work leans really heavily into psychoneuroendocrinology.
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How do you bridge the gap between neuroendocrine pathways like HPA access dysfunction or hormonal dysregulation and the lived emotional experiences of your patients?
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What does that look like?
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Oh, that's amazing.
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I'm gonna first talk about it from my approach as a clinician, and then I want to talk a little bit about my approach as an educator.
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So, with that is fill into this, kind of like the breadcrumbs through the forest.
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Everything kind of just falls before me and I follow it.
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I was seeing a lot of really, really ultra-sensitive women in the perimenopausal-menopausal range.
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And then with my specialty in perinatal mental health, I would get a lot of those patients.
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So naturally, they'd want to know what is going on with me?
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Why is this happening?
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Is there anything I can do to prevent it?
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And so going down into the pathophysiology of that in a very thoughtful, user-friendly way of why this might be happening was really empowering for that.
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And I don't want to just call women, men too.
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I would say men with lower testosterone or all these life changes.
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Um, but really is what is our body and our brain doing during times of transition?
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And that is not talked about enough.
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It's not studied enough, and it's it's just happening.
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And this generation of women in perimenopause, right now, I've noticed, they want answers, they want help, they're starting the conversation.
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And so it's ripe for the taking.
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And they want to know what is going on.
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And I work one day a week in a precision medicine clinic where we take individual clients and we just we look at everything, their labs, their life history, their surgeries, their trauma, their everything, and kind of go deep.
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So, really, it started with questions from my patients of what is going on.
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And so I wanted to know what's going on on a neurotransmitter level, you know, when estrogen decreases, our serotonin and our dopamine decrease.
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Well, when our dopamine decreases, what's that doing to women with ADHD in midlife?
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They're really struggling.
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And so then, does that set the nervous system on any fight or flight mode?
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And then how does that feedback loop continue?
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So it really started with all of the questions, and then well, what are some of our answers to all of those areas?
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I found that with my patients, just having some answer of what's going on and why, a lot of them felt like they were crazy.
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So, knowing, you know what, I know, I think I know why this might be happening.
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Here are some thoughts on that, and here's some things that we can try to help your nervous system calm down, to help get back into the parasystem, to help rebalance some of those hormones.
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They just had they felt empowered, at least having some knowledge.
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And now translating that to my students in this course this summer, there was a whole section on care across the menstrual cycle, perinatal mental health, menopause, and perimenopause, and what we do, how we assess, how we talk to these people about that, and what are some of our treatment options?
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So I feel like I just kind of word vomited, but we did not answer your question.
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Yeah, I thought especially the perimenopause or low testosterone, you know, then look taking that holistic lens of like, I guess, first of all, created a space so people can ask questions and look at their life holistically, biologically, psychologically, the trauma, and figure out what's going on.
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I mean, that's empowering in and of itself.
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Thank you.
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Very happy.
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And then yeah, thank you.
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It's a great question.
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Thank you.
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Yeah, I mean, I think maybe kind of just continuing on that kind of line of thinking, this is a question that I don't know why we haven't asked others, because obviously we've had other guests on here who have been duly certified like yourself with FNP and Psych, but I think you in your role as in academia and all your experience that you've had, what how do you differentiate the way that we prescribe psychotropic medications in primary care versus psychiatry?
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I mean, what what is the difference?
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I have a colleague who tells me, you know, we need a lot of what we call post-grad CERT students who are coming back and getting recertified.
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And they basically say, you know, this is not a program just to learn how to prescribe CERECWL.
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So that's that's not it.
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So what else you know goes into prescribing, you know, from a psych mental health nurse practitioner role that you that they don't get in the primary care and things like that?
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Or where do how do you see the difference?
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And because everybody prescribes, you know, Prozac or Lexapro.
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I mean, that's that's not an art, but but what what kind of differentiates that for you?
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I think it's all in the comfort level of the provider and how stressful that they anticipate it to be.
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So I would I would do a lot of this with the my last position that I worked in, where I was embedded within a primary care setting with specialty providers, 50 primary care providers.
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And they would come to me before they saw a patient and they'd see the patient on their schedule and say, Oh, this is a postpartum depression patient.
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What should I do?
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And I go, Well, have you seen them yet?
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And they go, No, I haven't.
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Like, well, oh, see them first and approach them as a human.
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So I'd say, This is a human.
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We're talking to a human being.
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You are also a human being, you have that in common.
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That's a good place to start.
00:18:28.799 --> 00:18:37.920
And ask questions, be genuinely curious and allow them that chance to answer it without fear of being judged.
00:18:38.160 --> 00:18:42.400
And that alone would just kind of take the temperature and the pressure in the room down.
00:18:42.640 --> 00:18:45.920
And I'd say, ask them basic things like, how's their sleep?
00:18:46.160 --> 00:18:47.279
How's their appetite?
00:18:47.440 --> 00:18:49.680
Are they enjoying things they used to enjoy?
00:18:49.839 --> 00:18:53.759
And so I think it really is a nervousness about, oh my God, what do I do?
00:18:53.920 --> 00:18:57.279
What if they need closer or something like that?
00:18:57.519 --> 00:19:02.400
And really, it's never as bad as they anticipated it would be.
00:19:02.640 --> 00:19:06.160
And I I'd say, you know, if it's out of your comfort zone, come ask me.
00:19:06.240 --> 00:19:16.400
I'm happy to walk you through this, or I'm happy to see the patient, but I prefer to educate them on here are some of your options and what do you think would be the best way to do it?
00:19:16.559 --> 00:19:18.720
So it was a good way to educate primary care.
00:19:19.039 --> 00:19:21.119
And many of them felt very empowered.
00:19:21.279 --> 00:19:28.400
I still have them messaging me to this day, and I haven't worked there in two years of I'm thinking of doing this with this patient.
00:19:28.559 --> 00:19:29.599
What do you think?
00:19:30.000 --> 00:19:38.960
So I really think it's just a nervousness and a fear of, okay, if I ask a question and it brings something up that I don't know what to do, then what?
00:19:39.920 --> 00:19:42.960
So it's knowing your resources, really.
00:19:43.279 --> 00:19:43.440
Yeah.
00:19:43.759 --> 00:19:45.440
I'd love to speak to them about that anxiety.
00:19:45.519 --> 00:19:53.279
That's I've you know seen that many times too, where you know, I've had somebody says, you know, if I'm gonna ask a patient about suicide, I want a psych person right on my hip.
00:19:53.440 --> 00:19:56.480
Because it's the anxiety of what if they say yes?
00:19:56.640 --> 00:19:58.640
You know, what what what do I do with that patient then?
00:19:58.799 --> 00:20:00.400
And so so that's a great answer.
00:20:00.480 --> 00:20:01.680
So thank you, Sean.
00:20:02.400 --> 00:20:03.200
Hey, friend.
00:20:03.440 --> 00:20:08.799
So uh when I say this, uh I don't believe that I'm hallucinating, but uh I believe that when Dr.
00:20:08.880 --> 00:20:11.119
Pepplau, when we have these podcasts, Dr.
00:20:11.200 --> 00:20:12.960
Pepplau is kind of speaking to me.
00:20:13.279 --> 00:20:14.640
Well, maybe that's not accurate.
00:20:14.799 --> 00:20:15.599
She's not speaking to me.
00:20:15.680 --> 00:20:17.039
She typically declares more.
00:20:17.200 --> 00:20:21.279
So she's today, she's declaring and she's saying, Convoy, get back to psychotherapy.
00:20:21.440 --> 00:20:24.160
So I'm gonna ask another question about psychotherapy, right?
00:20:24.240 --> 00:20:35.359
So can you share a few practical examples of how you are preparing your students to develop greater insight into their own counter-transference without shame?
00:20:36.160 --> 00:20:38.319
Sean, this is an amazing question.
00:20:38.480 --> 00:20:39.119
I love it.
00:20:39.200 --> 00:20:43.759
We start this from the nanosecond they are in our classroom.
00:20:44.000 --> 00:20:48.160
We talk about reflective practice from that very second.
00:20:48.720 --> 00:20:58.400
And this is, I think, one of the strengths of our program is our reflective practice and how we set the tone for that for our students to reflect and receive feedback.
00:20:58.480 --> 00:21:04.079
So we give a lot of lead-in time of what is reflective practice and what does it look like?
00:21:04.319 --> 00:21:08.000
It's not just dear diary, today was whatever.
00:21:08.240 --> 00:21:10.559
And then giving and receiving feedback.
00:21:10.720 --> 00:21:15.920
A lot of people receiving feedback, we know, don't take it well, or they their hackles go up.
00:21:16.240 --> 00:21:19.920
So it really is both reflective practice and receiving feedback.
00:21:20.000 --> 00:21:22.960
And we we tee that up so beautifully.
00:21:23.279 --> 00:21:28.720
And I'm just thinking of my students that just are finishing their course today, seeing their reflective practice.
00:21:28.799 --> 00:21:38.880
And we require reflective practice in each of our courses, reflective journals, whether it's typed or audio or through some art medium.
00:21:39.359 --> 00:21:51.680
And I we just get to see the trajectory of that over the type of the course of their program and how deep they go in, how much they examine counter transference and transference and their biases.
00:21:51.839 --> 00:21:57.119
And we talk about that in class too, when we start to do case studies in class.
00:21:57.359 --> 00:22:37.279
And I will lovingly say to student you know what i i think i'm noticing some counter transference here what do you what do you think about that what what is this patient bringing up in you or maybe sidebar obviously not calling them out in front of their peers but having read their journals and knowing their history of okay I see this coming up knowing your background knowing what went on in your childhood and the way you're responding to this patient now so we talk a lot about that and our students are really teed up for receiving that feedback because they know it's coming from a place of deep love and respect for them as humans.
00:22:37.599 --> 00:23:01.200
Thank you so very much I I I appreciate that I I'll share one of the strategies that I've kind of developed over the years to target this is that I remind all of our psych NP students that in the physician training pipeline one year of their psychiatry residency, those psychiatric trainees are learning how to they get a year of psychotherapy themselves to learn how to separate their stuff from their patient's stuff.
00:23:01.359 --> 00:23:15.759
So we do not have the luxury of time to mandate that with an advanced practice nursing but what I do do is, you know, in our practicum courses for for hours, we have direct hours which ANCC or AAMP requires a minimum of 500 today.
00:23:15.839 --> 00:23:17.279
God knows what it's going to be tomorrow.
00:23:17.440 --> 00:23:28.400
And then we have some additional hours of indirect hours and I always encourage students I say you can acquire your indirect hours by getting individual psychotherapy to learn how to separate your stuff from your patient's stuff.
00:23:28.559 --> 00:23:45.200
So I appreciate your approaches here and I would encourage everybody who's out there who wants to be a psych NP or is a psych NP to recognize that you're the biggest cynic in the world if you don't think you could benefit from that which you provide, which means we all probably need our own psychotherapy at some point in time.
00:23:45.519 --> 00:24:06.640
I love that we bring that up to our students as well and I had a student we I happen to be precepting one of my students at we we have our students in a free neighborhood clinic in the evenings providing psych services and she said to me she goes you know what it with all the things we've talked about in this class I decided to start therapy for the very first time in my life.
00:24:06.880 --> 00:24:23.200
She said I didn't think that I needed it but we all so openly talk about things that we might be working on in therapy not oversharing or whatever but just interesting things that might come up and it really inspired her to say you know what I really could benefit from seeing a therapist and she did.
00:24:23.440 --> 00:24:31.440
And there was a lot of stigma in her family about that but she she was really happy to say that she saw the benefit in that too.
00:24:31.759 --> 00:24:50.480
Fantastic thanks I'll pass it to Melissa thank you so looking at the future of integrated healthcare what advice would you give to FNPs and PMHMPs who want to deepen their understanding of psychoneuro endocrinology while keeping the human connection at the center of practice.
00:24:50.799 --> 00:24:59.039
I it all comes down to curiosity just embracing that curiosity I don't I don't surround myself very often with people that aren't curious.
00:24:59.200 --> 00:25:09.920
So it always boggles my mind when of those who are not so it's just embracing that curiosity and then being aware of what your patients are looking for and who's coming to see you.
00:25:10.079 --> 00:25:18.960
So a lot of kind of the rabbit trails that I've gone down or the deep dives have come from my own patients of can you help me with this or what's going on?
00:25:19.119 --> 00:25:21.920
And I think, well, I can't really find much information on it.
00:25:22.079 --> 00:25:23.839
I'm going to start looking into it.
00:25:24.000 --> 00:25:35.119
So using that as a barometer for what people are wanting and seeing and using that to inform your own practice because you're going to learn a whole lot and that's never a bad thing.
00:25:35.200 --> 00:25:38.480
Being a lifelong learner is good for us in so many ways.
00:25:38.799 --> 00:25:51.839
But knowing what our patients are wanting to know what they're coming to us with and then maintaining that really genuine deep curiosity I think is the biggest thing that I can say for that answer.
00:25:52.079 --> 00:26:11.519
One thing that I meant to say earlier is when you've said during this podcast that you've followed breadcrumbs or cookie crumbs through the forest I just wanted to elevate that you also noticed that there were breadcrumbs to follow and then did did that, which I don't you know I I just wanted to kind of elevate that step in it as well.
00:26:11.920 --> 00:26:12.400
That's true.
00:26:12.480 --> 00:26:44.079
And well you know I think it comes up for a lot of us but we just are you know head down plowing through the day getting through the day not noticing and I know my therapist he always says to me and I can hear it in my head Sean I know you said you're hearing voices from Peplau I hear voices from my therapist saying just notice so when I think I just notice and I think we all have it in ourselves but it's just are we taking that time and having that mental space to actually see oh my gosh what is unfolding before me.
00:26:44.240 --> 00:26:51.759
Somehow I have that gift where I just not head down plowing through I'm I'm noticing some of these things coming up.
00:26:52.319 --> 00:26:59.599
My the voice in my head is the power of the pause the power of the pause moment the power of the pause pause right very true very very true.
00:26:59.839 --> 00:27:02.240
Well this is great and I got a little goosebumps there.
00:27:02.319 --> 00:27:05.759
So thank you Elizabeth for that last response that's uh that's amazing.
00:27:06.000 --> 00:27:09.359
What we do right now is I'm gonna have our previous guest Dr.
00:27:09.440 --> 00:27:11.920
Josh Waddle he's got a question for Dr.
00:27:12.000 --> 00:27:16.319
Elizabeth here so I'm gonna cue that up real quick and we'll see a response on the other side here.
00:27:16.559 --> 00:27:17.599
Thank you thank you thank you Dr.
00:27:17.680 --> 00:27:27.920
Elizabeth you know your role as a director in the PMH and P space I would love to know where do you see the education of PMH and Ps going in the next five years?
00:27:28.079 --> 00:27:32.000
There's a lot of questions on hybrid and virtual and in-person.
00:27:32.240 --> 00:27:42.799
What do you see needs to be the consistent factor in these educations to ensure we're producing good providers for health awesome thanks Josh appreciate it we'll look forward to that answer.
00:27:42.960 --> 00:27:44.720
Awesome all right what do you think?
00:27:45.119 --> 00:27:46.559
That is an amazing question.
00:27:46.640 --> 00:27:51.599
I I feel like I've said that with every prompt that you guys give me this you're keeping me on my toes here.
00:27:51.920 --> 00:27:54.640
What I think needs to happen is still that in-person learning.
00:27:54.799 --> 00:28:14.960
So the the online programs it especially in psych mental health I mean come on we need that in-person learning a lot of our jobs I mean even for telehealth only we need to know how to read people how to get the feelings and the vibes and that the nonverbals and that connection piece and that felt sense.
00:28:15.279 --> 00:28:19.680
We need that and too with our jobs this is a very stressful field to be in.
00:28:19.759 --> 00:28:20.160
I love it.
00:28:20.240 --> 00:28:28.880
I can't imagine anything else but we need that camaraderie and that support and I it really doesn't compare when you're doing it online versus in person.
00:28:29.039 --> 00:28:33.039
So I really think at minimum education programs need to be hybrid.
00:28:33.279 --> 00:28:47.119
They just do we do a hybrid program where we meet at least once a month in person and it really is flexible for students but they really value that in-person time and what I hear them say is we wish we could meet in person more.
00:28:47.519 --> 00:28:55.680
And so I really think that that face-to-face in-person time where you can feel the feels in the room, that's important.
00:28:56.079 --> 00:28:58.559
So I think that's that is really key.
00:28:58.799 --> 00:29:00.400
And is that feasible for everybody?
00:29:00.559 --> 00:29:10.559
No, but I don't think it should be normalized that everything should be telehealth and you quick check boxes and you meet in person for one day out of the whole three year program.
00:29:10.720 --> 00:29:14.079
I don't think that that's appropriate, especially for psych mental health.
00:29:14.240 --> 00:29:35.839
And then I want to say too we're we need to start educating our students if we haven't already on the really really complex mental health presentations because primary care is catching a lot of these bread and butters so to speak and I would always love when I had someone that would come to me with it was just depression or just anxiety and I go, oh my gosh, what it's like Christmas morning.
00:29:36.000 --> 00:29:49.920
I love all my patients but we need to set the the expectation for our students that, you know, primary care is going to catch a lot of those we're gonna be sending the really we're going to see seeing the really complex presentations.
00:29:50.319 --> 00:29:57.200
So we need to up our game in terms of educating and and be and being mentally prepared for that scenario.
00:29:57.920 --> 00:30:07.200
Wonderful way to end this podcast and uh I will just share as well I know this is an audio podcast but you know you can't see Sean and Melissa are just kind of jumping and doing cartwheels here with your responses.
00:30:07.279 --> 00:30:14.400
So I think they're we're all kind of in agreement and uh and again just like I wanted to say with this podcast just a friendly conversation among friends.
00:30:14.559 --> 00:30:15.599
So thank you Dr.
00:30:15.680 --> 00:30:24.240
Elizabeth Hoppinsberger It's always such a risky thing but thank you very much Elizabeth for being here and thank you for listening.
00:30:24.400 --> 00:30:24.880
Appreciate it.
00:30:25.039 --> 00:30:46.559
Look for another episode coming out soon please feel free to like subscribe send comments like we've said before have any thought for another guest let us know we'd love to have them on so we didn't I'll wait for the thing