What If Medication Management Started With Trust with Dr. Kris Vandenberg-Harrison

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Yeah, we for all the heart before shots, before fest, had days, we have compassion.
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This one's for every nervous, past, present, and future.
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Let's go.
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We are the commonest stone, the beacon of hope.
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Every beat, every breath, we honor the oath.
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From night shift to daybreak, loving our tone.
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Peppa sort of connection hills on the loan.
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For fluence the futures, we read a five care, not just meds and machines.
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We're presses for prayer.
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With hands that comfort, eyes to see truth.
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Filling in a chart, notice what we do.
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We are nurses, with hearts wide open.
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Welcome back, everybody.
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Good to have everybody here back.
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Another episode of Peplo's Ghost.
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Welcome to my new guest here.
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Really looking forward to Dr.
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Chris Vanderberg Harrison.
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You know, it's a small world.
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When I met her a few times at conference, the International Society of Psych Nurses, I don't know why.
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I was just kind of drawn to her a little bit and then found out that we have kind of a career connection of both presenting for uh Dr.
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Dr.
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Barclay's board prep stuff.
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So it's a small world.
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We know Dr.
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Barclay.
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Send our love to him.
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No need to send our love.
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He's doing well.
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I don't want to kind of get everybody anxious and like, oh, something wrong with Dr.
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Barclay.
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Nothing's wrong, but it's just a fun thing that uh Chris and I kind of share with also shared with my colleague and friends, Dr.
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Kate Molino from California and Dr.
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Melissa Chapman-Hayes from Minneapolis.
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So thanks again for everybody.
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And thank you, the listener here, uh, for joining us and such.
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So I'm just gonna kind of get into it, Chris, and really kind of tap into your vast knowledge and understanding.
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You've got you've you know your seasoned educator, experience in the psych mental health field for over 30 years.
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I hate to say that number, but uh you know, you must have started when you were 11, so that you look great.
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And this is an audio podcast, so I'll just share it to people.
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But you know, would you mind kind of just uh taking us through that time, you know, you know, thinking of this as Peplau's, you know, ghost podcast and her history of you know birthing our profession here in 1950s and such.
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What have you seen in your practice?
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You know, shifts on how you know advanced practice nurses operate, how the Psych Mental Health Nurse Practitioner Program uh practice has changed clinically in education.
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You know, just kind of take us through what you've seen and uh and kind of start us off that way.
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Sure.
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Well, taking you all the way back to 1991, I guess was my first time to experience any psychiatric nursing.
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And I was a diploma nurse.
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So, you know, the white dress, the white cap, the peplau, you know, therapeutic relationship with center, number one to nursing.
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And I've definitely seen that evolve through the 30 years.
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I'm embarrassed to say that as well.
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But it's been a nice, refreshing 30 years.
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What I'm really excited to see is how we're almost bringing things back full circle.
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And there's so many of us now talking about the importance of integrating psychotherapy back into our medication management practice.
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I definitely have seen a lot of evolution throughout the years.
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Yeah.
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Even the diploma nurse, wow, that's something that uh some of our new graduates from who might be listening have to look it up, what that is.
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I mean, that's uh that's that's a good old days of uh yeah, the white pinning and yeah.
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Yeah.
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I like this idea of cyclic stuff.
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You know, anything that kind of stands out for you that you've seen that's you know more specific on you know the cycle of psychotherapy and in its role, like you said, you know, maybe when you're going through and getting your diploma, you you know, heard about this new person called Peplau.
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But now she's kind of one of our patron saints of of the practice and such.
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But uh, what else have you seen that's uh that's you know, what's old is new again kind of thing?
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Oh, good question.
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What's old is new?
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You know, I think meeting the patient where they are and hearing their story.
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That's how how I learned to be a nurse was you got to sit down, you have to learn who the person is.
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Talk to them, say, tell me about you.
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And for so long I did that.
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And then things started to change where we had a lot of patients we had to see.
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The I saw the break between therapy and psychology and medication management.
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And it was like, what do you do?
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Are you a medication management person or are you a therapist?
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And I was like, well, why do I have to be one or the other?
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And so for many years I've struggled with that.
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And how do I blend the two?
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And I have been fortunate in being an educator that I've been able to have the students who I blend the two together.
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And so you don't have to choose.
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You get to be, you get to be a nurse number one.
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That's what I tell my students.
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You're a nurse number one, you're a psychiatric nurse and practitioner number two.
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And so being able to blend both those pieces is I think, I think we're really starting to see it come back.
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How do I see that?
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Just in my own practice, you know, my patients will tell me, they're like, you know, thank you, thank you for listening to me.
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I know you're not my therapist, but I appreciate you taking the time to listen to me.
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So it's funny how even they see a difference between, you know, there's therapy and there's med management.
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And I'm trying to show them how we can blend the two.
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And and they appreciate it.
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And I think many of our patients are asking for that.
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Yeah, very well said.
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Thanks, Chris.
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I mean, I I love that example and uh reminds me of just an experience I had just this week in the clinic, and uh I had a psychologist come up to me and you know, thank me for you know taking a person that they she referred to me.
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And I was kind of kind of a little embarrassed.
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I was like, Well, I I don't think I did very much for her, you know, she didn't need a medication, you know.
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I just kind of talked to her a little bit and we kind of did some things.
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And she's like, no, no, no, that was perfect, and the patient loved that just you know being there and connecting with it.
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So yeah, it just kind of emphasizes what you said.
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So thank you.
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I'll turn it over to Chris Kate.
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Oh, Chris, I don't know where I came from.
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Kate.
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Yeah, thank you, Dan.
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You know, so Chris, I'm interested.
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You you talked about your background in education and how you've seen firsthand how our PMH and P curricula has really evolved over time.
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I'm curious, similar to along the lines of what Dan was asking, what do you see as you know the biggest gaps or friction points between what students are taught in graduate school and then the actual day-to-day realities of NP clinical practice?
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You know, I find this with my students in simulation, oftentimes they'll say, Well, you're not giving me enough information.
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I need more information.
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I can't make a decision without enough information.
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And so trying to really teach them that when you're in the real world, you don't, you only have so much, you only have what you gather or what has been given to you.
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And teaching my students that over time you evolve in with a patient, you might change a diagnosis or change their medications or change how you approach them.
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And I think we, you know, in education, it's you see a patient, they give you the symptoms, you diagnose.
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And really, in true reality, it's not that way.
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You have to get to know the patient before you can actually formulate a whole diagnosis or treatment plan.
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So that's the biggest gap is trying to get them to say, it's okay.
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I don't know everything in the first visit.
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Yeah, that's so insightful.
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You're right.
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It is a really we we are making the decisions we make based on the best information we have at the time, which is teaching students to sort of hold that a little bit of uncertainty is that's a really important skill for them to have.
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Yeah.
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Yeah.
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Thank you.
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Yeah, I'll pass it off to Melissa.
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And my question is going to really play off of what you just said and what Kate was asking.
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So, how do you help students or trainees develop true clinical intuition and nuanced diagnostic skills when dealing with complex real-world cases where they will have partial information or need to make those judgments about how to move forward?
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That's why simulation is so wonderful, because we can actually guide it that way and give our students, you know, not all the information and and teach them how to move past that, get to know the patient, figure out what questions they need to ask.
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And it allows us to see what is their intuition and help guide them.
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So often in clinical experiences, it's the provider really leading the visit.
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And students aren't allowed to necessarily practice, you know, their their intuition, what way would I go?
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I get, you know, I have students all the time come to me and say, it's so frustrating when I'm in clinical because in my head, I formulated a whole plan, and then out of my preceptor's mouth comes something completely different.
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And I say to them, that doesn't mean what you were thinking was wrong.
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That was your intuition.
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That was your way of guiding the treatment plan.
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And so in simulation, we get to do that a little bit more.
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So we're fortunate at UCCS where we have a simulation clinic.
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Our students are all across the country, but they come in like telehealth visit.
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So they don't have to come to campus, but we have a budget where we have a simulation lab and we have real patient.
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Well, they're not real patients, but they're actors who simulate patient experiences and allow them to kind of navigate through that a little bit more.
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I'm not sure if that quite answered you, but yeah, I I mean I think so.
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That's having simulation would be as close as they can get to practicing since they're not able to make those determinations as students.
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Yeah.
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Yeah.
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I'm I'm wondering, and I and maybe I'm just kind of seeking some validation here.
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I know, you know, just simulations in general.
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I you know follow students, you know, from that first simulation when they're very, very nervous and kind of don't know what to say, and so they get really anxious.
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And two, you know, they you see them, and uh, we just had our students, you know, kind of complete their last simulation, and I'm just like, you're ready to practice.
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You know, just kind of put the stamp on them and say, Here ready.
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Yeah.
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In your simulations, do you ever kind of maybe take the opportunity is a great way to say it to throw them some curveballs and maybe kind of how do you think about that?
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And and what sort of curveballs do you mind kind of sharing?
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And I'm sure none of your students will listen to this podcast that you can share all your students.
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Yeah, well, I mean, that's a great question, Dan.
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Recently I had a group of students working together, and it was a whole put-together simulation about depression.
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But what I felt was that they were having a hard time communicating therapeutically.
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So I'm like, I'm gonna switch this up.
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These are students about to graduate, and I just want them to feel like it's okay to just talk with the patient.
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So that was a huge curveball because what they were looking for was diagnosis and medications and therapy.
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And I was like, you know, I just want to talk.
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I'm not sure that I want to do medication, or that's how I had the actor portray.
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I'm not sure that I even want to do medication.
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I just want to talk about it.
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And that, you know, it seemed so simple, but for students was really challenging because they had to go back all the way back to what is a therapeutic relationship and how do I just talk to my patient?
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You know, even as they continued to educate the simulated patient or the actor, I guess, you know, we would bring them back to, well, no, let's just I don't want to be educated.
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I just want to talk about it.
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I want to tell you how I feel about it.
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And getting them to focus in on more open-ended questions.
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And these are graduate students, some of them being doctoral students.
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So they were really challenged.
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I mean, this is, you know, nursing 101 therapeutic relationship, but being able to give them that opportunity to practice that, they all afterwards were like, thank you.
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That was so far out of our comfort zone.
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And to me, it should be not, it should be within your comfort zone, right?
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As a nurse.
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So that's kind of curved ball just recently at the Remust Students.
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That was fun.
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Yeah, thank you.
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That's great.
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I mean, I I love this idea.
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And I think that's um, you know, obviously goes to your expertise in this too.
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I think, you know, thinking of a faculty member too.
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You know, it's uh that idea of, you know, checking all the boxes, making sure the students can I have everything, but but your experience and your expertise in, you know, understanding what a student needs when they graduate to feel comfortable.
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It's not always and I I try to say this some, you know, at least once or twice to my students too.
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You know, you you don't need every appointment, doesn't need to come away with a prescription, you know, but but something they need to leave with something.
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And so sometimes we can't have that physically.
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So yeah.
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Sometimes be and heard is all they need to leave with.
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I think that's yeah, huge.
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Yeah, I think that's so much more you know valuable to people, but um hard to quantify that as always.
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Yeah, that is true.
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So, Chris, I'm curious.
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You hold dual certification as both an FNP family nurse practitioner and a psych nurse practitioner.
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How does your grounding in primary care influence your psychiatric diagnostics and clinical decision making, especially when you have patients with complex somatic complaints or medical comorbidities?
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Yeah, and let me make one clarification.
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I'm I am duly educated.
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I'm no longer certified as an FMP.
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I was at one point, but it just was kind of too much for me to keep up with.
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So as far as, I mean, I it's hard for me to even think back to what it would be like to practice without having that dual education.
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Because when I see my patients, I see them holistically.
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I know that's kind of a catch word we throw around, but I do.
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I mean, I'll give you another example.
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I saw a patient recently who had been through numerous psychiatric providers for primary care, and nobody could treat his anxiety.
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And as he sat in front of me on telehealth, we j I just said, tell me about your anxiety, talk to me about it, give me more information.
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And I just sat there for 20 minutes and listened to him.
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And I thought to myself, I don't know, this was an intuition thing with having the dual education.
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I was like, this is not psychiatric, this is not anxiety, and I can't quantify and tell you why it's not, but it's not.
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And ended up getting him in with a neurologist, and he was later diagnosed with a neurological condition that was not anxiety.
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I'm sorry, I can't remember the one what it was off the top of my head.
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But that's something that being exposed to both medical and psychiatric conditions together, that it's hard to teach, you know, it definitely is something you have to experience.
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I will say with my patients, it's a little bit more difficult on the uh the flip side when they have more somatic complaints.
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And then I'm trying to tease out, you know, is this psychiatric?
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Because this guy he had no somatic complaints other than he was shaking and he had anxiety.
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It was Huntington's.
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That's what he ended up getting diagnosed with.
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Huntington's so a big, I mean, and it had been missed for about two years.
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So it is a little bit harder for me when people are, you know, with their medical because there's that FMP in me that wants to go, well, I just kind of want to fix that, you know?
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And so trying my best to tease those out the best I can.
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Well, thank you.
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I I love how you illustrated sort of how your your two streams of training can work together and also how they can battle a little bit and conflict.
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And that's really useful.
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Yeah.
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Okay.
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So over your esteemed career in psychiatric practice, I'm sure that you encounter patients with persistent mental illness, treatment resistance, and complex trauma.
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What clinical strategies or frameworks have proven most effective for you in sustaining long-term therapeutic engagement with these patients?
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Oh, that's that's a difficult question.
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I think meeting the patient where they are at that time.
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I can come into an appointment with a very preconceived idea of today, we're gonna talk about, you know, a little bit about your trauma and how the medication has helped with some of the symptomology that presents with that trauma.
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And my patient may walk in the door or on telehealth and they're they're not even ready for that.
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They want to talk about the car accident they got into yesterday or their kid that yelled at them.
00:16:00.879 --> 00:16:07.840
And being able to, that has taken me many years to be able to say, okay, my plan doesn't have to be implemented today.
00:16:08.080 --> 00:16:09.840
Matter of fact, I don't even have to mention it.
00:16:10.159 --> 00:16:25.279
You know, I can just sit back and listen to my patients and the complexities, you know, with trauma so often it ebbs and flows when patients want to delve into that or and deal with it.
00:16:25.440 --> 00:16:34.159
And I it's taken me a lot of time to learn that, that I just have to be present with where they are at that moment and meet them where they are.
00:16:34.480 --> 00:16:37.600
Well, I imagine there's a lot of trust then because you're seeing them where they're at.
00:16:38.240 --> 00:16:38.720
Absolutely.
00:16:38.799 --> 00:16:38.960
Yeah.
00:16:41.440 --> 00:16:41.600
Yeah.
00:16:42.159 --> 00:16:44.159
Trust is that number one building blog.
00:16:44.480 --> 00:16:52.480
I would say if my patients could tell me one thing, you know, that they gain from me being their provider is that they trust me.
00:16:52.720 --> 00:17:01.360
If I ever hear that, I mean, that is just gives me goose goosebumps because that is everything that I want to do as a provider is to be there for my patient.
00:17:01.440 --> 00:17:15.039
And I I will often tell them, you know, I'm here for when things completely fall apart in whatever way, whether that's your fault or not your fault, I'm 100% here not to judge, but to help you figure out how to put the pieces back together.
00:17:15.279 --> 00:17:17.119
And that's the trust.
00:17:18.079 --> 00:17:18.480
Lovely.
00:17:18.640 --> 00:17:19.200
Thank you.
00:17:19.759 --> 00:17:20.079
Yeah.
00:17:20.160 --> 00:17:22.960
I mean, yeah, it's so very well said.
00:17:23.039 --> 00:17:27.119
And I, you know, I I gotta ask the next question, just kind of, you know, maybe going off that too.
00:17:27.200 --> 00:17:36.960
I think, you know, again, maybe thinking from you know, beginning practitioners, students who might be listening, you know, the the challenge always I think is to keep them coming back, right?
00:17:37.039 --> 00:17:40.319
So that beginning part of that therapeutic relationship is is also important.
00:17:40.480 --> 00:17:48.160
But I I think, you know, again, based on your experience and how long you've been doing this, I think there's another side of this that you know can present some challenges.
00:17:48.240 --> 00:18:02.400
And I wonder if you can speak to this maybe a little bit, you know, after you've been seeing somebody for five, you know, 10 years, maybe even more, you know, what sort of what sort of challenges, you know, come up with that kind of longevity in your relationship with a patient?
00:18:02.799 --> 00:18:14.000
You know, thinking maybe some counter-transference or other things, but but what are some things that maybe come to your mind that's that that present themselves in maintaining that trust in that relationship we were just talking about over long periods like that?
00:18:14.400 --> 00:18:18.319
I think the hardest part is keeping the boundaries within that therapeutic relationship.
00:18:18.400 --> 00:18:27.680
And I mean, it can be something as simple as if I've seen someone for 10 years, in my head and in my heart and in my soul, they're my friend, number one.
00:18:27.920 --> 00:18:34.720
And being able to say when they walk in the door, okay, yes, you're my friend, but I'm your provider and you're my patient.
00:18:34.880 --> 00:18:38.000
And being able to separate out those two, it's been very challenging.
00:18:38.160 --> 00:18:44.319
I recently had a patient after 14 years ask for her records because she was going somewhere else.
00:18:44.480 --> 00:18:49.039
And I live in a small town and I ran into her and she, you know, kind of high.
00:18:49.119 --> 00:18:50.319
And we talked for a minute.
00:18:50.400 --> 00:18:54.799
And I said, Can you can you share with me a little bit about why you're going with someone else?
00:18:55.039 --> 00:18:58.480
Because I mean, it really bothered me for months knowing this.
00:18:58.640 --> 00:19:01.039
And she said, I just feel like we got too close.
00:19:01.839 --> 00:19:03.920
And I I appreciated that from her.
00:19:04.079 --> 00:19:11.759
It was wonderful feedback for me to get because we had, you know, the first thing that we would talk about was, oh, how are your kids doing?
00:19:11.920 --> 00:19:13.359
And, you know, how are things going?
00:19:13.519 --> 00:19:14.319
How's the weather?
00:19:14.400 --> 00:19:16.240
You know, just friendly conversation.
00:19:16.480 --> 00:19:21.119
And at that point in her life, she needed a provider, not a friend.
00:19:21.519 --> 00:19:33.920
And it really set me back to think about the patients that I've had for a long time and how I need to remember to respect those boundaries and that sometimes they need more than me.
00:19:34.319 --> 00:19:37.039
You know, they need they need a fresh set of eyes.
00:19:37.200 --> 00:19:40.400
They need someone that doesn't know their whole history, their whole baggage.
00:19:40.480 --> 00:19:45.519
But that is that's challenging emotionally for me because I develop a relationship.
00:19:45.759 --> 00:19:55.519
I like to say that I have great boundaries, but you know, again, I'm a person and in my heart and soul, it's hard not to be a friend to somebody.
00:19:56.000 --> 00:20:07.440
Wow, thank you for that vulnerability and and just the uh, I would say the confidence that it takes to kind of share those kind of things because what I heard there too is you were, you know, you were open to the idea that this is a learning experience for you as well, you know.
00:20:07.519 --> 00:20:15.680
And so so I you know, really applaud you for, you know, taking that extra step and learning from, you know, it's it's one of those things I I try to remind myself as well.
00:20:16.160 --> 00:20:20.240
I I try to make sure that I'm not learning more from the patient than than they're learning from me.
00:20:20.319 --> 00:20:24.319
But there is definitely a dynamic there where I continuously learn from patients all the time.
00:20:24.400 --> 00:20:27.519
So thank you for that experience, that that example.
00:20:27.920 --> 00:20:29.200
You're welcome.
00:20:29.599 --> 00:20:31.599
And I'd like to pick up on that a little bit.
00:20:31.680 --> 00:20:35.119
Uh just you know, something you mentioned, Chris, about living in a small town.
00:20:35.279 --> 00:20:42.160
And, you know, we know that NPs are often positioned as providers who are working in smaller areas, more rural areas, whatnot.
00:20:42.319 --> 00:20:47.039
And that kind of can come with a its own set of challenges when we are providing mental health care.
00:20:47.200 --> 00:20:57.839
I'm curious over you know, the last couple of decades, while you've been doing this work, how you have learned to draw boundaries or you know, guidance you give to your students working in this type of setting.
00:20:58.240 --> 00:20:58.720
Yeah.
00:20:58.960 --> 00:21:05.920
It one thing I've done to help myself is I've expanded out with telehealth, you know, outside of my small community.
00:21:06.160 --> 00:21:13.839
I would say as a provider, one of the challenging parts is feeling like I failed a patient when I see them not doing well.
00:21:14.000 --> 00:21:18.799
It's not only did I fail them, they're living in my community, I failed my community now.
00:21:19.039 --> 00:21:22.480
And so I've kind of had to do that a lot with my students.
00:21:22.559 --> 00:21:24.480
I talk to them about how that feels.
00:21:24.720 --> 00:21:37.359
I'm like, that's a very valid emotion to have when you're treating someone down the road and then you see them relapse or they end up in jail, you know, you feel like not only you failed them, you failed your whole community.
00:21:37.680 --> 00:21:43.039
So I have been very good about, I mean, simple things like my husband goes to the grocery store.
00:21:43.200 --> 00:21:46.880
I don't, you know, the shopping I shop out of town.
00:21:47.039 --> 00:21:49.279
I have a primary care provider out of town.
00:21:49.440 --> 00:21:52.000
I try to separate out some of that.
00:21:52.240 --> 00:21:57.759
So, because I don't want my patients to feel like I'm here in this community watching them as well.
00:21:58.000 --> 00:21:59.839
I want them to have that freedom.
00:22:00.559 --> 00:22:07.599
But being able to, you know, at there was one point where I said, oh, I'm just going to take care of my community because that's what I need to do.
00:22:07.759 --> 00:22:11.599
And then I realized for me as a provider, that was hard.
00:22:11.920 --> 00:22:20.400
I needed to take care of other communities as well, ones that weren't part of my everyday, you know, going to the grocery store, the post office, whatever it might be.
00:22:20.880 --> 00:22:32.960
I just so I teach my students, you know, it's okay to, you know, especially if a a patient acknowledges you and, you know, out in public to say hello to them.
00:22:33.279 --> 00:22:36.480
But you have to remember that they're just living their life too.
00:22:36.640 --> 00:22:38.480
You know, that's not an appointment.
00:22:38.640 --> 00:22:42.160
You don't have to feel bad about what's happening with them at that point.
00:22:42.400 --> 00:22:43.359
I don't know.
00:22:43.680 --> 00:22:45.759
It's a hard one, really hard.
00:22:46.160 --> 00:22:54.400
So I think I I I'm just gonna take away from that that the way to get uh rid of a lot of chores in your life is to work in a small town and you can offload that to your partner, right?
00:22:54.880 --> 00:22:55.359
That's right.
00:22:55.680 --> 00:22:56.559
That's a great strategy.
00:22:56.640 --> 00:22:57.359
I love it, Chris.
00:22:57.519 --> 00:22:58.160
That's great.
00:22:59.839 --> 00:23:00.400
Melissa.
00:23:00.720 --> 00:23:01.440
Yes, thank you.
00:23:01.599 --> 00:23:11.359
Uh um my head went to actually when I lived in Iowa City and I saw a provider, and I just remember the provider telling me, because Iowa City is like 80,000 people, right?
00:23:11.519 --> 00:23:13.519
But you see, it it feels smaller than that.
00:23:13.759 --> 00:23:17.759
If we see each other in the grocery store, I'm probably not gonna acknowledge you, right?
00:23:18.319 --> 00:23:20.000
That's kind of the boundary that she had set.
00:23:20.079 --> 00:23:23.920
Like it's not personal, it's just a boundary, or how she said it.
00:23:24.319 --> 00:23:24.640
Yeah.
00:23:24.880 --> 00:23:25.759
Okay, question.
00:23:26.160 --> 00:23:26.319
Sure.
00:23:26.880 --> 00:23:28.559
My mind went back into my memory.
00:23:28.880 --> 00:23:34.079
So actually, you know, this this goes along well with a number of things that you've shared today.
00:23:34.319 --> 00:23:37.920
Psychiatric nursing demands high emotional bandwidth.
00:23:38.160 --> 00:23:41.279
And burnout among new grads is a growing concern.
00:23:41.519 --> 00:23:51.759
What advice or practical self-care boundaries do you stress to your students and early career colleagues, learning colleagues, to ensure they build a sustainable lifelong practice?
00:23:52.160 --> 00:24:01.279
It's funny because I have what I call a behavior lab with my students where we just talk about emotions and feelings and it's an optional thing that they can be a part of.
00:24:01.440 --> 00:24:14.559
But one of the things I always say to them is, I'm not going to give you all that mumbo jumbo self-care talk, you know, because when people tell me to go do yoga and do meditation and all these things, I do not do that.
00:24:14.720 --> 00:24:15.920
That is not me.
00:24:16.400 --> 00:24:21.039
And for so many years, people were like, Well, you need to do meditation.
00:24:21.200 --> 00:24:22.640
You should work out more.
00:24:23.119 --> 00:24:25.920
And what I need to do is talk more.
00:24:26.400 --> 00:24:28.160
That's what's therapeutic for me.
00:24:28.319 --> 00:24:34.079
To go to a conference and run into Dan and be able to just have a conversation about something.
00:24:34.240 --> 00:24:36.160
That those are things that relieve me.
00:24:36.319 --> 00:24:47.359
Hearing someone else who's stressed a little bit in their job or that they have to meet the AACN essentials, you know, something so we all have different ways of coping.
00:24:47.440 --> 00:24:59.680
And I think we've gotten into this little box as nurses of being able to say, you know, meditate, do yoga, do all these things, and and realize that's not where everybody finds their self-care.
00:24:59.920 --> 00:25:05.119
So just being able to expand outside of that, um, there is a high burnout.
00:25:05.200 --> 00:25:06.880
And I was one of those nurses.
00:25:07.119 --> 00:25:14.319
I was one that applied to law school, that got into law school, that said, I'm not going to be a psychiatric nurse anymore.
00:25:14.640 --> 00:25:24.480
And what changed to that was recommitting to education, saying, okay, before I go to law school, let me go on and get a graduate degree.
00:25:24.640 --> 00:25:29.680
And maybe that'll that'll, you know, prompt me in a different direction or move me in a different direction.
00:25:29.920 --> 00:25:37.839
And I did a full qualitative study in that master's program where I asked patients what it was like to be locked up in a unit.
00:25:38.079 --> 00:25:43.920
And the words and voices I heard from them to this day impact how I am as a nurse.
00:25:44.079 --> 00:25:52.079
It forever changed me because as they told me they felt like they were being cattle herded through a process and that they had no control.
00:25:52.720 --> 00:25:56.240
It made me step back and think, who am I as a nurse?
00:25:56.400 --> 00:25:59.599
And how can I change that, shift that whole paradigm?
00:25:59.759 --> 00:26:02.559
Um, and that is that's what helped me with my burnout.
00:26:02.720 --> 00:26:09.759
It wasn't going to yoga classes or meditating, it was diving deeper into nursing.
00:26:10.079 --> 00:26:15.599
So I think I think we have to just take different approaches on what self-care may look like.
00:26:16.240 --> 00:26:19.839
It doesn't always mean, you know, being away from nursing.
00:26:19.920 --> 00:26:22.880
It might be digging deeper into nursing.
00:26:23.200 --> 00:26:28.880
It sounds like actually finding like your purpose and drive and why for doing that came from that qualitative study.
00:26:29.200 --> 00:26:30.799
And thank you for the self-care comment.
00:26:30.880 --> 00:26:32.960
Because that's a non-I mean, same, same.
00:26:33.039 --> 00:26:34.799
Like mindfulness is great, right?
00:26:34.960 --> 00:26:36.720
I'm breathing's great.
00:26:36.960 --> 00:26:39.920
And yes, we need to not box people.
00:26:40.559 --> 00:26:44.720
Like you need to do my students always giggle and say, thank you.
00:26:44.799 --> 00:26:53.200
Because if one more person brings me pizza and then tells me, you know, to have a quiet moment, I feel like I'm gonna go insane myself.
00:26:53.519 --> 00:26:54.000
Right.
00:26:55.920 --> 00:26:58.319
Oh, so that's that's yeah, that's so great.
00:26:58.480 --> 00:27:03.039
Uh yeah, and I, you know, I would just say too, I think this podcast has really kept me from burning out.
00:27:03.119 --> 00:27:06.960
So thank you for the listeners and thank you for Kate, Melissa, and Chris, you too.
00:27:07.039 --> 00:27:08.880
It's uh something that fills my cup.
00:27:08.960 --> 00:27:13.920
So so the next what we'd like to do here is have a recording of our previous guest, Dr.
00:27:14.000 --> 00:27:15.440
Kathleen McDermott.
00:27:15.599 --> 00:27:19.759
She's gonna ask you a question, and uh, we'd love to hear your response on the other side.
00:27:19.839 --> 00:27:20.640
So here we go.
00:27:20.799 --> 00:27:21.039
All right.
00:27:21.359 --> 00:27:21.759
Here we go.
00:27:22.000 --> 00:27:25.519
All right, as we're doing here, we're asking the question for our next guest.
00:27:25.680 --> 00:27:26.400
Thank you, Dr.
00:27:26.480 --> 00:27:29.119
Kathleen McDermott, for asking question for Dr.
00:27:29.200 --> 00:27:30.400
Chris Vandenberg.
00:27:30.559 --> 00:27:31.680
What do you got for her?
00:27:32.240 --> 00:27:33.279
Hello, Dr.
00:27:33.359 --> 00:27:34.480
Chris Vandenberg.
00:27:34.640 --> 00:27:36.480
I look forward to meeting you at some point.
00:27:36.799 --> 00:27:41.599
My question for you I've I've stalked you a little bit online to learn a little bit about you.
00:27:41.759 --> 00:27:44.000
I understand that you've been in practice for a long time.
00:27:44.160 --> 00:27:44.960
I have too.
00:27:45.119 --> 00:27:56.640
I'd be curious, excuse me, I'd be curious to hear your thoughts on how on the evolution of psychiatric mental health nurse practitioner practicing.
00:27:58.160 --> 00:28:05.759
I'd be curious to hear your thoughts on how things have evolved over the course of your time practicing.
00:28:06.079 --> 00:28:11.680
And and if you're open to it, even beyond that, where do you see the practice going?
00:28:11.839 --> 00:28:13.200
What's your hope for that?
00:28:13.440 --> 00:28:15.920
And does that align with what you're seeing currently?
00:28:16.559 --> 00:28:17.599
Can't wait to hear your thoughts.
00:28:18.880 --> 00:28:19.759
Thank you for the question.
00:28:20.640 --> 00:28:29.519
And I think we've talked a little bit about the evolution of the psych nurse practitioner and how it's coming back, or I feel like it's coming back full circle.
00:28:29.599 --> 00:28:35.279
Now that might be because in my long career, I feel like I'm coming back full circle.
00:28:35.599 --> 00:28:41.039
So, you know, where do I where do I see the psych nurse practitioner role evolving to?
00:28:41.839 --> 00:28:57.599
I I want to see it come back to the integration of really getting to know somebody versus just the prescription management, you know, here's a pill, here's a script, go, go, go, the more, the merrier, the more the money.
00:28:58.319 --> 00:29:01.359
And and again, that's I've practiced a long time.
00:29:01.680 --> 00:29:08.400
So that's kind of going back to what I always envisioned myself being as a nurse practitioner.
00:29:08.799 --> 00:29:11.200
But there's definitely been a lot of evolution.
00:29:11.680 --> 00:29:12.880
Yeah, yeah, there has.
00:29:13.039 --> 00:29:17.039
And so I'm hoping that there is still a practice in our future as well.
00:29:17.200 --> 00:29:25.359
And, you know, I think that's what we do as educators to try to, you know, leave a little bit for the next generation and the next group of students that we take care of.
00:29:25.440 --> 00:29:32.000
And yeah, I always like the the comments that sometimes we say at our college is, you know, we are training people to take care of us in the future.
00:29:32.079 --> 00:29:34.000
And so let's do a good job, Chris.
00:29:34.400 --> 00:29:35.359
I hope that is true.
00:29:35.599 --> 00:29:37.279
Yeah, we all hope that's true, right?
00:29:37.359 --> 00:29:39.119
So well, thank you again, Dr.
00:29:39.200 --> 00:29:41.200
Chris Vanderbergen Harrison.
00:29:41.359 --> 00:29:42.559
Thank you so much for being our guest.
00:29:42.640 --> 00:29:46.319
This has been a true pleasure, and and thanks for sharing your expertise here with us.
00:29:46.559 --> 00:29:53.119
Those listening, we'll have another podcast episode soon, and and you'll hear from Chris again with another question for our future guests.
00:29:53.279 --> 00:29:54.240
So thank you so much.
00:29:54.400 --> 00:29:59.839
Keep listening, like, subscribe, uh, add comments again, share those who want to be here with us too.
00:29:59.920 --> 00:30:02.720
So thank you so much, and uh look forward to a new episode.
00:30:04.079 --> 00:30:06.319
Carrying the torch through the blood and the rain.
00:30:06.480 --> 00:30:08.480
We are nurses, the world can't forget.
00:30:08.720 --> 00:30:10.720
We give our all, no regrets.
00:30:15.920 --> 00:30:17.119
We are nurses.
00:30:17.440 --> 00:30:18.960
So answer the hands to hell.
00:30:21.279 --> 00:30:23.279
Voice that whisper, you're not alone.