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

00:03:29.960 --> 00:03:34.599 That realization ultimately inspired her to write her book, Nursing Intuition. 00:03:35.000 --> 00:03:50.439 In today's conversation, we dive into what nursing intuition really is, how it differs from clinical judgment, why experienced nurses often recognize subtle changes before the monitors do, and how new nurses can begin developing this skill from the very start of their careers. 00:03:50.680 --> 00:04:03.320 We also talk about Jennifer's own nursing story, overcoming workplace bullying, finding her love for emergency nursing, and why learning to trust yourself may be one of the most important skills you'll ever develop as a nurse. 00:04:03.560 --> 00:04:21.480 Whether you're a nursing student, a new grad, or an experienced nurse who's ever had that quiet feeling that something's not quite right, I think you'll walk away from this episode with a whole new appreciation for the incredible blend of science, experience, and intuition that makes nursing such a remarkable profession. 00:04:21.879 --> 00:04:25.560 Okay, let's jump into today's conversation with Jen Johnson. 00:04:25.959 --> 00:04:30.839 I'd like to welcome Jennifer Johnson to the Life After Nursing School podcast. 00:04:31.000 --> 00:04:32.759 I'm so excited to have you, Jen. 00:04:32.920 --> 00:04:35.319 I've been a follower for actually quite some time now. 00:04:38.839 --> 00:04:46.199 It's like the weirdest most complimentary thing ever, where you're just like, nobody follows, like nobody listens. 00:04:46.360 --> 00:04:50.439 Nobody, I'm just shooting this out into the internet superspace to be like, meh. 00:04:51.079 --> 00:04:52.040 It's so true. 00:04:52.199 --> 00:04:54.279 You don't realize the impact that you have on the other end. 00:04:54.360 --> 00:04:56.279 And you know, you just go with your daily life. 00:04:56.439 --> 00:05:02.759 I've had a previous coworker even message me a couple of times in the last month being like, hey, I shared your page with a nursing student. 00:05:02.839 --> 00:05:04.360 Oh, I referred another girl to you. 00:05:04.439 --> 00:05:05.800 And I'm like, that's so nice. 00:05:06.360 --> 00:05:07.240 Like it's the best. 00:05:07.719 --> 00:05:08.040 Yeah. 00:05:08.199 --> 00:05:09.000 I just, I don't know. 00:05:09.079 --> 00:05:13.560 I don't think people realize the impact that has on the person actually creating the content and putting stuff out there. 00:05:13.800 --> 00:05:14.199 Absolutely. 00:05:14.360 --> 00:05:14.519 Right. 00:05:14.759 --> 00:05:17.719 And of course, because you're just like constantly putting you out there. 00:05:17.799 --> 00:05:19.959 You're like, hope I don't get fired this week. 00:05:20.199 --> 00:05:21.719 Hope I don't say something stupid. 00:05:22.039 --> 00:05:23.479 You're like, is anybody out there? 00:05:23.639 --> 00:05:25.879 Like I feel like that Adele song, like, hello. 00:05:26.519 --> 00:05:26.759 Hello. 00:05:27.079 --> 00:05:28.439 Is anyone anyone? 00:05:30.279 -->

00:05:39.319 Um, but Jen, can you please like share a little bit about yourself and what your life looked like after nursing school and what led you to write the book about? 00:05:40.839 --> 00:05:41.319 Yeah. 00:05:41.560 --> 00:05:44.120 So everything, you know, fell into nursing. 00:05:44.279 --> 00:05:48.759 It was never kind of a thought process, ended up just kind of falling into it. 00:05:49.000 --> 00:05:52.359 When I graduated, I was then dating my now husband. 00:05:52.439 --> 00:06:02.199 And so he's like, hey, there's there's an opening at this teeny tiny little rural hospital, one RN for merge, one RN with two LVNs or RPNs on the floor. 00:06:02.439 --> 00:06:03.560 You know, have that. 00:06:03.719 --> 00:06:05.479 And I'm like, sure. 00:06:05.799 --> 00:06:08.120 So, you know, you got to play house. 00:06:08.439 --> 00:06:09.799 There was a job opening. 00:06:10.039 --> 00:06:12.599 It seemed like it was, you know, made in heaven. 00:06:12.839 --> 00:06:17.879 Um, the worst bullying experience of my entire life and career. 00:06:18.120 --> 00:06:21.959 Yeah, kind of like five years of the joys of that. 00:06:22.359 --> 00:06:27.319 Fast forward where we get married, and I'm like, haha, I can't stay here anymore. 00:06:27.479 --> 00:06:30.759 We are not even joking, literally living next door to your mother. 00:06:30.919 --> 00:06:34.039 So we're gonna have to draw some clear boundaries. 00:06:34.199 --> 00:06:39.719 I'm gonna we're gonna have to pop off here because this is only gonna get worse once the kids come. 00:06:39.879 --> 00:06:40.199 Yeah. 00:06:40.519 --> 00:06:52.759 So moved down south, finally got to go into a much larger center, stroke center, and got to meet the most fun people, some of whom I actually just volunteered at my kids' camp last week. 00:06:52.839 --> 00:06:58.439 And I got to re-hit up my buddy, who he and I were working together with these 300 kids. 00:06:58.680 --> 00:07:07.799 And it was just like no time had passed, even though it's probably been, you know, we've done it yearly for the last three years, but before that, like we kind of lost touch for about 10 years. 00:07:08.039 --> 00:07:16.519 So, you know, just getting back into it and and actually finding the love of nursing and like, okay, these are my people and and this is what's going on. 00:07:16.680 --> 00:07:30.439 And in a really big emerge, which, you know, if you're an undiagnosed ADHD or a diagnosed ADHDer, you tend to fall into a merge that's just kind of what calls to a the chaos calls, and we go, yes. 00:07:31.239 --> 00:07:37.079 So ended up back in a merge, and just things were going really well. 00:07:37.319 --> 00:07:42.439 Ended up being my husband was headhunted by another hospital system about an hour up the road. 00:07:42.519 --> 00:07:44.199 So we're like, sure, let's move. 00:07:44.439 --> 00:07:50.279 Had a few years jumping from the pediatric hospital and then to the like did a year there. 00:07:50.359 --> 00:07:54.120

I was like, this is cool, but it's the same six things over and over and over again. 00:07:54.279 --> 00:08:00.839 And as much as I love dealing with parents when it's like one every 50 people, I can't do it when it's all parents. 00:08:01.000 --> 00:08:02.199 So I'm gonna, I'm gonna bounce. 00:08:02.359 --> 00:08:03.639 I'm gonna go back to adults. 00:08:03.719 --> 00:08:04.599 I miss them. 00:08:04.919 --> 00:08:10.759 So went to the trauma center, kind of stuck around there, and then needed a full-time line. 00:08:11.079 --> 00:08:25.719 You know, the kids were born and they're starting to grow up, and I'm like, okay, we need some structure and ended up falling into my job now, um, which is an emergency department, which is like a little sister or little brother of kind of the the larger healthcare system. 00:08:26.039 --> 00:08:31.159 So a little bit rural, but we've got a CT, we've now got RTs 24-7, God bless. 00:08:31.479 --> 00:08:51.799 And then COVID hit, and it was just chaos, as per anybody who was even remotely paying attention during that time, whether you were bedside, in hospital, in home, clinics, management, like nobody came away unscathed. 00:08:52.039 --> 00:09:04.519 And so up in Canada, there were a group of uh lawyers that had come forward and and with the best intentions, were like, we'd love to do everybody's, you know, all these frontline responders their wills for free. 00:09:04.759 --> 00:09:10.440 And at the time, unfortunately, all we heard was you're not gonna make it. 00:09:10.840 --> 00:09:18.840 So, you know, it really, if I was already kind of circling the train a little bit, that just last little kick over the edge. 00:09:19.159 --> 00:09:31.879 And it got me thinking, my kids were four and five when COVID hit, you know, if I I'm choosing to continue to go into work, if I die, how do I explain to them why I continue to choose to go to work? 00:09:32.040 --> 00:09:38.120 And so, you know, had a couple of nice stories, and you're writing down the nice little stories and it's cute and everything. 00:09:38.280 --> 00:09:45.560 And because I was so sleep deprived and so out of my mind, the trauma, there was no more blockade for the trauma. 00:09:45.639 --> 00:09:48.440 So it just came flying through. 00:09:48.759 --> 00:10:03.240 And after writing years worth of the little stories that we turn into two-minute nuggets for everybody else at 3 a.m., I've now gone into detail with it and gone back and said, like, okay, what's the theme here? 00:10:03.400 --> 00:10:11.160 And so Llewellyn, who's a metaphysical publisher out in the out in the States, they were having online book fairs and I kept meaning to catch them and I kept missing them. 00:10:11.240 --> 00:10:12.759 And I was just like, what the heck's going on? 00:10:13.000 --> 00:10:17.879 The one that I caught, the author was talking about her book, Intuition at Work. 00:10:18.040 --> 00:10:19.879 And I'm like, Intuition at work. 00:10:20.040 --> 00:10:22.280 I'm like, there I use my intuition all the time at work. 00:10:22.440 --> 00:10:27.480 And it was just this like snap moment of, oh my god, that's it. 00:10:27.639 --> 00:10:28.200 That's the theme. 00:10:28.280 --> 00:10:39.720 So go back and sure enough, every single story had some element of intuition, whether I knew whether I was trusting my gut, whether I wasn't, did was I believed, was I not? 00:10:39.879 --> 00:10:40.759 Did anything happen? 00:10:40.920 --> 00:10:43.080 Did did something not great happen? 00:10:43.320 --> 00:10:45.480 And going, like, okay, here we are. 00:10:45.800 --> 00:10:48.040 I've I've cranked out this book in like six weeks. 00:10:48.200 --> 00:10:50.040 I'm like, this is insane. 00:10:50.200 --> 00:10:53.400 I don't, and to be fair, I don't remember writing the book. 00:10:53.720 --> 00:10:57.000 I think I've blocked it out mentally and physically. 00:10:57.160 --> 00:11:02.200 I remember getting up really, really early, like a three, four o'clock in the morning to like continue to write. 00:11:02.360 --> 00:11:06.759 I remember staying up super late, but it just all spilled out. 00:11:07.080 --> 00:11:12.360 And you're looking at, you're like, okay, this idea of intuition and nursing, we all talk about it at 3 a.m. 00:11:12.600 --> 00:11:17.160 That gut feeling, the docs can call it Spidey Sense, and that's 100% acceptable. 00:11:17.639 --> 00:11:23.800 We we call it just a gut feeling, and we're like, and the depending on the doc, sometimes it's like, oh, well, you know, what do you mean? 00:11:23.960 --> 00:11:25.400 Where's your where's your evidence? 00:11:25.480 --> 00:11:26.440 And and all this kind of stuff. 00:11:26.519 --> 00:11:34.519 So I thought, okay, if I put this out there without any science behind it, I think I actually would be risking my license a little bit. 00:11:35.160 --> 00:11:47.800 And the university prepared nurse is is dying to throw in some references, and I'm going, okay, maybe there's one or two within the last five to ten years, and that'll be enough, kind of thing. 00:11:48.519 --> 00:11:54.040 There were like 800 studies on specifically intuition in nursing. 00:11:54.280 --> 00:11:58.920 Wow, it was unbelievable the amount of science. 00:11:59.000 --> 00:12:02.120 And I'm sitting there going, like, you're joking. 00:12:02.280 --> 00:12:15.400 I'm reading study after study and and going, like, okay, the the science is here, and we've all been taught if the science is there, it doesn't matter how you feel about it, you teach it because the science is backing it. 00:12:15.560 --> 00:12:23.080 And I'm like, okay, well, guess if somebody's gonna be the one to kind of you know say something, it might as well be me. 00:12:23.320 --> 00:12:27.000 And so I wrote the book on intuition and nursing. 00:12:27.320 --> 00:12:28.200 Oh my gosh. 00:12:28.360 --> 00:12:31.639 Just a little quick little round of applause for you because that's amazing. 00:12:31.800 --> 00:12:38.040 Wait, there's so

many things in your story though that I need to touch upon before we jump into intuition, which I cannot wait to talk about. 00:12:38.200 --> 00:12:38.519 Okay. 00:12:39.400 --> 00:12:43.320 First, backing up to the initial five years of bullying. 00:12:43.400 --> 00:12:48.680 Like I'm so hung up on that because now this is like you were a new grad, right? 00:12:48.920 --> 00:12:53.240 Also, what I want to point out too is that you said, okay, you had those five years of being bullied. 00:12:53.560 --> 00:12:58.120 You also then sort of lived lived next to your mother-in-law who like maybe it was too close. 00:12:58.280 --> 00:12:59.320 You needed to set boundaries. 00:12:59.560 --> 00:13:06.920 Sounded like you set boundaries, and then you literally like went to a place you loved and moved and were happier. 00:13:07.000 --> 00:13:12.600 And I love that because I think it's so scary to set boundaries, especially with the people we love the most, right? 00:13:12.680 --> 00:13:16.040 Our family, like, hey, we're like a little too close to you. 00:13:16.200 --> 00:13:16.840 You know what I mean? 00:13:16.920 --> 00:13:19.160 Like it's like cool. 00:13:19.400 --> 00:13:20.920 Yeah, that's really hard to do. 00:13:21.000 --> 00:13:25.320 But I just want to highlight here for anyone that's like knows they need to set a boundary, but they're not. 00:13:25.639 --> 00:13:36.280 If you just it's hard, that uncomfortable thing, you may literally be like Jen and end up in a place that you love to work, end up with a great relationship with your whoever it is that you need to set that boundary with. 00:13:36.440 --> 00:13:41.960 And it will just propel you forward in the right direction, even if initially it sets you back a little bit, right? 00:13:42.120 --> 00:13:44.680 It's hard having it's so hard. 00:13:45.000 --> 00:13:47.000 And sometimes they're not reciprocated. 00:13:48.280 --> 00:13:51.240 Or they take a minute to understand why they might feel hurt. 00:13:51.480 --> 00:13:54.759 We go through all the conflict resolution and whatnot, right? 00:13:54.840 --> 00:13:56.200 All of the conversations. 00:13:56.680 --> 00:14:03.320 It's a whole thing where it's like, you know, hey, put a helmet on the kid when they're on the ATV or their bikes. 00:14:03.480 --> 00:14:05.240 And she's going, Well, what do you mean? 00:14:05.320 --> 00:14:06.600 Like, I would never hurt the children. 00:14:06.680 --> 00:14:08.600 And I'm like, I'm an ER nurse. 00:14:08.680 --> 00:14:10.600 Your son used to be a paramedic. 00:14:11.160 --> 00:14:14.519 Real medical help is two hours away from here. 00:14:14.759 --> 00:14:24.040 Real medical help, like the hospital that I work with, you know, there's no vent, there's no RT, there's no CT, there's no MRI, there's there's no PEDs really. 00:14:24.840 --> 00:14:28.680 Real medical, true medical help is two hours away. 00:14:28.920 --> 00:14:32.200 But wait, tell me about those five years of bullying. 00:14:32.280 --> 00:14:33.240 Like, what did that look like? 00:14:33.400 --> 00:14:34.440 Was it undermining? 00:14:34.600 --> 00:14:35.400 Was it legit? 00:14:35.480 --> 00:14:37.879 Like, I don't know, did they come after you? 00:14:38.040 --> 00:14:40.840 Was it a nurses eat nurses kind of a situation? 00:14:41.480 --> 00:14:42.440 Of course it was. 00:14:42.680 --> 00:14:47.800 Of course it was, because they warn you in school, hey, just so you know, nurses eat their young. 00:14:47.960 --> 00:14:51.480 And at the time you're kind of going, like, okay, this is a standard practice. 00:14:51.639 --> 00:14:52.759 I need to be aware of it. 00:14:52.920 --> 00:14:56.280 They don't say though whether it's acceptable or not acceptable. 00:14:56.440 --> 00:14:56.759 Totally. 00:14:56.920 --> 00:15:02.120 They just say, hey, this is what's gonna happen, or this is more likely what's going to happen. 00:15:02.280 --> 00:15:02.840 So great. 00:15:02.920 --> 00:15:03.960 I kind of saw it coming. 00:15:04.040 --> 00:15:20.440 I saw it for what it was, very much undermining, very much giving me heavy assignments, even though we have a union up here that regulates you can't go from a night shift within 24 hours to a day shift because she was the like mid-manager, nobody could really figure out what she did in a day. 00:15:20.600 --> 00:15:25.320 She was like 65, she did, you know, did whatever she wanted. 00:15:25.480 --> 00:15:28.200 And you know, the one day we had like sat down. 00:15:28.280 --> 00:15:41.960 And I think so, in a town of like less than 5,000 people over the span of 20, 25 years, she had pushed out like 15 RNs in a town that small out of the hospital system, which the hospital system was dying. 00:15:42.200 --> 00:15:45.000 So everybody knew that this was what happened. 00:15:45.160 --> 00:15:52.840 It was very well known, you know, especially with the hospital and a town that small, and everybody knows everybody's deal, everybody's business. 00:15:53.000 --> 00:15:58.680 You really can't afford to push people out when you have a very small school of people around that are could be your applicants, right? 00:15:58.759 --> 00:16:00.600 Like you you really can't percent. 00:16:01.000 --> 00:16:13.960 There were only eight full-time lines, there were five or six part-time lines, there were maybe five or six other full-time nursing jobs within the town. 00:16:14.519 --> 00:16:16.360 Virtual nursing was not a thing. 00:16:16.519 --> 00:16:20.360 There wasn't a lot of Zoom communications or anything like that. 00:16:20.440 --> 00:16:27.400 Like there, it was really just bedside and public health, and and maybe an awk health job here and there, but like that was it. 00:16:27.560 --> 00:16:30.920 And you know, working at Hydro and being the awk health nurse at Hydro. 00:16:31.400 --> 00:16:33.240 So it's like, what? 00:16:34.280 --> 00:16:50.680 And again, like she comes in, she's scheduling me all these double backs where I'm like nights today, nights today,

nights today, nights today, you know, every single scheduling me every single weekend because I'm part-time and doing whatever she wants, even though we've got a union, nothing was ever done. 00:16:50.759 --> 00:16:55.879 And so it got to the point where the day where I got to quit, so it had been five years. 00:16:56.040 --> 00:17:00.200 I had already gotten a job, southern Ontario from Northern Ontario. 00:17:00.600 --> 00:17:09.160 And we've been waiting three months because we needed two full-time incomes to be able to move from north to south because the you know it's so costly down here. 00:17:09.639 --> 00:17:13.639 And so my husband calls me, he goes, Hey, I got that job. 00:17:13.879 --> 00:17:15.720 And I said, We can move. 00:17:15.960 --> 00:17:16.920 He goes, Yes, we can move. 00:17:17.000 --> 00:17:17.799 I'm like, oh my God. 00:17:17.879 --> 00:17:27.879 I remember, and again, phone on the wall, like crumpling down onto the floor in the kitchen with the long cord, and just like, oh my god, I get to quit. 00:17:28.039 --> 00:17:30.519 And then like, ha, I get to quit. 00:17:30.759 --> 00:17:31.799 So went. 00:17:34.440 --> 00:17:52.839 So went up, got the exact same outfit that I interviewed in, exact same heels, exact same like little, you know, white dressy, you know, suitsy thing, walked in, and thank God it wasn't like winter time because I would have froze, but like go in there and go see the chief nursing officer. 00:17:52.920 --> 00:17:55.480 And he's been, you know, a tool to me this whole time. 00:17:55.559 --> 00:17:57.400 And I'm like, do not be unprofessional. 00:17:57.559 --> 00:17:59.319 You're still you're not burning a bridge. 00:17:59.559 --> 00:18:01.639 You getting out is you winning. 00:18:01.879 --> 00:18:04.120 So just cut it off as it is. 00:18:04.200 --> 00:18:04.840 And you know what? 00:18:04.920 --> 00:18:07.160 You know, oh, thank you so much for this opportunity. 00:18:07.319 --> 00:18:08.680 I've learned a lot. 00:18:08.920 --> 00:18:12.200 I'm continuing in emergency medicine, and this is where I've gotten my start. 00:18:12.279 --> 00:18:20.120 And I wouldn't have known about that unless I'd come here and trying to find the positive, like buried in all the negative. 00:18:20.279 --> 00:18:24.920 And then a little, I walked myself up to the floor and I'm like, where is she? 00:18:25.079 --> 00:18:26.920 Because she's working Monday or Friday. 00:18:27.640 --> 00:18:28.279 Seven to three. 00:18:28.360 --> 00:18:29.400 I'm like, where is she? 00:18:29.559 --> 00:18:32.279 And so, and everybody's looking at me because I'm dressed up. 00:18:32.360 --> 00:18:33.319 They're like, What's happening? 00:18:33.400 --> 00:18:36.360 I'm like, the tables have turned. 00:18:36.840 --> 00:18:37.960 The tables have turned. 00:18:38.039 --> 00:18:39.079 I'm so free. 00:18:39.319 --> 00:18:47.000 And you know, not that I'm still bitter 18 years, 18 years in, recounting this tale. 00:18:47.160 --> 00:18:49.559 And so I'm

like looking around and was like, Oh, where is she? 00:18:49.640 --> 00:18:50.680 I'm like, where is she? 00:18:50.759 --> 00:18:51.559 Let's go. 00:18:51.799 --> 00:18:53.000 And she comes around the corner. 00:18:53.160 --> 00:18:55.720 I'm like, oh hey, I got something to tell you. 00:18:55.799 --> 00:18:57.000 She's like, You quit. 00:18:57.160 --> 00:18:58.200 I know already, bye. 00:18:58.440 --> 00:19:00.600 And like she's got an Irish accent and off she goes. 00:19:00.680 --> 00:19:04.600 I'm like, I'm like, da-da-da, gonna walk myself. 00:19:04.920 --> 00:19:12.360 And her last act, I gave a month's worth of notice just to be again super appropriate, super professional. 00:19:12.680 --> 00:19:18.440 Because again, it it's gonna take them a long time to fill this spot because she's always known all the other nurses. 00:19:18.759 --> 00:19:27.720 So I do my two weeks and then I go in for the last two weeks, and as a last act, she has wiped out all of my shifts for the last two weeks. 00:19:27.880 --> 00:19:28.920 I'm like, you know what? 00:19:29.240 --> 00:19:30.759 You think that's gonna bug me? 00:19:31.640 --> 00:19:32.200 Done. 00:19:32.600 --> 00:19:35.000 Yeah, thank you so much for my time back now. 00:19:35.319 --> 00:19:35.720 See you. 00:19:36.039 --> 00:19:39.480 Got no goodbye party, got no goodbye gifts. 00:19:39.559 --> 00:19:41.160 It was five years that I was there. 00:19:41.240 --> 00:19:43.799 Wow, got nobody sent a card. 00:19:43.960 --> 00:19:47.000 No, I'm like, I see it for what it is. 00:19:47.160 --> 00:19:47.720 That's okay. 00:19:47.799 --> 00:19:49.240 It was a learning experience, awful. 00:19:49.720 --> 00:19:52.519 Totally, totally bigger, brighter things. 00:19:52.759 --> 00:19:56.200 The toxic work culture totally exists in healthcare. 00:19:56.279 --> 00:20:04.840 And it is amazing when you go from one toxic, even if it's a you one unit in the hospital and you go to another unit that's not toxic, it's like night and day. 00:20:05.160 --> 00:20:09.640 And really the people you work with can make or break just if you love the job or not. 00:20:09.799 --> 00:20:18.200 Like it could be your specialty that you want, but if the people around you are terrible humans, you're gonna you're gonna probably hate your job, right? 00:20:18.279 --> 00:20:25.079 Like and and if you find a sweet spot line, I mean, I could be doing any sort of nursing. 00:20:25.240 --> 00:20:27.799 Does emergency nursing really work for me? 00:20:27.960 --> 00:20:28.200 Yes. 00:20:28.279 --> 00:20:34.360 The quick turnarounds, the in and out, the problem solving, the solving a puzzle, you know, the adrenaline. 00:20:34.440 --> 00:20:36.200 Yes, it fits me to a T. 00:20:36.519 --> 00:20:42.279 However, if you were to stick me on med surge with my line that I've got currently, happy as a clam. 00:20:42.519 --> 00:20:44.360 Be like, yeah, right. 00:20:44.759 --> 00:20:45.079 Doesn't matter. 00:20:46.039 --> 00:20:47.240 I so agree with that. 00:20:47.319 --> 00:20:48.759 Oh my gosh, it totally resonates. 00:20:48.840 --> 00:20:54.759 And I think sometimes we get things a little backwards, like we're we're chasing the specialty, or I guess you call in Canada the line. 00:20:54.840 --> 00:20:55.480 Is that what you call it? 00:20:55.559 --> 00:20:58.440 Like a so a line is just like your line mates. 00:20:58.519 --> 00:21:06.680 So, you know, we have you know, two days, two nights, five off, or you're on a continental, but if you're full-time, you're typically on the same line. 00:21:06.920 --> 00:21:08.680 So you end up with the same people. 00:21:08.920 --> 00:21:16.680 There'll be a little bit of part-time people kind of flitting in and out, but for the majority, you're kind of stuck with those linemates because they don't shuffle them up. 00:21:16.840 --> 00:21:23.000 Thankfully, our boss is actually pretty awesome, and she tries to flip the lines every year or so, which is so nice. 00:21:23.160 --> 00:21:25.720 Cause then you're like, Oh, my body, I haven't seen my body in a year. 00:21:25.960 --> 00:21:27.480 Like, yes, now we're on the same line. 00:21:27.720 --> 00:21:28.120 Perfect. 00:21:28.279 --> 00:21:33.640 But yeah, specialties, ER, PACU, oncology, all the things. 00:21:33.960 --> 00:21:36.200 And even the whole nurses eat their young, you're right. 00:21:36.279 --> 00:21:41.880 It's sort of like, hey, buckle up, this happens when really why are we shining a light on it and making it okay? 00:21:42.120 --> 00:21:51.240 And I will say, I'm sure almost any nursing student you talk to nowadays, they feel it just from being a student, you know, and and I see it as a clinical instructor. 00:21:51.400 --> 00:21:53.720 I walk in there and the staff aren't happy to see me either. 00:21:53.880 --> 00:21:59.160 They don't they think, you know, and I'm not I try to be helpful, but at the same time, it's like I get it. 00:21:59.240 --> 00:22:00.680 I'm not one of you guys. 00:22:00.840 --> 00:22:02.600 I can't do everything that you are doing. 00:22:02.680 --> 00:22:05.720 I don't even work at the hospitals that I bring students into. 00:22:06.039 --> 00:22:11.079 So yeah, yeah, it there is definitely something there, and I hate it. 00:22:11.160 --> 00:22:11.799 I really hate it. 00:22:11.960 --> 00:22:15.000 I wish we were more of a supportive workforce. 00:22:15.079 --> 00:22:18.920 And I I think I want to think we're getting there, but I don't know. 00:22:19.720 --> 00:22:25.000 The new generations are not putting up with it at all, which I am so for. 00:22:25.240 --> 00:22:25.480 Yeah. 00:22:25.720 --> 00:22:31.480 A buddy of mine was complaining, we've got this newer grad who's now doing our haze chairs. 00:22:31.559 --> 00:22:41.720 So kind of like middle acuity is gonna need an RN scope and are just a little bit too sick for like the quick in and out RAS, but they usually will take. 00:22:41.799 --> 00:22:46.840 So the nurse that we had for the last like year, she would take

eight to eleven patients. 00:22:47.000 --> 00:22:47.960 She was phenomenal. 00:22:48.120 --> 00:22:50.360 She killed herself, like she she rocked it. 00:22:50.440 --> 00:22:51.880 She was an absolute rock star. 00:22:52.120 --> 00:22:53.799 And so now we've got this newer nurse. 00:22:53.880 --> 00:22:55.720 She caps herself at five. 00:22:56.039 --> 00:22:59.640 And she's not upset about that's she's not upset about and 00:23:00.120 --> 00:23:04.519 And so my buddies kind of texting me and he's she's like, you know, like I can't believe she's only take taking five. 00:23:04.600 --> 00:23:07.880 I'm like, hold on now, turn the script around. 00:23:08.200 --> 00:23:10.039 She knows to cap herself. 00:23:10.440 --> 00:23:15.000 And we're mad because she actually's doing it and she's actually doing it. 00:23:15.240 --> 00:23:20.279 The thing that we all want to do, we all want to cap, we all want to run like crazy. 00:23:20.440 --> 00:23:26.600 And yet we're getting mad at her for actually, again, setting the boundary and like saying, no, no, no, five is max. 00:23:26.680 --> 00:23:28.920 And once one goes, I can get another one in. 00:23:29.079 --> 00:23:35.079 If one all of a sudden they're being admitted, we can move them to a different area or like a chair freeze up. 00:23:35.319 --> 00:23:39.720 Absolutely, I will happily take another person, but no, I'm gonna cap five. 00:23:39.960 --> 00:23:42.200 Whereas the rest of us are running around like maniacs. 00:23:42.279 --> 00:23:45.000 I'm like, Yeah, and then burnt out and not wrong, guys. 00:23:45.160 --> 00:23:46.440 Like she's not wrong. 00:23:46.759 --> 00:23:47.400 I agree with you. 00:23:47.480 --> 00:23:52.600 I know Gen Z, there is a lot of evidence that shows that they are so driven by work life balance. 00:23:52.680 --> 00:24:04.279 And they aren't driven really by money, like the rest of us have been, you know, where they're like, no, I want a job that fits my life, that supports me, not living a life that supports my job, right? 00:24:04.360 --> 00:24:05.319 Or only working. 00:24:05.480 --> 00:24:07.720 And I think we can all learn from that. 00:24:07.799 --> 00:24:09.079 And I hope we can embrace that. 00:24:09.160 --> 00:24:14.759 And I love that you sort of stuck up for that new nurse because hello, she's like doing the Lord's work. 00:24:14.840 --> 00:24:16.440 We need to get on board with this. 00:24:16.600 --> 00:24:18.759 She's setting boundaries and eMERGE. 00:24:18.920 --> 00:24:20.039 Who would have thought? 00:24:20.440 --> 00:24:21.400 I love that. 00:24:21.640 --> 00:24:21.960 Okay. 00:24:22.120 --> 00:24:24.279 I want to obviously talk all things intuition. 00:24:24.360 --> 00:24:32.440 And just for reference for those listening, Jen's book is called Nursing Intuition: How to Trust Your Gut, Save Your Sanity, and Survive Your Career. 00:24:32.600 --> 00:24:33.799 And it's on Amazon, right? 00:24:34.279 --> 00:24:35.640 Burns and Noble Indigo. 00:24:36.200 --> 00:24:37.720 Oh, it's a Burns and Noble? 00:24:37.960 --> 00:24:38.519 Oh, yeah. 00:24:40.039 --> 00:24:44.600 I love nursing intuition because it's something we hear about, like you said, we talk about all the time. 00:24:44.840 --> 00:24:47.160 Yet it's kind of hard to define. 00:24:47.480 --> 00:24:53.640 So I don't know, maybe for newer nurses or people that are like, I don't know really what nursing intuition is. 00:24:53.880 --> 00:25:00.759 Can you sort of give us a definition or just explain to us a little bit about what nursing intuition is when we're talking about it? 00:25:01.079 --> 00:25:01.960 Absolutely. 00:25:02.200 --> 00:25:05.000 So again, nursing's predominantly female. 00:25:05.319 --> 00:25:11.319 We as females trust our guts implicitly and have been since at least age 12. 00:25:11.640 --> 00:25:14.759 You see a guy at the bar, immediate no. 00:25:15.079 --> 00:25:18.920 Have never talked to him, don't know who he is, just looking at him. 00:25:19.079 --> 00:25:22.440 The again, the Gen Z, the vibe is wrong, the vibe is off. 00:25:22.759 --> 00:25:25.400 There's something there, hard no. 00:25:25.720 --> 00:25:30.120 And you get that intuition, you get that idea, and you're like, nope, cut off. 00:25:30.440 --> 00:25:34.519 I don't, I've never talked to him, could care less, but there's just something there. 00:25:34.680 --> 00:25:35.799 And we trust it. 00:25:36.039 --> 00:25:39.480 There's somebody walking behind us, you're like, oh, my hair's on the back, your neck go up. 00:25:39.559 --> 00:25:41.640 You're like, I'm gonna cross the road. 00:25:41.960 --> 00:25:45.720 This is all in relation to your survival. 00:25:45.960 --> 00:25:49.559 So self-survival, we're always in self-survival mode as females. 00:25:49.720 --> 00:26:06.360 Again, I can't speak to the males, but as a female, you're constantly watching your peripherals, you're always on guard, especially critical care scenarios where people kind of get extra violent, get really good at sussing people out, and being like, you're gonna be a problem later. 00:26:06.600 --> 00:26:17.559 If I don't put a lid on this now, you are gonna spin and you're gonna get angry and you may get violent, or something's gonna blow up in my face, I'm gonna chart my behind off. 00:26:17.720 --> 00:26:27.880 And just make sure that if this is right in court, we have a whole lot of notes as to what precipitated because you know that something's coming down the pipe, so you can feel it. 00:26:28.360 --> 00:26:32.039 So to take that into nursing, it's another skill. 00:26:32.200 --> 00:26:34.279 It takes time, it takes effort. 00:26:34.519 --> 00:26:39.079 The way that I kind of figured out I was even doing this, I was playing a game at triage. 00:26:39.400 --> 00:26:47.640 I thought, you know, I'm 12 hours at triage, I've gone from seeing one to five patients in 12 hours to 120. 00:26:48.120 --> 00:26:53.880 And being that sorting system, you've got five minutes, that's all you've got at

triage, and on to the next. 00:26:54.360 --> 00:26:59.880 So, you know, you you kind of see people sitting there, and in order to keep myself engaged, it was like, okay, let me see. 00:27:00.039 --> 00:27:01.240 Do I think they're sick? 00:27:01.559 --> 00:27:05.079 Just by looking at them without talking to them, maybe, maybe not. 00:27:05.160 --> 00:27:05.720 I don't know. 00:27:05.880 --> 00:27:10.360 Um, then they come in, you get more of the story, you're like, oh, bells are going off. 00:27:10.519 --> 00:27:15.880 I'm starting to ask questions that maybe I don't typically ask, and they're out of my mouth before I realize. 00:27:16.120 --> 00:27:18.920 And in a merge, thankfully, most people answer the questions. 00:27:19.000 --> 00:27:24.600 They may or may not be truthful or to the full extent of the truth, but people answer the questions. 00:27:24.680 --> 00:27:27.640 So you're like, hey, how long is this one going on for? 00:27:27.799 --> 00:27:29.960 And all of a sudden you're going down a different path. 00:27:30.120 --> 00:27:31.640 And an idea pops into your head. 00:27:31.799 --> 00:27:35.480 Oh, I need to make sure that it's chest pain, but it's also into their back. 00:27:35.640 --> 00:27:37.960 It's maybe a little bit like tight. 00:27:38.200 --> 00:27:40.120 I need to make sure it's not triple A. 00:27:40.360 --> 00:27:41.960 I need to make sure, you know, what about the rip? 00:27:42.200 --> 00:27:43.880 Do you have any ripping or tearing sensations? 00:27:44.039 --> 00:27:47.160 Do you have any like unilateral BP differences? 00:27:47.319 --> 00:27:49.960 And then you again thought I was just good at my job. 00:27:50.120 --> 00:27:53.880 So then you play in the game and you're kind of getting, okay, this one's really sick. 00:27:53.960 --> 00:27:57.400 Well, I want to kind of follow their progress through the ER and what happens at the end. 00:27:57.480 --> 00:28:04.360 And so, oh yeah, you were bang on that person decided to punt out at in, you know, six hours in, and you're like, okay, perfect. 00:28:04.440 --> 00:28:05.880 I made the right call on that one. 00:28:06.039 --> 00:28:08.279 Well, now let's make it one step further. 00:28:08.519 --> 00:28:10.360 Maybe let's guess what they're coming in with. 00:28:10.519 --> 00:28:11.799 Okay, oh, is it abdominal? 00:28:11.880 --> 00:28:12.440 Is it chest? 00:28:12.519 --> 00:28:13.160 Is it back? 00:28:13.319 --> 00:28:14.440 Is it head? 00:28:14.759 --> 00:28:15.880 Just guessing. 00:28:16.039 --> 00:28:17.799 Okay, somebody's clutching your their chest. 00:28:17.960 --> 00:28:18.519 That's a problem. 00:28:18.680 --> 00:28:21.319 You come on in here, and we're gonna get that sorted out. 00:28:21.480 --> 00:28:22.840 Pretty self-explanatory. 00:28:23.079 --> 00:28:26.759 But somebody holding their abdomen, you're like, I wonder, is it constipation? 00:28:26.920 --> 00:28:29.319 Is it, you know, appendicitis? 00:28:29.400 --> 00:28:30.519 Is it dimeticulus? 00:28:30.680 --> 00:28:37.160 Like, and again, just goofing off, just trying to keep myself engaged for that full 12 hours. 00:28:37.640 --> 00:28:42.759 And the more often I would guess, the more often I was right. 00:28:42.920 --> 00:28:47.720 And then that validated me to be like, oh, I really did recognize that that person was sick. 00:28:47.960 --> 00:28:51.880 And I called it, and sure enough, yeah, they proved to be sick later. 00:28:52.120 --> 00:28:54.360 So that validation was like super helpful. 00:28:54.519 --> 00:29:04.360 And then when it came time when I wasn't at triage and I had my five to whatever patients that emerge, and you go, oh, this person's colors off. 00:29:04.759 --> 00:29:09.640 As in, like, they're kind of gray, they're kind of getting a little green, a little yellow. 00:29:09.799 --> 00:29:11.720 Okay, something's something's changing. 00:29:11.799 --> 00:29:12.600 Now they're sweating. 00:29:12.680 --> 00:29:13.559 You're like, uh oh. 00:29:14.039 --> 00:29:16.200 You know, the vitals may be fine. 00:29:16.680 --> 00:29:19.559 Sure, in that moment, they will be fine. 00:29:19.799 --> 00:29:24.200 They may not be fine 10, 15, 30 minutes an hour, you know, an hour from now. 00:29:25.319 --> 00:29:30.759 So, you know, then being able to go to my docs and be like, hey, I've got Mrs. 00:29:30.920 --> 00:29:32.600 So-and-so in bed three. 00:29:32.759 --> 00:29:44.039 All of a sudden, like she really was fine before, but now, you know, her, you know, vitals again are okay, but now there's been a change, there's been a change in meditation, there's been a change in how she's breathing. 00:29:44.200 --> 00:29:45.960 All of a sudden her sats are dipping. 00:29:46.120 --> 00:29:51.960 You know, I feel like we're missing something, or I feel like we're something's coming down the pipe, something's brewing. 00:29:52.200 --> 00:29:54.600 Can you just come and see this patient again? 00:29:55.160 --> 00:30:00.279 Good doc will stop everything and be like, yes, and go and see your patient. 00:30:00.360 --> 00:30:03.960 And this is the again, the benefit of remerge having physicians 24-7. 00:30:04.840 --> 00:30:11.000 But am I going to my physician being like, oh my God, my intuition is saying um that you need to come and see? 00:30:11.640 --> 00:30:13.160 No, absolutely not. 00:30:13.319 --> 00:30:14.840 The people at work still make fun of me. 00:30:14.920 --> 00:30:16.039 They're like, Is it your intuition? 00:30:16.120 --> 00:30:17.079 I'm like, shut it. 00:30:19.640 --> 00:30:21.079 They laugh, but it works. 00:30:21.319 --> 00:30:31.000 But if you say to your physician, or if you don't, if you're not quite comfortable going to a physician, you want to kind of run it by your charge nurse or another coworker, you're like, I just want to run this by you. 00:30:31.079 --> 00:30:31.880 You know, it's 3 a.m. 00:30:32.120 --> 00:30:33.000 I'm having a brain for it. 00:30:33.079 --> 00:30:34.920 I just want to see what you think. 00:30:35.240 -->

00:30:37.799 And maybe they get the same vibe, maybe not. 00:30:38.039 --> 00:30:42.200 But if you push for it and go talk to your physician, worse comes to worse. 00:30:42.279 --> 00:30:45.079 You say that you're advocating for your patient. 00:30:45.640 --> 00:30:46.279 Use that word. 00:30:46.440 --> 00:30:59.160 That word stops people because they know that if I'm then gonna chart, MD notified, advocated for patient, MD aware, no new orders received. 00:30:59.480 --> 00:31:00.840 They know how that looks. 00:31:01.000 --> 00:31:04.920 They know that I'm real mad if your name is actually spoke with Dr. 00:31:05.000 --> 00:31:09.319 Fernandez and like no new orders received. 00:31:09.480 --> 00:31:11.960 You know, they they know that I'm mad at that point. 00:31:12.039 --> 00:31:13.319 And I'm like, that's fine. 00:31:13.480 --> 00:31:15.000 I've done my due diligence. 00:31:15.079 --> 00:31:21.480 I will continue to be on top of this patient and do vitals more often than not, and and really keep an eye on them. 00:31:21.799 --> 00:31:26.440 But trust me, six hours from now, it's not gonna be good. 00:31:26.600 --> 00:31:28.279 And then we're gonna be playing catch up. 00:31:28.519 --> 00:31:33.319 When I told you six hours prior, look it, something's changed. 00:31:33.559 --> 00:31:35.799 I love a few things that you said about intuition. 00:31:36.120 --> 00:31:42.279 First, I want to verify with you that we can pretty confidently say everyone has intuition. 00:31:42.440 --> 00:31:46.600 Of course, we can speak more to the females because that's you know what we are in our experience. 00:31:46.759 --> 00:31:47.480 That's all we know. 00:31:47.720 --> 00:31:47.880 Right. 00:31:48.039 --> 00:31:48.680 It's all we know. 00:31:48.759 --> 00:31:57.240 So whether you're a nurse or not, whatever you do in life, we all have that intuition because that is part of sort of our fiber flight, our survival response. 00:31:57.480 --> 00:31:57.799 Okay. 00:31:58.120 --> 00:32:09.480 And then I love that you actually kind of highlighted that intuition can be used for not just, oh, I have a bad feeling this patient is gonna die or this patient is, you know, gonna decompensate. 00:32:09.720 --> 00:32:12.600 You can also have intuition like, oh, this patient's okay. 00:32:12.759 --> 00:32:13.240 They're fine. 00:32:13.480 --> 00:32:14.920 My intuition is okay. 00:32:15.160 --> 00:32:21.880 Yeah, or this patient, I think we're going to have some type of bad social interaction. 00:32:22.039 --> 00:32:28.440 They are going to get very angry or combative or something, like I'm getting these feeling or these vibes, right? 00:32:28.600 --> 00:32:31.799 That something isn't right from even a social standpoint. 00:32:32.039 --> 00:32:32.440 Absolutely. 00:32:32.600 --> 00:32:55.000 And again, like nobody is more peripherally safety aware than somebody where you know, people are walking through the department at all hours in all different states of coping or not coping, or drug use or alcohol use or or whatever else, you know, these aren't your typical patients that make it up to the floor or the or their family members. 00:32:55.240 --> 00:33:00.120 Sometimes it is the family members that you're just like, oh, this is not gonna go well. 00:33:00.360 --> 00:33:02.600 You know, yeah, I totally agree with that. 00:33:02.759 --> 00:33:09.000 I also love how you share your triage example for testing your intuition. 00:33:09.160 --> 00:33:19.000 So just if people aren't in emergency care, there's uh typically a triage nurse assigned to that role for the shift, and they basically take the intake of the patient. 00:33:19.079 --> 00:33:23.640 They're checking in, they're telling us chief complaint, we're going through all kinds of different questions. 00:33:23.880 --> 00:33:27.880 I know in the states we use ESI levels, emergency severity index. 00:33:28.360 --> 00:33:29.160 We do CTAS. 00:33:29.319 --> 00:33:32.200 It's the same, it's the same system, it's just a different name. 00:33:32.360 --> 00:33:35.000 We got we got real fancy with the Canadian triage acute. 00:33:36.840 --> 00:33:47.079 It's it's funny too because I think back, I know most of my bedside career was in the ERs in the ER for seven years as a bedside nurse and then did some management stuff. 00:33:47.240 --> 00:33:52.200 But oh, I know, don't even go, I don't want to go there. 00:33:52.519 --> 00:33:57.640 But you can tell, like, really, who is intuitive triage nurse and who isn't? 00:33:57.720 --> 00:34:03.079 Because I know there's one nurse, not gonna say names, who would be like, hey, I'm giving you a belly pain. 00:34:03.160 --> 00:34:05.160 They're fine, they're stable, blah, blah, blah. 00:34:05.319 --> 00:34:08.920 And then I would go in there and be like, oh, dude, this woman's circling the drain. 00:34:09.000 --> 00:34:10.599 Like this is she is not good. 00:34:11.159 --> 00:34:11.400 Right. 00:34:11.559 --> 00:34:22.039 And I feel like we can be taught all the ways to do assessment skills and and gathering data and this and that, but we really don't talk about the nursing intuition. 00:34:22.199 --> 00:34:24.119 And I remember I loved triage. 00:34:24.519 --> 00:34:26.119 That is like, to me, it was like such a fun role. 00:34:26.199 --> 00:34:30.920 And again, I think so, like, yeah, ER nursing was definitely my jam. 00:34:31.159 --> 00:34:39.239 But I remember this, I remember this couple walked in the door and they're wearing their winter jackets and they're holding this baby, and all I can see is the baby's arm. 00:34:39.400 --> 00:34:43.559 And I just see the arm like moving like this, and I'm like, is that baby having a seizure? 00:34:43.639 --> 00:34:45.079 And it's like all the way down. 00:34:45.159 --> 00:34:50.119 And the parents are like, do, do, do, do, like walking in, like, they're yeah, like, oh, we just figured we'd stop by. 00:34:50.440 --> 00:34:50.840 They don't know. 00:34:51.159 --> 00:34:51.319 Yes. 00:34:51.480 -->

00:34:52.679 I'm like, they don't know. 00:34:52.840 --> 00:34:53.079 Right. 00:34:53.239 --> 00:34:53.719 They don't know. 00:34:53.880 --> 00:34:58.279 And I immediately, like, I just like kind of watched them walk in, and that arm looked a little funny to me. 00:34:58.360 --> 00:34:59.799 And I was like, something is not right here. 00:34:59.960 --> 00:35:02.519 And I like immediately I grab the baby from them. 00:35:02.599 --> 00:35:05.400 I don't even triage them in the triage room because you know, they're gonna know. 00:35:05.799 --> 00:35:06.679 So you're grab and go. 00:35:06.920 --> 00:35:08.440 Yes, sprinting back. 00:35:08.519 --> 00:35:10.039 And the parents were like, What's going on? 00:35:10.119 --> 00:35:10.760 Where you what's going on? 00:35:10.840 --> 00:35:11.480 You just took my baby. 00:35:11.800 --> 00:35:15.320 They were like confused because they don't have that nursing intuition. 00:35:15.480 --> 00:35:20.760 And I just I feel like I would love to capture data on like, okay, you're the triage nurse. 00:35:20.920 --> 00:35:25.079 How accurate were you on the scale, you know, of your ESI or whatever you use? 00:35:25.320 --> 00:35:29.800 And if you were accurate along, you know, as your patient progressed, you can do you can do a study. 00:35:29.960 --> 00:35:31.400 You can do a study, no problem. 00:35:31.720 --> 00:35:31.960 Right. 00:35:32.039 --> 00:35:39.800 Because I feel like we get to a part, I know in the ER that I worked at, you had to kind of be there for at least a year or two before they made you like a specific triage nurse, and then you had to take a course. 00:35:39.880 --> 00:35:40.920 And that was great. 00:35:41.159 --> 00:35:45.800 But I would just love to know, you know, because maybe that's something the nurse would take that feedback. 00:35:45.960 --> 00:35:50.280 That's something I need to work on, or I need to lean into my intuition, or what are they doing that I'm not doing. 00:35:50.599 --> 00:35:59.000 And also we'd get better care if you have a very intuitive nurse with experience, of course, you know, in triage, the right patients are going to get the right care at the right time. 00:35:59.240 --> 00:36:02.679 So I absolutely love that that was your experience with intuition. 00:36:02.920 --> 00:36:09.880 And I love talking about how if we know something's going on with the patient, how we approach the provider. 00:36:10.119 --> 00:36:18.519 Because I will say, when I was first a nurse, I definitely would have the intuitive feeling, but I'd also be like, I don't know what's happening, but I feel like this patient's not doing well. 00:36:18.679 --> 00:36:24.519 And really, my intuition was helped me more so with those patients that were actively circling the toilet. 00:36:24.679 --> 00:36:28.679 I didn't have as much of the intuition with like, oh, you know, this person's playing me. 00:36:28.840 --> 00:36:34.599 They're just drug seeking or this, like I didn't have that yet, but I just yeah,

that came later. 00:36:34.840 --> 00:36:35.639 That came later. 00:36:35.800 --> 00:36:36.039 Right. 00:36:36.599 --> 00:36:41.240 But I feel like at least initially, I was like, wow, that patient looks terrible. 00:36:41.400 --> 00:36:42.360 I don't know what to do. 00:36:42.519 --> 00:36:51.960 And and I think it was really hard to trust that feeling because I'm like, I have three minutes of experience, and here I am knowing something bad's gonna happen. 00:36:52.199 --> 00:37:01.000 So I guess my question for you is how do we strengthen that feeling and how do we articulate that or how do we escalate? 00:37:01.079 --> 00:37:03.159 If we're like, okay, I know something's wrong with my patient. 00:37:03.320 --> 00:37:04.760 What do you think the steps would be? 00:37:05.079 --> 00:37:05.960 Sorry, I want to add in. 00:37:06.119 --> 00:37:10.440 I love that you have certain verbiage that you feel like works, like advocating, right? 00:37:10.760 --> 00:37:11.480 Advocating. 00:37:12.039 --> 00:37:12.679 Advocating. 00:37:12.920 --> 00:37:15.960 Listen, I'm just covering all my bases. 00:37:16.199 --> 00:37:19.960 I'm just making sure I's are dotted, T's are crossed. 00:37:20.199 --> 00:37:23.320 I'm just making sure that we're not missing anything. 00:37:23.559 --> 00:37:26.280 I'm just not sure we've got the whole story. 00:37:26.519 --> 00:37:26.920 Yes. 00:37:27.079 --> 00:37:34.119 And you're just like, okay, you know, like because in Emerge, if you get 5% of what's going on, great day. 00:37:34.440 --> 00:37:39.000 Because you need to operate on the fact that you are missing 95% of the story. 00:37:39.159 --> 00:37:41.720 You haven't got that patient's whole life story in front of you. 00:37:41.800 --> 00:37:45.159 You haven't got their last six months of medical data in front of you. 00:37:45.400 --> 00:37:47.240 They barely know which medications they take. 00:37:47.400 --> 00:37:49.480 Oh, the little white pill for hypertension. 00:37:49.960 --> 00:37:51.079 Great, which one? 00:37:51.240 --> 00:37:52.360 There's like 16. 00:37:52.679 --> 00:37:54.440 Like, please, you know. 00:37:54.920 --> 00:37:56.679 Oh, I don't know who my family doctor is. 00:37:56.760 --> 00:37:58.199 Oh, I don't know when I saw them last. 00:37:58.280 --> 00:38:00.360 Oh, I don't know when my last menstrual period was. 00:38:00.519 --> 00:38:05.559 I don't know how much I drank or when I drank last, or I don't know how many stairs I fell down. 00:38:05.720 --> 00:38:07.480 That changes everything. 00:38:07.720 --> 00:38:10.760 So you have to operate on like worst case scenario. 00:38:11.000 --> 00:38:17.960 Because again, I would rather be wrong and be safe than be like, oh, a little cavalier and be like, ah, it's nothing. 00:38:18.039 --> 00:38:21.400 And then all of a sudden it's like, oh, oh, that was a bad call. 00:38:21.480 --> 00:38:25.720 And now I'm in, now I'm in court, you know, nine months later trying to defend my actions. 00:38:25.960 --> 00:38:26.119

Yeah. 00:38:26.599 --> 00:38:27.800 Not going to go well. 00:38:28.039 --> 00:38:28.360 Yeah. 00:38:28.760 --> 00:38:47.559 So there's actually a study, granted, it was done in 2008, but they found that so a nurse who's just, you know, kind of starting to trust their intuition, they think that something's wrong, they call the provider, provider comes in, they have one look over the patient, they do not change anything and they go, you know what, things are actually okay. 00:38:48.119 --> 00:38:59.159 Studies say that the patient experience and the patient's like plan of care and trajectory actually improves with no interventions, but just one more physician touch point. 00:38:59.639 --> 00:39:04.119 So you can be wrong and still improve your patient outcome. 00:39:04.360 --> 00:39:05.320 Oh, I love that. 00:39:05.639 --> 00:39:07.000 Do not be afraid to be wrong. 00:39:07.240 --> 00:39:08.199 Involve in wrong. 00:39:08.440 --> 00:39:12.280 And it's a little easier in emergency medicine, which we talked about because the providers are right there. 00:39:12.360 --> 00:39:14.840 You literally can go tap them on the shoulder and say, come over here. 00:39:15.320 --> 00:39:23.639 Where my first year of nursing, I was on a surgical floor, and I remember this one patient, okay, that was she was circling the drain. 00:39:23.880 --> 00:39:30.440 And I, of course, was working nights, and she was assigned to the scariest surgeon known to man. 00:39:30.599 --> 00:39:35.240 And this female surgeon would eat you alive, yet was an incredible surgeon. 00:39:35.320 --> 00:39:35.480 Okay. 00:39:35.559 --> 00:39:38.599 So had the respect for her, scared shitless of her. 00:39:38.679 --> 00:39:39.000 Okay. 00:39:39.240 --> 00:39:40.679 So I knew she was about to be well. 00:39:40.920 --> 00:39:41.720 And I was panicking. 00:39:41.960 --> 00:39:45.320 I remember I went to my peers and I said, This patient is really sick. 00:39:45.400 --> 00:39:47.240 And my peers are kind of like, Well, what do you think's going on? 00:39:47.320 --> 00:39:48.199 And I'm like, Well, I don't know. 00:39:48.360 --> 00:39:57.400 And I'm giving them the data that I could at least, the tangible data, because it's hard to say, my gut's telling me, you know, so I was like, Well, you know, these are the vitals. 00:39:57.480 --> 00:39:58.679 And they're like, Oh, they're not that bad. 00:39:58.760 --> 00:40:01.240 And I'm like, well, but you know, she's really working to breathe. 00:40:01.320 --> 00:40:06.440 She's the, you know, the like, I tried to paint the clinical picture as best I could to support my feeling. 00:40:06.760 --> 00:40:09.880 So I remember they were like, okay, yeah, maybe something's going on. 00:40:10.039 --> 00:40:13.720 But they're like, you know, I wouldn't call that surgeon with just that. 00:40:13.800 --> 00:40:14.679 And I'm like, oh, yeah. 00:40:14.840 --> 00:40:19.240 So then I remember I got the resource nurse, the overnight resource nurse who had critical care background. 00:40:19.320 --> 00:40:20.119 Here I am, a new grad. 00:40:20.280 --> 00:40:21.240 And I'm like, oh, thank you. 00:40:21.400 --> 00:40:23.320 You know, we let her leave the room. 00:40:23.400 --> 00:40:24.679 Yeah, the poor resource nurse. 00:40:24.840 --> 00:40:27.079 She's just like, oh gosh, Caroline's on tonight. 00:40:27.720 --> 00:40:30.280 So she comes in and she's like, oh my gosh, this patient is so sick. 00:40:30.360 --> 00:40:33.159 Even the resource nurse was like, I don't know if we should call that surgeon. 00:40:33.240 --> 00:40:34.199 It's three in the morning. 00:40:34.280 --> 00:40:37.720 And I'm like, yeah, but like the uh she starts blowing the drain. 00:40:38.119 --> 00:40:41.320 Finally, it becomes, I'm in that room all night long. 00:40:41.480 --> 00:40:43.240 Finally, it is change of shift. 00:40:43.320 --> 00:40:44.440 Well, a little bit before that. 00:40:44.519 --> 00:40:46.360 The surgeon comes in and rounds at like 6 a.m. 00:40:46.519 --> 00:40:47.240 And she comes in. 00:40:47.400 --> 00:40:50.840 She is like ripped shit mad at how sick her patient is. 00:40:51.079 --> 00:40:57.960 And of course, I'm like, well, I should have called her, but everyone scared me and basically was like, I wouldn't call her. 00:40:58.119 --> 00:41:06.440 What I also should have done back now, and I hope if this is a new grad listening or feel like they've been in this position or could find themselves in this position, is why didn't I just call a code? 00:41:06.599 --> 00:41:08.360 Why didn't I call an RRT? 00:41:08.599 --> 00:41:12.039 I think I was so scared of making this a thing that it wasn't. 00:41:12.119 --> 00:41:13.159 Like I was, I don't know. 00:41:13.320 --> 00:41:18.280 I didn't truly trust my intuition enough to call the surgeon and say, hey, your patient is sucking wind right now. 00:41:18.360 --> 00:41:18.920 You need to do something. 00:41:19.079 --> 00:41:19.800 What do you want me to do? 00:41:19.960 --> 00:41:23.159 They should not be on my surgical unit and I have three minutes of experience. 00:41:23.240 --> 00:41:25.240 I shouldn't even be taking care of her, you know? 00:41:25.400 --> 00:41:26.119 But I didn't. 00:41:26.199 --> 00:41:27.079 I was too scared to do that. 00:41:27.159 --> 00:41:32.440 So instead, I got all these other people to confirm that yes, she's sick, but also they were like, I don't know if you should call. 00:41:32.679 --> 00:41:33.400 So I don't know. 00:41:33.639 --> 00:41:40.119 End of that situation, I was I looking back, I'm like, I should have called an RRT or and or I should have called the darn surgeon. 00:41:40.280 --> 00:41:41.320 Like, this is their job. 00:41:41.400 --> 00:41:42.119 This is their patient. 00:41:42.440 --> 00:41:42.679 You know? 00:41:42.760 --> 00:41:43.559 So 100%. 00:41:43.960 --> 00:41:44.119 Yeah. 00:41:44.199 --> 00:41:47.320 And I think as a new grad, it's so hard to trust that feeling. 00:41:47.480 --> 00:42:05.320 But I feel like with what you

were saying about knowing only 5% of the story, I think really starting with asking questions, gathering any other evidence that can support the way you're feeling, so that you can then appropriately advocate for your patient and articulate, like, hey, something is going on, especially when you're when the doctor's not right there. 00:42:05.559 --> 00:42:09.320 Truly, you have carried that now for how long. 00:42:10.519 --> 00:42:11.720 It haunts me. 00:42:12.039 --> 00:42:19.960 So would you rather have been wrong and it haunts you, or God forbid, poor outcome, patient dies? 00:42:20.360 --> 00:42:21.960 You're gonna carry that patient with you. 00:42:22.199 --> 00:42:26.760 We already have enough patients to that we you know mentally carry with us for our careers. 00:42:27.000 --> 00:42:30.440 And again, most of them start out when we're young and we're afraid to call. 00:42:30.679 --> 00:42:35.159 But now that I'm you know 41 and could give a shit. 00:42:35.320 --> 00:42:35.480 Yeah. 00:42:35.720 --> 00:42:36.599 It's like, you know what? 00:42:36.760 --> 00:42:38.039 You want to chew me out? 00:42:38.360 --> 00:42:38.840 Sure. 00:42:39.320 --> 00:42:40.440 I know I'm right. 00:42:40.679 --> 00:42:43.400 And I and even if I'm wrong, fine. 00:42:43.639 --> 00:42:46.039 I'm not carrying this patient on my conscience. 00:42:46.119 --> 00:42:47.559 I'm not doing it anymore. 00:42:47.880 --> 00:42:49.639 You want to talk about work-life balance? 00:42:49.800 --> 00:42:58.519 I would rather be wrong and have them do better without doing without changing a thing and have you be notified, and then it's off me. 00:42:59.000 --> 00:43:15.320 Like I looking back, I would rather remember that this surgeon chewed me out in the middle of the night on the phone, but yet the patient was then transferred to where they should have been, getting the care they should have gotten, than me being too scared to wake up that surgeon in the middle of the night. 00:43:15.720 --> 00:43:16.519 You know, I don't know. 00:43:16.599 --> 00:43:18.840 So I just feel like we need to normalize that too. 00:43:19.000 --> 00:43:23.960 Definitely calling RRTs, even if we even if we're like, ah, there's just something not right, who cares? 00:43:24.199 --> 00:43:29.320 If you've got access to resource teams, holy crap, utilize them. 00:43:29.720 --> 00:43:55.000 I keep, I keep my in my perfect nursing world, there would be one extra critical care nurse to pair up with the primary nurse who called to help them understand what's gone on, reaffirm that yes, you did the right thing, a little bit of education as to the critical scenario, and then help them tee up the rest of their patients who've probably been left to their own devices for anywhere from five minutes to two hours. 00:43:55.240 --> 00:43:56.440 Yeah, that's so true. 00:43:56.679 --> 00:44:00.280 So the people who start out on med surge could be coming down to critical care. 00:44:00.360 --> 00:44:04.360 So why not utilize

this moment because that you give them knowledge? 00:44:04.519 --> 00:44:04.920 Guess what? 00:44:05.000 --> 00:44:05.639 At 3 a.m. 00:44:05.880 --> 00:44:13.960 the next time their buddies going through the exact same thing, the nurse that you've now taught goes, Oh, this is what my patient did three months ago. 00:44:14.199 --> 00:44:19.639 And they said it was this process and that process, but I really benefited from calling the R team. 00:44:19.720 --> 00:44:21.000 So, like, why not? 00:44:21.159 --> 00:44:21.720 Why not? 00:44:21.960 --> 00:44:22.599 Why not? 00:44:22.840 --> 00:44:27.720 Yeah, I think I almost think I didn't even think of it in the moment because I was so green, you know? 00:44:28.440 --> 00:44:31.000 One, you never know, like what's acceptable. 00:44:31.159 --> 00:44:31.720 What can I do? 00:44:31.800 --> 00:44:32.519 What can I can't? 00:44:33.079 --> 00:44:35.320 And I love imposter syndrome too. 00:44:35.400 --> 00:44:37.639 You're kind of like, who am I to call an RT? 00:44:37.720 --> 00:44:40.679 Like, who am I to, you know, and it's like you need to do it. 00:44:41.000 --> 00:44:44.840 Put on, put on those big girl panties and be like, you know what? 00:44:45.079 --> 00:44:46.199 We're doing it. 00:44:46.519 --> 00:44:59.639 Because if you can take your own ego out of the mix and be like, I am doing this for my patient, do you know how much easier all of this gets when you're finally pushed to the point of hold. 00:45:00.039 --> 00:45:04.440 Holy crap, I need help now that your ego has left the building. 00:45:04.519 --> 00:45:06.039 Now it's all about the patient. 00:45:06.199 --> 00:45:06.920 Let's go. 00:45:07.159 --> 00:45:07.960 I'm mad. 00:45:08.199 --> 00:45:10.119 And for me, I get mad. 00:45:10.360 --> 00:45:11.960 And then stuff gets done. 00:45:13.000 --> 00:45:14.920 So like that works. 00:45:15.480 --> 00:45:19.880 But I mean, even calling the doc and be like, Oh my god, I'm so sorry for waking you up. 00:45:20.119 --> 00:45:21.559 I don't even say that anymore. 00:45:23.079 --> 00:45:25.240 This is an expectation of your job. 00:45:25.559 --> 00:45:27.079 Am I sorry that it's 3 a.m.? 00:45:27.320 --> 00:45:28.599 Sure, I'm sorry that it's 3 a.m. 00:45:28.840 --> 00:45:36.760 But I'm not sorry that I'm calling because this is my job to tell you because you are not here, this person's starting to crumple. 00:45:36.920 --> 00:45:38.039 You need to come. 00:45:38.360 --> 00:45:38.599 Yeah. 00:45:38.760 --> 00:45:43.079 And I think with intuition, you have initially that gut feeling. 00:45:43.240 --> 00:45:49.400 And then I think it's like you said, sort of like your ego or your logical side starts being like, well, no, no, no, hold on. 00:45:49.559 --> 00:45:52.679 You know, and then it looks for signs to tell you that everything's okay. 00:45:52.760 --> 00:45:53.880 Because that just is right. 00:45:53.960 --> 00:45:54.840 We want to stay safe. 00:45:54.920 --> 00:45:56.039 We want to stay comfortable. 00:45:56.280 --> 00:45:57.639 So then you get confused. 00:45:57.720 --> 00:46:00.119 You're like, well, a part of me is like, something's not right here. 00:46:00.199 --> 00:46:02.519 And the other part of me is like, you have no evidence of that. 00:46:02.679 --> 00:46:06.199 Or like, or showing you evidence of like things are okay. 00:46:06.519 --> 00:46:11.960 It's like this internal battle that you're like, oh, do I trust this little piece of me that's like something's not right? 00:46:12.199 --> 00:46:16.199 Or do I go with the tangible evidence that shows things are stable? 00:46:16.440 --> 00:46:17.079 It's tough. 00:46:17.400 --> 00:46:18.920 So another fun study. 00:46:19.079 --> 00:46:19.400 Yeah. 00:46:19.639 --> 00:46:31.800 Critical care nurses are more apt to not only utilize their intuition but trust it and then make decisions off of it for the simple fact of they don't have the time to second guess. 00:46:32.760 --> 00:46:33.240 Amen. 00:46:33.400 --> 00:46:35.480 So then we're using it more. 00:46:35.720 --> 00:46:37.400 We get validated more. 00:46:37.559 --> 00:46:40.519 And then we go, oh, that feeling meant that something was off. 00:46:40.679 --> 00:46:42.199 That means that I need to do something. 00:46:42.360 --> 00:46:44.519 Now we understand that feeling. 00:46:44.599 --> 00:46:51.480 Now we understand how that works within our workflow to be like, why am I all of a sudden like I've got this heaviness in my gut? 00:46:51.559 --> 00:46:55.720 And like I just I look at this patient, I'm like, uh, not great. 00:46:55.960 --> 00:46:57.320 I'm not deciding that. 00:46:57.400 --> 00:47:02.199 That's just my body going like not it's things aren't going to go well, not good. 00:47:02.599 --> 00:47:09.159 So can you still monitor for a period of time to see if okay, yes, uh, maybe I'm just being oversensitive. 00:47:09.240 --> 00:47:09.880 I don't know. 00:47:10.039 --> 00:47:11.960 I'm tired, it's three in the morning. 00:47:12.119 --> 00:47:13.320 Let me just keep an eye on it. 00:47:13.400 --> 00:47:14.920 And so keep track of the vitals. 00:47:15.000 --> 00:47:29.159 Do vitals more often, eyeball your patient more often, do an assessment more often because again, the more data you have to back you, the more the physician's gonna listen if they really want to truly go on to the tangent of like just data only. 00:47:29.320 --> 00:47:37.320 So they're now starting to call nursing intuition like nurse worry and using that as an indicator of patient deterioration. 00:47:37.720 --> 00:47:47.880 So again, same feeling, same baseline understanding, but trying to find the verbiage that works best to have us be believed. 00:47:48.119 --> 00:47:48.360 Yeah. 00:47:48.440 --> 00:47:51.000 And it sounds like intuition is just like a muscle. 00:47:51.159 --> 00:47:56.199 The more you exercise it, the more reps you put in, the stronger it gets, the more confident you get. 00:47:56.440 --> 00:48:00.519 And then you can be like, yeah, I am

quite certain this is not gonna go well for this patient. 00:48:00.599 --> 00:48:06.920 And then you can call and advocate so much more effectively just because of your own conviction, you know, of trusting that skill. 00:48:07.240 --> 00:48:14.199 And I think that's why there's sort of this myth that like seasoned nurses have intuition and new grads don't or they haven't developed it yet. 00:48:14.440 --> 00:48:22.760 But that is partly true because you might have it as a new grad, but like my example, I didn't even know how to use it to my advantage. 00:48:22.920 --> 00:48:27.720 I didn't even know how to let it guide me and to go get more evidence and to come up with a story. 00:48:27.880 --> 00:48:31.559 And I think I love that you highlighted you can go in and do more vitals. 00:48:31.639 --> 00:48:37.400 You can go in and assess, even though you work might say, oh, in your 12-hour shift, it's one full head-to-toe assessment. 00:48:37.559 --> 00:48:39.960 You can go in and do 10 of them if you want. 00:48:40.119 --> 00:48:47.240 It doesn't absolutely nobody is going to fault you for doing more vitals and more assessments, not one person. 00:48:47.559 --> 00:48:47.880 No. 00:48:48.199 --> 00:48:51.079 And I think a big thing too that helped me as a new nurse. 00:48:51.159 --> 00:48:55.400 I I just clearly, you know, Jen, I have such a special place in my heart for new grads and new nurses. 00:48:57.240 --> 00:48:57.720 Yeah, right. 00:48:57.800 --> 00:49:02.360 They're just they're a sweet population and they're just trying to get into our profession and spread their wings. 00:49:02.440 --> 00:49:04.840 And I think it's such a huge learning curve. 00:49:04.920 --> 00:49:12.119 But when it comes to intuition, if you feel like something's not right, I know looking back, I a lot of times would tell my like charge nurse. 00:49:12.199 --> 00:49:16.039 It's like I wouldn't go straight to the doctor, but I'd be like, hey, something's not right in that room. 00:49:16.199 --> 00:49:23.079 I would pull them in, you know, because we will, we will definitely usually help each other out, you know, more so than maybe a physician. 00:49:23.400 --> 00:49:32.599 But that would also just help me feel validated, like, oh yeah, you know, this doesn't look good, or let's come back in here in an hour, or let's come up with this other plan. 00:49:32.920 --> 00:49:36.119 I felt better too because I'm like, okay, we're doing something about it. 00:49:36.280 --> 00:49:40.039 I'm not just ignoring a bad feeling and hoping everything works out. 00:49:40.360 --> 00:49:46.519 I now have a colleague that I trust that is experienced that is telling me, yeah, you're right, you're on to something. 00:49:46.679 --> 00:49:47.720 Let's look at these lab values. 00:49:47.800 --> 00:49:49.720 Let's look, you know, and it was like a learning moment. 00:49:49.880 --> 00:49:56.920 So I feel like you're a new grad nurse, you've had a gut feeling, or you're worried you're gonna have one at some point, because you will go use your coworkers. 00:49:57.000 --> 00:49:59.480 Let me tell you, they're like the best people to learn from. 00:49:59.800 --> 00:50:00.119 Yeah. 00:50:00.360 --> 00:50:03.400 Find that one nurse who loves to teach. 00:50:03.559 --> 00:50:10.360 You know, if you're scared of your charge nurse because they're burnt out, they're they're nitpicky, they're awful, it's toxic. 00:50:10.519 --> 00:50:11.480 I get it. 00:50:11.720 --> 00:50:12.840 You can go around. 00:50:13.000 --> 00:50:17.800 And again, being on the other end of the age spectrum, you get real comfortable. 00:50:18.039 --> 00:50:19.079 You want to bitch me out? 00:50:19.400 --> 00:50:20.199 Have adder. 00:50:20.440 --> 00:50:21.800 Like I can care less. 00:50:22.119 --> 00:50:24.920 I'm sorry, again, I'm just advocating for my patient. 00:50:25.000 --> 00:50:25.880 You're the charge nurse. 00:50:26.039 --> 00:50:31.159 I'm telling you that my patient's not doing well because you also need to be aware, right? 00:50:31.240 --> 00:50:31.400 Yeah. 00:50:31.559 --> 00:50:46.199 So if you have a concern about your patient, please bring it to the charge nurse because there's nothing worse than being the charge nurse, thinking that everything's all fine and dandy, and then you know, the resource team comes down, or all of a sudden there's a code blue in the back, and you're like, What was happening? 00:50:46.360 --> 00:50:48.440 Like, what do you mean you didn't reach out to me? 00:50:48.599 --> 00:50:49.480 I could have helped. 00:50:49.639 --> 00:50:51.079 We could have dealt with this sooner. 00:50:51.240 --> 00:50:56.280 And, you know, you want to use it as a learning experience and not shame them or blame them or anything. 00:50:56.360 --> 00:51:07.000 Because again, it's a weird, weird career, and there are so many avenues and tips and tricks, and every floor is different, let alone every hospital. 00:51:07.079 --> 00:51:13.639 And it is really hard, and you just need to be so kind to yourself because it's hard. 00:51:14.360 --> 00:51:15.639 Adulting is hard. 00:51:16.039 --> 00:51:16.599 So true. 00:51:16.760 --> 00:51:17.720 It's so true. 00:51:18.039 --> 00:51:30.360 And a profession that is so heavily influenced by evidence-based practice and data, it is hard to then be like, oh, my gut is telling me, you know, and it's like, well, people are specific about that. 00:51:30.760 --> 00:51:44.760 But what I think I appreciate in your story too, of how you came to write your book, it sounds like you spent a lot of time putting pen to paper, just like it almost, I mean, I don't know if it was like a journaling or just more of a creative writing flow. 00:51:45.079 --> 00:51:49.800 And then you looked back and you realized intuition played a key part in all of your stories. 00:51:50.119 --> 00:51:57.400 Do you feel like that would help if there were a situation where maybe you or if you're like, I want to strengthen that intuition muscle of mine?

00:51:58.199 --> 00:52:00.760 I feel like there is a power in reflecting, right? 00:52:00.840 --> 00:52:02.679 And being like, so much. 00:52:03.000 --> 00:52:03.559 So so much. 00:52:03.800 --> 00:52:09.559 I even remember when I was a new grad, I or when I was new to the ER, so I had a year of experience, then I went to the ER. 00:52:09.880 --> 00:52:14.840 My preceptor is so badass, and she looks like she always looks like she's doing nothing, and yet she's doing everything. 00:52:15.000 --> 00:52:15.559 Like, how? 00:52:15.960 --> 00:52:16.199 You know? 00:52:16.360 --> 00:52:20.920 And she would go into my patient's room, you know, we would be assigned together, but she'd let me go in and do everything. 00:52:21.000 --> 00:52:23.079 And then she'd come in and she'd be like, oof, they don't look good. 00:52:23.159 --> 00:52:23.800 And I'm like, what? 00:52:23.880 --> 00:52:24.440 What do you mean? 00:52:24.679 --> 00:52:28.199 And I would be like, I didn't even pick up on that they didn't look good. 00:52:28.360 --> 00:52:33.639 But she was so good about literally like walking into the door, just being like, Hey, I'm Amy, blah, blah, blah. 00:52:33.800 --> 00:52:38.440 And then she would be like, and then she'd come out being like, oof, that guy, he's slick. 00:52:38.599 --> 00:52:39.400 I'm like, he is? 00:52:39.720 --> 00:52:40.920 And I'd be like, what do you mean? 00:52:41.079 --> 00:52:41.720 And then I would run. 00:52:42.199 --> 00:52:48.599 Again, like, if you haven't seen this, it is a ton of experiences that you've never had access to. 00:52:48.679 --> 00:52:48.920 Yes. 00:52:49.079 --> 00:52:51.720 You've never seen somebody who's been highlighter yellow. 00:52:51.960 --> 00:52:57.960 You've never seen somebody who's gone from like pale to gray to green. 00:52:58.199 --> 00:53:00.599 Like you haven't seen that progress yet. 00:53:00.760 --> 00:53:05.320 So you know, at pale, you're like, ugh, I'm already, I'm already kind of keyed up because they're pale. 00:53:05.480 --> 00:53:09.240 So but are they pale because they can't breathe or their sats crap? 00:53:09.559 --> 00:53:11.639 Are they pale because they've got no hemoglobins? 00:53:11.800 --> 00:53:13.240 What is happening and what's the reason? 00:53:13.400 --> 00:53:14.760 And again, guess. 00:53:15.000 --> 00:53:16.119 It's okay to guess. 00:53:16.280 --> 00:53:23.480 You can play a game with yourself to just oh totally like, oh, and again, we're kind of notorious in the eMERGE for playing games, right? 00:53:23.720 --> 00:53:26.039 Because again, just trying to keep yourself into it. 00:53:26.119 --> 00:53:29.480 And so it's like, okay, what do you think that patient's hemoglobin is gonna be? 00:53:29.639 --> 00:53:30.599 Well, it looks like six. 00:53:30.679 --> 00:53:31.079 I don't know. 00:53:31.159 --> 00:53:32.360 Like it just looks awful. 00:53:32.440 --> 00:53:34.119 Like they look like they're see-through. 00:53:34.199 --> 00:53:35.079 I don't understand. 00:53:35.320 --> 00:53:47.720 And so then again, you're just goofing off, and you know that it's not actually gonna be six, but like you're like, oh, like it's something crazy, and then all of a sudden you're like, oh, it was it was six? 00:53:48.760 --> 00:54:12.760 Okay, holy crap, I I was right, and then you get that validation, and then write it down, write it down because honestly, you know, when I think about it in 18 years of year nursing, I can't even guesstimate the number of people that I've touched, I can't guesstimate the number of bodies I've wrapped, I can't even guesstimate the number of like family members that I've cried with over the years. 00:54:12.840 --> 00:54:22.679 Like, I wish I had something to kind of refer back to, and especially on those like awful days where you're like, I'm not learning fast enough, this isn't happening, this maybe this isn't for me. 00:54:22.760 --> 00:54:23.880 I'm screwing this up. 00:54:24.039 --> 00:54:27.880 You can go back into your own experiences and be like, no, no, no, no, no. 00:54:28.039 --> 00:54:30.039 I am learning, I am growing. 00:54:30.199 --> 00:54:37.880 It's just not what I thought it would look like because my expectations were sky high because nursing school said my this is what I was gonna do. 00:54:38.119 --> 00:54:43.960 And unfortunately, nursing school and what happens at the bedside are two very different things. 00:54:44.280 --> 00:54:44.920 Absolutely. 00:54:45.079 --> 00:54:49.159 And I love that you say write it down because I think that also helps with confidence. 00:54:49.320 --> 00:55:07.240 And they say that in general, like you should almost have like this note on your notes app that's like wins, and it's just like things that you've accomplished so that when you're feeling like down on yourself or you're not feeling confident or you're battling imposter syndrome, you open that notes section and you read all the things that you've accomplished and you're like, oh yeah, like I have done things. 00:55:07.480 --> 00:55:26.679 And I think if you can actually start a little log of like things you were like clinically right about, you might then be like, hey, I know more than I think I know, and I'm actually good at what I do, and I now have more confidence to now lean on that intuitive bustle and advocate appropriately. 00:55:26.760 --> 00:55:29.000 And I think that's a really great way to do that. 00:55:29.159 --> 00:55:30.280 And I I never thought of that. 00:55:30.440 --> 00:55:31.559 I think that's wonderful. 00:55:31.880 --> 00:55:33.800 Can I do a shameless plug? 00:55:34.360 --> 00:55:36.840 Please, that's what this is about. 00:55:37.000 --> 00:55:37.480 Oh my gosh. 00:55:37.800 --> 00:55:39.079 We're plugging all our nurses. 00:55:39.639 --> 00:55:40.920 The plug in the nurses. 00:55:41.079 --> 00:55:53.960 So in speaking, after writing the book and speaking, yeah, ran into new graduate nurses in well, actually first semester of first year, and you know,

just three hours of me just gibber jabbering about all my stories. 00:55:54.280 --> 00:55:58.360 And all of their questions were like, Well, how do I manage work-life balance? 00:55:58.440 --> 00:55:59.720 How do I mitigate grief? 00:55:59.880 --> 00:56:02.039 How do I, you know, advocate for my patients? 00:56:02.199 --> 00:56:07.159 All these things that they were like looking that they were already aware of in like moment one of nursing school. 00:56:07.240 --> 00:56:09.639 I'm like, I don't think I've ever asked myself these questions. 00:56:09.800 --> 00:56:12.840 So, like, uh let me let me come up with something. 00:56:13.000 --> 00:56:22.599 So I created a journal that it's shift summaries, so like your top priorities and like skills checks, shift what went well, what didn't go so well. 00:56:22.760 --> 00:56:23.800 Did you drink some water? 00:56:23.960 --> 00:56:25.320 How many steps did you do? 00:56:25.639 --> 00:56:31.720 Med questions for when you get home, and things to look up when you get home because nobody's more keen to learn than a new grad nurse. 00:56:31.880 --> 00:56:35.639 So I've created a study because I'm trying to figure out why all these nurses are leaving. 00:56:35.720 --> 00:56:41.639 So 30 to 60 percent of nurses, new nurses, leave nursing entirely within the first two years, which is insane. 00:56:42.119 --> 00:56:45.880 And trying to get a handle on why everybody is going. 00:56:46.440 --> 00:56:49.800 And so right now I've got a study going on, it's completely free. 00:56:49.880 --> 00:56:50.920 I will send you out a journal. 00:56:51.079 --> 00:57:02.920 If you've got less than two years experience or you're about to graduate, I need participants, I need your data, I need your opinions as to how we who've already been there can help change things. 00:57:03.079 --> 00:57:13.240 And so trying to get hospitals on board with like maybe you know, bringing this in for orientations and stuff like this, because we all love our apps, but like that's one more thing. 00:57:13.400 --> 00:57:15.079 We already shouldn't be on our phones at work. 00:57:15.639 --> 00:57:18.599 This way, quick jot down, run away. 00:57:18.679 --> 00:57:24.920 And then when you get home, you've had time to decompress and cry and you know have a glass of wine. 00:57:25.000 --> 00:57:29.800 And then the next day you're like, okay, what was that medication that I was like thinking about again? 00:57:30.039 --> 00:57:33.559 You can go back, it's no longer a missed learning opportunity. 00:57:33.800 --> 00:57:34.920 Now you have that information. 00:57:35.000 --> 00:57:37.880 Then now this also turns into a reference guide for you. 00:57:38.039 --> 00:57:38.280 Yeah. 00:57:38.440 --> 00:57:46.760 And you can kind of keep track of all of your wins so that when you have that knockdown drag out day, you can go back in and go, I am learning, I am growing. 00:57:47.000 --> 00:57:59.159 Yeah, I think there's a lot of power to putting pen to paper, like literally, not just typing on my phone or whatever, but actually getting out a journal, a paper, whatever, and writing down how you feel. 00:57:59.320 --> 00:58:01.000 There's no one there checking your grammar. 00:58:01.079 --> 00:58:03.400 There's no, you know, you can be so brutally honest. 00:58:03.800 --> 00:58:10.440 And I think it just you at least I know for me, and I haven't gotten into a great journaling practice, but when I am really stressed, I will journal. 00:58:10.519 --> 00:58:11.720 Or there's something I'm not sure about. 00:58:11.960 --> 00:58:13.960 When I need clarity, I will journal. 00:58:14.199 --> 00:58:17.639 And I always end the journal entry feeling lighter. 00:58:17.800 --> 00:58:27.240 Even if it's like a five-minute journaling session, I just feel like I mentally could transfer that energy out of my body and I can, yes, and I can't. 00:58:27.400 --> 00:58:28.679 Or just move on. 00:58:28.920 --> 00:58:38.280 There's actually a nurse acronym for identifying the emotion, what was happening around, and just jot form two seconds to just quickie get it down and walk away. 00:58:38.440 --> 00:58:48.280 Because again, um let me grab my coffee and it's you know midnight, and I've I've gotten into my cozy pajamas and I'm I'm hauled up with my favorite pen and my like great. 00:58:48.440 --> 00:58:49.880 We all would love to do that. 00:58:50.119 --> 00:58:51.320 It is not reality. 00:58:51.639 --> 00:59:13.240 So the more you can just like quick jot and come back to it, to be fair, personally, that was the biggest learning was being able to come back to it and reliving those moments and going like, oh, I didn't realize that I had actually stored away all those details as much as I had until because I was so used to condensing the story into two minutes. 00:59:13.400 --> 00:59:17.880 So going back in and being like, no, the room was actually really cold that day. 00:59:17.960 --> 00:59:18.760 It was 2 a.m. 00:59:19.000 --> 00:59:28.199 I remember some of the nurses who were there, and and I remember what happened when this happened, and walking yourself through it also was like hella healing. 00:59:28.440 --> 00:59:36.039 Cried my eyes out, had to come in and out of multiple stories multiple times because I kind of was like, Oh, yeah, I have a hit of wall, I can't do it anymore. 00:59:36.199 --> 00:59:37.559 And I gotta pull out. 00:59:37.800 --> 00:59:38.679 You can pull out. 00:59:38.760 --> 00:59:41.000 Nobody's saying that you have to do it all in one day. 00:59:41.320 --> 00:59:45.000 Like, there's no, there's again, nobody checking you. 00:59:45.159 --> 00:59:47.960 This is just for your own growth and healing. 00:59:48.039 --> 00:59:55.880 And there's actually so much data surrounding physically writing and getting it out on paper, which is why everyone's like, is this gonna be an app? 00:59:55.960 --> 00:59:57.720 I'm like, I can't with the apps. 00:59:57.880 --> 01:00:02.360 Like, hey, it's like I mean, maybe it's

like$30,000 for the friggin' app. 01:00:02.440 --> 01:00:04.679 I'm like, uh, no, I don't have that kind of money. 01:00:04.920 --> 01:00:06.440 Sorry, not happening. 01:00:06.760 --> 01:00:09.639 And you know, this is available on Amazon and all this kind of stuff. 01:00:09.720 --> 01:00:17.320 But like, if people would love to reach out, like I am always, always looking for more people to bring into the study and like I will have a mail you free stuff. 01:00:17.480 --> 01:00:17.960 Absolutely. 01:00:18.280 --> 01:00:19.240 Yeah, absolutely. 01:00:19.400 --> 01:00:20.519 Okay, I love that so much. 01:00:20.599 --> 01:00:22.440 I feel like this is a good way to segue. 01:00:22.599 --> 01:00:25.960 How can listeners connect with you, learn more about you? 01:00:26.119 --> 01:00:27.400 Where can they find you? 01:00:27.720 --> 01:00:32.440 Yeah, so TikTok and Instagram is at ernurse.genj-en-n. 01:00:33.000 --> 01:00:47.639 My email jenj-e-n at nursegen.ca, and my website's nursegen.ca2n and LinkedIn, honestly, I am like live and well on LinkedIn probably every moment that I possibly can be. 01:00:47.800 --> 01:00:50.920 I think it's Jennifer Johnson B S C N R N. 01:00:51.240 --> 01:00:54.039 And that's only because there's like a million Jennifer Johnsons. 01:00:54.679 --> 01:01:01.240 Should've kept my maiden name, but you know, if you find Nurse Jen, it will take you everywhere or TikTok or Instagram. 01:01:01.400 --> 01:01:03.400 Okay, I have my final question for you, Jen. 01:01:03.960 --> 01:01:10.280 If you could go back to New Grad Nurse Jen, tell yourself and why. 01:01:13.400 --> 01:01:15.800 Oh I know it's a loaded question. 01:01:16.440 --> 01:01:17.720 Such a loaded question. 01:01:17.960 --> 01:01:20.840 She's not worth the tears that you cried. 01:01:21.960 --> 01:01:33.079 She is not worth, you know, now hating a town because of her environment, because of one person. 01:01:33.240 --> 01:01:42.599 However, always trying to look for the silver lining, had she not been so awful, I would not have been as motivated to leave. 01:01:43.400 --> 01:01:46.360 And I wouldn't have met all these wonderful people. 01:01:46.519 --> 01:01:50.599 I probably would have wasted a way in that town, I would have been miserable. 01:01:50.920 --> 01:02:02.360 She, as awful as she was, a, I know that I can live through that now, not without its pitfalls and its medications, and a heavy, heavy dependence on wine. 01:02:02.679 --> 01:02:05.800 But, you know, I was able to live through that. 01:02:05.960 --> 01:02:07.159 I got through it. 01:02:07.400 --> 01:02:11.079 And I then wrote a book because guess who's in the book? 01:02:11.480 --> 01:02:22.599 There's nothing greater than, you know, taking that trauma, repurposing it to, you know, if anybody else can feel better about what they're going through from my pain. 01:02:22.760 --> 01:02:22.840 Yeah. 01:02:23.159 --> 01:02:23.639 Perfect. 01:02:23.800 --> 01:02:30.280 And really, if I ever needed a new therapist, because God bless, you always need at least one on, you need one therapist and then one on backup. 01:02:30.440 --> 01:02:35.480 You just I hand them the book and be like, so this is volume one of why I am the way I am. 01:02:35.960 --> 01:02:38.360 We're gonna save each other a lot of time. 01:02:38.519 --> 01:02:43.639 It's pretty entertaining, it's pretty easy to read, but like you need to know what you're getting into. 01:02:44.119 --> 01:02:44.920 Yeah, here you go. 01:02:45.000 --> 01:02:45.880 Here's some pre-work. 01:02:46.039 --> 01:02:46.519 Here you go. 01:02:46.679 --> 01:02:47.079 Yes. 01:02:47.880 --> 01:02:50.920 Well, Jen, thank you so much for joining me today. 01:02:51.079 --> 01:02:57.240 I truly believe that you've given our listeners permission to trust the most powerful tool, which is actually themselves. 01:02:57.559 --> 01:03:05.880 And thank you for bringing awareness not only to how intuition plays in nursing, but just reminding us that both nursing is science and an art, right? 01:03:06.039 --> 01:03:07.079 Not just one or the other. 01:03:07.320 --> 01:03:12.679 We're honestly so fortunate to have you in our profession and to have your voice help leading our profession. 01:03:12.760 --> 01:03:14.840 So don't make me cry. 01:03:15.079 --> 01:03:17.480 Oh my god, don't do it. 01:03:17.960 --> 01:03:20.119 Hey, no, I will. 01:03:21.960 --> 01:03:25.320 Well, that's it for today's episode of Life After Nursing School. 01:03:25.480 --> 01:03:30.840 I hope you feel more confident and ready to tackle the challenges that come with starting your nursing career. 01:03:31.000 --> 01:03:37.800 Remember, the first year or two might not be easy, but with the right mindset, you can overcome anything. 01:03:37.960 --> 01:03:44.679 If you found value in today's episode, I'd love for you to hit that subscribe button so you never miss a future episode. 01:03:44.920 --> 01:03:48.840 Also, please consider leaving a review on your favorite podcast platform. 01:03:49.000 --> 01:03:52.039 It helps so much in reaching other new nurses like you. 01:03:52.199 --> 01:03:55.480 Thanks for listening, and remember, you've got this. 01:03:55.720 --> 01:03:57.880 Take care and see you next time.