Dan:

Nurse Alice. Thanks for being on the show.

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Nurse Alice:

Thank you so much, Dan.

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Dan:

So I'm curious, how did you get in that role? How did you become a nursing medical correspondent for NBC?

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Nurse Alice:

So first let me just be quite honest. I never set out to do that. It really, I have to say, was just my passion that drove me into all of the right places and spaces and meeting the right people. But my why was my dad. My dad, retired military service person, had military benefits, but we lived in an area that didn't have access to the best hospitals, best healthcare. You would say there are social determinants of health that impacted his wellness. And then even before I became a nurse, I saw these things and I thought, "This isn't right. Someone's got to change this so people don't have to experience the same things my dad did." And ultimately my dad died of a massive heart attack in an emergency room, largely because it didn't have the best resources, but also I believe there are elements of implicit bias, just lack of care, lack of surveillance, dare one say medical errors from just negligence and other things that happened.

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Nurse Alice:

And so early on before I became a nurse, I was already motivated and fired up and I told myself, my family, "I'm going to be the best cardiac nurse in the world so no one else ever has to go through this. I'm going to work to change the system and the process to get better outcomes." So this is before I'm a nurse. So I set out on my journey and concurrently I begin to volunteer and do community work with the American Heart Association, going to churches, schools, businesses, anyone who will listen and talk about how to be heart healthy, because I wanted to talk to people before they became patients, before they were in that emergency situation. The healthcare dollar really should be more focused on preventative care, and we're not there yet, but I'm doing all of these things and I'm at a health event.

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Nurse Alice:

And one of the communication folks at American Heart Association kind of swings by my booth and it's like, "Wow, Alice, how'd you get everyone over here? You seem really good with the people. I mean they seem to understand everything you're saying. You make very complex things simple and applicable and you individualize it." These are all things that we as nurses do. We're patient educators. And so I get invited to do KJLH Radio in Los Angeles to talk about how to be heart healthy during the holidays.

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Nurse Alice:

Wonderful. Everyone loves it. Viewers call in. It's great. And then they invite me back to talk about strokes, symptoms of stroke and what you should do. So American Heart Association, working with them, I was able to do other radio stations and other shows with them to help promote heart healthy, important, issues to the general public, not just in those physical events, but using radio and television with them as well. And then the producers, every place I would go, I'd build good relationships and they'd also ask me health questions. I'm like, "Hey." And I'd answer their question, and, "Can you come back and talk about this?"

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Nurse Alice:

And next thing I know I'm doing radio all over the place. I was like a Fox News Radio person for about two and a half years. And then it spilled over more into television. And then there's digital. So a lot of things have happened. And once I started doing this television producers saw like, "Oh yeah, let's get that nurse who talks about health issues." So next thing you know I'm doing all of these things and I'm doing multiple networks, and the way I landed up at NBC is I was doing multiple networks and NBC said, "Hey, Alice, we really want our viewers to stick with NBC and when you're on all these other places, they follow you. So can you stay here with us exclusive for NBC?" And I said, "Sure." And so that's kind of how that landed. I never set out to do it. To me, I was just doing the patient education that we normally do, just using a different platform.

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Dan:

Yeah. That's an awesome story. I mean, what a great way to turn a childhood sort of tragic event into something that's life's work. And then you can hear it in your voice, how motivated you are around it. And it's awesome that you got picked up and now are spreading that across multiple channels, which is amazing. One question I have around that too, is when you started, traditionally you see physicians as sort of the medical experts on a lot of shows. Did you ever feel resistance in that way or were they surprised when you were talking that they found out you were a nurse? Was there anything in that space that you noticed?

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Nurse Alice:

Oh, Dan, absolutely. There were times early on in my career where I was trumped because I wasn't a physician, meaning, I remember this one specific topic was about heart disease and heart attacks. And they called me back and said, "Alice, we really love you, but we're going to hold on to you and bring you back for something else. We're going to have Dr. So and So," I'm not going to say his name because he's on television, "Dr. So And So come and talk about it." And I said, "He's an OBGYN. You're going to have him talk about heart health? Really?" Because at this time, I'm a very experienced cardiac clinical nurse specialist working at what is arguably the facility that does the most heart transplants in the world. And I'm like, "Really?" And so, although I think subtle things had happened prior to that, that was the most obvious kind of throwing up in my face type of thing that, wow, they really just want a doctor on television.

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Dan:

Yeah, right. And they don't understand. They don't understand the nuances between-

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Nurse Alice:

No, they don't.

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Dan:

-the idea. It's like, "Oh, the physician knows everything about every body part there ever could be. Or every disease."

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Nurse Alice:

Exactly.

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Dan:

And it's like they don't understand that people specialize so much that's not true now. Could he speak to heart health? I'm sure, generally could. But if you're an expert in heart health and cardiology, that's much more relevant.

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Nurse Alice:

Right, Dan. And so what I took away from that is it was the quote unquote prestige of being a physician. And I mean, I have a couple letters behind my name too, but these physicians. So I thought, "Hmm, they're being called upon just because of their credentials or their status." I said, "But you know what? I'm a nurse. I am part of the most trusted ethical profession out there." And nurses, we are really good at providing service. We're with patients 24/7. And I know I have something, nurses have something, while I love working with physicians, that physicians just don't have. I have that TLC, that bedside mannerism, because we're trusted with so much more information than physicians are provided. That's just honest.

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Nurse Alice:

And so moving forward, I learned how to package stories and really cater to the producers. I took some journalism courses and I took the best of what I knew of nursing, the best of what I had learned in those courses, and I learned how to produce a segment, which is something that most health experts that come on television don't know how to do. They just come on. They're invited on as a guest. Well, I learned the back behind the scenes. So where to get the stories, how to pitch the stories, what does a producer need to make their job so easy all they got to do is hit record.

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Nurse Alice:

I come to the studio, makeup, hair, done, ready. I have bullet points. I've written the intro for your anchor. I have statistics. I have everything you need. So I became a one stop shop. And I think that was really what separated me from the rest of these physicians because rather than sitting back and waiting to be invited, I invited myself to the party because I was that much more eager to get out there to educate patients about things that really happen. And I made the producer's job easier. So that and consistency, I think, is really what opened the door for me to stay on television as long as I have been.

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Dan:

I love it. That's so cool. I mean, you came with the whole package. You came up prepared. I mean, you did what nurses do. We show up, we do the work, we're prepared for it, and ready to go. So that's awesome. So what was it? Two days ago? The RaDonda Vaught case sentencing occurred? I'm sure that's been a hot topic. Is that in the patient safety theme around that sort of what's driving a lot of your media time at the moment?

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Nurse Alice:

Yes. And I'll say this, obviously I'm a nurse. I love being a nurse. I wouldn't do anything else if given the choice to do a redo. Not at all. I take great pride in being a nurse. This story is one that has made national news. It's unprecedented case of a healthcare professional being criminally charged for a medical error. And I think, you've seen the views of nurses, obviously we're outraged. And I think that there's a lot of energy around this and I'm hoping that we can take all of this energy and really bring it back to the nursing profession so we can tighten up some things where we need to tighten up. And then also work on some of our other stakeholders or partners who are in this because I definitely believe that the healthcare workplace is a flawed system. I mean, because of the workload, resource issues, staffing issues, pay issues, there's so many issues that go into play that can make a healthcare environment unsafe.

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Nurse Alice:

And for those who don't know, a CNS is an actually an advanced practice nurse, a little different from the nurse practitioner, which is more kind of a medical model. But I would work collectively with systems in patient populations and I would have kind of one foot at the bedside, still being very clinically astute as a advanced practice nurse at the bedside, and then have one foot in the boardroom. So I was very intimate with a lot of the booby traps that made work flows difficult and challenging for our nurses, that put our patients at risk and caused our organization numerous dollars. So a lot of my role included cost avoidance.

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Nurse Alice:

Now you don't see as many CNSs around anymore. I'm hoping that that's going to change a little bit, but clinical nurse specialists are instrumental in working in hospitals around patient safety. But I want to make sure that we're supporting our nurses. I did a lot of education onboarding and training of not only new nurses, but new to specialty, as well as those nurses who've been practicing for a couple years but wanted to step up their knowledge. And we can't take our eye off of that. Just because someone's onboarded doesn't mean that they're just on autopilot. And I think organizations don't invest in the continuing education and support and reevaluation of what nurses need when they're at the bedside. All they want to do is throw in new service lines, increase patient volume, and all of these things, but you can't forget the workforce that's there. And nurses need so much support because we want to, we want to help move the organization along. We support strategic initiatives, but you have to support us, because if we're not supported, we're going to make mistakes. We're going to be unhappy. Patients are going to be unhappy and we're just not going to meet the goals.

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Nurse Alice:

And I think hospital systems set nurses up for failure in that sense. So we got to work on those hospitals. And at the same time when we support our nurses, then we can form a more nonthreatening environment where we can talk about our gaps in knowledge or the workarounds that haven't been identified and bring those to the forefront so nurses don't find themselves trying to meet an outcome, but setting themselves up for failure by just doing a workaround and not reporting it up. And we got to be the solution to the problems that we're seeing.

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Dan:

Yeah. And I think in some systems that I've worked in, UCLA being one and then some trauma centers in Arizona, on the physician side, they had the M&M meetings where they would reflect on traumas that went well and went bad and they would talk about the evidence and what they could do better. And sometimes they were closed doors. Sometimes they were open door. At UCLA they were definitely open door. And so as a new grad in the ER, I would go attend those things and it created this safe space where you could talk about what happened with the team that you worked with to understand what you could do better and you move forward and you look at the evidence and the research on it, and that culture is so needed.

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Dan:

And then you look at the majority of healthcare systems and they're just like annual education day. Let's put up that poster board on restrains again.

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Nurse Alice:

Right. Read and sign.

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Dan:

Like, "Okay, you're good." Yeah. "Read that, read it and sign it, and you're good. Okay, you're competent." And there's so much better technology. There's so much better training. There's just so many things that just we don't use. And it hurts patients at the end of the day because you're sort of like checked off once you go through your orientation and no one looks back unless you have issues. And that's not the way sports works. That's not the way other industries work. And the culture of safety doesn't work that way, so that we have a lot of work to do there.

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Nurse Alice:

Absolutely. And I'm so glad you brought up M&M's, mortality and morbidity meetings. I'll be honest. Most of the organizations I've worked, they didn't say they were closed door, but they didn't necessarily send out an invite to everyone.

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Dan:

Yeah. Right.

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Nurse Alice:

And you had to know that it was happening in order to be there and M&M's, root cause analysis, all of those types of meetings, I think that nurses really need to be on board and involved. And even if it didn't happen on your unit, even if it wasn't your patient population. Like the aviation industry, if there is a problem, if a plane goes down, everyone in the industry learns about that. That's one of the things that doesn't happen in healthcare.

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Nurse Alice:

So for example, many times when I've seen things go wrong on a particular unit, usually everyone's kind of hush hush. They're trying to problem solve on that unit. And then later there's kind of this well prepared speech that goes out to everyone else that kind of tells you a little bit about the problem, but not really all of the problem. And it's definitely not going to another hospital for them to learn from the mistakes. So I think that's one of the flaws that we have in our organizations. And then even when there are, let's say it's something that becomes a civil case. There are non-disclosure agreements that organizations have these people sign in order to reach these undisclosed amounts of settlement. And I think that's another flaw in that we can't learn from the error because now, and we've seen this. So for example Vanderbilt wasn't forthcoming with reporting what happened. It makes you wonder who else is doing that? Couldn't be the first.

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Nurse Alice:

And so when you know the process, and having worked in patient safety, I was actually a patient safety manager for a short stint at a large academic center. I saw firsthand, all, Dan, all of the mishaps and then the near misses. And it's almost like I equate it to. "There are aliens here, but we can't tell everyone there's aliens because it'll cause mass hysteria." But it's happening. And I think we got to address the elephant in the room. I mean, obviously there is no industry that is perfect. And I think healthcare for so long has kind of been this somewhat perfect healthcare system. And if we don't get ahead of that and lead those conversations, reporters, news stories, are going to take us down when they find out about things that are happening in our industry.

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Dan:

Yeah, for sure. Well, I mean, you just look at the persona of nurses in the media right now. Every single thing on LinkedIn, every single video I see, is a nurse like sitting down on the ground with their hand on their face and their head down, sort of exhausted, or the pictures of RaDonda like crying in the courtroom or it just this persona of this profession that looks like we're just some beaten down sort of group of people that just have no way of coping and everything's going wrong. And look at this next bad news story. And we're quitting all over the place. We're all burned out. And it's like, while there's truths behind some of those things, that's not how we should be portrayed in the media and there's no context to it.

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Dan:

So people make assumptions when there's no context to these images and these stories and things. And so we have to get out and tell this story differently, or I feel like we're going to just kind of slowly destroy the profession and people aren't going to join nursing because they just see it as this depressing work yourself to death sort of thing.

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Nurse Alice:

I believe so, too. And there was a Woodhull study and a Woodhull study revisited. And Diane Mason was a lead investigator on the revisited. And they looked at the presence of nurses in media. And I think in the original study, it was 4% of nurses were called on as experts who were represented in the media. And when they did the revisited, 20 years later, it was 2%. And of the stories that nurses were represented in, it was largely labor issues, things like strikes, bad stuff.

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Nurse Alice:

It wasn't us talking about education or policy or getting ahead talking about things. It was what's happening to us and our profession and the images are not favorable. I mean, like you said, you see us with our heads down, we're crying. Yeah, we're getting to a point where we're not being supported and it's starting to be shown on mass media. And so while we do need to fix those conditions and continue to talk about labor issues and unsafe work environments and things like that, we also need to get into the media and be leaders in conversations, become the storytellers, instead of allowing someone else to tell the story and then just invite us in for this piece or that piece.

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Dan:

Yeah. I mean, through the pandemic, I know you were on lots of things during the pandemic. Our friend, James Simmons as well was on there. And I was working for Trusted Health at the time and so I was getting calls all the time around, "Well, why are nurses making $200 an hour?" And in my head, I'm like, "Why not? If you look at any other industry where there's a shortage of labor, wages go through the roof." And it's like, "But, whoa, that can't be. It's killing hospitals. Hospitals can't sustain it." I'm like, "That's not the problem here. The problem is the hospitals can't forecast their needs and now their blaming nurses for their problems instead of actually understanding the issues and being thoughtful and future focused and all these different things."

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Dan:

And we had to turn these reporters assumptions around so much because they had talked to hospital CEOs and associations and things and they just come firing both guns at you with these questions about, "Well, how can you do this? Your price gouging," and all this stuff. And you have to explain like how this whole thing works. And I think we need to have nurses positioned to destroy some of those assumptions because there's a lot of misinformation out there, especially around health and nursing in general.

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Nurse Alice:

Absolutely. These reporters have no idea what nurses do, the type of work that we do. And listen here, gas prices are going up. I just drove around the corner the other day. Gas was 6.49. Ridiculous. And so there is such a thing as inflation, but I also have to say, I believe healthcare systems put themselves in this predicament by not taking care of nurses, by not fostering the growth and support of the largest segment of the healthcare workforce, hello. And because we're the largest segment of the healthcare workforce when there is an increase in supply and demand and plus you don't treat your workers very well, of course you're going to have to pay more. But I get the argument that this isn't sustainable. And I think about those things and it's a really tough intersection. Obviously the end goal is we want people and patients to be healthy.

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Nurse Alice:

That's the end goal, but how do we get there? Well, you need a workforce, you need supplies, you need a healthy work environment. And so let's start with that, hospitals. Because that's not what you're giving us. And I also believe that some of the people who are saying these things about nurses making too much money, I hate to say, I believe many of them are kind of our C-suite folks who were so used to collecting these large bonuses for things. And now realizing that, "Oh, I can't collect this large bonus. I need to reinvest it back into the workforce." Well, you should have been doing that from the beginning.

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Nurse Alice:

And then also COVID really shined a light on the dire need of nurses, the shortage of nurses even more. It shined a light on health inequity and health disparities. And so this was the first time since I've been alive where our healthcare system has really been challenged to do what it's supposed to do. And I think for so long some of these places have been kind of coasting, enjoying, like, "Oh, well it's not that bad." But then the pandemic hits. Now you got to show your stuff. This is what you're here for, so let's do it. And I think those dollars had previously been allocated in other places. And this was the time where we needed to put those dollars really to work. And it was like a shock to these folks that, "Oh, wow, this is how much this costs?" Yes. I should be more than just rolled up in a room rate because that's what nurses, we're rolled up in the room rate.

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Dan:

Right. I posted recently you find out the true colors of an organization in crisis and we saw the true colors of lots of organizations in crisis, both good and bad. And I think there's a lot of opportunity there. And especially around patient safety. I think that's sort of the biggest piece here. There's so much waste in systems. There's so many broken tools that healthcare workers have to use. There's just a huge risk there. And the Vaught case is one that highlighted the multiple Swiss cheeses that could line up and cause something. But at the end of the day, because nurses are with patients 24/7, it's easy to make us the fall person because at the end of the day, all those checks and balances come down to one person's decision. And it's easy to blame and scapegoat out on that.

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Dan:

What are some of the changes that we can make, with the Vaught case sort of bringing it to the limelight? I mean, that is one case I made in the media, but that happens every day in health systems all over the country. What are some things that we can take away as a profession and advocate for so we can make some of the lasting changes, that'll support our profession, but also keep patients safe?

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Nurse Alice:

Right. So I could be here all day talking about this. But the first couple things that I want to say is I hope this was a wake up call to nurses to, so often we have a work list, a task list, of so many things that we're supposed to do. And I think this should be a wake up call for nurses to say, "Hey, this is too much. I can't safely complete all of these things." Because nurses, we just get it done. Many times we don't complain and we just do it. Whatever it takes, we're going to do it. We're going to jerry rig something, we're going to do a workaround, but we're going to get it done. And I think this is a time for nurses to slow down a little bit. I hate to say this because we don't want to feel like we're slowing things down. But I think for safety, we need to bottleneck the system so the folks in the office or the C-suites can see like, "Hey, maybe I can't push 200 surgeries through in the day. But to do it safely, so if nurses speak up, maybe I can only do 150."

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Nurse Alice:

I think that's one thing with nurses. We have to speak up. And don't just speak up once you're at the end of your rope. I think this is an opportunity to identify things ahead of time. So when we talk about medical errors, we always talk about the things that obviously went wrong. Wrong side surgery, gave the wrong medication, but what about the near misses? And that's something that I've always been very hyper aware of in my role as a CNWS because again, part of my role was to kind of identify these issues, prevent them from happening, cost avoidance, prevent any patient harm, prevent staff dissatisfaction.

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Nurse Alice:

And we got to speak up more. And no one wants to be the person to slow things down, but you have to, you have to. Because we've heard the saying, people will treat you the way you allow them to treat you. So nurses need to speak up in that sense. I also want, nurses, we have to learn how to play in other sandboxes. So I'll say this. Sometimes our nurses, they identify issues, but they don't necessarily want to participate in the unit practice council or be a part of any type of particular committee groups in their hospitals to move things up. And I think it's important that we learn these things, participate in these things, and move these things up our chain of command, because otherwise you can identify a problem, the whole unit can identify the problem, but if no one documents it and puts it down, remember if you didn't document it, you didn't do it. If it's not there, there's no evidence to show that there's an issue.

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Nurse Alice:

So I think staff nurses can work greatly with their nurse managers, the directors of their unit, to kind of move these things forward. And I also think that it's important that nurses outside of your own respective hospital, that we collaborate, and benchmark practice with other organizations, because we're so much stronger together than we are alone or as just one unit. And even if one hospital is able to fix everything in their hospital, if the hospital across the street is still having problems, we've still failed as a healthcare system.

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Dan:

Right. Because it's all people, whether they're a competitor hospital or not. And when we started the pandemic and we sent some nurses over to New York in that first wave, we had over 100 nurses that were heading over. And so we recorded, we had a live kind of session because I mean literally they're entering a war zone. And sort of the three takeaways that we focus on, which I think are relevant to this as well that nurses no matter what's going on can focus on, one is protect yourself. And so make sure that you have the PPE and the resources. So in this context, make sure you have the resources, the support, make sure that you're advocating for your own personal protection. The second is then protect your license, because you can't practice nursing without it. And if you can't be a nurse, you can't help people. And so how do you do that? You can do that with malpractice insurance. You can make sure that you're not taking on assignments that are too heavy, you're advocating for yourself as a professional. The third one is protect your patients. And you need to advocate for the things that you need to protect your patients, whatever that is.

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Dan:

And if you could just focus on those three things, no matter what organization you go into, it doesn't matter the drama, the politics, the ratios, the union, non-union, it doesn't matter. If you focus on those three things, then you're acting as a professional, and you're going to be doing your best to make sure that you're safe and your patients are safe. And I think a lot of nurses overlook that, "Oh, the hospital will protect me if there's lawsuit." No, they won't. They don't care about you. They're going to do everything to protect themselves.

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Dan:

And so while there is some protection potentially there, every nurse should have liability insurance on the side. Every nurse should be able to stand up and advocate and see the system and what's broken and make sure it's documented in some way so if things like this happen, like the Vaught case occur in your system, you have the documentation to say, "Look, I brought up this thing. It's broken for 10 years. I've been bringing it up every six weeks. Look at here's my email chain. Here's my documentation." And it just protects you in general, but it also hopefully makes impact on the patient care.

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Nurse Alice:

Yeah. Dan, I think one of the things I just want to comment that when nurses say, "Oh, I'm protect." Well, how we thought we were protected by the hospital. I've always been very involved in the policy and procedures that were renewed and written at the hospital. And the little print that's there is provided you don't deviate from any of the hospital policies and protocol. So why else would you need coverage? When you make a mistake. So when you make a mistake, you don't fall under policy and procedure, so then you're kind of like a sitting duck. So to me it's a no brainer that nurses protect themselves and have their own liability type of insurance. And I think that's something that many nurses didn't realize, that the hospital only covers you when you stay within policy and procedure and protocol. But when you make an error, that's not what happens, for the most part. There's usually something that's deviated. And by that deviation you by default are no longer covered by the hospital. And I've seen so many nurses find that out the hard way.

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Dan:

Yeah, for sure. And you want someone in your corner and it's like literally 100 bucks year to get it. For travel nurses, that's one hour of work. Come on.

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Nurse Alice:

We spend more money on food and Starbucks.

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Dan:

We spend more money on potlucks at the unit than we do. But, no, I think those are the things. And if every nurse just sort of took initiative on those three things I think it would make a big difference. And when you don't have them, I think the other piece is, like you said, we need a coordinated voice to bring that up. And whether that's through council's, internal organization, or some other way, with your associations or the state agencies or whatever it is, we've got to do that. I mean, I've seen it. And I know a lot of nurses are probably listening, thinking like, "Hey, I brought this thing up to my manager. It never gets fixed." But I've seen things where one nurse saw one physician in a small hospital do something completely out of practice, out of scope, reported it to the California Department of Public Health. And within weeks removed the physician, had a whole audit on that hospital. One nurse's report changed the entire life cycle and kept patients safe around conscious sedation.

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Dan:

I've seen the same thing when the technology wasn't working right and alarms and alerts weren't going to the right people and there was patient errors. Nurses brought that up again. The state came in and did some review and forced a remediation plan for the hospital. So I just don't want to hear nurses going back on TikTok and Instagram complaining and putting up the memes about how horrible their managers are unless they've actually taken those steps to make a change when it's needed.

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Nurse Alice:

Exactly. And let's also remember that there's checks and balances. It may not feel like it because you're depending a lot on your particular unit, your particular hospital, to fix things. But there's a checks and balance. And if you ever feel like the patients or the public safety is at risk, I mean obviously do your due diligence, get all the information you can, and try to correct it. But let's say it doesn't get corrected. There's the Department of Health. You can report to JCAHO. I mean, these are things. And I think collectively as nurses maybe we haven't done those because we had so much hope in our organizations that they would fix it. Or maybe we just got so disappointed that nothing was happening that maybe we forgot or we were overworked and didn't have the time.

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Nurse Alice:

But I think this is really an important time because we've seen what's happened with RaDonda for us to prevent further situations like that. I mean obviously try to work it out through your unit and make changes. But if you can feel that there continues to be a state of unsafety, it's important that you use your checks and balances. I mean most places have a whistle blower type of system where they can report issues that they feel are not being heard that put people at danger. There's the Department of Health. You can report to the Joint Commission. Those are all things that you can do. But I also want to say this, because some people will say, "Well, I feel like I'm snitching." Well, I started to say, "Have the conversation amongst each other." I think collegial conversation, people don't like to feel like they're policing, quote, unquote, policing, someone else's practice.

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Nurse Alice:

Just a quick example. The other day I was going to transport a patient who English was a second language. I spoke some Spanish, but not to the extent of having to be able to explain EMTALA documents and things like that. And so the nurse who was on orientation, I asked her, I said, "Do you have a translator or do you speak Spanish?" She's like, "No." And then, so she looked to her preceptor and her preceptor proceeded to, in very broken Spanish, try to translate. But what she was saying was just, "Sign here," without explaining the document. And in a very nonthreatening way, without earshot of the patients, when I said, "This is an important document that you're asking the patient to sign and you're just asking them to sign without explaining it to them. And you can see there's a line there that says translator. You're supposed to call a translator."

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Nurse Alice:

So, "We don't have a translator in house." "Well, do you have one of those blue chromocone phones? Do you have a line that you can call? Do you have an iPad?" And the truth was they did. They just didn't take the time to do it. And so for a moment it made them feel uncomfortable because I was kind of calling them out. But in the end, okay, it's a lesson learned. Some things you can't do a workaround. Do the right thing and right things will happen. When you do the wrong things, wrong things will happen. And in patient's best interest and considering being culturally and linguistically competent, that's what we're supposed to do. And so sometimes doing the right thing takes a little bit longer. That's why I said earlier sometimes it feels like we're going to bottleneck the system, but you got to do the right thing. If you want to be faster but that means doing the wrong thing? I don't want to do the wrong thing. I'll be slow and I'll be right.

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Dan:

Yeah. And you can see now that there's precedent set that you do the wrong thing and you can be right there in the courtroom with national media around you. I think there's an approach. So it's deal with it locally, address it with whoever it is, the person like you did individually, with the manager or the leadership team that's there, the council. If that doesn't go anywhere and it's still an issue, you can elevate it and escalate it up through the organization or beyond that into regulatory agencies.

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Dan:

And a big thing that I think we skip over or we forget in nursing school and when we get out into practice is our obligation is not to the organization. It's to the population we serve. As a professional our goal is to keep people safe, population safe, not the healthcare organization. So if you think about it as you are an agent of change for the population that is experiencing nursing care that you're delivering, then it removes you from some of that drama too. You have the professional obligation to do that. And at the end of the day, you go to the Board of Nursing, that's what they look at. Your obligation is to your patients. It's not to any single entity. And so I think we have to keep that in mind as well, that we're trying to fix the entire system, and we can only do that by having data, reporting things that aren't great, and addressing them in real time.

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Nurse Alice:

Right. And for those who are listening who are afraid if they're going to do these things that they're not going to be liked or well received on their unit, I would rather be respected and do what's right. And I wouldn't mind. I wouldn't mind, okay, so maybe it's not always going to be warm and fuzzy, but you know that Alice, she's not always fun and stuff, she might remind us of something that's going to take a little bit longer, but she's always going to do the right thing. And I want to be known as the nurse who's always going to do the right thing.

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Dan:

Yeah. And I'll tell you, my preceptors were those people. I got to grow up with some of the most amazing preceptors as a nurse and every single one was unafraid to stand toe to toe with name the title and defend what they believed was right and push back on things that weren't right. And I think that is a superpower that we need every nurse to have. And I know it's within all of us because we do it every day with patients, we do it with our physician partners, we do it to get the care done. Now we also have to do it when we're working in a system that's broken. And my hope is that we can share that data a little bit better and make the changes in real time because if all four million of us do that, then we have some massive changes that we can lead across the system.

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Nurse Alice:

We are so massive. I mean together, if we all just did the same thing, I mean we could make change transcend throughout this healthcare around the world. I mean, as the largest segment of the healthcare workforce, they've got to listen to us. If we all just put our foot down and said, "You know what? I'm going to do what's right, not necessarily what's fastest for you." Or not be afraid to speak up. You just cannot be afraid to speak up. But also this. How can anyone truly argue with patient safety? I'm speaking up because I have a concern for patient safety. You're going to argue me down about patient safety? Come on. So, there you go. They're going to look like so silly arguing. So, what I'm hearing is you want me to compromise patient safety. Is that what I'm hearing? I mean, sometimes it's also you got to not be afraid to speak freely because, again, like you said, our duty is to the patient and to the public, not necessarily to the C-suite.

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Dan:

Who doesn't understand the workflow either and is trying to jump to assumptions. And, man, I've experienced that lately, a ton. Just non-evidence based assumptions about what should and shouldn't happen in health systems. It's just scary sometimes.

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Dan:

So we got to wrap up a little bit here. So, I think we hit on a lot of different things here, specifically around patient safety and the role that nurses play in that, how they can stand up, speak up. I think the other piece is nurses need to get into the media more and it's not a scary thing. Like you said, it was very organic for you to do that. And then once you had the opportunity you doubled down and made that sort of your mission and came with preparation and gusto and all the things that have made you now a correspond on the NBC, which is amazing. We need more nurses to do that.

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Dan:

And I would say, nurses, get out of the echo chamber a little bit too. Social media is great, but you need to get out of the nursing kind of echo chamber there and get the message out to all the other connections you have in the world, and I think together we can raise the voice and make the change. And times now. There's so much stuff. We had the Nurses March. We have the Vaught case. We have staffing and stuff. There's 20,000 open nursing roles at any given moment in the country. So we can vote with our feet. We can vote with our voice. We can vote with ballot that's coming up with the primaries. There's so much opportunity for nurses just leverage our voice. And you're a perfect example of how nurses can do that, Alice.

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Dan:

What we like to do at the end here is hand off a piece of information, that one nugget to take away out of our wide ranging conversation. What would you like to hand off to our audience?

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Nurse Alice:

Oh gosh. I think one of the things is I really just want to empower nurses to stand their ground and to not be afraid to speak up. I think for so many people, sometimes it's because you're the newer nurse on the unit, maybe you're a new grad, or maybe you feel like your voice doesn't matter. And I want everyone to know that your voice matters, because quite honestly, there are probably other people on your unit who want to say the exact thing that you want to say, but they're too afraid as well. So, please, I really want to encourage nurses to speak your truth, stand up for yourself, stand up for your patients. And I promise you, the first time you do it, all of the other subsequent times it will get so much easier.

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Dan:

Yeah. Don't be afraid. And build that culture. Talk to your teammates to get the information and make it okay to have those conversations. You can do that without permission. You don't need to be a formal leader. You don't have to be charge nurse. You don't have to have any of that stuff. You can literally have those conversations every single day and that makes a culture change. And so, nurses, you have the power. You have the power to do this. So, Alice, thanks so much for being on the show. Just really appreciate your time. Where is the best place that people can find you if they want to learn more about your work with NBC or just connect with you on social in other ways?

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Nurse Alice:

Sure. So if you are a NBC watcher, you can go to NBC's website and catch me there. But I do have a website it's asknursealice.com. So you can go there and check out many of the things that I'm working on. There'll be a lot of new things, Dan. I have a book that I'm working on that's coming out and it's largely around health disparities. I also am doing a little bit of storytelling. Now, I know all nurses, we've seen so much, there are so many stories to tell, and I'm actually working, this is kind of like a exclusive. For so long, Hollywood has not favorably portrayed nurses. And I am working with a media production on a medical scripted show where the lead character is a nurse. And so it will be an opportunity to really showcase and highlight what nurses do and really tell stories the way that they really happen in the hospital. And insert along the way many of the issues that nursing professionally are dealing with to help brings awareness to the public.

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Dan:

Oh my gosh. That is awesome. Can I be an extra?

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Nurse Alice:

Yeah. Listen, I'm so excited for this. I'll be honest. Some of this is, it's loosely based on my story. So I've told you the story about my dad already. So you can see there's going to be lots of twists and turns in this medical scripted drama. But one of the goals is to actually get nurse writers to participate. So to create opportunities for nurses to get into storytelling spaces.

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Nurse Alice:

Now, I'm not saying leave the bedside, not at all. But in the evolution of your career there may be other things that you want to do and some nurses really want to be storytellers. I can talk on NBC to raise these issues. We can have all of the networks, but there are other avenues in which we need to tap into the public, which can then lean on their elected officials, to then help make the changes that we need and want to see around nursing and healthcare issues, public health, gun safety, many of those things that are important to the safety and health of the public. And I feel like nurses are excellent people to drive that conversation. So it's nurse created. There will be nurse writers in the room. And come on, Dan, love to have you on.

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Dan:

I mean, I grew up on MASH and ER, and so that shaped my entire view of medicine before I became a nurse. And then MacGyver, that was the other one. And so those three shows are like my personality in a nutshell. And so, yeah, I've always dreamed about the equivalent of like sort a Dr. House or whatever that was nurse focused, that wasn't Nurse Jackie or Nurse ratchet. It was the professional that was driving the care like we do every single day. So I'm so excited to see that. And when that comes out we need to have you back on and just promote the heck out of it because it's such a needed piece in the world of entertainment and media and portrayal of our profession.

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Nurse Alice:

Yes. I'm really excited about it. And so that's also just kind of a testament that you can do anything in nursing. Wherever there are people, there'll be problems, and that's where nurses need to be. And so it's important for us to be present to help guide the conversation, guide what's happening, because we know what's best for our patients. We know what's best for our patients. So it's good for us to be there, provide that support, and guide these conversations, whether it's in the hospital, outside the hospital, in the clinic, writing a media script. There's so many ways that we can educate and help public health in the world today.

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Dan:

Agreed. Agreed. Well, thank you so much again for being on the show. We'll put those links to your website and your media channels in the show notes as well. And keep us up to date on the production and if we can help in any way, I know our listeners would be interested, and I'm personally interested. So just appreciate your time today.

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Nurse Alice:

Thank you so much, Dan.

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