November 5, 2020

Episode 40: Why conversations about nurse leadership need to start earlier

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Podcast

Description

Our guest for this episode has some strong opinions on nursing education and nurse leadership, and how we can evolve both of those areas. 

Jannah Amiel became a pediatric nurse in 2007, but quickly realized that her passion was in teaching after seeing that the traditional nursing school model wasn’t setting up many students for success. After working in academia for several years, she ultimately launched TootRN, a one-to-one tutoring program that prepares nursing students for their NCLEX. She’s also a nursing Content Manager at Osmosis, where develops content that’s custom tailored to Nursing students. 

In her conversation with Dr. Nurse Dan, Jannah shares her thoughts on what she thinks is working in nursing education and where she thinks we need improvement. She also talks about why our thinking about nurse leaders is antiquated and causes us to miss out on promising talent and why conversations with nurses about leadership need to start much earlier in their career. 

Links to recommended reading: 

Podcast

Transcript

Dan:
Jannah welcome to the show.

Jannah:
Thank you. Thank you for having me. I'm excited.

Dan:
Tell me what you're working on right now. What's top of mind as you work through the Osmosis world.

Jannah:
Yeah. Well, you touched on it. Nursing. I live, breathe, eat all things nursing. And for a long time, Osmosis has been in this education space, but largely it has been for medical students, MDs, DOs, that type of field. And now we're starting to get into the actual nursing field and nursing education and making sure that we're including the RNs in the game. And that's really exciting. We made five pilots of some videos and content that we're working on and that's out in the wild getting looked at and we're getting feedback on it. And a lot of eyes have seen it and are feeling really excited about it. I'm super, super stoked about it.

Dan:
I love it. I do a fair amount of speaking to nursing educators across the country. And I talk about Osmosis every time when they talk about disruption. Because I think your model you're tying back to clinical competency and board style questions, the learner centric ways that you've built content and engage people is so cool. And I feel every other week, there's a new role that has a nurse coming into the company. How are you scaling up that side?

Jannah:
There's so many directions that we can go in with nursing. And for all intents and purposes right now, I am overseeing a really small team of nurses to make this really big product. But what's cool is that in this type of space we can bring nurses on and we don't need to be the nurses coming in. As a subject matter expert to tell us what's true and right in the world of health care. But also it gives nurses the ability to stretch out beyond that role. What you traditionally think about what the nurse is going to do in an education company? Is going to make stuff so you can teach it.

Jannah:
But what's really nice is that we're allowing people to stretch out of that box and we're allowing nurses to contribute in other ways. Besides what we think about is the standard traditional model of what the nurse can do. And that's been really exciting because that adds to our product. That adds to Osmosis and what we're trying to do in the market, that we really are empowering people to be creative and come with it. Whatever you got come with it, let's see what it is and how we can change education.

Dan:
I love it. That's how Trusted Health is to. We have this role called a nurse advocate, which is our clinical to clinical connection for nurses that are working out in the world. And the nurse advocate role is something that in nursing school, you never hear about. You never hear about the opportunity to go work in a tech company and support your fellow nurses. You never hear about the opportunity to go work in an education company and do something different with your nursing degree. You're seen as a subject matter expert like you said. And I've been in that role for sure. And it's exciting to build these like new places that nurses can change the world. And I'm excited about it.

Jannah:
Yeah. You're totally right. It's the innovation piece. That's the thing. That's a sticking point for me. It's that trying to get nurses to get out of this box of, "This is what you are and this is what you're going to be doing forever and ever." But we have so much to contribute. And I always think, who better than a nurse? We see it all. We are the front line and if you've got ideas and if we think about ways we can fill voids or change, I mean, it's the nurse we got to come to expand those thoughts.

Dan:
Well, I'm not going to disagree with that.

Jannah:
No, thank you.

Dan:
Like I said, I interact with a lot of nurse educators across the country. A lot of nursing students across country. I teach and there's two sides to nursing education. If you go on Instagram and you see all the memes nursing school is portrayed as the worst place on the planet. That's set up for everyone to fail. And it's this evil land, which being on the other side as faculty I know it's not. I know there are things in place that are frustrating, but also there's some things working. I would love to hear your perspective on what you think is working with nursing education? And where you think there's an opportunity for a lot of innovation?

Jannah:
Yeah. That gets me too. Because as much as I want to say, "That's not true." Unfortunately, I've seen some institutions very few where the experience is not at all of the experience that I would want as a nursing student. And I would want to give as a faculty member. One of the big things that I hope to see change in nursing education is really the way we deliver what it is that we need to note. We tend to traditionally and nursing teach in silos. Learn this and then now you've learned it now learn this and not you've learned it. And we have heavy emphasis on, "You must master all these skills and learn all of these different pathology processes and procedures and all of that stuff." And that's fantastic. But I think that it doesn't set up nurses at basic level.

Jannah:
I'm talking about RN just graduated is working at the bedside. It doesn't set them up for what the real full scope of the experience of being an RN is. And I think that that is a space that we can really start to develop more. And we're now starting to see things come around about innovation and nursing and a more of a push of leadership and nursing. But these are the conversations and these are the teaching points. And the skills that I hope to see become more standardized at a very basic level one all the way through. Instead of waiting until your post-graduate. But now we're having these conversations about all these other things you can be doing. I feel we missed out on so much time and we miss out on so much talent by waiting to have these conversations later in education.

Dan:
I agree with that. And I think what I keep saying, why does every single nursing school teach cardiac anatomy? What is the point of every faculty member in the country, every school doing a cardiac lecture? It's been done, the heart hasn't changed in 100 years. XYZ school doesn't know it any better than the other school. There's resources where you could actually stop spending time on these lectures about basic stuff and use really well-designed content to supplement that baseline.

Dan:
And it changes that faculty model of being a content expert to a context expert. Now they're coming in and saying, "Hey, here's my world experience in this patient population." You're going to go do your clinicals on. Let's translate what this thing means to that and what you do about it and how we indoctrinate you into the culture of positive nursing. Instead of spending all our time focused on these bullet points about stuff that is standardized at this point.

Jannah:
Yeah. 100%. When I was teaching as a faculty member, I used to always tell my students I still do now. I would say, "If I had a nursing school, you would only learn first anatomy and physiology, get that out of the way. And then we're going to talk about the real experience." Learn the thing first, the body. And then let's really talk about what it's like to care for this patient and what that experience is? And what your role is? Because I agree, we've been doing the same thing for so long and nursing has changed and healthcare has changed and people have changed. And we haven't changed though in the way we deliver the education. And that can be frustrating.

Dan:
Yeah. And especially with the move now to mostly online, there's way better ways to do it. And I love this slow drip methodology that Osmosis has. Which is let's ask you questions every day and figure out where your gaps are and then curate content to fill those gaps. And it's going to be different for everybody. And I had a conversation with a faculty member the other day. What's the benefit to the institution if they do that?

Dan:
And I said, "Well, imagine if you knew what every gap of every student was every day, and you could go into let's say, you're still lecturing. You go into the lecture and now you tailor your content to where most people are struggling. Instead of covering all 55 PowerPoint slides as fast as you can." It changes the whole dynamic of how you teach. Now, you got to be more flexible, but you could actually be more impactful. And I think that's the mindset that we need to have shifts within some of our programs.

Jannah:
100%.

Dan:
Let's talk a little bit about nursing leadership. I know there's leadership content on the Osmosis. I know you're passionate about it. What are some of the trends you're seeing in nursing leadership and where are you most excited to disrupt that?

Jannah:
Oh, yeah. This is my jam nursing leadership. I think that... I hate to say traditionally, but really it's one of those things we say it all the time, all the time, all the time. And there's a connotation to leadership and nursing that I have found a lot of students and a lot of registered nurses associate with something like going to the Capital and standing on the steps and you're advocating for some type of policy change. And that's what leadership means in nursing. And that's part of it, but that isn't it in and of itself. And so when I think about leadership, what's really important for me. And what I'm been really pushing for is that leadership starts from the very beginning. You can be a nurse leader as a staff nurse, working at the bedside, caring for your patients. It happens there and it's happening at that level.

Jannah:
It can happen at an institutional level at the facility that you work in. It can happen in your community and statewide and higher and higher. But I think that we're missing that beginning piece. I always think about, imagine an associate degree nurse, he or she graduates and they take their NCLEX, they pass fantastic. Now they're out there, they're ready to work. They're working in the field. And let's say that they've been working now for a few years and they decide, "I'm going to go back to advanced my degree." And they go back their advanced degree and they learn a little bit more and they're a little bit more empowered to do different things. And at that point where we start to do those advanced degrees, where we start to have the conversation about, "Well, this is how you can be a nurse leader in these ways."

Jannah:
But for me, the problem is what about that gap of the years that you graduated? You were entry-level, you've worked for a few areas before going back to advance your degree. You have all of this invaluable experience. You have ideas. You have thoughts about how you can change things to the betterment of your patient outcomes. To the betterment of your facility outcomes. But you don't have the tools to take that charge and to utilize your voice. And for me, this is where the big need for leadership is absent. And that for me is problematic because I feel we're really not leveraging nurses in the best way possible. If we're waiting so long to have these conversations about what it is to be a nurse leader. And I don't want nurses and students to think that to be a nurse leader means I have this advanced degree and all of this education and I've been in the field for 30 years. No, this stuff happens early on.

Dan:
Yeah. I think that's really important point to hit on. Which is leadership is influence and you can influence it any point. And even taking your first job on your first day in a health system, you're influencing patients, providers, family, other nurses, you're leading in some sense. But we don't ever give credit to that. It's well, you're not really a leader unless you have a bachelor's and then you can lead as a staff nurse. And then while you're not really a manager, unless you have your master's. And you're not really a chief nurse, unless you have a doctorate or you've been around for a really long time.

Dan:
And it's these old models of leadership as a role rather than leadership as a behavior. And I think we have opportunity to help give people tool sets to lead as a behavior. And there's tons of opportunities within the health systems. I mean, shared governance, committees, improvement committees, the unit councils, all these different things exist within health systems and in nursing education you're not always exposed to all of those nor do you have... You're not taught the tools on how do I show up to those and actually influence no matter what my clinical years of experience are.

Jannah:
Right. That's exactly it. And I think that we are missing the target and missing a big opportunity when we don't have these conversations in nursing education really early. And I think about it makes feel, "Oh, you do one of those things when you think about." Well, how much have we missed out on? Because this new nurse didn't have the tools or the know-how, or the encouragement to lead by maybe utilizing their voice to say, "Hey, I have this idea. I have this thought. I've been thinking about this." But it's one of those things, it's if I don't know how to do it, if I've never been educated on how to do it, no one fostered that for me. And all these years, I've been kind of keeping it to myself not really knowing how to channel this part of who I am as a professional. We missed out on a lot of opportunities and a lot of growth that way.

Dan:
Yeah. And I think there's also a difference in the leadership between the millennial nurses coming into the profession and the baby boomer nurses who have been here for awhile. About how they conceptualize leadership. What are your thoughts on that?

Jannah:
There's two things for me, I think that some of it... And this really interesting, I wonder if it's a meta stereotype. That millennials had this idea that the baby boomers think of them in this one way. And the baby boomers have this idea that the millennials think about them in one way. I think there's a world where that's true. And then there's a world where yes, it is true that we have these very different generational traits. And I think that if we're not harnessing those things and really capitalizing on how we can help empower these nurses and their different roles, that's a missed opportunity. We know that there is some truth that millennials, they want to get into the field and they want to start working. And they want to maybe as perceived as move fast up the chain because they want to contribute.

Jannah:
They want to do work that feels meaningful. They feel they're able to facilitate change and do all the things that they've set out to do. And sometimes we find that's a different type of work ethic than we see in the baby boomers. Who have a different understanding of how you climb that ladder so to speak. And making sure that you are, I don't want to say stay in your lanes, but doing your tasks as you're assigned. And you continue to grow and type out this predictable manner. And that's where we seek some of those big differences. And I think that, of course both have the potential to lead in amazing ways. And I think that what I have found personally with millennial, nurses and students that are coming out is they want to get to that point faster because they're so invested in being a part of something big and meaningful. And they're clear about what has to change. And they're clear that why I want to go do it?

Dan:
Well. And they see in their age group that if there's a problem you start a company and solve it. There's the Googles, the Apples, the Startup Companies, Silicon Valley. That they see these people that are their age that have built multi-billion dollar solutions to the world's problems. And then you in our healthcare and you're, "Well, Oh wait, I can't even work day shift unless I've been here for five years. That doesn't make sense. That doesn't compute with me. What's the value of five years?"

Jannah:
Exactly.

Dan:
I think it's that mindset of, "Well, I know I can do it, why are you holding me back?" Or "Why do I feel held back?" And it's an interesting conversation. And I'm on the border of millennial, I'm like the Xennial generation. I like the description of that, which is you have the optimism of a millennial and the pessimism of Gen X. That's perfect that this guy is really well. But and I would get frustrated too. And I always took the non-traditional path. I never did the manager, chargers major director level.

Dan:
I jumped around to simulation and then education and then innovation and then research. And all these roles where I found where there was a cool fit and opportunity rather than following a path. And I think we have more and more nurses that want to do that. Including people joining Trusted Health in these non-traditional roles or Osmosis in these non-traditional nursing roles. And I think we could do a better job of promoting what else is out there. And how do you piece it together as a puzzle to build your career rather than following a prescribed track?

Jannah:
Yeah, for sure. You reminded me when I was getting my master's degree. I remember one of my instructors, my professor, she said, "You're an enigma." And at first I was, "Oh, that's a cool compliment." But I realized there was a little frustration behind that. Because I had that same attitude in the sense of, "Yes, I know what I can do, but this is what I want to do. And I realized that it doesn't fit this traditional model that we're used to seeing, but this is what I want to do in nursing." And if we had more of that type of foster that and the nurses and see what it is that they want to do. What they want to contribute, imagine the things that we can change. And for me, it's such an untapped potential. And I want to see more nurses do this, or more students do that. And then the generations before us that are going to be handing down. You're passing the torch to help to facilitate that.

Dan:
Yeah. I mean, one of the biggest pieces of my career. And I'd love to get your take on what other tools or actions people should take relate to this. But one of the biggest thing was hooking up with a mentor who was able to navigate those white waters with me and give me perspective. And also say, "If it's not a fit, don't do it. You're not forced into these tracks of thinking." And saying, It's okay to say no." Or "It's okay to say yes." That allows me to think differently about my whole career. What other ways do you think nurses at all levels of their career should be supporting their trajectory? And should they connect with mentors? Or there other ways that they can figure out the track they need to be on?

Jannah:
Yeah, definitely mentors. I think that first and foremost, that has been a huge benefit to me and my career personally as well. And really helping you to decide or even not decide. But what I found most beneficial with mentors is that they can often see something in you that you don't see in yourself. And they pick up on those cues and they pick up on something in you that they see and think, "Huh, you would be really good in this." And they helped to push you into something that you may not have thought about before. And I think the other thing that I would definitely recommend is getting involved in boards, getting involved in groups and committees even outside of healthcare. Outside of the hospital, outside of where you work, if it's in your community, maybe there's a community board that you have, or if you have an interest in a specific market of the world that's you feel all of a sudden that really nursing, how can I contribute?

Jannah:
I say go for it. Because there are so many places where you can be a registered nurse, or even licensed practical nurse. And nurse at any level and contribute in such a meaningful way. And bring ideas and bring change and really start to carve out new avenues that didn't exist before. And your experience as a nurse is invaluable to that. And I always tried to push people, nurses, and students to get outside of that healthcare box. You don't have to participate in things that are in the hospital, think about things that are happening in community that maybe you're really interested in. And you might not think that there's a way, 'Well, I'm a nurse. How can I be helpful on this community board?" But you can. And there's an opportunity to build new niches that didn't exist before.

Dan:
I agree. And I think we have to open up our way of thinking about what nurses contribute to. And I've seen it in the tech world as well. Nurses are, "Well, I take care of patients. What am I going to tell a software engineer?" Well, you can tell them a lot, you know a lot, you have a different perspective. You give them insight into things that they're trying to build solutions for. And there's a marriage there that is awesome. I think you bring your nursing lens no matter where you are you're always a nurse. Once you're trained that way, whether you're practicing at the bedside or somewhere else you have that mindset now and you got to use it. And every part of the community you can.

Jannah:
Exactly.

Dan:
I want to dig in a little bit to The Raise the Line Initiative that you and Osmosis have been doing. I love it. I think it's weekly podcast with your CEO Shiv on providing information around COVID and healthcare and all this stuff. Tell us more about that?

Jannah:
Yeah. Actually The Raise the line Initiative was of course in response to COVID. But one of the things that we heard so much about during the beginning of COVID if you will. Was in talking about flattening the curve, flattening the curve, which we're all trying to do. Where we want to be done with this experience. We want people to be healthy and back to their normal lives. But in order to do that we're thinking about, well, we have to increase the healthcare capacity. Because we need to make sure that we have the workforce in place to take care of all of the people that need this healthcare now. And that's really where Raise the Line came from. And in doing that, one of the things that we hope to do is try to get people back into the workforce.

Jannah:
Those who have been out of work because of what's been going on with COVID. But also trying to increase that workforce capacity that we're talking about. And we started putting together end to end training to get people into the healthcare field quickly to help with this Raise the Line Initiative. With our nursing assistant program, where we're working on now. And with this podcasts that we do the Raise the Line podcasts. We have a lot of fantastic and interesting people that come on from healthcare from tech space. To talk about what their experience is to give us some jams and what they find most interesting. Things that they're hoping to fill the void that might exist right now. And it's been really fantastic because it helps to inform what we're doing as a healthcare education company in the tech space. And really to... We hope to enlighten the listeners and teach them something new that they hadn't considered before.

Dan:
I'm a huge fan of it because it's short and sweet it's to the point. You get the little nuggets that you need and the guests are fantastic. I had the chance to be a guest a few months ago and enjoy the experience. And then I see the people you're pulling in now, I'm, "Wow, these aren't random people off the street. These are the leaders of healthcare across the country." And I think that's a testament to the Osmosis team and how great you are and how connected you are. Which makes you really relevant in that industry which is amazing.

Jannah:
Yeah. For sure. For us, it's really important that we collaborate with all of our partners. Everybody do this together because we know this is not individual effort. In order to Raise the Line, in order to help educate people better in the healthcare space whether it's a patient who's looking up data, or if it's somebody who is in the healthcare workforce, we do that better together. And we do that when we start with people first, we start from the heart.

Dan:
What is the most innovative thing that you're working on right now to disrupt nursing leadership, nursing education? Can you talk about that?

Jannah:
Yeah. There's two things. There's actually... Right now with our nursing product that we're working on, we're creating some really exciting content. One of the things that you touched on before is how the old school models of nursing education have looked. And that's something that I'm looking to break in the most beautiful way possible truly. And present content in a way to nursing students and for nursing faculty that they haven't seen before. To really put it in the language, put it in the experience of what it means to be a nurse dealing with XYZ issue in this patient. What is a real nurses experience there? And that's something that I find super valuable and something that feels it's missing. We have all these different pieces that we have to put together to figure out what the big picture is.

Jannah:
But what if we presented it in a completely different way that captures all of that? And speaks to the nursing student all the way from this is what this diseases is for instance, all the way through the whole entire experience of having to care for a patient. Dealing with this and what it is that the nurse's role is. That's one thing that we're working on. That's really exciting. And I think is going to shake some things up in the best way possible. And also the leadership piece, really trying to make sure that we are creating nurse champions from the beginning. Don't wait to have the conversation. Let's build this and now.

Dan:
I think about it at Bay. Maybe we collaborate on this in the future. It's what did nursing school miss? And how can Osmosis fill that in? Let's get real. I mean, that'd be fun. We should do a whole thing on that.

Jannah:
Would love it.

Dan:
Well, I'm super excited for what you're up to because I saw how disruptive it was to the medical education model. And it's time to bring it into the nursing education world. And I'm excited to see that happen. I think your advice around leadership and education is right on. And as young nurse leaders and new nurse leaders and established nurse leaders we can always level up. There's a lot of ways to do that. I think we talked about a lot of them. Jannah, thank you so much for being on the show. What would you like to hand off to our listeners?

Jannah:
Well, first thanks for having me it's fantastic. My big thing is I want nurses, any anyone who's listening right now to really feel empowered where you are and to really utilize your voice. You've got so much to contribute. You've got so much to contribute to the healthcare field and beyond. Utilize that your voice is powerful. What you bring to the table is a powerful and I want to see so much more of that in nursing at every level. You don't have to wait for a specialized degree. You don't have to wait for a certain amount of years. If you've got something in you share it, because you contribute to things on such a huge level. This is how we drive change. This is how we improve the world.

Dan:
I don't know how to double down on that, but go for it. And also check out Jannah and Osmosis. We'll put the links in the show notes, but if you're in nursing at any level there are resources there that will make you a better clinician, a better leader and really engage you in all things healthcare. Jannah thanks so much for being on the show.

Jannah:
Thank you.

Dan:
And where's the best place to find you outside Osmosis?

Jannah:
Yeah. I mean you can send me an email. That's one place to find me. I'm also on social media. People do that. LinkedIn is a great place to find me. Feel free to email me at smosis.jannah.email@osmosis.org.

Dan:
Awesome. Thanks so much again. Check her out on LinkedIn and at osmosis.org and we'll check you out on the next handoff episode.

Jannah:
All right. Take care.

Thank you and welcome to the Trusted Community!
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