May 5, 2021

Episode 56: A candid conversation about mental health

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Description

We’re wrapping up season three of the show with a very special episode in honor of Nurses Week 2021 and Mental Health Awareness Month. Joining Dr. Nurse Dan are two very special nurses who have been working on the frontlines of the COVID-19 pandemic: Tayler Oakes and Tina Vinsant

Tayler, Tina and Dan had a very candid conversation about what the last year has been like for them, how their mental health and overall well-being has been impacted and what they wish their facilities and the healthcare system as a whole would do differently to support nurses. 

We also had a chance to get Tina and Tayler’s reactions to Trusted Health’s second annual study on frontline nurse mental health and well-being, which looks at how the pandemic has impacted nurses, their career plans and their commitment to nursing 

Links to recommended reading: 

Podcast

Transcript

Dan:
Tina and Tayler, welcome to the show.

Tina:
Thank you.

Tayler:
Yeah, thank you. I'm excited to be here.

Dan:
Well, let's start with Tina. So Tina, can you tell us a little bit about yourself, your background, how long you've been a nurse and what you're currently working on?

Tina:
My name is Tina. I've been a nurse for going on my sixth year. Started out on a step-down unit. And then just about a year ago, I transferred to CVICU. I've been working in the intensive care unit. For about a year so I've been floated to the COVID ICU several times. So I've had quite a bit of experience with that, although not exclusively.

Dan:
Awesome. And Tina's also the host of Good Nurse Bad Nurse, an amazing podcast that I've been on and we'll continue to work with her on. So you got to check that out as well. Tayler, how about you?

Tayler:
So I have also been a nurse for about six years now. I've pretty much exclusively worked actually in pediatrics and pediatric oncology, but I do a good bit of aid work and deployment nursing. So when the pandemic hit, I actually worked for about seven or eight months on the Navajo Nation as a public health nurse. And I'm now currently back in my little pediatric oncology world as a traveler.

Dan:
That's the nice thing about nursing is you can kind of jump around and go where the help's need and where the interest is really easily. So that's awesome that you've done several different things and those are kind of like polar opposites, right? Pediatric oncology and public health nursing seems like very different ends of the spectrum.

Tayler:
Yeah. I don't think they can be more different. My friends think it's so funny because they're still back in their pediatric oncology world and I was like, "Okay, well I need to figure out how to get hypertension medicine for my patients and get them clean water." And it's just a completely different world.

Dan:
Yeah. So I'm excited to explore this with you and to get the pulse check from both of you because you have two different experiences and it'll be really interesting to hear your perspective, but first Tayler, let's start with you. How have you felt the past year personally and professionally and how has the pandemic kind of hit you or impacted you personally?

Tayler:
It's been really hard for me, honestly. I have definitely felt the toll of it from a mental health perspective. And quite frankly, it's been really hard for me to deal with seeing what I'm seeing and seeing what we've all seen in the healthcare industry. And then kind of the general public's reaction that doesn't have the insider look that we have. And I felt like there was a sense of general indifference to what was happening and what was happening to people. So that was really hard for me. It actually kind of took a toll on me for a while and made me change my career goals. So I definitely felt the impact of the pandemic in that sense.

Dan:
And when you say that, do you specifically mean people who don't believe COVID is impacting people or killing people or kind of a big deal like the ones that call it just a flu or it's just a cold that kind of thing?

Tayler:
Yeah. So that was really hard people frankly, not believing what we're saying and what we're seeing, but then also people that kind of we're like... When we say, "You might not be affected by this as horribly as other people will, but it's really important that we put measures in place to protect each other." And then people still kind of being like, "Meh. That's not that important." That's their own father, I'm healthy, whatever they're poor or whatever. I think that's the first time that a lot of us have experienced anything like that. And it was really hard for me to deal with of like, "Wow, people can be really indifferent to the suffering of others." And I haven't really seen that to this scale, especially in this country. So that was really hard for me to deal with.

Dan:
Yeah. And then every day you show up to work and you're dealing with it firsthand and seeing the suffering and you're like, "Why can't people just see this?" Walk a day in my shoes and you'll change your mind.

Tayler:
Yeah, it was that. And also I think this was kind of specific the area that I was in and the population I was working with was just the healthcare disparities were so in your face and so blatant. And that was really frustrating to see. And a lot of those problems have existed before COVID, but I didn't have much exposure to them. And other nurses probably have a different perspective on that, but that was really hard for me to even just experience that what I would see and just being outraged by that.

Dan:
That's really good insight. Tina, how about you? How has the pandemic kind of impacted you personally and professionally and also your physical and mental health?

Tina:
I definitely can relate with Tayler. I hear what she's saying and what I'm hearing her say. I have heard that over and over and over again from nurses all over our hospital from all over actually. And it's same story, over and over again. I personally, I think just here at home, I have been able to spend a little more quality time with my immediate family because there's not as much to do. So that's been kind of nice. That's really probably the only positive thing that's come out of it. As far as my extended family, our in-laws, there's friends, we haven't seen in over a year.

Tina:
So that's been obviously difficult. I think that's similar to everyone's experience and then professionally it has been absolutely nothing but difficult, nothing but hard. It's just been unimaginable. I don't know. I think it was eye-opening for a lot of nurses. I mean, I think I've had some personal accomplishments this past year professionally, I got my CCRN, I transferred units. I've had some things that have happened that were positive, but I could have done that without a pandemic. So I'm not going to give credit to COVID for this.

Dan:
I'm curious, let's start with you, Tina, what outlets did you have for the stress? Where did you turn when you had just a horrible day or a week that was just kind of overwhelming? What were some of the tactics you used?

Tina:
That's interesting. Because I do have a podcast, so I probably have an outlet, maybe that a lot of people don't and I can just whine and complain to thousands of people and not only to the people that listen to the podcast, but I have met so many people like you and just all over the nurses that I've connected with. There's a lot of nursing podcasts out there and I've made friends with a lot of them and we get together and talk about this stuff and it's helpful to just talk to other people who are going through... When I hear Tayler say the thing she's saying, I just empathize with her so much. I feel it.

Tina:
I know what she's going through. I've seen it in the eyes of the nurses where I work, that work specifically on the COVID unit. And I've seen the look in their eyes change over the past year. And they've gone from being people with this, bright eyed and positive attitude and excited about nursing to just PTSD and people you would never expect to have a negative outlook when it comes to nursing and healthcare. And it's just like even they couldn't handle it.

Dan:
Yeah, it shift. Yeah.

Tina:
Yeah.

Dan:
How about you, Tayler? What were some of the coping mechanisms you used?

Tayler:
It was really hard because I usually hang out with my friends and we kind of debrief about work and all of my friends pretty much are nurses and I didn't see them for a year, but I didn't have that coping mechanism, that in-person interaction. A lot of times I developed a habit of just going for a walk every night and that honestly helped me so much. I know it sounds so basic and probably everyone gives that same advice, but it really did help. And also just finding outlets to talk about the frustrations that I was seeing, like some forums online and just connecting with other nurses saying, "This sucks. We're all going through this and this really sucks." But being able to talk about it with each other, I think was really helpful for me.

Dan:
Yeah. That's good insight. And I've talked to other nurses and friends in the profession and they said, the first couple of weeks it was kind of like, "We can get through this. Lets kind of rally." Then a couple months went by and it's like, "Okay, we're helping." And now it's like, "All right, we're done. I'm over it. This can't be a rally game every time something happens." And so I feel a similar message of it's just grading and there's no relief from it. And it's really hard to move past it, but that really transitions us into some of the survey results. So again, we surveyed over a thousand nurses asking specifically about their mental health and wellbeing and how healthcare facilities and leaders might support or not support that. And one of the first findings we had was that two-thirds of the nurses don't feel that the industry, prioritizes nurses, mental health or wellbeing. And I'd love your reaction to that. So let's start with you, Tayler, how does that sit with you? Does that sound surprising?

Tayler:
No, it's not at all surprising to me and I can only speak to my personal experience with this. And I kind of have two. When I was in the throes, in the bowels, as we say of the pandemic, dealing with horrible things of just dealing with people dying every day and having this immense suffering around me, the resources that I had available, I had none. It was horrible. We virtually had no support. There was no debriefings, nothing. And I think it's important to acknowledge that a lot of the staff that I was working with, we were in a community where the entire community was either their family or people they knew really well. And they were also dealing with this and they didn't have any support either. So that was a very low resource facility in a very poor part of the country where healthcare disparities are very present.

Tayler:
And now I'm at this elite teaching facility that quite frankly has more funds than they know what to do with sometimes it [inaudible 00:09:30] and I can't imagine what possible more resources we could have for our mental health and wellbeing. All over the break rooms, across the hospital, there's a QR code you can scan and talk to a mental health professional whenever you'd like. Yoga classes are offered and all these things. I honestly can't imagine what more they could be doing. It's almost hard for me to see the difference in how the nurses here are treated and how the nurses that I was working with in that area were treating because we always talk about the healthcare disparity, in regards to patients. But I think it's really important to acknowledge that exists when it comes to staff as well. And until we start addressing those it's going to be really difficult to find a solution to this need that seems to just only keep getting bigger.

Dan:
Yeah. And that's interesting. I mean, you highlight kind of the big differences between facilities and there's some that have a lot of funding and maybe associated with academic institutions and can pay for help. And then, there's others that are just like, "Hey yeah, we might have an EAP program, employee assistance program, maybe call them." Or not address it at all. And I think that's part of the issue that nurses are feeling as well. Tina, how about you? What do you think about those results?

Tina:
I'm definitely not surprised. Mental health has never been a priority in this country, period. I mean, a pandemic hits and nurses' health and wellbeing is not being prioritized. That's not a shocker because we don't prioritize mental health at all for anyone. So the state that I live in is probably one of the worst in the entire country and the region that we live in, in the state, there are literally no resources for mental health problems. So it doesn't surprise me at all that hospitals are getting it wrong or they're just not putting forth any effort whatsoever to try to give resources or try to help nurses who are going through this.

Tina:
I would love to see hospitals do some sort of rotation for nurses and not have one unit handling all of the COVID patients. I think initially that was sort of like, "Well, we don't want exposure to all these different people, so we'll keep it to a small group." And really, what it's done is it's taken that one group of nurses and just absolutely beaten them down. And everyone else has some level of exposure to it and we have to deal with it on a certain level. But it's absolutely astronomical when you are talking about the nurses who have dealt with this every day for a year.

Dan:
Yeah. So you mentioned a couple of ideas around strategies and I wasn't surprised by this either. I mean, just knowing how hospitals work and I think also the nursing culture of a very shift based kind of culture, none of the mental health pieces are embedded. I mean, you don't show up to work and people are kind of like, let's all take a moment to focus and calm and when there's a bad thing that happens, whether there's a code or a sick patient or a bad interaction with a family or something, there's no debrief. It's like get over it, move on to the next thing. And there's like this coat of armor. Do you think if health systems offered, like Tayler was mentioning a counselor that you could call at any time or line or a mentor related to helping coach through physical and mental wellness, do you think that nurses would opt into that? Or do you think the profession also has kind of a coat of armor that's hard to break down that they may not use those resources, even if they were available?

Tina:
I think that we almost have to develop that coat of armor because it's a coping mechanism that we don't have any other choice, but to develop. Typically, you're going through what you just described. You have a patient that codes that dies. You have another patient in the ICU, we have another patient or two other patients. And so you have no other choice, but to just pull up your boot strap to keep ongoing, you just got to deal with it later. And that's what we do. We go home and it's all pushed down there. And at some point either that night or the next day it'll come out typically with me, that way it usually works with me.

Dan:
Yeah. Or it sticks long-term. For me, it would come up like, "Hey Dan, tell me about the worst thing you've seen." Family members always want to ask that, but they don't really want to know. And then you're just like, "Well, let me tell you about this really hard time." And it's almost like you're trying to vent it out, but you can't because no one else understands it. And so it's hard. Tayler, I'm curious to your response to that too. And you have some of these resources in your current role. Are nurses taking advantage of it?

Tayler:
I think so. I think nurses really do utilize it, but I think, to ask if we put this in place, are nurses going to use it? I think it's important to acknowledge that's not the only solution. I think a lot of the mental health wear and tear comes from a root cause of short staffing and the conditions in the hospital. So I think it kind of does put the pressure on us of like, "You're having mental health problems. You need to fix it."

Tayler:
When all of our mental health problems could probably be affected a lot by decisions that the institution makes, if they would put measures in place to make working conditions better for us, then that would also have a huge impact on this. And maybe these resources wouldn't be so needed. Like Tina was saying a patient dies. You have two more in the ER that need a bed. So I think it's just a system problem as well. And it's bigger than just saying like, "Okay, well here's a therapist. Talk to them if you need them." But get back to admitting the patient after one just died. So it's really hard.

Dan:
Yeah. So it's part of the culture of just get over it, and move on. We have work to do there's other people and kind of disregarding, or just not acknowledging the impact that has emotionally on people. And that kind of leads us into the next finding here, which is, we ask nurses to rate their facility from one to 10, one being there's no support at all related to mental and physical wellbeing. And then 10 being it's extraordinary. The average rating was around a 4.6, but one out of every five nurses rated their facility as a one, meaning there's zero support and we've heard both sides, right? Tina, you talked about maybe not having a lot of resources, Tayler having some, but I'm curious, Tina, what in an ideal world would you want or like to see more of, to support nurses' mental health and wellbeing?

Tina:
I think I would like to see an effort being made. I expect that mistakes are going to be made and things aren't going to work. We try something, it doesn't work, you try something else. But when there's nothing being done, I mean, if there were measures in place, for example, policies, if you have a patient that dies, the policy is that we bring in another nurse that takes on the rest of your patient load so that you can take an hour or something. I mean, that sounds ridiculous because it's impossible, but in a perfect world, that's exactly what would happen. And it would not be expected that you could just keep going. It should be expected that you're human and you need to process that. At the very least, acknowledge that this was something that is going to be devastating to your psyche in some way. And so we need to have a way of processing it. Definitely you have to go call this number. You don't have a choice. You need to sit down and deal with it.

Dan:
Like make it part of the workflow. Not just, hey, if you need this because we know nurses in general may not just pick that up because they feel obligated to whatever the next patient is or the coat of armor we talked about, but this is what you do now. This is how you will deal with it because it's evidence-based and we know it helps. And we are here to take care of you and make it acceptable again, to do that. That's interesting. And I think about when you talk about that, what other industries could we learn from? And I think, the military does debriefings after missions, right? And whether someone dies or not, there's a debrief where you have to kind of talk about the whole thing and how it impacted what you could do better. And we don't even do that.

Dan:
There's a code, you go to the next thing and you don't ever talk about it unless there's a really bad outcome. And now the quality people are there and talking about what we could do better, but there's never that common debrief of what needs to happen next and what could the team do better? And what support do we need as kind of second victims in this space? And I think there's a lot healthcare could learn from other industries around how to debrief stressful situations, potentially. Tayler, I'm curious what in a perfect world would you want to help nurses find mental health and wellbeing support?

Tayler:
In a perfect world, like Tina said, I think staffing would allow for us to have such conditions. We talk about trauma from work and mental health burnout from work only we're only talking about when a patient dies. I think it's really important to talk about working every day when the work is really hard and you're really stressed out and you're really short staffed that also takes a huge toll. So I think just addressing a lot of the issues that are talked about all the time in nursing, like short staff, not getting breaks, having too many patients, having too high acuity of patients, I think that would have a huge impact on our mental health and preventing burnout. But I do agree with what y'all are saying about how the military has kind of mandatory debriefings and it's not like, "No, you're not going to try to be tough and just brush it off. We are going to debrief this and talk about it."

Tayler:
Because I think it's really interesting a few years ago, when I was staff at a pediatric hospital, we had this mass trauma event and there was a large amount of death and we saw these horrible things and the hospital did make us do a debriefing. They made us talk to a therapist and they made us all have a debriefing with each other. And I just remember thinking, this event was horrible, but we see horrible things all the time, every day in our job and then are expected to go home to our families and act normal and none of these measures were ever put in place then. So I definitely agree with that thought that would be implemented.

Dan:
Yeah. There's definitely a need for system change. And I was speaking with a colleague of mine around mental health too. I think it was on the podcast even. And on the medicine side, on the physician side there's boards of medicine that require disclosure of any mental health visits basically, or mental health issues that the physician might have. Well, they're applying for their license in certain states. And so like you talk about putting stigma on things like this, that would be the fastest way to not disclose and create the suit of armor. I haven't seen that in nursing and I'm hoping it stays that way, but I mean, that's just one symptom of the system, including what you mentioned to staffing and just not acknowledging that this is a crazy stressful thing. And we've normalized the craziness as something cool by putting it on Grey's Anatomy and ER, and House and all the TV shows and things, but it really does impact people to the core. And we got to normalized addressing it, it sounds like.

Dan:
That's actually a good transition into the next piece. So we asked nurses how the pandemic has affected their commitment to the profession. So would they stay in nursing or not? This was kind of disturbing. So we had about 54% of nurses say I'm equally committed or more committed to the profession. That's great. A little bit more than half of nurses said, "Hey, nursing's for me, I'm more dedicated to the profession." But 45% said, "I'm less committed to the profession of nursing than I ever was before the crisis hit." And we're already in a nursing shortage. You've been in a nursing shortage I feel like forever. It's continuing to get worse. There's a stat saying that there's potentially 175,000 nurses needed every single year open positions for nurses every single year through 2030. This just really surprised me. So I'm curious, Tina, what are you hearing from your colleagues and friends about their commitment to nursing after going through a year of the pandemic?

Tina:
I had witnessed and proceed before this ever started, that nurses tend to come out of school, work a couple of years and then jump ship and decide, this is just too hard. It's not for me. And I mean, bedside nursing and decide to go into something else because it's just too hard, the lack of respect. And when the pandemic hit and a few months into it, it really was compounded and it's just gotten worse. I just keep hearing from people over and over again. And again, people that I'd never would have thought would have failed on nursing, just going, "This is not worth it. I just feel so disrespected and so unappreciated. And it's taken such a toll on my mental health that I can't do this anymore." And they're literally just going to do something totally different. One of my dearest friends who is just the most amazing nurse was literally considering like opening a flower shop and that's been my experience. And that's been what I've seen over the past year.

Dan:
I've heard the same thing, or even just take a break for a while and just get away from it. And like you said, open a flower shop or go teach sailing or whatever it is, something to get away from the kind of day-to-day brutal work conditions that are happening. Tina, how are you feeling personally? How did this impact you related to this question?

Tina:
That's funny. Because I go back and forth and generally it seems to go along with periods where the numbers kind of go up at the hospital. It's always been this way, but it ebbs and flows. And it's been a lot worse this past year where staffing seems like it's getting better. We have a lot of nurses coming off orientation and it's okay. And then there's like, "Oh yeah, I love nursing. I love taking care of patients and this is great." And then all of a sudden we'll start hemorrhaging nurses, they're just like, "I'm taking a travel assignment, I'm doing this." And then you look around and you've got eight triples on the floor and there is no help. And they're like, "Oh, and by the way, if you hear the phone ring, be sure and help out by answering the phone and you just want to go and crawl."

Dan:
Yeah, I'll get right on that phone. Right?

Tina:
Exactly. And so I kind of wavered myself. I go through these periods where I'm just like, "What else could I do?" And I even started a master's program and I'm just thinking, "I think I would like to teach." And I love to teach actually I know I would like to teach. And so I've started that in January and it's going to take me a couple of years. I'm not doing anything in time soon, but I'm broadening my options for sure.

Dan:
Yeah. You're making the plan to not be only tied potentially to the bedside. And like you said, kind of use nursing as an option to try other things. Tayler, how are you feeling about these results? Do you feel more or less committed personally? And what are you hearing from your friends?

Tayler:
So I think the results are incredibly alarming obviously, but I'm not at all surprised by it. I definitely the same thing as y'all been hearing the same things. And I see the same thing at the bedside. And I mean, I have one friend who was like, "I literally cannot do this anymore. I will be a barista at Starbucks. I don't care. I cannot do this anymore." And I just think it's so sad honestly, that people are that mistreated and burnout. So I'm definitely seeing that. In regards to my personal feelings and I think it's almost important that I put a disclaimer on this, that in the hospital setting, [inaudible 00:24:05] pediatrics and I think we're a completely different world.

Tayler:
And then when the pandemic kit, that was awful, but I was not in the adult ICUs, watching people die all day every day. So I definitely think that I have a different take on this than the nurses that have been experiencing that do, but I do feel more committed to nursing. I completely understand that's not everyone's feeling and that is totally fine. I don't think you should come out of this experience in that way, but I do feel more committed. But when I say I'm more committed to nursing, I'm more committed to bringing about change and helping care for my patients. I don't know anyone that's more committed to what a lot of the healthcare industry has become and the way that we are often treated like that we aren't committed to. And that's what has to change for everyone's sake. I don't know a single nurse. That's like, I really hate taking care of people. I don't want to do that anymore. It's just the way we're treated. And the way that the system treats us is I think the reason people are feeling the way that they do.

Dan:
Yeah. So it's kind of made a calling for almost activism to change the system. Not necessarily leave the profession, but like if things were better at a system level, nursing's not the problem. It's more the conditions that you have to practice nursing.

Tayler:
Yeah, totally. The systems that are set up to make us fail. Honestly, the systems that prevent us from giving the care that we want to, to patients, I think that's what causes this feeling the most is people want to care for people and they want to do their best. And they're not able to. When Tina was saying, I can't imagine it, because I've never worked in and adult ICU but with your tripled and adult ICU you're not going to be able to give people the care that you want to. And I think that's what leads to that feeling of I hate this. I'm so disrespected. It's not even watching people get sick. It's this feeling of helplessness of I'm in a system that is not help these people that's what needs to change.

Dan:
Yeah. That makes a lot of sense. Thank you for sharing both of you on that. That's a personal question, but I appreciate the honesty and openness related to it because I think there's probably a lot of nurses out there that are feeling similar. And I think you validated some of their feelings and also gave them some insight so appreciate that. And that kind of leads into the last question that we'll talk about today, which is every single healthcare system right now has some sort of hero campaign, a big system out here in California, even gave nurses hero bonuses. They call them hero bonuses. There's healthcare hero posters, everywhere, big cities where in hotels, we're putting light, you need to do the lights in the building. That's spelled a hero, they're doing the seven o'clock kind of music and clapping and all that kind of stuff.

Dan:
But we're also seeing that nurses see that as sort of like well, it was nice for a short term. It's like an oversimplification of what we do. And it doesn't represent what we are, which is a hero is someone that sacrifices themselves for the good of others. And while you can do that in a short term, it's not a long-term strategy or a career. We even read the comic books. Every single hero burns out at some point. They leave and go away. Superman went to his hideout forever. Batman stopped it. I mean, even in the comic books, heroes can't maintain it, let alone real human beings and nurses. So I'm curious to hear how you react when you hear the word hero now. And how has that changed over the pandemic? Tina, I want you to kick us off.

Tina:
I have mixed feelings about it. Marvel comics did an entire comic book series about nurses and made the nurses the hero. It's pretty cool, actually the way it was done. And it was based around actual nurses in their lives and their stories that worked this past year in the pandemic. I think a lot of times, people in the general public don't understand the level of education and skill and responsibility that nurses have when it comes to patient care and what we are required to know and what we do for patients. A lot of people don't understand. So I think maybe this has kind of helped to educate people and let them know that nurses are not just handmaidens to the doctors. We actually have a skillset. We are professionals and we have assessment skills and critical thinking skills. I like that part of it.

Tina:
I liked the part where we're getting a little bit of respect, but it's one thing to say, "Oh, hero, hero, hero." It's another thing to just say, "Oh, I'm sorry. We cut out all of our elective surgery. So we don't need all of our nurses. So we're going to just let you stay home. And by the way, you don't qualify for getting unemployment because we're not actually laying you off. And if you go take a travel assignment, you'll be fired. You won't be able to come back." And so it's one thing to be called heroes and have posters put up all over the hospital. It's another thing to be treated with disrespect and as if you're disposable.

Dan:
That makes a lot of sense. I've heard similar things as well. Tayler, how do you react to the hero term?

Tayler:
I have stated this publicly, and I'll say it again. I have really strong feelings. I absolutely hate it. I think we are simply humans caring for other humans. And I think that every single one of us is doing the absolute best we can, at least I would hope so, but I am not Superman. I can not scoop in and fix things. And to set that expectation on us is what leads to dehumanizing a profession and burnout in my opinion. I think that's what leads to this feeling of what we're feeling is because the general public calls us heroes, and then it's almost like an expectation to be sacrificial.

Tayler:
And I will put you above myself, which we do kind of at work, but when things were really bad and we didn't have PPE to paint us as heroes and expect us to go into that unprotected and almost die for other people I think it was really damaging. I also think it's really important to acknowledge how the healthcare systems exploited that rhetoric when we were in the depths of the pandemic, like scared and wanting PPE, and they looked at pizza parties and slapping a hero's work here sign on the front of every single hospital building as their solution. And they're like, "No, be our hero." And I'm not a hero. This is my career. Pay me, give me decent working conditions. I'm a professional.

Dan:
That's a good perspective. I think, yeah. The pizza party thing still gets me. That's the least helpful thing that you can do to acknowledge someone's great work is give them a pizza party. And I'm curious to your reaction Tayler on this too. So when the public now, and this was really the message of public, we have healthcare heroes, the heroes are here, they're saving the world, they're saving our population, they're saving whatever. Do you think that had an impact on how the public saw the pandemic as well? Like, "Oh, well we have heroes. So I can go do whatever I want." They'll save me. The healthcare systems there to save me. Do you think that had any impact?

Tayler:
Yes, absolutely. I think the most ironic thing to come out of this was the Super Bowl. I forget what they did, but they honored nurses and they honored us as healthcare heroes and they gave a bunch of free super bowl tickets to nurses, and then they gathered, what was it? 25,000 people in a [inaudible 00:31:10] together. And I think that's the ultimate picture of how the last year has gone. It's like you're a hero, but we're not doing anything to help you.

Dan:
Right. In fact, we're going to bring 25,000 people together and hope that they don't get COVID so that we can overrun your hospital again. Right?

Tayler:
Yeah. I read a quote that really resonated with me. It was someone saying like, "We're always referred to as the frontline heroes as the frontline." And then the pandemic bridge point is like, "Okay, we're not the frontline anymore. You are the frontline, the public is the front line. You need to wear a mask and social distance. We are the last resort. We can not be expected to protect all of you from this and save you. And we are not your protection. I think it kind of almost shifted the responsibility of the pandemic from the general public, to the heroes, to the nurses on the front lines that are going to save us all. And then you don't have to do anything.

Dan:
Tina, what do you think about that?

Tina:
It sort of does make it seem like we've got people that have this under control. And so you can just go about your business and go on and do your thing, get together with your barbecues and weddings and baby showers. And those were the things that we were seeing at the hospital. We were seeing entire families coming in with COVID because they had all gotten together for a birthday party or a wedding or a backyard barbecue. And you've got 50 people and then literally half of them end up with COVID or more, and of them, a handful of them actually end up in the hospital and a few of them end up dying.

Tina:
And when I say a few, I mean, a few, not just one person. And that was the story over and over and over again. And people, they don't get it, they would not get it. And those very people when you're having to hold up a iPad to FaceTime with your loved one in the unit, because they're not allowed in the hospital. And then you would look on the iPad and there would be 20 people in a room hovered around the iPad. And you're just like, "Okay, they don't get it. They never will get it. If they don't get it now, there's no way they're ever going to get it."

Dan:
From the nursing perspective now you're just like, "This is never going to end." If this is how the behavior is, where's the light at the end of the tunnel. And don't dare post that on social media either like your frustration with that, because then you get ridiculed from all the naysayers and things as well. And I think that all leads back into that burnout and kind of impact your mental health. There's no escaping it. You can't just get away from it at home. It follows you.

Tina:
That's true.

Dan:
Well, I really appreciate the honesty and the open conversation here. And I'd like to end the show because we have a fair amount of nurse leaders, healthcare leaders that listen to this as well. And I think your advice and your insights here will help shape the way that we change the system, which I, 100% believe needs to happen. I think the worst thing that could happen from the pandemic is that we go back to the way it was. And so let's start with Tayler. What would you like the nurse leaders and healthcare leaders who are listening to know about your experience over the last year and how can they support you moving forward?

Tayler:
I think the biggest thing is just acknowledging what we've been through and maybe cut us some slack. I feel like, when the pandemic was really bad and everything, they kind of pushed like, "Okay, we don't care about your whiteboards anymore. If you can work and save people it's fine." We don't care about all the asinine things that we have to care about in a hospital. But now things are a little bit settling back to normal, not even really, but things are better. And the infamous whiteboard conversation is already happening again. And I've seen multiple people now are fully vaccinated and they want to go home, see their families, see their friends and their [inaudible 00:34:50] is being denied.

Tayler:
And it's like, cut us a break. I think that almost sounds like we want slack or substandard care, which is not, we need time to heal and recuperate from what we've been through. We were in a fight or flight mode and just go, go, go for so long. People are going to have a hard time now trying to adjust. We need some time off, just listen to your staff and whatever they need, they should all be trying to do their best to accommodate people to a reasonable level. That's all I can ask of my employers.

Dan:
That's a great ask. And I think one of the take-homes there is we were able to quickly remove the non-value added tasks out of the workflow when we had to. And so why would we put them back in? And maybe the whiteboards, one of those or whatever the form you have to fill out to get the one thing that... All of that stuff that we over process. I think one of the things we can learn is we provided great care, despite relaxing some policies. And so maybe we could look at those critically and say, "What could we keep off of the nurse's plate so that they can actually get back to the work of caring?"

Tayler:
Yes. I think you articulated that much better than I did and got what I was trying to say. So thank you.

Dan:
No, I think you said it great. I was just trying to kind of wrap it up. And Tina, what would you like leaders to know about your experience and what would you like them to do differently moving forward?

Tina:
Well, I think that what I really would like to get across to nurse leaders and to administrators is that nurses deserve respect. We deserve to be treated as professionals. And I think that it's something we've always had to fight for, but the pandemic has definitely magnified the problem exponentially. And this is exactly what we've been talking about. It's taken what was a problem of a shortage of nurses who are willing to work at the bedside and basically turned it into a full-blown crisis, but respect to nurses and really to any employee is equivalent to being treated like a professional, being paid proportionately to the level of skill and education that we're expected to have. It's been given safe nurse to patient ratio so that we don't feel like we're having to risk our license every time we go to work, these are basic things that you would think would be sort of common sense, but this is what nurses have to fight for. And being treated with respect, like a professional to me is what I want as a nurse.

Dan:
Yeah. I think that's a great way to sum it up. And I was just thinking the professional piece is the biggest piece. And I think all leaders listening need to remember that these are professionals, they're not children or not just employees. We have a professional obligation and practice and treat us like that. We're knowledge workers, we're highly educated. And some of the practices we have, don't allow us to express that and sometimes hinder the ability to work as a profession. So I think that's awesome insight. Tina and Tayler, I just really appreciate this so much. I'm hoping this will spark some conversation and change and hopefully we'll be able to change the system moving forward. I would love to ask each one of you where people can find you if they want to connect and maybe learn more about what you're up to Tina, tell us about Good Nurse Bad Nurse and where people can find you.

Tina:
Well, you can find Good Nurse Bad Nurse on any platform anywhere you listen to podcasts. And we have a website, goodnursebadnurse.com. And all of the episodes are on there. We're on Instagram, mostly at Good Nurse Bad Nurse, but we're also on Facebook.

Dan:
Awesome. And Tayler, where can people find more about you?

Tayler:
You can find me on Instagram at where's Tayler, T-A-Y-L-E-R. I'm pretty vocal on there about my thoughts regarding nursing and COVID and everything happening. So yeah. Feel free to follow me and reach out there.

Dan:
Well, thank you both for being on the show. I really appreciate it. Stay safe out there. And if we can help let's change the system and let's hope that we can build a better nursing profession and better health care system as the pandemic hopefully wraps up in the next few months. Thank you so much.

Tina:
Thank you.

Tayler:
Thank you.

Thank you and welcome to the Trusted Community!
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