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Where Nursing Gets Personal: Life in Long-Term Care · Hearts of Excellence

• [00:00:00] Payton Nienaber: I've always said that hospital life and long-term care life are kind of like DC and Marvel. Yeah. They're the ca- same concept, but completely different franchises. [00:00:10] awesome ... you know, you may have ICU, you have three patients, and you're slammed the whole shift. [00:00:14] But then you've got long-term care, you've got 20 plus patients, and you're gonna be just as busy, but it's gonna be a different kind of busy. Yes. Right. So yeah, down to even surveys, they're- Oh ... they're same concept, but they're completely different. [00:00:26] Right.​ [00:00:29] Amanda: You are listening to Hearts of Excellence, brought to you by Majestic Care, where real stories from long-term care come to life. [00:00:37] Chelsey Gheyara: today, we are gonna sit down with Peyton, who is the director of Nursing Services at Majestic Care of Newberg's location. [00:00:45] From the moment she started as a CNA in 2014, Peyton has committed to providing excellent care. She's worked in almost every nurse management role within Majestic Care, and today she's a DNS and a board-certified [00:01:00] family nurse practitioner. But Peyton's journey is more than just about titles and accomplishments. [00:01:06] It's about the stories that have shaped her passion for long-term care. Welcome, Peyton. [00:01:11] Payton Nienaber: Thank you. It's an honor to be here. [00:01:12] Chelsey Gheyara: Yes. [00:01:13] Paul Pruitt: At least this is an HR interview, so I can ask this. How old are you? [00:01:16] Payton Nienaber: I will be 31 in July. Wow. [00:01:20] Paul Pruitt: All right. That's [00:01:20] Chelsey Gheyara: awesome. So- [00:01:21] Paul Pruitt: So you're a nurse practitioner. [00:01:22] Payton Nienaber: I did. I just graduated in December. [00:01:24] Chelsey Gheyara: Congratulations. [00:01:26] Paul Pruitt: That is phenomenal. That's [00:01:26] Chelsey Gheyara: amazing. [00:01:27] Payton Nienaber: It was rough. [00:01:27] Paul Pruitt: I can imagine. Congratulations. [00:01:30] Payton Nienaber: It was rough. Well, you [00:01:30] Chelsey Gheyara: look great. [00:01:31] Payton Nienaber: Thank you. And you made it through, [00:01:32] Chelsey Gheyara: and you're here. [00:01:33] Paul Pruitt: I was gonna say, kudos. I mean, the DNS role in itself is just... How long have you done that role? [00:01:39] Payton Nienaber: since last June. [00:01:40] Paul Pruitt: Here or just- [00:01:42] Payton Nienaber: Here. [00:01:42] Mm-hmm. [00:01:43] Paul Pruitt: But through your [00:01:43] Payton Nienaber: career. The overall, I think I took my first position in 2021. [00:01:47] Paul Pruitt: So how many years would that [00:01:48] Payton Nienaber: be? [00:01:48] Paul Pruitt: So be- Almost five ... [00:01:49] Payton Nienaber: that'd be five years. Yeah. [00:01:50] Paul Pruitt: Wow. So you were about 25 when you took your- Yeah ... first DNS. Wow. [00:01:55] Payton Nienaber: I was not- Commend you ... ready, but I, I did it, so. But [00:01:58] Chelsey Gheyara: you learned- [00:01:59] Paul Pruitt: [00:02:00] That's [00:02:00] Payton Nienaber: one of the hardest jobs [00:02:00] I did. A lot. I learned, and I've grown, and- [00:02:02] Chelsey Gheyara: Yeah. Well, I can't wait- ... learned ... to talk all about it and to dive into that for our listeners today. I'm [00:02:09] Paul Pruitt: really- Can I ask another question? [00:02:10] Chelsey Gheyara: Yes, go ahead. [00:02:11] Paul Pruitt: So what is your, specialty for nurse practitioner? Was it geriatric? [00:02:13] Payton Nienaber: I did family. [00:02:14] Paul Pruitt: Family? [00:02:15] Okay. [00:02:15] Payton Nienaber: Yeah. So kind of a broad range. You can do a little bit of everything. So- Yeah ... did I have an idea what I wanted to do? No, not really. But I Okay. So I did family. I'm like, "That gives me a, a broad aspect of things- Yeah ... that I could focus on." [00:02:28] Paul Pruitt: Yeah. Okay. Very cool. So- [00:02:29] Chelsey Gheyara: That's really cool. Wow. [00:02:30] Paul Pruitt: That's amazing. [00:02:31] Chelsey Gheyara: Yeah. I'm excited to talk about- ... that journey and all of the things, and how cool having a nurse practitioner leading our, our nursing team and our, our residents' care in our buildings. It's just really super cool and- It is ... not something you see every day. So- It's not common, [00:02:49] Payton Nienaber: no. [00:02:49] Chelsey Gheyara: Yeah, that's phenomenal. All right, Peyton, when you first started as a CNA, was there a particular experience or a patient that made you realize long-term [00:03:00] care was more than a job? [00:03:01] Payton Nienaber: There were a couple residents, I started as a CNA in 2014- Wow ... so it's been about 12 years, and there's a couple residents I still remember their names to this day. [00:03:10] Chelsey Gheyara: Really? [00:03:10] Payton Nienaber: one of them r- in particular, she had, I think, four kids, and only one that really ever came to see her, and she told me all the time, she's like, "You're more of a daughter than my family is." [00:03:20] So- Aw ... and even she couldn't hardly remember anything because of dementia, but even when I wasn't there, they would be like, "She's asking for you again." Aw. So, that just kind of really hit home. You know, her family doesn't come and see her, and you see that a lot in long-term care, unfortunately. Yeah. But, just knowing even when I wasn't there that she was asking because she just saw me as a daughter figure for her- [00:03:41] that's like, okay, this is, it's more than just a job. Yeah. Like, you mean a lot to these people, [00:03:46] I have one resident that passed suddenly, and I still talk to his daughter to this day. [00:03:50] Chelsey Gheyara: Aw, that's [00:03:51] Payton Nienaber: really sweet. So it's, my daughter was diagnosed with type 1 diabetes, and his daughter works pediatrics, and she actually came in and saw us in the hospital. [00:03:58] Chelsey Gheyara: Wow. [00:03:59] Payton Nienaber: So just [00:04:00] having those special relationships that you build with families and with residents- it makes it so much more than just a job. [00:04:06] Chelsey Gheyara: Yeah. That's beautiful. [00:04:08] Paul Pruitt: Yeah, that's, you know, it's interesting 'cause one of our other podcasts, we were talking about senior living- [00:04:12] Payton Nienaber: Mm-hmm ... [00:04:13] Paul Pruitt: but it goes back to the connections. [00:04:14] Payton Nienaber: Mm-hmm. [00:04:15] Paul Pruitt: How, and I think that's the whole thing where I, throughout my therapy journey when I was a therapist and tried different areas to see if I would, um, spread my wings and- Mm-hmm ... whether it was hospital, outpatient, that just realizing, like, it's the connections- [00:04:31] Payton Nienaber: that I really fell in love with. [00:04:33] Paul Pruitt: It's the journey of helping someone through their life- [00:04:36] Payton Nienaber: make decisions, whether it be discharge home or even having to talk about end of life. Yeah. That's a difficult conversation, but being able to be honest and share- Mm-hmm ... with somebody about that- Mm-hmm ... it's, it's quite amazing and rewarding. [00:04:50] Paul Pruitt: Yeah. So I would agree with you- It definitely [00:04:51] Payton Nienaber: is ... [00:04:52] Paul Pruitt: that it definitely does change- and reshapes who we are as a clinician. [00:04:55] Chelsey Gheyara: I love the perspective it gives you on- [00:04:58] Paul Pruitt: Yeah ... [00:04:59] Chelsey Gheyara: [00:05:00] different people. I always thought it was interesting when I was a clinician of seeing- Being challenged by those residents or patients, if you're in the acute care setting, that are grumpy. [00:05:11] And the one that people- Yeah ... always talk bad about, and you're like, "No, they ha- they have a story." They have purpose. And not that people, you know, talk bad, but we all know, you know, the people that are just not very nice, and you're like- Right ... "Oh, gosh. Okay, how is my shift gonna go? Are they gonna be mean to me?" [00:05:27] But also, they have a soft side. [00:05:30] Payton Nienaber: Right. [00:05:31] Chelsey Gheyara: And those were some of my fa- favorite residents too. Uh, uh. And it just teaches you perspective of people. Right. Like, they're going through something. That reminded me when you said some people's family don't even come. [00:05:41] Paul Pruitt: Right. [00:05:42] Chelsey Gheyara: Mm-hmm. And, you know, they're, they're people too, so- Right [00:05:45] that's really, really cool. When you look back at your early days in long-term care, what's a story that sticks with you, a moment when you knew that this was your calling? Those questions are kind of similar, so however you feel like answering that. [00:06:00] So [00:06:00] Payton Nienaber: I originally went into nursing wanting to work pediatrics. [00:06:04] Chelsey Gheyara: when I was in elementary school, we did m- these math-a-thon things for th- St. Jude, and I was like, "I wanna work peds-" Nice ... "and I wanna work at St. Jude." Now, you couldn't pay me to work there. I don't think I could handle it. Yeah. Yeah. But I, in high school, did a clinical rotation in a, a nursing home, and I dreaded it, honestly, at first. [00:06:23] Payton Nienaber: Yeah. I was like, "This is not at all what I..." Like, I wanted the other end of the spectrum. And then I started it, and I fell in love with it. [00:06:30] Chelsey Gheyara: And I have tried multiple times to leave and try different- Yeah ... avenues like the hospitals, and every time I end up right back. So it's just, I'm like, "That's, that's where my heart feels like I... [00:06:40] Payton Nienaber: That's where I'm led to be." [00:06:41] Chelsey Gheyara: You know, that's where my heart is. And even on the worst days, I'm, I love my job, and I love what I'm able to do for the residents- Yeah ... and now for the staff, too, being in management. [00:06:50] So really, my whole healthcare career is kind of- Yeah ... a story as t- like, a testament to long-term care and my passion for it- Yeah [00:06:59] Payton Nienaber: 'cause I didn't wanna [00:07:00] do it at first. [00:07:00] Chelsey Gheyara: Wow. [00:07:01] Paul Pruitt: What made you decide to do your nurse practitioner? [00:07:03] Payton Nienaber: going into nursing, that was my end goal. [00:07:06] Paul Pruitt: Okay. [00:07:06] Payton Nienaber: So I had that goal set for myself. I finally did get it done, so it wasn't easy, but I made it. [00:07:12] Paul Pruitt: ' Cause is that a master's? [00:07:14] Payton Nienaber: Mm-hmm. [00:07:14] Paul Pruitt: Okay, so you do a master's, and then you specialize- [00:07:18] Payton Nienaber: in an area of nursing. [00:07:19] Yep. So I got my master's with a family nurse practitioner's focus. [00:07:22] Paul Pruitt: That's really, really cool. Yeah, it's definitely, I would say geriatrics is different than pediatrics. For sure. [00:07:28] Chelsey Gheyara: And there's a space and a place for us all. Yeah. Mm-hmm. But it's definitely heart work, for sure. [00:07:33] Paul Pruitt: if I go back to the days, way back to when I first started in nursing homes, we've evolved. [00:07:38] Mm-hmm. Because again, I go back, we saw your basic hips and knees- maybe a couple diagnoses. [00:07:45] Payton Nienaber: Now fast-forward to today, multiple diagnoses. [00:07:50] And hips and knees are more going home. Mm-hmm. They're usually more your healthy type elective surgeries- Right [00:07:57] Paul Pruitt: that type of thing. But the medical [00:08:00] complexity that we have taken on in skilled nursing, our nursing homes, has skyrocketed. [00:08:06] Payton Nienaber: Oh, for sure. [00:08:06] Paul Pruitt: So do you see your nurse practitioner element helping- [00:08:10] Payton Nienaber: I think it does ... with that [00:08:11] Paul Pruitt: component? [00:08:12] Payton Nienaber: You know, I'm able to look at labs or to look at a person and kind of see more of a bigger picture. [00:08:17] Mm-hmm. Whereas before, it was just streamlined to that nursing focus. [00:08:21] Paul Pruitt: So now I can kind of see the full body focus and understand a little bit more where things are coming from and what may be causing this. And it, it helps to think of like what should we look into- Mm-hmm ... as to what may be causing this. [00:08:36] Payton Nienaber: So it do- I think it has helped- [00:08:37] Paul Pruitt: honestly. ' [00:08:38] Cause I remember back in the day when, Medicare, CMS was, put out their initiative about hospital readmissions. [00:08:45] Mm-hmm. And I think about it, and again, we were actually in the emergency room over the weekend, with some issues. And long story short is we were sitting there talking, my wife and I were talking, and it was one of those conversations where it's like [00:08:59] what our [00:09:00] elderly experience when they go to- [00:09:02] Chelsey Gheyara: Mm-hmm. [00:09:02] Paul Pruitt: Mm-hmm ... an emergency room. [00:09:04] Yeah. And it's not bad, it's just they have to triage. [00:09:07] Chelsey Gheyara: Mm-hmm. [00:09:07] Paul Pruitt: So someone coming in with possible UTI, possible- Right ... this, they're not gonna s- be seen first, so they could be there for hours upon hours. We didn't leave until almost 1:00 in the morning. [00:09:16] Payton Nienaber: So you think about if I was 80- Mm-hmm ... I had dementia, I had all these other comorbidities- Mm ... and I'm sitting there for that many hours- [00:09:23] to where, what can we do in the nursing home? Mm-hmm. What can we look at the bigger picture- Mm-hmm ... and say analytically, what else can we do to prevent this? [00:09:31] Paul Pruitt: Because- Right ... really that is driving for the best care- [00:09:34] Payton Nienaber: for our seniors versus sending them to a hospital. Which again, they're not doing anything wrong or bad. [00:09:40] It's just, again, they're triaging for the most medically complex. [00:09:43] Yeah. And especially with the dementia population, it's just, it's harder on them being in a- Yeah [00:09:47] diff- different atmosphere even if it's just for a few hours. [00:09:50] Paul Pruitt: Absolutely. So if we can keep them at home where they're comfortable and they feel safe and look into those things, I think it makes a huge difference. [00:09:56] Yeah, I would agree. [00:09:58] Chelsey Gheyara: Yeah, absolutely. There's a [00:10:00] lot of work involved in balancing school and a career and education and all those things, especially when you are already in the trenches- Mm-hmm [00:10:09] in long-term care and healthcare as a whole. Tell us about a time, if there was a time, when you thought you might not be able to keep up with- Every [00:10:17] Payton Nienaber: single day ... your, with [00:10:19] Chelsey Gheyara: your school and how you made it through. [00:10:20] Payton Nienaber: Every single day. I actually started my nurse practitioner journey in 2021 doing a RN to MSN track, and I didn't finish it. [00:10:32] So that was not long after I'd taken my first director of nursing role, and I couldn't find a balance between- Yeah ... being a mom and being a wife and having this, big, heavy role that I had just taken on, and also school. So I ended up with my bachelor's. And then I started back on my master's right before I started with Majestic. [00:10:54] And then I took the director role right in the middle of the heavy stuff. So [00:11:00] just about every day I wanted to quit. Yeah. And I was like, "I don't think I can do this." Yeah. And I texted Brandy. [00:11:06] Brandy was, Brandy's a big part of why I was able to do it. Wow. And the people I work with, they gave me a huge support and made sure that I was able to keep school as a focus and as a priority just as much as our building. Yeah. That way I could get it done. Yeah. But I think probably every day she had to talk me off a ledge, 'cause I was like, "I don't think I can do this. [00:11:23] I think I'm just gonna quit." [00:11:25] Chelsey Gheyara: Wow. [00:11:25] Payton Nienaber: So having a big support system, you know, my family, the people I work with, is really the only reason I made it through. So they- [00:11:32] Chelsey Gheyara: gave me the push when I couldn't find it within myself, and [00:11:36] Payton Nienaber: that's, that's what made this journey different than the first time I tried- Mm-hmm [00:11:40] is that I had that, whereas I didn't before. And that's the only reason I survived I think. Wow. It's definitely not easy. Yeah. [00:11:49] Chelsey Gheyara: That's really special. And for our listeners who don't know, Brandy is one of our senior executive directors- Yeah ... here at Majestic Care, and she was our very first [00:12:00] podcast guest. [00:12:00] Yeah. So anyone listening to this, go back and listen to her episode, too, because it's pretty phenomenal. But she's definitely one of those leaders that pours into- For sure ... others. She does. That's really, really cool. [00:12:11] Payton Nienaber: So being a caregiver is one thing, right? Being a nurse, caregiver, therapist, whatever you are, by stepping into leadership, that's a whole new ballgame- Whole different ballgame [00:12:20] Chelsey Gheyara: especially in your director of nursing role. Was there a moment when you realized you could make a bigger impact as a leader rather than just as a caregiver? [00:12:31] Payton Nienaber: Yeah, so before I took my first director of nursing role, I worked in a building as a floor nurse, and I kinda had the same consistent team that worked with me all the time. [00:12:41] And the director of nursing we had was leaving, and they kept telling me, "Peyton, you should do this." And I'm like, "I've only been a nurse a few years. There's no way. Like, I can't handle it." But they pushed me. They were like, "You make such a big difference for our residents, and you push and advocate for [00:13:00] us as the staff." [00:13:00] so eventually they talked me into it, and I applied and I got it. And like I said, I was not cut out for it at the time, but I've had a lot of people throughout my journey that have helped me grow and learn and develop myself as a leader. [00:13:13] And now I'm, I'm much more comfortable with it. But they were kind of the push that was like, "Hey, you should- Yeah ... you can do this." [00:13:21] Paul Pruitt: So what was the areas where you said, y- where you didn't feel like you could- What that ... you did it well or- [00:13:26] Payton Nienaber: I- [00:13:26] Paul Pruitt: Like- Let's [00:13:27] Payton Nienaber: see. I became a nurse in 2018, so I'd only been a nurse for three years. [00:13:31] Paul Pruitt: So I feel like at that point you're still a, a baby nurse, and there's still a whole lot that you can learn. [00:13:37] I knew the nursing clinical side of it, but you've got regulatory and you've got, you know, the managerial, the administrative side of it. Yeah. [00:13:45] Payton Nienaber: Things that I'd never seen f- on a floor nurse side. So having to learn all of that I think was the biggest curve for me. So knowing that there's a lot more on the back end that goes into it than what you see- Yeah ... on the front side- Mm-hmm ... but as j- a floor staff. [00:13:59] Paul Pruitt: So [00:14:00] here at Majestic w- we belong to an organization called APCA, one of the elements is for MDS nurses- Mm-hmm [00:14:07] to become- Oh, cool ... RAC certified. So it's kind of the gold standard for a certification saying that they really understand the MDS- Mm-hmm ... which is the tool we use for quality measures, financials, and clinical picture. But they also offer a program to become certified as a director of nursing. [00:14:25] Chelsey Gheyara: it was something that, I know a couple of our leaders, I think, [00:14:29] Paul Pruitt: I can picture her. She's our DNS at Fairfield. [00:14:33] Chelsey Gheyara: Caprice? [00:14:34] Paul Pruitt: Caprice. Caprice, I believe, went through [00:14:36] Chelsey Gheyara: it. Oh, cool. ' [00:14:37] Paul Pruitt: Cause we did like a t- like a sample, like let's try it. I, I'd be curious for anybody to go through it. [00:14:41] It's, it's free- Yeah ... to us because we're members, so- That's cool. Okay ... it's something to go through because I'd be more curious, to your point, [00:14:50] weighing heavier on the sides of regulations, finance- Mm-hmm ... like more the leadership managerial side than the clinical side. [00:14:57] Payton Nienaber: Cause obviously you're a good nurse. [00:14:59] Paul Pruitt: You obviously did [00:15:00] all of that- Right ... component. Now again, you can always learn, we can always learn more clinically. [00:15:03] Payton Nienaber: But it's, it is a whole nother ballgame when you talk about managerial and leadership- Right ... and accountability and all those other elements that go into it, and getting the staff kind of all in the sync together. [00:15:15] Chelsey Gheyara: Right. [00:15:15] Paul Pruitt: It's a different- [00:15:16] Chelsey Gheyara: ballgame. I'll have to [00:15:16] look into that. Yeah, that's really cool. [00:15:18] Paul Pruitt: It is. It's something that we're hopefully gonna promote throughout our company, that for our DNSs, here's an opportunity to come s- to get a certification. [00:15:26] Chelsey Gheyara: Right. For [00:15:26] Paul Pruitt: sure. And then, um, for, The administrators, they could actually go, or executive directors become QAPI certified. [00:15:32] Chelsey Gheyara: Oh, [00:15:33] cool. Which is for process- Yeah ... improvement, quality assurance, and so on. That's awesome. I love that. [00:15:38] Paul Pruitt: Yeah. [00:15:39] Chelsey Gheyara: I love hearing about- We'll have to look into that ... your journey, and we're not even close to being done- But I love hearing all about this. There's- Yeah. It's, it's really, really cool when you start, you, you mentioned, you're like, "I wasn't cut out for this," and oftentimes, you know, we've heard that for, you know, depending on- Yeah [00:15:57] what your beliefs are and whatnot. Mm-hmm. But it's, what is [00:16:00] that saying? Like, God doesn't call the qualified, He qualifies the called. [00:16:04] Payton Nienaber: Yep. [00:16:05] Chelsey Gheyara: Oh, that's cool. [00:16:05] Paul Pruitt: So, [00:16:05] Chelsey Gheyara: yeah. That's a very cool saying. It made me think about that. Like, there's so many times we've all probably been like, "I'm not ready for this, Houston- Yeah. [00:16:13] Yeah ... we have a problem." But it's really cool. Thank you for sharing that- Yeah, absolutely ... that story. so you've had the chance to wear a lot of hats at Majestic Care. was there a time when you felt overwhelmed by a situation, but pushed through because you knew it would benefit your teammates, your team that you serve, and the residents? [00:16:31] Payton Nienaber: Again, probably weekly. I feel like we face a different challenge every single day. You know, there's things that we could probably write a book, you, I can't make this up, and it's- Yeah ... 100% true. Like, there's things you don't think you would ever see in your career, and we've seen it all. [00:16:47] every day is a different challenge, and trying to figure out how to navigate that and overcome it is, I feel like, a continued learning experience. Yeah. if you're [00:17:00] facing something you thought you'd never see and you're like- Yeah ... "What do I do?" got to learn to adapt and work your way around it and figure it out because there's no map to how to navigate long-term care at all. [00:17:12] Yeah. And one building's gonna be different from another, and one resident is gonna be different from another. They're all different. Yeah. So it's a constant learning experience on how to navigate these roadblocks that you're gonna hit almost every single day- Yeah ... 'cause it's always something. Yeah. [00:17:28] Paul Pruitt: It's amazing when I think about, you know, you referenced, like, not knowing the regulations, and I remember talking to... [00:17:36] So this was back when I was administrator. Mm-hmm.I had a person apply to be the director of nursing, and was coming from acute care. And we were talking and she's like, "I don't know the regs." And I'm like, "You [00:17:48] know, you can learn the recs." [00:17:49] Payton Nienaber: can't learn clinical practice. Right. [00:17:52] So I need a good, strong clinical leader because I need somebody that really believes in evidence-based care, evidence-based practices. [00:17:59] Paul Pruitt: If we can [00:18:00] do that right- Mm-hmm ... and well, the regulatory will follow. [00:18:04] Chelsey Gheyara: Right. Yeah. [00:18:04] Paul Pruitt: Same thing, the, the roadblocks that we get thrown at us every day. I mean, I remember one time a guy showed up- vodka in his PICC [00:18:13] Chelsey Gheyara: line. Oh my gosh. Wow. [00:18:14] Paul Pruitt: Like I would, like y- to your point, I, I don't know if I would ever see- Whoa. [00:18:17] things, then all of a sudden I'm like, "He did what? And what is that again?" You're like, "What?" And I remember calling my medical director, and I'm like, "Remind me again, PICC line." And he goes, "Dumps in the heart." And I'm like, "Oh. Oh my goodness." Right. So but, you know, again, going back to clinical practice. [00:18:34] Payton Nienaber: Uh-huh. [00:18:34] Paul Pruitt: What does that mean? What do we have to do clinically? How do we assess? How do we put all- Mm-hmm ... the parameters in place? So on. And I think if we just keep going back to what is good care. [00:18:44] Payton Nienaber: Taking it back to what does good care look like? What is good care? What would we want for any of our loved ones? [00:18:49] Paul Pruitt: What do we want for ourselves? [00:18:51] Payton Nienaber: And again, it's hard because even that's a hard question, 'cause what I want could be different than what you want. [00:18:57] And I may not agree with you, but [00:19:00] if you're able to make your own decisions, I have to honor and respect your decision- Mm-hmm ... as a person- [00:19:05] whether I agree with it or not. But again, going back to and educating, here's clinical practice. Mm-hmm. Here's what we educate to. So again, I think long-term care, I think that's part of the love. [00:19:15] Chelsey Gheyara: Yeah. [00:19:16] Paul Pruitt: Is nothing's the same. [00:19:17] Chelsey Gheyara: Everything keeps evolving. Yeah. Everything keeps flipping- Always [00:19:20] Paul Pruitt: and turning and twisting. I always say, if I could handle the blood and all of that- Mm-hmm ... in a, like in a trauma one emergency room- Uh, [00:19:27] Chelsey Gheyara: yeah ... [00:19:28] Paul Pruitt: I'm there. Because if it, that constant rush- Yeah ... of change. [00:19:32] Payton Nienaber: And that's the same thing- Absolutely ... that we go through every day. [00:19:34] Chelsey Gheyara: Yeah. And I wish more people knew that in healthcare, which- Right [00:19:38] is what we're trying to open the door for- Yeah ... with this podcast, is because there's so many people that I think are in other, levels of care, which maybe- Mm-hmm ... that's where they belong, and that's awesome. And I don't think many people realize that how quickly our days change, and we have to- [00:19:55] Payton Nienaber: pivot and adapt, and we have to solve for things because maybe, you know, the physician's not [00:20:00] at the nurse's station- Right ... with us every day. Right. You're it. We can't just page them. Mm-hmm. Right? and it, it's just, it's so thrilling, honestly. Yeah. And it's- Yeah ... it teaches you so much as a person, I feel like. [00:20:13] Chelsey Gheyara: It does. So I, I wish someone listening to this, that they're not really sure, maybe it's a new grad, maybe they're not really sure. If they have a daughter or a son that's not sure about what their nursing or what their administrative career might look like, just give it a try. Come on in. The water's warm. [00:20:30] Payton Nienaber: Yep. [00:20:30] Chelsey Gheyara: You'll learn so much. Yeah. [00:20:32] Paul Pruitt: So I'll, when you talk about people understanding what we're up against, so in my career, I had the opportunity of running an alt tech and a nursing home together. [00:20:40] Chelsey Gheyara: we were part of a larger organization, and Julie Bolson was our director of emergency preparedness for the whole system So all of the hospitals and everything. So r- she came over when we had JACO going on to LTCH. Mm-hmm. I have never been through a JACO survey in my life, so I'm like, "Okay, here we [00:21:00] go." [00:21:00] Paul Pruitt: And we're sitting in, a meeting with the surveyor, and she's asking questions, and people are divulging everything, just talking through everything and stuff. And I'm like, "What in the world is going on here?" Because that's not how we handle survey process- Right ... in long-term care. [00:21:16] Chelsey Gheyara: And Julie's, like, putting thumbs up, like, "This is going great." [00:21:19] Paul Pruitt: And I'm like- [00:21:20] Chelsey Gheyara: Yeah, it's so different ... [00:21:21] Paul Pruitt: so different. Mm-hmm. So then I said, afterwards I'm like, "What was that?" And so we were talking, and she goes, "What is..." She goes, "I don't understand." And I said, "When my survey for long-term care happens, you need to come- [00:21:32] Chelsey Gheyara: experience." And again, so she came and experienced that, and she goes, "Well, is this random?" [00:21:39] Paul Pruitt: I'm like, "Yeah." [00:21:39] Chelsey Gheyara: Yep. [00:21:40] Paul Pruitt: So she came in, and she actually came into the survey process where they talk about emergency preparedness, 'cause that's her wheelhouse. Mm-hmm. So she came in. I had to actually stop the survey process and walk her out of my office 'cause- [00:21:52] she was fighting with the surveyor. Oh, no. And I'm like, "This isn't going well." And so then w- all that said, [00:22:00] she walked away. She goes, "I have such a different appreciation with what you guys go through." [00:22:06] And again, it's not one's right or wrong, but she goes- Mm-hmm ... "It is night and day difference." And we always thought it was so hard with JACO. [00:22:12] Chelsey Gheyara: She goes, "You guys..." Yeah. So she was my biggest advocate to what- Wow ... you were saying earlier. She would go back to the system level and say, "Look, you guys don't know what it's like." Random, walk in at any time of day. Mm-hmm. Weekends. There is no planned schedule. There is no nothing. [00:22:26] Paul Pruitt: And then you literally are in survey mode- [00:22:29] Payton Nienaber: the whole time they're there- Yeah ... because you can't just [00:22:32] stop. You never know. Yeah. [00:22:33] Paul Pruitt: Right. So- [00:22:33] Payton Nienaber: So I've always said that hospital life and long-term care life are kind of like DC and Marvel. Yeah. They're the ca- same concept, but completely different franchises. [00:22:44] Paul Pruitt: Yeah. [00:22:44] Payton Nienaber: So- That [00:22:45] Paul Pruitt: was a great- That's [00:22:45] Payton Nienaber: awesome ... you know, you may have ICU, you have three patients, and you're slammed the whole shift. [00:22:49] But then you've got long-term care, you've got 20 plus patients, and you're gonna be just as busy, but it's gonna be a different kind of busy. Yes. Right. So yeah, down to even surveys, they're- Oh ... they're same [00:23:00] concept, but they're completely different. Right. [00:23:02] Paul Pruitt: People don't realize that until you, you, you switch gears. [00:23:05] Payton Nienaber: Right. Yeah. And you, you try to switch from one team to another, and it's like, "Whoa, hold on." Yeah, what is- "This is so different." Yeah. Yeah. Yeah. [00:23:12] Chelsey Gheyara: Absolutely. Peyton, what's a story about one of your residents that really got to you? Maybe a time when you went above and beyond to advocate for them. [00:23:22] Payton Nienaber: So we have a resident just recently, and he's been to our facility a few different times and, come for rehab, go back home. [00:23:32] And this last visit, his wife became ill. So he was thinking that he was gonna have to move somewhere else so that she could be there too, and he was, in tears. Yeah. Like completely torn up about it. And me and our social service assistant, we met with him, and we were like, "Look, we can handle her here too. [00:23:51] So we will... You know, you talk to your family. We'll do everything we can to keep both of you here." Yeah. "That way you don't have to go anywhere." So then [00:24:00] he's crying tears of joy. You know, he's like- Wow ... "I love it here. I've never felt so loved in a place." That's awesome. And he's like, "You guys are my family, and I didn't wanna have to leave." [00:24:10] 'Cause they were looking at taking him, I think, to another state, and he's just like, "I don't wanna do that." Yeah. So, and we, we now have two of them, him and his wife, but I... That, that really hit home. Yeah. Just that he's in tears that he's... Just for the fact that he's got us advocating for him. Yeah. Like, "If you want this, we're gonna make it happen." [00:24:30] Yeah, that's really, really special. [00:24:32] Paul Pruitt: Oh, and just the impact of being able to stay with his wife. [00:24:35] Payton Nienaber: Mm-hmm. Mm-hmm. Oh, yeah. Oh my [00:24:36] Paul Pruitt: gosh. You know what I mean? [00:24:37] Payton Nienaber: Yeah. But also stay somewhere where you're comfortable- Right ... and you feel at home. You know? Right. Yeah. He's, he's been with us enough, like we are his home away from home, and he was, like, visibly torn up that he was gonna have to leave. [00:24:50] So just the fact that- Yeah ... we were able to, like, listen and be like, "We can make this happen. You know, we'll be your people. We'll advocate for this if it's what you really want," it just [00:25:00] made a whole world of difference for him. Yeah. [00:25:01] Paul Pruitt: That would be heartbreaking- Yeah. Mm-hmm ... being, not being able to stay there. [00:25:06] Yeah, I mean, it's kind of like- [00:25:07] Chelsey Gheyara: That's really sad ... [00:25:08] Paul Pruitt: almost like being, ripped out of two places, right? Yeah. So you're taken out of your home. [00:25:13] Payton Nienaber: So then you plant your new home. Where you're comfortable. Mm-hmm. [00:25:15] Mm-hmm. [00:25:15] Paul Pruitt: and then knowing if you have to leave, then the next layer is then what about your wife? [00:25:21] Payton Nienaber: Like, and to your point, if you're going to another state or if... I don't know if they were looking to move the wife to another state too, and I mean, that's just- [00:25:27] Mm-hmm ... [00:25:28] Paul Pruitt: what a huge disruption- Yeah ... in anybody's life. Yeah. So [00:25:30] Payton Nienaber: kudos to you guys. [00:25:31] Paul Pruitt: So [00:25:31] Payton Nienaber: it was a lot. Absolutely. And he was carrying that burden, so we're like, "You don't have to do this alone." [00:25:36] Chelsey Gheyara: Yeah. [00:25:36] Payton Nienaber: Like, "You've got us in your corner." Oh, that's beautiful. "We will fight with you and do what we can to keep you here." And we did, He's like a whole new person. [00:25:43] Paul Pruitt: That's awesome. [00:25:44] Payton Nienaber: So just seeing him flip from being so upset over this to what he is now, like It's night and day. [00:25:49] Chelsey Gheyara: So being able to do that and be that for him [00:25:52] Payton Nienaber: made my day as much as it did his. That's cool. Yeah. I think I cried with him. [00:25:57] Chelsey Gheyara: I love it. I love it so much. [00:26:00] I like how you said that, that you don't have to do this alone. [00:26:03] Mm-hmm. Yeah. That's really, really special. So don't... I, I love that you were like it impacted, you were able to reflect- Oh, yeah ... and on how much it impacted you. [00:26:12] Payton Nienaber: Because that's, that matters for our care team members to see the impact they have on our residents- For sure. Yeah ... and their families. It helps them keep going, I feel like. [00:26:21] Chelsey Gheyara: That's really, really cool. As you look toward the future of long-term care, where do you see room for change? What's something you hope to see evolve in the industry? [00:26:32] Payton Nienaber: So this is a big one. [00:26:33] I wanna see more people understand that long-term care especially is a people business. [00:26:41] Chelsey Gheyara: So I feel like a lot of times we can get wrapped up in the numbers, and the quality measures, and [00:26:49] Payton Nienaber: Medicare, Medicaid, everything that goes into it. [00:26:50] I know that plays a big part of it, but you're also working with humans. [00:26:54] Chelsey Gheyara: So understanding that when it comes down to your staff, like the whole thing, it's a people [00:27:00] business- Yeah ... and people need to be the forefront of it. I feel like [00:27:03] Payton Nienaber: some people these days, they come into it just looking for an income, but it's so much more than that. [00:27:09] Like, it's more than just a number or a paycheck. Like, you're taking care of people, and they're vulnerable pe- vulnerable people. [00:27:16] they're people that can't speak up for themselves sometimes, or people that don't have others to speak up- Right ... for themselves, and you are that person. So understanding that and focusing more on the person versus the numbers, I think would make a huge difference in long-term care- [00:27:30] if everybody had that outlook. [00:27:33] Paul Pruitt: I would agree. [00:27:33] Chelsey Gheyara: Yeah. Absolutely. [00:27:35] Paul Pruitt: I always think the one thing, and again, I 100% agree- Wow ... with you on that one. The only other thing I would throw in there to change is- ... the med pass. [00:27:44] Chelsey Gheyara: Oh, for [00:27:44] Paul Pruitt: sure. I was talking to her- She's like- Can [00:27:46] Chelsey Gheyara: we streamline this? She's like, "Yeah." Oh, yeah. [00:27:49] Paul Pruitt: Absolutely. So I agree with everything about it's a people business- Yeah ... and we're taking care of people, and how do you balance the operational efficiencies and all those- Mm-hmm ... numbers, KPIs, [00:28:00] OK... What do they call them? OKRs and all that with the people side- Mm-hmm ... the, the quality of- Right ... just taking care of people. [00:28:08] But the one thing I just, I was talking to Miriam, she runs our pharmacy, services, and I was just like, "Is there anybody that can figure out how to do this different?" Because- [00:28:17] Payton Nienaber: Yeah. [00:28:18] Paul Pruitt: Anybody ... this is just un- If you ever, if you ever have to watch a nurse pass meds- Oh, my gosh ... in long-term care, it's, it's just, it's a nightmare. [00:28:25] Payton Nienaber: It's [00:28:26] Paul Pruitt: rough. It, it is. It's just- That's [00:28:27] Chelsey Gheyara: for sure. Yeah. [00:28:28] Paul Pruitt: It's just not a normal- You figure out a way to change [00:28:30] Chelsey Gheyara: that, let me know. [00:28:31] Payton Nienaber: Yeah. I'm all for it. Well, [00:28:32] Paul Pruitt: Kate, maybe you and I can come up with a solution. [00:28:34] Chelsey Gheyara: Yeah. We will. We'll try something. [00:28:36] Paul Pruitt: You could [00:28:36] Chelsey Gheyara: make a lot of money off of that too, I'm sure. [00:28:38] Paul Pruitt: Yeah. Well, it's just, it doesn't tie into what the strength of being a nurse. [00:28:43] Chelsey Gheyara: I mean, and no wonder our nurses feel like just passing meds. [00:28:46] Now, again, I always talk to our CMO, our chief medical officer, I'm like, "Part of the problem is you guys." 'Cause the nurses only pass the meds that you guys keep writing orders on. [00:28:54] Right. There's lots of meds. Yeah. There's so many meds. [00:28:57] Paul Pruitt: So stop writing all these orders. Yeah. Yeah. There are so [00:28:59] Chelsey Gheyara: [00:29:00] many. [00:29:00] Paul Pruitt: So I'm not advocating to cut med costs or anything like- But I think there's a point where you get polypharmacy. It's like, okay- Yeah ... why are we doing this again? But- Right ... but again, we can figure out [00:29:10] Payton Nienaber: that- We actually do polypharmacy reviews sometimes- Yes [00:29:13] Paul Pruitt: in [00:29:13] Payton Nienaber: our building just to look and see, 'cause there are so many meds and for what? Oh, of course. [00:29:16] Paul Pruitt: Right. There's a point where you're just like, "Okay, why?" Like, [00:29:19] Payton Nienaber: three different meds for the same thing. Right. [00:29:21] Paul Pruitt: Like, why? Right. [00:29:21] Chelsey Gheyara: Right. [00:29:21] Paul Pruitt: So- And I'll be honest, if I'm 80-some years old, even 70-some- ... just give me my Diet Coke. [00:29:28] I don't need the multivitamin at this point. Yeah. [00:29:30] Payton Nienaber: I'll be the one that's like, "No, [00:29:31] Chelsey Gheyara: thank you." The Diet [00:29:31] Payton Nienaber: Coke will be your multivitamin. [00:29:33] Paul Pruitt: This will be my multivitamin. This [00:29:34] Chelsey Gheyara: is gonna [00:29:36] Paul Pruitt: keep me going. I don't need the multivitamin. Just give me my Diet Coke- Right ... and don't thicken it. [00:29:39] Chelsey Gheyara: Right. That's the only thing I need. [00:29:40] Yeah, no thickened... Well, and too, I mean, to that point is we do offer so many activities- Yeah ... and opportunities for our residents. We do, you know, Peyton, you mentioned it beautifully, we are advocating for our seniors. Mm-hmm. Right. Because we do want them, 'cause when they are up, and they're out- And [00:29:57] Paul Pruitt: moving [00:29:57] Chelsey Gheyara: they feel better, right? Yes. Yeah. there's meds [00:30:00] that we need. But w- we're not, we want them, we wanna be a part of the solution. [00:30:03] Paul Pruitt: Right. [00:30:03] Chelsey Gheyara: Right? So I love- Sure ... I love that, love that conversation. Peyton, looking back at your career, what piece of advice would you give to someone just starting out in long-term care? [00:30:15] Payton Nienaber: Have patience, and give yourself some grace. [00:30:19] Chelsey Gheyara: it's gonna be crazy. It's, like I said, it's a whole different ballgame than maybe anywhere else you've come from. And it's, it's gonna be challenging. It's gonna test your skills, it's gonna test your knowledge, and it's most definitely gonna test your patience. [00:30:32] Payton Nienaber: So have some patience, and give yourself grace. [00:30:36] Chelsey Gheyara: Because you're gonna mess up. I don't know how many times I tell my boss, I'm like, "Hey, listen, I need to tell on myself. I did it wrong." And give yourself grace, because you're not perfect. [00:30:46] Paul Pruitt: And you're gonna have those challenges, and sometimes you're gonna make the wrong call, but that's okay. [00:30:51] You just gotta learn from it, and you've gotta move on and figure out how to fix it. So patience and grace are two of the, the best qualities [00:31:00] you can have if you're coming to long-term care. And I would so agree with you. I remember taking my first BOM, business office manager job. Mm-hmm. And, [00:31:07] and I had been in long-term care. [00:31:08] I was a therapist and that, so I'm thinking, but it took me a good six months sitting in that seat just to feel comfortable- [00:31:15] Chelsey Gheyara: Mm-hmm ... [00:31:15] Paul Pruitt: have a conversation. [00:31:17] I'd go home, and I'd be like, "I am not sure." And I'm thinking, I'm pretty smart," but I'm like, "Oh my God-" "... this is a whole different world." [00:31:23] Chelsey Gheyara: Yeah. [00:31:24] Paul Pruitt: And the challenge- Yeah ... of, you know, what you were doing on a day-to-day basis. So- [00:31:27] Chelsey Gheyara: Yeah. [00:31:28] Paul Pruitt: Yeah ... I absolutely agree. Just, and recognizing that, you know, through our failures- come great success. [00:31:36] Payton Nienaber: And my daughter always said it best. She always would say, "Your failures don't define you." [00:31:42] So they're, they're not your defining moment. They're not gonna- Mm-hmm ... last forever. It's just a [00:31:47] Paul Pruitt: road bump. [00:31:48] Payton Nienaber: And you just keep moving forward. You [00:31:49] just have to learn from it and move on. [00:31:51] Chelsey Gheyara: Yeah. Would you give any other advice for newer leaders, young leaders? what would you tell folks that are [00:32:00] just starting out in their career, but they're not sure if they wanna be a leader or not? [00:32:04] Payton Nienaber: So you're taking care of residents and these people, and now you're on the back end of it, so you can advocate for more maybe than what you were able to as a floor nurse, and you have a bigger voice. And you can use that. You know, I may have argued with state a time or two. [00:32:21] Like, I get where you're coming from regulatory-wise, but think of the human aspect of this.So have that humanity and understand that people are going through things, from residents to staff, and [00:32:33] treat them like the humans that they are and not just an employee or not just a resident. [00:32:38] Right. Like, look at the bigger picture. Look at who they are as a person. You know, especially with dementia people, look at who they used to be because a lot of times that plays into who they are today- [00:32:47] Paul Pruitt: and why they're acting. You know, I've got patients that will try to build things, and it's because they used to be an engineer. [00:32:54] Payton Nienaber: Wow. Or they'll try taking things apart, and it's because they used to work in construction, you know? Right. So [00:33:00] look at who they used to be, and look at how that plays into who they are today. And as for your staff, look at them as a big picture. What do they have going on? I feel like that's one thing I've tried to do different as a leader is, for the staff, don't just treat them as an employee but as a person because we all have things going on. [00:33:16] Mm-hmm. Like I said, I've got a kid that's seven and is a type 1 diabetic. And, you know, I've got things going on, too. I've gone through school, and I've... Life is hard. [00:33:26] Chelsey Gheyara: And there's no reason to come to work and it be harder, you know? Mm-hmm. So if we can be a little lenient or look at the bigger picture and see what we can do to help that person versus [00:33:37] Payton Nienaber: just treat them as another s- person on your staff and make a difference, then why don't we? [00:33:43] Yeah, I think that's well said, Payne. we've talked about it on even our other podcasts with other leaders is when you, you can't just leave it at the door. [00:33:52] You know, you can't just, somehow do a magic switch- Yeah ... and then when you walk in the door I'm a whole different person. [00:33:59] Paul Pruitt: I bring all my [00:34:00] baggage with me. Yep. Yeah. And I'm trying to do the best I can. I'm trying to have a great day. I, but again, you know, things happen behind [00:34:08] Payton Nienaber: me- [00:34:08] Paul Pruitt: And again, and I mean, think about all of our lives, right? personally, I remember when my dad passed away, you know? And, you know, you get your three-day what is it? [00:34:18] Bereavement. [00:34:19] Payton Nienaber: Mm-hmm. [00:34:19] Paul Pruitt: I remember coming back to work, and it w- it was probably one of the hardest days. [00:34:24] Chelsey Gheyara: Part of it was the compassion of the people I worked with, 'cause we had good- Yeah ... connections, so they cared. [00:34:29] But that almost made it harder, because when they would come up, I'd be like- Yeah [00:34:32] Paul Pruitt: I'd have to go and sit in the corner- Yeah ... and cry. I get it. Yeah. Because I'm like, "I can't do this right now." [00:34:36] Chelsey Gheyara: Yeah. [00:34:37] Paul Pruitt: But I still had to function as a therapist. Right. I still had to function as a clinician. I still had to meet my re- residents and patients where they were at. So i- it's difficult, but it's- Mm-hmm [00:34:46] having those connections and knowing that people have got your back, and they're, they're there to help support you through it makes- Exactly ... a huge difference. [00:34:52] Payton Nienaber: We've all got baggage, and like you said, it's- Yeah ... you can't just flip a switch and turn it off- Yeah ... no matter how hard you try. [00:34:58] Paul Pruitt: And I feel like I've worked at some places that [00:35:00] that's what they expected, was for you to flip a switch and turn it off. [00:35:02] Payton Nienaber: And if you didn't, you're in trouble for it. So I mean, I've had staff come in my office and just sit down and cry- [00:35:07] Chelsey Gheyara: because of the things they have going on. And sometimes just that listening ear can make them feel so much better. [00:35:12] I tell people, "My door's open. If you need to come sit, rant, rave, throw a fit, cry your eyes out, whatever you need to do, uh, there's a chair right here." [00:35:20] I'm like, "I'll give advice. I'll sit and listen. whatever you need at the moment, just know that you can come in here, or you can come to me for these things." So I had one lately that she's got something big at home going on, and I just told her, I'm like, "If you ever need to talk about it, I'm here." [00:35:34] Payton Nienaber: And then the next day, I got a, a novel of a text message just thanking me. "You know, I've never had this. I don't have people at home that I can talk to about this So just you saying that you're here to listen made a, a big difference." So I think as leaders, we have the opportunity to make a difference not only for our residents, but also for our staff, too. [00:35:52] Paul Pruitt: Just to know that we understand you're human, and so are we. And that's okay. I think, you know, Chelsea, too, you know, [00:36:00] when you talk about leaders is recognizing that, the old-school methodology of leadership, [00:36:07] because I said type attitude- Mm-hmm ... is so wrong. [00:36:11] Chelsey Gheyara: It's the emotional intelligence of saying, "You know what? [00:36:14] Paul Pruitt: I see you're having a really rough day." Mm-hmm. "What can I do to help?" [00:36:17] Chelsey Gheyara: Right. [00:36:17] Paul Pruitt: Exactly. And to your point, sometimes it's a listening ear. Sometimes it's, you [00:36:21] know, it might be just going to buy somebody a Diet Coke- Mm-hmm ... or a candy bar. It might be just e- buying them lunch. Mm-hmm. Who knows- [00:36:28] what they need at that moment in time, but it's recognizing that. And I think, Payton, what I would ask you always to challenge our organization, that we never get that way- [00:36:37] Payton Nienaber: to where we're treating people as a number or just as a other pawn. [00:36:41] Because again, at the end of the day, if we can build strong stability of our workforce- [00:36:47] Paul Pruitt: that just drives up the quality that much more. [00:36:50] Payton Nienaber: understand our systems- Mm-hmm ... our processes, and so on and so forth, and they know our residents. [00:36:56] Paul Pruitt: Yeah. You know, when you know your residents, all their little idiosyncrasies- Uh-huh ... it's just like our [00:37:00] kids. When I knew, I know what my kids- Right [00:37:02] and know how they are, [00:37:04] it makes life a lot easier- [00:37:05] Payton Nienaber: for everyone. [00:37:06] Yeah. [00:37:07] Chelsey Gheyara: Absolutely. So. [00:37:09] Payton Nienaber: Yeah. [00:37:09] Chelsey Gheyara: Payton, what does excellence mean to you? [00:37:11] Payton Nienaber: I think kind of like we've talked about, it just means going above and beyond. You know, having the humanity to understand- Yeah ... that things are going on, and going the extra mile, even if it's just something small, may make a huge difference to somebody. [00:37:23] You know, like you said, just- Yeah ... buy them a Coke or- Right ... buy them Starbucks. You know, that may just completely 180 their attitude or, their outlook on things. Right. So even the small things can make a big difference in the big scheme of things. Yeah. So I think excellence means going above and beyond, and recognizing those small things that you can do to make a difference in somebody's life. [00:37:48] Paul Pruitt: You know, just sitting there talking that through, there's so much that went through my head- ... just in those few minutes. Because I think about, you know, excellence has so much to it. [00:37:57] Chelsey Gheyara: Mm-hmm. [00:37:58] Paul Pruitt: But even just being [00:38:00] nice. [00:38:00] Chelsey Gheyara: Mm-hmm. [00:38:01] Paul Pruitt: I mean, I was traveling, the end of last week and so you never wanna travel with me, I'll just be honest. [00:38:09] 'Cause delays are my thing. Like, I'm not sure why, but- ... all of a sudden now every time I travel, it's a delay. But, so I get to the airport, and it's about noon, and I knew my flight wasn't gonna be till later that day, but got there and I thought, "Okay, I'll just get there. [00:38:25] Instead of working in the hotel, I'll just work at the airport." [00:38:27] Payton Nienaber: Mm-hmm. [00:38:27] Paul Pruitt: Flight took off at, like, 10 something at night. So finally get in the plane, [00:38:32] Fly from Detroit to Grand Rapids. So I went from Baltimore to Detroit, Detroit to Grand Rapids. [00:38:39] Got to Grand Rapids, and then we just kept circling- Oh, wow ... 'cause the weather. [00:38:44] Chelsey Gheyara: Circling, circling, while we were diverted back [00:38:46] to Detroit. But I understand, like, a lot of baggage, right? But it's like this isn't anybody's fault. [00:38:53] Right. [00:38:53] Mm-hmm. [00:38:54] Paul Pruitt: Right. Like, just be nice. [00:38:55] Chelsey Gheyara: Yeah. [00:38:56] Paul Pruitt: Right. Like, show some kindness to the- Mm-hmm ... like that person at the [00:39:00] ticket counter, she didn't purposely- Oh, gosh. Yeah ... just make my life miserable. [00:39:04] Chelsey Gheyara: It's not her fault. Yeah. [00:39:04] Paul Pruitt: So I just went up and sh- you could tell, like, she was just waiting. I said, "I just need to know when I can fly next." [00:39:10] And she goes, "Well, this is when." And I'm like, "Okay." And she goes, "Anything?" I said, "Nope, I'm good." So I went and found a hotel and- [00:39:17] Payton Nienaber: But again, just be nice. [00:39:18] I think sometimes that's all we have to remember is- [00:39:21] just look at somebody and just say, "You know what? You're having a rough day. [00:39:24] Paul Pruitt: What can I do to help you?" Yeah. That's [00:39:26] Payton Nienaber: it. That's, you never know what somebody's going through. Mm-hmm. So even just that one little speck of kindness, it maybe seems small to you, but to them- Right ... it's like, "Okay, so- [00:39:35] Paul Pruitt: It's a game-changer ... [00:39:36] Payton Nienaber: it's gonna be okay." [00:39:37] Chelsey Gheyara: Yeah. [00:39:37] Paul Pruitt: Yeah. [00:39:38] Payton Nienaber: Well, Peyton, thank you so much for being here with us- Absolutely. Thank you ... today on the Hearts of Excellence podcast. Thank you for being here, as always. I love it. Paul, and this is only the beginning, so I'm excited for what's ahead for Newberg, and thanks for spending some time with us today. Yeah, [00:39:54] absolutely. [00:39:55] Thank you. [00:39:56] Chelsey Gheyara: thank you for tuning in to the Hearts of Excellence. Peyton's journey is a beautiful [00:40:00] reminder of the power of persistence, passion, and advocacy in long-term care. If you're interested in learning more about the culture at Majestic Care or wanna find out more about our career opportunities or care for a loved one, visit majesticcare.com/contactus. [00:40:14] We're here to support you or your next chapter. Have a good day.