Latest / Banter At The Bedside / How to Advocate for Yourself in Healthcare - Not Feeling Heard

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How to Advocate for Yourself in Healthcare - Not Feeling Heard · Banter At The Bedside

• 0:00
  SPEAKER_01: I want to say violence is never the answer.
• 0:03
  SPEAKER_01: Aggression is never the answer.
• 0:05
  SPEAKER_01: That's right.
• 0:06
  SPEAKER_01: You shouldn't feel dismissed, but we live in a world where healthcare workers are attacked every single day.
• 0:14
  SPEAKER_01: You're giving our great examples of how to just speak.
• 0:18
  SPEAKER_02: She'd be doing it.
• 0:21
  SPEAKER_02: She's like, I have this idea.
• 0:22
  SPEAKER_03: All her workers are like.
• 0:30
  SPEAKER_03: Hey everybody, it's Kaylee.
• 0:31
  SPEAKER_03: Welcome back to Banter at the Bedside.
• 0:33
  SPEAKER_03: Today we have an episode talking about when we feel dismissed.
• 0:37
  SPEAKER_03: This could be the patient, this could be the family member, or maybe even the healthcare workers trying to help them.
• 0:42
  SPEAKER_03: As always, this is for entertainment purposes only.
• 0:46
  SPEAKER_03: This is not for education.
• 0:47
  SPEAKER_03: If you need care, please seek your care from your medical provider.
• 0:51
  SPEAKER_03: These are our opinions.
• 0:52
  SPEAKER_03: We don't represent any organization or entity.
• 0:55
  SPEAKER_03: And if you're new, I'm Kaylee.
• 0:57
  SPEAKER_03: I'm a cardiac IC nurse of almost 18 years.
• 0:59
  SPEAKER_03: And we have with us Abby, our other main co-host.
• 1:02
  SPEAKER_03: She's a nurse practitioner, nurse practitioner of almost eight years.
• 1:06
  SPEAKER_03: And we have Amanda, aka Mama, back again.
• 1:09
  SPEAKER_03: And she's a CIC nurse of almost 20 years.
• 1:12
  SPEAKER_03: Yeah.
• 1:13
  SPEAKER_03: So we're really excited to have you back if you're returning.
• 1:15
  SPEAKER_03: And if this is your first time with us, welcome.
• 1:17
  SPEAKER_03: This is a little mini-series that Abby and I have started, and it's all about helping, hopefully helping patients feel like they can advocate for themselves a little bit better when they're either in the hospital or maybe just going to see their primary care doctor or wherever it is.
• 1:31
  SPEAKER_03: So we're happy to have you guys.
• 1:32
  SPEAKER_01: Yeah.
• 1:33
  SPEAKER_01: And this was again something that was requested by a listener.
• 1:38
  SPEAKER_01: And so we do take listener requests.
• 1:40
  SPEAKER_01: You can go to banter at the bedside.com or send us a DM.
• 1:45
  SPEAKER_01: Our DMs are open and on all the social medias.
• 1:48
  SPEAKER_01: And we're happy to talk about certain topics if there's something that you want us to explore.
• 1:54
  SPEAKER_01: Because that's really what we're about here is building that community between patients and healthcare workers and amongst healthcare workers.
• 2:01
  SPEAKER_01: I can say from a patient, I have like personally felt dismissed as a patient, and I think it's made me a little bit more aware to not do that to other patients.
• 2:15
  SPEAKER_01: So when I was 21, 22, and I had dengue fever in the recovery of dengue fever, which is a mosquito-borne illness for those who don't know it.
• 2:27
  SPEAKER_01: From I lived in Costa Rica for a summer and I got it, unfortunately.
• 2:32
  SPEAKER_01: But I had some heart rhythms that were abnormal after, and that's a rare side effect, but it can occur after a dengue fever because it's a viral illness.
• 2:43
  SPEAKER_01: And I went into a bunch of doctors and I was in nursing school and I told them, I'm like, I feel like my heart's like racing, like I'm just they're like, drink less caffeine.
• 2:54
  SPEAKER_01: So I stopped drinking caffeine.
• 2:56
  SPEAKER_01: I was really tired.
• 2:58
  SPEAKER_01: And then I was like being woken up, and I was like, I'm waking up feeling like my heart's racing out of my chest.
• 3:04
  SPEAKER_01: And they're like, it's just anxiety.
• 3:06
  SPEAKER_01: And I'm like, well, I've had that my whole life.
• 3:08
  SPEAKER_01: This doesn't, this don't like I know what anxiety is.
• 3:13
  SPEAKER_01: I know what a panic attack feels like.
• 3:15
  SPEAKER_01: This doesn't feel like that.
• 3:16
  SPEAKER_01: And I just there was one day I was in class and I was doing a presentation and I started feeling it, and then I felt like I couldn't breathe.
• 3:24
  SPEAKER_01: And so of course, all the nursing students jumped into action and they hooked me onto our monitors, and I had like a pulse, uh, pulse ox of 88%, and my heart rate was nearly 200.
• 3:36
  SPEAKER_01: So they took me to the ED.
• 3:38
  SPEAKER_01: And of course, by the time I got into the ED and triaged, it was fine, but they like left me in the ED for a little bit and he came in and I'm like telling him, and he's like, So it just sounds like anxiety, like you're giving a presentation, you just got a little anxious.
• 3:53
  SPEAKER_01: And I was like, No, it really doesn't feel like that to me.
• 3:58
  SPEAKER_01: I'm like in my nursing scrubs, like I'm in my nursing, I'm with nursing students.
• 4:03
  SPEAKER_01: Like you would think, like I'd maybe be given a little bit of credit.
• 4:07
  SPEAKER_01: And he was about to discharge me, and but I was still on the monitor, and all of a sudden it starts alarming, and it's again like 190, and I'm like, I feel it, I can feel it.
• 4:16
  SPEAKER_01: And he's like, Yeah, yep, let's give you some of this Metobrolol here.
• 4:22
  SPEAKER_01: Let's calm that.
• 4:24
  SPEAKER_03: Yeah, also a pulse box of 88%.
• 4:28
  SPEAKER_03: Right.
• 4:28
  SPEAKER_02: That don't just look, I mean, you have your patient, and then you have these other vitals, like you got to look at the whole picture here.
• 4:35
  SPEAKER_02: Was he dismissing you calling it anxiety before putting you on the monitor or after putting you on the monitor or both?
• 4:41
  SPEAKER_01: So the first set of vitals were at the nursing school, and then when we got there, it had like gotten better because it would be like brief episodes, like it would break.
• 4:51
  SPEAKER_01: But it was it was really dismissive because he was like, I don't think you were right, but I have like my whole like project group, and they're all like, No, we all saw it, like we all saw it.
• 5:02
  SPEAKER_01: He was like, you know, they're not that accurate, like those at the nursing school, and so it's just like so it was just like everything we said, he was like dismissing, like, no, no, no.
• 5:17
  SPEAKER_01: And it was so I can understand how that can feel.
• 5:20
  SPEAKER_01: Like you keep bringing something up, and it's like, no, no, no.
• 5:26
  SPEAKER_01: So I I do understand what it feels like.
• 5:30
  SPEAKER_01: And I think for me, what helps was having my classmates there that saw it and were like, no, what we saw was real.
• 5:41
  SPEAKER_01: Because I think if I had been alone, I would have been like, Yeah, I guess I don't know.
• 5:45
  SPEAKER_03: It was nice that you had advocates there with you, and I think that's important too.
• 5:48
  SPEAKER_01: Yeah.
• 5:49
  SPEAKER_03: So I can appreciate the first part of that where it was like, okay, maybe you can cut back on the caffeine, maybe you can do this because that's that's reasonable, right?
• 5:58
  SPEAKER_03: We're not just jumping to like giving you all these medications.
• 6:00
  SPEAKER_03: No, right.
• 6:02
  SPEAKER_03: Um, but I also think as a nurse and as a person who's received healthcare, there do seem to be, I won't say only physicians, but like physicians and providers who it seems like that's their natural response.
• 6:14
  SPEAKER_03: It's almost like no matter what I say, it's gonna be well, it's probably not that.
• 6:18
  SPEAKER_03: And I don't know why that is, that's a personality trait of the I think so for a lot of people.
• 6:24
  SPEAKER_03: And it's really easy because I'm like, yeah, like why would you go into a field where your job is literally to help people if you're not even gonna listen to it?
• 6:31
  SPEAKER_01: And listen and listen.
• 6:33
  SPEAKER_01: And it's I don't get it.
• 6:35
  SPEAKER_01: I don't either, because in NP school for me, it's like one of the things that they taught, like you get these histories, and I was taught ask, ask what they think it is, because you'd be shocked how often patients are accurate.
• 6:49
  SPEAKER_01: Like, even my mom last year, she called me and she was like, I just threw up and I'm I I have this bad stomach pain.
• 6:57
  SPEAKER_01: And I'm like, I don't like, I'm like, it could be so many things.
• 7:00
  SPEAKER_01: What do you feel like it could be?
• 7:01
  SPEAKER_01: She's like, I think it's my appendix.
• 7:03
  SPEAKER_01: And I was like, Okay, go to the hospital.
• 7:05
  SPEAKER_01: And when she eventually went to the hospital, which is another part of the story for a different day.
• 7:11
  SPEAKER_01: But when she did go to the hospital, it was her appendix, and it's like you would be shocked how often, like as a patient, they know like there's just something in her body that's like, it is this.
• 7:28
  SPEAKER_03: And it's so dangerous though to dismiss people like that because it was just anxiety.
• 7:34
  SPEAKER_03: Well, now they're probably gonna have anxiety about going to the doctor.
• 7:38
  SPEAKER_03: And maybe they won't go seek care the next time and it's something real.
• 7:42
  SPEAKER_03: So it's just it really does, it really bothers me when I hear patients and family members or other people say that that has happened to them.
• 7:50
  SPEAKER_03: And you know, they might be crazy pants and it might and it might be nothing, or maybe they come in the hospital all the time, or maybe it is just anxiety, but either way, we still have to treat them, we have to listen to them.
• 8:00
  SPEAKER_02: Listen to them.
• 8:00
  SPEAKER_02: And every patient's symptoms are gonna be different.
• 8:03
  SPEAKER_02: I mean, we deal with a lot of MIs, and not everybody has the same kind of symptom, and that's why we go in and say, tell me about your day.
• 8:10
  SPEAKER_02: When did this start?
• 8:11
  SPEAKER_02: How long has it been going on?
• 8:12
  SPEAKER_02: Were you sweaty?
• 8:13
  SPEAKER_02: Were you diaphragic?
• 8:14
  SPEAKER_02: Were you short of breath?
• 8:15
  SPEAKER_02: Were you and not everybody's been experienced that?
• 8:17
  SPEAKER_02: Some people are gonna have just abdominal issues, especially in some of the female um population.
• 8:23
  SPEAKER_02: And you can't just lay a bunch of, you know, everything is black and white.
• 8:29
  SPEAKER_02: There's so much gray to our job.
• 8:31
  SPEAKER_02: And patients know their bodies better than we do.
• 8:34
  SPEAKER_02: Yeah, we're there as providers and nurses to take care of them, but we don't know their body.
• 8:39
  SPEAKER_02: We don't live inside of them.
• 8:41
  SPEAKER_02: No.
• 8:42
  SPEAKER_03: And how many times have you been humbled when you've had a patient like that and they're like saying their chest hurts or whatever it is?
• 8:48
  SPEAKER_03: And I'm like, I think they're just maybe they're having some anxiety because they did have a heart attack, right?
• 8:52
  SPEAKER_03: And now they're freaking out over every little thing, or something like that happens, and you're just like, oh, it's probably just this or whatever, and then whatever happens, and you were completely wrong, and something big happened, and you're like, oh, ooh, that could have been bad because no matter what, I'm still gonna record it, we're still gonna treat it.
• 9:09
  SPEAKER_03: But in my head, maybe I've had a thought like they are really just wiggle out, this is not, and then it's like, oh my god, their LED has closed all the way down, like that.
• 9:17
  SPEAKER_03: And so, you know, things like that happen, and it really puts it into perspective where it's like, I need to cut that out.
• 9:24
  SPEAKER_02: I just need to cut that out.
• 9:25
  SPEAKER_02: And it's easy to do as humans.
• 9:27
  SPEAKER_02: I mean, it's like the boy that cries wolf, right?
• 9:29
  SPEAKER_02: Like that whole story, the little story you learn when you're little, but um, especially people who may be on the call bell often or have a lot of ailments, and you know, they'll end up telling you I'm a hypochondriac, and you're like, Oh, okay.
• 9:44
  SPEAKER_02: So, you know, it it can be very easy to dismiss sometimes.
• 9:48
  SPEAKER_01: Yes.
• 9:49
  SPEAKER_01: And I'm sure outpatient with all of the like my chart messages, like just the constant.
• 9:55
  SPEAKER_01: Uh, even with my family, like I'll get sent to labs and they're like, they won't do anything about this lab.
• 10:03
  SPEAKER_01: And I'm like, well, I mean, it's just barely out of the normal.
• 10:06
  SPEAKER_01: Like, there is some there's a way to approach it and educate on why we might not be working something up because sometimes those workups are millions of dollars.
• 10:17
  SPEAKER_01: And yeah, that if you can't justify to insurance why, you know, oh, the potassium's a little bit out of range and the kidney function's a little bit out of range, why you're doing a million-dollar workup now, as opposed to monitoring if there's no symptoms, but that's on us to educate on that.
• 10:39
  SPEAKER_01: Like this is where where you have to monitor this, see, you know, it could just be a lab error, and that's sometimes the case.
• 10:47
  SPEAKER_01: But I think to just dismiss someone's concerns or feelings, especially with my chart now, or all of the access to the charts, and they see like a red number, and it's like it's like, oh, yeah, there's a lot more of those questions, and it takes more time and energy for the providers, but I think we need to do that.
• 11:10
  SPEAKER_03: Um yes, and and and do it in a way where it's like, look, I'm not like you said, I'm not dismissing your concerns.
• 11:18
  SPEAKER_03: I'm just letting you know that like that's okay.
• 11:21
  SPEAKER_03: And like this is why.
• 11:22
  SPEAKER_03: So yeah, that's right, you know.
• 11:24
  SPEAKER_02: And you know, sometimes you'll have patients or family members that'll be looking up at the monitor and they're like, Oh yeah.
• 11:30
  SPEAKER_02: I said, Look, if I'm not moving fast, you don't have anything to worry about.
• 11:35
  SPEAKER_02: You know, and it because it can be worrisome hearing bells all day.
• 11:41
  SPEAKER_02: It can be for us.
• 11:42
  SPEAKER_02: I can't imagine it's a patient who's not used to it or a family member of the patient.
• 11:46
  SPEAKER_02: Yeah, oh yeah, yeah, that can definitely increase anxiety for sure.
• 11:50
  SPEAKER_01: But if you're feeling dismissed, there's ways that we can all approach it too.
• 11:55
  SPEAKER_01: We can, and I I I want to say violence is never the answer, aggression is never the answer.
• 12:04
  SPEAKER_01: That's right.
• 12:05
  SPEAKER_01: You shouldn't feel dismissed, but we live in a world where healthcare workers are attacked every single day, and the quickest way I can tell you, the quickest way to not have things addressed is getting aggressive.
• 12:20
  SPEAKER_01: Like the correct is it is so triggering on so many levels, and we feel so unsafe a lot of the time that it is the quickest way for me to like I'm I'm going to back out, I'm going to collect my thoughts, probably call security, and then once security's here, then I'm going, I can come in and address things with you.
• 12:44
  SPEAKER_01: Or like in the hospital, it's the quickest way to get you kicked out, to get that family member kicked out.
• 12:51
  SPEAKER_01: And that happens.
• 12:52
  SPEAKER_01: It does.
• 12:54
  SPEAKER_03: It does.
• 12:55
  SPEAKER_01: Like my last facility, if you were kicked out, you were kicked out for life.
• 13:00
  SPEAKER_01: The only way you could come back into the hospital would be if you were coming in through the ED, and that's because as a patient, and that's just because of federal laws.
• 13:10
  SPEAKER_01: But you would get kicked out, you would never be allowed to come and visit any family, whether they're dying or not.
• 13:18
  SPEAKER_01: Like you were fully trespassed.
• 13:20
  SPEAKER_01: Like they would wow, they would, yeah.
• 13:22
  SPEAKER_01: Like you were fully trespassed.
• 13:24
  SPEAKER_02: Not even just for that foreign to me for your family member, but like for multiple family members for like that's crazy.
• 13:31
  SPEAKER_02: Yeah.
• 13:32
  SPEAKER_03: Part of me wants to be like, that's great.
• 13:33
  SPEAKER_03: And part of me wants to be like, well, that seems extreme, I guess.
• 13:36
  SPEAKER_03: Well, right.
• 13:37
  SPEAKER_02: That's how I feel too.
• 13:38
  SPEAKER_02: And I say that's crazy.
• 13:39
  SPEAKER_02: It's like, oh, I have lots of thoughts about that on both sides.
• 13:42
  SPEAKER_02: No.
• 13:43
  SPEAKER_03: But then it's like they're they're really taking it to the mat to like protect the people that work there.
• 13:48
  SPEAKER_01: So to get trespassed though, you really had to you must have acted out.
• 13:52
  SPEAKER_03: You had to with the capital way.
• 13:55
  SPEAKER_03: Yeah.
• 13:55
  SPEAKER_03: And I I'm glad you said that because you know, getting violent, like you said, whether it's physically, verbally, like you you just I can empathize, I think, and understand how you could get to that point.
• 14:07
  SPEAKER_03: Like I've had points where I feel like I'm gonna scream because nobody's listening or nothing's happening.
• 14:12
  SPEAKER_03: No um but you know, we we just can't do that.
• 14:17
  SPEAKER_03: And I hate it for people, but yeah, that's the quickest way to actually probably it's gonna delay whatever you were trying to do.
• 14:24
  SPEAKER_03: Yes, um, so yeah, you just can't do that at all.
• 14:29
  SPEAKER_01: This is the quickest way, as Kaylee said, getting delayed.
• 14:34
  SPEAKER_01: And delays it can can make a big difference.
• 14:38
  SPEAKER_01: It's even a short delay, it can make a big difference.
• 14:42
  SPEAKER_03: So, like for us in the hospital, let's just say if you're a family member and you're you're you feel like your concerns are not being addressed, and you talk to your nurse, the provider, you know, the I think and like the healthcare workers, like the nurses might get mad at me for saying this, but if you're on the other side, you just ask for the next person up.
• 15:01
  SPEAKER_03: There's always somebody that it can escalate to who can come talk to you.
• 15:05
  SPEAKER_03: Yeah.
• 15:05
  SPEAKER_03: And that way the nurse and the provider they can continue like doing what they need to do, and then someone else can come in.
• 15:11
  SPEAKER_03: So you can ask for some places, like I think Abby has said before, they have patient advocates.
• 15:16
  SPEAKER_03: You can talk to the charge nurse, you can ask for a supervisor, whoever that is in your facility.
• 15:21
  SPEAKER_03: There's usually like somebody that deals with patient experience, that kind of thing.
• 15:25
  SPEAKER_03: And you know, I think as a nurse, like every time I hear that I automatically like cringe because I'm like, ugh, this is gonna be tough.
• 15:31
  SPEAKER_03: But if that's what you have to do, get to feel heard or like feel like somebody's listening to you, that's what you have to do.
• 15:38
  SPEAKER_03: Yeah.
• 15:39
  SPEAKER_03: So you just need to say, like, I want to speak to your supervisor.
• 15:41
  SPEAKER_03: And if someone else comes in and you don't feel like that was enough, you say, I want to speak to your supervisor.
• 15:45
  SPEAKER_03: You just keep taking it up, and that's okay.
• 15:47
  SPEAKER_03: That's what you need to do.
• 15:48
  SPEAKER_03: And then the people at the bedside can still be doing what they need to do in taking care of the patients.
• 15:53
  SPEAKER_02: I think some people, I think that's great advice, and I think that's exactly what you should do.
• 15:57
  SPEAKER_02: But I think there's so many people, and I hear whether it's my family or patients' families, they say, Well, it's what the nurse said, and so, or it's what the doctor said, or I don't want to question anything.
• 16:08
  SPEAKER_02: I think it takes a certain personality too.
• 16:11
  SPEAKER_02: Like there's a lot of peacemakers out there who don't want to ruffle feathers and want to trust the process.
• 16:15
  SPEAKER_02: And I think that's beautiful, and we should be able to do that.
• 16:18
  SPEAKER_02: But if something just doesn't feel right, something's, you know, something it's not if you can advocate for your person in a better way to get something done, you should absolutely do that.
• 16:28
  SPEAKER_02: And it might feel uncomfortable, but you gotta do it.
• 16:31
  SPEAKER_02: Yeah.
• 16:33
  SPEAKER_01: And there's some facilities, even this conversation is reminding me, there's some facilities that have a code activation for the patients.
• 16:45
  SPEAKER_01: Um, so there was it it was out of Johns Hopkins.
• 16:49
  SPEAKER_01: It's a very known story.
• 16:51
  SPEAKER_01: Um, it was an 18-month-year-old Josie King, and unfortunately suffered second-degree burns, I believe it was, from um bath water.
• 17:03
  SPEAKER_01: I don't know the story behind that.
• 17:06
  SPEAKER_01: Um it was at Johns Hopkins and ended up unfortunately passing away from dehydration.
• 17:15
  SPEAKER_01: And the family had kind of asked some things, but didn't feel like they were being listened to or that things were being missed, like and that they, you know, they're at Johns Hopkins.
• 17:27
  SPEAKER_01: So who are they to question Johns Hopkins?
• 17:31
  SPEAKER_01: And I think we all know that that's a very renowned facility, and that that does come sometimes with it.
• 17:39
  SPEAKER_01: Like no one might be even like making you feel bad.
• 17:43
  SPEAKER_01: You just might even be dismissing yourself and like I am at this world-renowned facility that people talk about.
• 17:51
  SPEAKER_01: So it's like they're at Johns Hopkins of all hospitals, and they didn't feel like they could, or they had said things, but they weren't listened to.
• 18:00
  SPEAKER_01: And uh, so she unfortunately passed, and the family's done a lot around patient advocacy, and there's a lot of different things that they've implemented, but one of it, and they've been at facilities that have implemented it, and it is a number that you can call that's like I really think that something is terribly, terribly wrong, and no one's listening to me, and it will activate like a code, and you call it, and it's just like a code in the hospital.
• 18:29
  SPEAKER_01: And I think a lot of people when it got implemented, we were like, oh god, this is gonna go off all of the time.
• 18:36
  SPEAKER_01: But you'd be it was very surprising.
• 18:39
  SPEAKER_01: I think I only saw it twice.
• 18:41
  SPEAKER_01: And one was legit.
• 18:43
  SPEAKER_03: Yeah.
• 18:43
  SPEAKER_03: I mean, I I I you know, I'm I'm with you.
• 18:46
  SPEAKER_03: I'd be like, oh god.
• 18:48
  SPEAKER_03: But like we are only one person, and if we're in a room with our other patient or something has legitimately happened, like we know what should happen.
• 18:53
  SPEAKER_03: It's like I tell my patients, I can see your monitor.
• 18:56
  SPEAKER_03: This nurse can see your monitor, those nurses over there can see your monitor.
• 18:59
  SPEAKER_03: Like, somebody's always gonna see if something's going on, and that is what should happen.
• 19:02
  SPEAKER_03: But we all know there are things times everybody is busy, they have their hands literally in something, so it is kind of nice to think that there is like a safety net there, especially if I was somewhere where my child was the patient.
• 19:16
  SPEAKER_03: Like, I don't think there's anything I I wouldn't do to make sure that my child was getting the short of obviously I'm not gonna be physically assaulting anybody or anything, but I think that's great.
• 19:27
  SPEAKER_03: I've had family members call the emergency response line.
• 19:30
  SPEAKER_03: Yeah, I mean because it was posted in the room, and it was never for something that was an emergency, just to be clear.
• 19:36
  SPEAKER_03: Yeah, a couple of times it was because they needed to go to the bathroom and it was taking too long.
• 19:41
  SPEAKER_03: But I'm like, then the emergency response team will call and be like, hey, this person like all from the room.
• 19:45
  SPEAKER_03: I'm like, let me go.
• 19:48
  SPEAKER_01: I think that's like what Amanda kind of touched on, though, too.
• 19:51
  SPEAKER_01: Like the little boy that cried wolf.
• 19:54
  SPEAKER_03: Like I'm gonna be like, You can't call this because they need to get on the dead paper.
• 19:59
  SPEAKER_01: This is actually the staff assist emergency.
• 20:01
  SPEAKER_02: We don't have the staff assist, even though you need assist from the staff.
• 20:05
  SPEAKER_02: The staff doesn't need the assistance.
• 20:07
  SPEAKER_02: Yeah, that's so scary.
• 20:10
  SPEAKER_03: Oh my gosh.
• 20:11
  SPEAKER_03: I mean, luckily those pay those times that those have happened, nothing bad had happened.
• 20:15
  SPEAKER_03: Right.
• 20:15
  SPEAKER_02: At least it's like oh, okay, it got even worse.
• 20:21
  SPEAKER_03: I'm just thinking that.
• 20:24
  SPEAKER_03: But yeah, um, I do think you're right.
• 20:26
  SPEAKER_03: A lot of patients and family members do self-dismiss where they're like, well, they told us so, so it must be right, or yeah, you know.
• 20:33
  SPEAKER_01: Having worked in some like really, really big name facilities too, like you cannot let the name of a facility or your trust in a facility allow you to self-dismiss.
• 20:45
  SPEAKER_01: And I it's great that you trust it and that these facilities do have names for a reason and that you can trust them.
• 20:53
  SPEAKER_01: But at the end of the day, everyone in healthcare is still a human.
• 20:56
  SPEAKER_02: Like and you should trust where your facility, like your closest facility, is you should be able to trust it.
• 21:02
  SPEAKER_02: You should be able to trust all your physicians, your mid-levels, your nurses, your nursing assistants, like everybody.
• 21:08
  SPEAKER_02: But again, we are all human.
• 21:09
  SPEAKER_01: Yeah, we're human.
• 21:11
  SPEAKER_01: We have checks and balances in healthcare for a reason, but it that still messes up.
• 21:17
  SPEAKER_01: Like even AI, even charts.
• 21:20
  SPEAKER_01: Like I just had one where they, you know, someone came in unknown and we found the original chart, but then the system merged the wrong patient's chart.
• 21:32
  SPEAKER_01: So we still didn't have the right chart.
• 21:35
  SPEAKER_01: So then we had the unmerge, and that's a huge deal.
• 21:39
  SPEAKER_01: That's yeah.
• 21:41
  SPEAKER_01: But big deal.
• 21:42
  SPEAKER_01: And that was just the technology, the technology messed up.
• 21:46
  SPEAKER_03: But you verify everything in that chart with the patient with a family.
• 21:48
  SPEAKER_03: That's why you check their allergies when they come in.
• 21:52
  SPEAKER_03: That's right.
• 21:53
  SPEAKER_02: You check the new armband.
• 21:54
  SPEAKER_02: Yeah, you you know, you get a new armband in this facility at our facility coming from another facility.
• 22:00
  SPEAKER_02: I'm still gonna say, hey, tell me your name, tell me your birthday every time.
• 22:04
  SPEAKER_01: And sometimes it's I will say in the ICU, I can get very focused on what I'm seeing.
• 22:13
  SPEAKER_01: And then if family is talking to me about something, like it will put a little seed in my head that I might have to like circle back to.
• 22:20
  SPEAKER_01: But if something is actively going on with the patient that I'm trying to fix, like it's not that I'm dismissing you, it's that I'm very zeroed in on the patient.
• 22:32
  SPEAKER_02: Well, and we can just say that to them too.
• 22:34
  SPEAKER_02: Like just give them that reassurance, like, hey, this is a big deal that's going on right now.
• 22:39
  SPEAKER_02: You're what you're saying is important to me, but I do need to address this right now.
• 22:43
  SPEAKER_02: As long as you just tell them and I literally had to do that.
• 22:46
  SPEAKER_03: Yeah.
• 22:46
  SPEAKER_03: We were trying to check off some blood.
• 22:47
  SPEAKER_03: And like the patient was fine, but there was a lot going on, and we needed to get the blood going.
• 22:53
  SPEAKER_03: And I I wasn't the primary nurse, it was a charge nurse, but we were trying to check it off, trying to check it off.
• 22:58
  SPEAKER_03: And then the family member showed up right then and was a lot had happened.
• 23:03
  SPEAKER_03: And she was like, Well, what's the plan?
• 23:05
  SPEAKER_03: What about this?
• 23:05
  SPEAKER_03: What about this?
• 23:06
  SPEAKER_03: And I was like, I'm gonna give us just a second, just give us just a second.
• 23:09
  SPEAKER_03: Finally, I had to be like, I we're gonna check this blood off, and it's we're gonna take five minutes, and then I'm gonna come over there, I'm gonna sit with you, and I'm gonna give you a full rundown of everything that I missed.
• 23:17
  SPEAKER_03: I was like, if you'll just give us a minute, because this is like we have to be like very specific with this and pay attention.
• 23:22
  SPEAKER_03: So that was crazy.
• 23:23
  SPEAKER_03: She was like, Okay, thank you.
• 23:25
  SPEAKER_03: Um, and that's what I had to do, and I was like, I'm sorry, I didn't mean to like push you away, but like this is something really serious, and we have to do like these checks and be focused.
• 23:33
  SPEAKER_03: And she got it.
• 23:34
  SPEAKER_03: And sometimes it's just that much.
• 23:36
  SPEAKER_03: And I I can understand like what you're saying, Abby.
• 23:38
  SPEAKER_03: If you're dealing with an emergency or something is happening, I think that is probably for us the times when we might quote unquote make somebody feel dismissed.
• 23:46
  SPEAKER_03: Because it's just right now, my time and energy has to be on this emergency thing.
• 23:52
  SPEAKER_03: I'm putting this needle in your body.
• 23:53
  SPEAKER_03: I'm I'm giving this medication, I need to make sure it's right, I'm programming this pump.
• 23:57
  SPEAKER_03: Or this we can talk to them.
• 24:00
  SPEAKER_02: When I we had to start chest compressions and I had to excuse the family member out of the way swiftly, you know, you just gotta do it sometimes.
• 24:12
  SPEAKER_02: Yeah.
• 24:12
  SPEAKER_01: I think part of for those that are in healthcare, I think the key to take from this is the circle back, right?
• 24:19
  SPEAKER_01: In those moments.
• 24:20
  SPEAKER_01: Don't just do it and then leave them hanging, like circle back.
• 24:24
  SPEAKER_01: And if you say you're going to come back, come back.
• 24:27
  SPEAKER_01: I know the I know the nurse and we might forget sometimes.
• 24:31
  SPEAKER_01: Like we forget we might we might feel bad.
• 24:34
  SPEAKER_03: Yeah.
• 24:34
  SPEAKER_03: And I do think that they're like, you said you were coming back with that, and you never came.
• 24:37
  SPEAKER_03: I'm like, and you're right, you're right.
• 24:39
  SPEAKER_03: Sorry.
• 24:40
  SPEAKER_04: Right.
• 24:42
  SPEAKER_03: And it's like, I am so sorry.
• 24:44
  SPEAKER_03: I I did.
• 24:46
  SPEAKER_01: But you know, it happened.
• 24:48
  SPEAKER_01: We're all human.
• 24:50
  SPEAKER_01: We are all human.
• 24:51
  SPEAKER_01: I will say, I was the big when I was a bedside nurse, I was in charge of implementing purposeful rounding, hourly rounding.
• 25:03
  SPEAKER_01: For sure.
• 25:05
  SPEAKER_02: Should be should be coming up with it all, y'all.
• 25:08
  SPEAKER_02: She'd be doing it.
• 25:09
  SPEAKER_02: She'd be coming up with it.
• 25:10
  SPEAKER_02: Every time Abigail's up, she's like, I have this idea.
• 25:12
  SPEAKER_02: All her coworkers are like, but it's not just an idea, it's a proper thought-of, proper written out with the objectives and the plan and the commitment.
• 25:22
  SPEAKER_03: How we're gonna measure the outcomes.
• 25:24
  SPEAKER_02: It is, it's just some funny professional because she is so she's so professional.
• 25:29
  SPEAKER_02: This Abigail.
• 25:30
  SPEAKER_03: Oh my god.
• 25:31
  SPEAKER_03: Do you remember when we had this hourly rounding thing and we had these magnets on the door and they wanted us to go and it would go from like eight, nine.
• 25:39
  SPEAKER_03: Yes, they wanted us to go move it every hour.
• 25:41
  SPEAKER_03: And I'm like, oh yeah, it would be 12 o'clock, and I'd I'd be like, oh shoot, let me go move it to one.
• 25:46
  SPEAKER_03: It's like it was such a funny way of trying to implement the hourly rounding.
• 25:50
  SPEAKER_03: I'm like, I could just go like how do you know?
• 25:53
  SPEAKER_03: Like every I've walked in this door 50 times and I haven't moved it.
• 25:57
  SPEAKER_03: Right.
• 25:58
  SPEAKER_03: I've been in here.
• 25:59
  SPEAKER_02: Right.
• 25:59
  SPEAKER_02: Like, don't you like how we just interrupted her whole story?
• 26:02
  SPEAKER_02: Can't even let her get a word in.
• 26:04
  SPEAKER_02: We just all right, sorry, Abby.
• 26:06
  SPEAKER_01: Go ahead.
• 26:06
  SPEAKER_01: That's that's a silly way to implement it.
• 26:09
  SPEAKER_02: I was just gonna say, I'm sure that's what you're gonna say.
• 26:13
  SPEAKER_01: That's a silly way to implement.
• 26:16
  SPEAKER_02: Let's let's hear your let's hear yours.
• 26:18
  SPEAKER_02: Because I remember you telling me about that at work one day, but I don't remember how you went about it.
• 26:21
  SPEAKER_01: I was just gonna say when I did it, like I really did do it like every hour I went in the rooms.
• 26:26
  SPEAKER_01: And just to highlight how big the circle back can be, I just have this kind of core memory as I was implementing it and being like, should I keep doing this?
• 26:37
  SPEAKER_01: It really motivated me to really push it.
• 26:40
  SPEAKER_01: But I went into the room and I did all my checks, and I said to the patient, okay, I'll be back in an hour.
• 26:46
  SPEAKER_01: And she just looked at me and she's like, You you really are going to be back in an hour, huh?
• 26:51
  SPEAKER_01: And I was like, Yeah, I I am.
• 26:54
  SPEAKER_01: And she's like, Cause you keep saying it and I keep thinking you're not, and then you keep you keep coming back.
• 27:01
  SPEAKER_02: And I was like that actually makes me want to cry.
• 27:03
  SPEAKER_02: And I that just kind of gave me chills.
• 27:05
  SPEAKER_01: And I was like, Yeah, uh, yeah.
• 27:08
  SPEAKER_01: Like, yes, we're all human.
• 27:10
  SPEAKER_01: There are times in those hourly roundings.
• 27:12
  SPEAKER_01: I forgot to bring the pain meds.
• 27:13
  SPEAKER_01: I'd walk in and they'd be like, pain meds.
• 27:15
  SPEAKER_01: I'm like, oh shoot, let me go back out and get it.
• 27:18
  SPEAKER_01: But yeah, just this is just the simple like consistency for our healthcare workers, like it really can make a difference.
• 27:27
  SPEAKER_02: There are lots of people in the world where people tell them they're going to do something and they don't do it.
• 27:33
  SPEAKER_02: So you carry that into wherever you go, wherever you're if you're a patient or at work, or you know, you have to build trust with these people.
• 27:40
  SPEAKER_02: And we're taking care of strangers, we're strangers to them.
• 27:43
  SPEAKER_02: And that's right.
• 27:45
  SPEAKER_02: They can't necessarily, you know, some people you're guilty until proven innocent, and some people you're innocent until proven guilty.
• 27:52
  SPEAKER_02: But, you know, I'm sure she had her own situations and experiences.
• 27:57
  SPEAKER_02: So I'm sure that meant so much to her.
• 28:00
  SPEAKER_02: Did you ever have a patient that were like, Can you leave me alone?
• 28:02
  SPEAKER_03: Like, I mean, I'm not gonna make a nap.
• 28:03
  SPEAKER_03: Don't come in here.
• 28:04
  SPEAKER_03: Yeah, I'm gonna nap.
• 28:06
  SPEAKER_04: Yeah, yeah.
• 28:06
  SPEAKER_03: I say I try to like I feel like every hour, like, unless I'm really busy in another room and I just can't get in there.
• 28:13
  SPEAKER_03: Like, I feel like I'm in my rooms every hour no matter what.
• 28:15
  SPEAKER_01: I can do a whole part, I can do a whole education.
• 28:18
  SPEAKER_01: And it it's a bee in my bonnet, I guess, as you guys would say in the south.
• 28:23
  SPEAKER_01: Be in my bonnet.
• 28:25
  SPEAKER_02: Wait a second.
• 28:26
  SPEAKER_02: Wait, wait, wait.
• 28:26
  SPEAKER_02: She took it back.
• 28:27
  SPEAKER_02: Yeah, she got to be in her bonnet about that.
• 28:29
  SPEAKER_02: Like, like a literal bee in your in your bonnet.
• 28:32
  SPEAKER_03: Yeah, it's like a way of saying, like, she's all worked up over this, or it's like she gotta be in her bonnet.
• 28:36
  SPEAKER_02: I don't know if I've heard that, y'all.
• 28:38
  SPEAKER_03: I out southern view.
• 28:40
  SPEAKER_02: That's a don't get excited.
• 28:42
  SPEAKER_02: It's the first and only.
• 28:43
  SPEAKER_02: Be in my bonnet.
• 28:44
  SPEAKER_03: Maybe I've heard it.
• 28:46
  SPEAKER_03: Pebble in your shoe.
• 28:48
  SPEAKER_03: Pebble in your shoe.
• 28:48
  SPEAKER_02: See really um what's the other thing?
• 28:52
  SPEAKER_03: Like all these are like chats my ass.
• 28:56
  SPEAKER_03: Like, what are all these white people saying?
• 28:57
  SPEAKER_03: It's like, yeah.
• 28:59
  SPEAKER_01: That really I've come up with my own, which is Lego under my foot.
• 29:06
  SPEAKER_02: Oh, that's a real thing.
• 29:07
  SPEAKER_01: Oh thorn in my side.
• 29:10
  SPEAKER_02: Okay, I know that one.
• 29:11
  SPEAKER_02: I know that one.
• 29:11
  SPEAKER_02: A thorn in my side.
• 29:13
  SPEAKER_01: But purposeful rounding is has been implemented so poorly, so many places.
• 29:18
  SPEAKER_01: So when I did do it, it I could do a whole, I actually have like an hour-long lecture on this.
• 29:24
  SPEAKER_01: So we could I could just do a whole education.
• 29:26
  SPEAKER_03: I've been surprised.
• 29:28
  SPEAKER_03: Nobody's around though.
• 29:30
  SPEAKER_03: That's true.
• 29:30
  SPEAKER_03: Because I that benefits the patient and me.
• 29:33
  SPEAKER_03: It does.
• 29:33
  SPEAKER_03: I'm in here.
• 29:34
  SPEAKER_03: I'm like, what else do you need?
• 29:35
  SPEAKER_03: Do you want some ice?
• 29:36
  SPEAKER_03: Do you want some water?
• 29:36
  SPEAKER_03: Pay meds, a blanket.
• 29:38
  SPEAKER_03: I'm gonna go get everything.
• 29:39
  SPEAKER_03: So, what do you need?
• 29:40
  SPEAKER_03: I'm gonna bring it all back in here because then I'm gonna go.
• 29:46
  SPEAKER_02: I want to know everything.
• 29:47
  SPEAKER_02: I don't want to be back and forth.
• 29:48
  SPEAKER_01: I'm like, buddy.
• 29:49
  SPEAKER_01: But the the consistency and that building of trust, I think is the other key part for the healthcare providers listening.
• 29:58
  SPEAKER_01: Like it compassion fatigue is real, burnout is real, but maintaining that trust can also help make our jobs a little bit not easier, but I guess more fulfilling in that way of like they do trust you and they're not that had to make you feel so good.
• 30:16
  SPEAKER_01: It did.
• 30:17
  SPEAKER_01: It was also came at like the perfect point where I was like, I don't know if this is working.
• 30:22
  SPEAKER_01: Like, I don't know, I don't know, like in that self-doubt moment.
• 30:26
  SPEAKER_01: And then that, and then she said that, and I was like, Oh man, it is working.
• 30:29
  SPEAKER_01: Okay.
• 30:30
  SPEAKER_02: See, I'm telling you, that's the that's the woo-woo, you gotta listen to those are your little affirmations, like, okay, this is why I'm doing what I'm doing.
• 30:38
  SPEAKER_02: I gotta keep going.
• 30:39
  SPEAKER_03: I'm glad that happened just when that when that happens.
• 30:42
  SPEAKER_03: I love it though, because I think do what you say, say what like do what you say you're gonna do, mean what you say, say what you mean, you know, like all that.
• 30:49
  SPEAKER_03: And everybody's that makes a mistake, like you said, or you might get busy.
• 30:51
  SPEAKER_03: But if you establish that relationship with your patient, if you're able to, then they'll they'll know that like you're gonna take care of them.
• 30:58
  SPEAKER_03: And maybe you don't come back, but you send somebody else in there, right?
• 31:01
  SPEAKER_03: You know?
• 31:02
  SPEAKER_03: Um, I love that.
• 31:03
  SPEAKER_01: And now I round on the nurses every hour, but that's you do starting for a different day.
• 31:10
  SPEAKER_03: We could talk about it too.
• 31:12
  SPEAKER_03: The physician came around yesterday, she was like, How's the patient?
• 31:15
  SPEAKER_03: She's like, And do you need anything?
• 31:16
  SPEAKER_03: Can I do anything for you?
• 31:17
  SPEAKER_03: I'm like, I know.
• 31:19
  SPEAKER_02: And then after the code this week, the attending who I adore was checking on us.
• 31:26
  SPEAKER_02: And I I feel like a lot of attendings do that just to make sure, you know, everybody's okay.
• 31:31
  SPEAKER_02: But the intentionality behind it, and it wasn't just a box that this person was checking, it was just very intentional.
• 31:38
  SPEAKER_01: So I appreciate us being rounded on to because healthcare workers, like for patients listening, we can feel dismissed too.
• 31:48
  SPEAKER_01: Like sometimes by each other.
• 31:52
  SPEAKER_01: Um, you know, I try, I say there were many times I called for a doctor or an NP or PA to come to my patient's room and then they didn't.
• 32:03
  SPEAKER_01: And I would feel kind of dismissed in what I was seeing by them.
• 32:07
  SPEAKER_01: So I've always said, like, if one of my nurses asks me to come to the room, I always go.
• 32:12
  SPEAKER_01: Even if I don't think I need to go, I will always go.
• 32:15
  SPEAKER_01: I will always show up if you ask me to come.
• 32:18
  SPEAKER_01: Um and sometimes just walking in, the things resolve because I'm magic.
• 32:23
  SPEAKER_03: Yeah, it's like that therapeutic um appearance.
• 32:26
  SPEAKER_03: Yeah, and I'm like, I swear it was just happening.
• 32:30
  SPEAKER_03: Right.
• 32:31
  SPEAKER_03: Making us look please believe me.
• 32:33
  SPEAKER_03: And I do think that's how we can relate to our patients a lot because it's like, no, we we go through this all the time.
• 32:38
  SPEAKER_03: And yeah, it's probably I don't know if it's probably a little bit more maybe nurses.
• 32:42
  SPEAKER_01: I I'm sure I don't know, Abby, you can say if you feel more now or less, but I think as a nurse practitioner, like I'm still not the final door like for the final stop.
• 32:53
  SPEAKER_01: You know, I being in the ICU, I have I will always have a physician and I always want a physician, as I've talked about previously, to be working with me.
• 33:02
  SPEAKER_01: So there are times that me and my physician will disagree.
• 33:08
  SPEAKER_01: There's been physicians that I've worked with in the past that I did feel dismissed on.
• 33:13
  SPEAKER_01: And then when I was right, you know me though, I was like, Uh-huh.
• 33:17
  SPEAKER_02: You just took it and went and went rub it right on in, honey.
• 33:22
  SPEAKER_02: And I'm gonna hear you say it.
• 33:23
  SPEAKER_01: I always make them say it.
• 33:25
  SPEAKER_01: I always make them say it.
• 33:27
  SPEAKER_01: And there was one physician that doesn't work with us anymore, and we kind of had this joke, like, oh, like let's do it this way, but we'll probably end up doing it your way in like three hours, anyways, because that was basically the relationship.
• 33:40
  SPEAKER_01: So I I do understand, like, there's times that I feel dismissed, there's times that I feel dismissed for the patient as well.
• 33:47
  SPEAKER_01: Where I'm like, I think we need to talk about that, but that's also why we have all of these layers, especially in these high acuity settings, is to have multiple advocates, but also teams, I will say teams can dismiss each other too.
• 34:02
  SPEAKER_01: So, like sometimes when you are calling for something another team that another team does, they will say, nah, it's fine.
• 34:10
  SPEAKER_01: Nah, you're fine, you don't need that.
• 34:12
  SPEAKER_01: And I think that happens in the outpatient world as well.
• 34:15
  SPEAKER_01: So just know sometimes your doctor, your provider might be advocating for you just as much.
• 34:23
  SPEAKER_01: And who they're trying to consult is not agreeing.
• 34:28
  SPEAKER_01: And we sometimes have the ability to consult other people, but insurance companies, like that can really limit you, especially if you're in a very like rural or like low resource area.
• 34:43
  SPEAKER_01: If the one doctor that can do that says, I don't need to see them, like what okay, like you we can't force anyone else to go, and that make that can make it really, really hard too.
• 34:56
  SPEAKER_01: So it it doesn't just happen to the patients, it happens to everyone, and I think we all need to be kinder to each other and listen more and have more communication.
• 35:07
  SPEAKER_01: Because again, it could just be like, you know, me and my doctors didn't specialize this, it's not calling out a specific team, it's just an example.
• 35:15
  SPEAKER_01: Like, we didn't specialize in kidneys, so if the kidney doctor is like, nope, don't need to see it, uh, you know, I don't have a ton to argue about, but also if you could just maybe take the five minutes to explain why, so I can explain why that would be helpful.
• 35:34
  SPEAKER_01: So it it does happen all over the place, and then I think for me, the hardest part though, I can't I'll I'll fight with anyone for my patient.
• 35:45
  SPEAKER_01: When it comes to my patient, I'll go ten toes down.
• 35:48
  SPEAKER_01: I don't that that is not a bad thing.
• 35:52
  SPEAKER_01: Absolutely.
• 35:53
  SPEAKER_01: Absolutely.
• 35:54
  SPEAKER_01: But when I get dismissed by patients, I think is a harder part.
• 36:00
  SPEAKER_01: Or when I'm like, I'm really concerned about this, they don't want to they don't want me to address it or touch on it or treat it, and that's fully within your right, but sometimes I'm like, man, I could just I could help you so much if you just some people just don't want help.
• 36:19
  SPEAKER_02: And some people are just and you try to get through to them and you just can't, and you have to, you know, you re we really do have to pour so much energy, our energy into people when we're taking care of them and when we're working with them.
• 36:32
  SPEAKER_02: But um yeah, yeah, there's just so many instances in which they're not gonna stop smoking or they're gonna eat whatever they want whenever they want.
• 36:43
  SPEAKER_02: And you know, there could be a whole a lot of issues behind all of that too, that you know, when we're taking care of them in this acute period, we can't get down into the psychology of it all.
• 36:53
  SPEAKER_03: It's really hard for patients to come to terms with how sick they are sometimes.
• 36:56
  SPEAKER_03: So it's like if I tell you, like, no, you I physically can't give you something to eat or drink because you are not strong enough to swallow it, they don't get it.
• 37:03
  SPEAKER_03: And then maybe their family's just gonna do it anyways.
• 37:05
  SPEAKER_03: I'm like, that's gonna go in your lungs, not like it's gonna cause a problem.
• 37:09
  SPEAKER_03: Or like, I would love to get you up, but you can't do it by yourself because you're probably gonna fall.
• 37:14
  SPEAKER_03: And and they just don't, you know, they just don't think of themselves as being like sick or weak.
• 37:18
  SPEAKER_03: And they try or maybe they do fall.
• 37:19
  SPEAKER_03: And it's like, I like I feel dismissed, or like they won't listen to me, and I understand why, but I'm like, You're gonna hurt yourself.
• 37:26
  SPEAKER_03: Like, you need someone has to listen to me.
• 37:28
  SPEAKER_03: You have to understand, like, I'm not trying to limit you, I'm trying to figure out how we can do it, but like you just can't get up and walk by yourself because you're gonna fall.
• 37:37
  SPEAKER_02: Or we get those STIMI patients and they get thrombolytics from the outline facility, and they come to us and they say, Well, I feel fine.
• 37:45
  SPEAKER_02: I'm going home.
• 37:46
  SPEAKER_02: I'm like, Oh no, brother, you ain't.
• 37:49
  SPEAKER_02: And these are reasons why.
• 37:50
  SPEAKER_04: Yeah.
• 37:51
  SPEAKER_02: And then I'm just they're I feel great.
• 37:53
  SPEAKER_02: I feel fine.
• 37:54
  SPEAKER_02: I'm good now.
• 37:55
  SPEAKER_02: I feel great.
• 37:55
  SPEAKER_02: I don't I don't need to be here.
• 37:56
  SPEAKER_02: And we educate all the reasons why as to why you're not going to be able to do that.
• 38:00
  SPEAKER_03: What makes me the most mad and frustrated though is the way that people dismiss like the rules.
• 38:05
  SPEAKER_03: And look, I understand it.
• 38:07
  SPEAKER_03: Visitation is hard.
• 38:08
  SPEAKER_03: You want to be in there, and if maybe, and this is something that happens every day.
• 38:12
  SPEAKER_03: And I I I understand.
• 38:14
  SPEAKER_03: You're trying to come visit your dad or your whoever that's super sick, and you have a kid and you want anybody to watch your kid, and you can't leave them at home.
• 38:21
  SPEAKER_03: So you bring them and then you get up here to the IC, and they're like, they can't come back.
• 38:24
  SPEAKER_03: How frustrating would that be?
• 38:26
  SPEAKER_03: You know what I mean?
• 38:27
  SPEAKER_03: Like, so you're really in a hard place.
• 38:28
  SPEAKER_03: But like if I go in there and say, Hey, I'm so sorry, like, you know, they're not allowed back here.
• 38:32
  SPEAKER_03: It's not me.
• 38:33
  SPEAKER_03: It's the policy.
• 38:34
  SPEAKER_03: Like, I'll get in trouble, my child, like the whole thing, and they're just like, Well, I'll be gone a little bit.
• 38:38
  SPEAKER_02: And it's like Yeah, I don't appreciate that attitude.
• 38:40
  SPEAKER_02: And if you come at with a better attitude, I mean, there's been times where I've gone out to the waiting room, which they don't need to be on there know how, but I've gone out to the waiting room and sat with that little five-year-old so that way his mom could see her father who was unwell.
• 38:54
  SPEAKER_02: So there are gonna be times that we bend, and there are gonna be times when we break rules, and there's gonna be times where we ask forgiveness instead of permission because um you can tell when you know, not every family is super close, but or friends or whatever.
• 39:09
  SPEAKER_02: Um, but you know, there definitely are times where rules just need to be bent.
• 39:15
  SPEAKER_02: Yeah.
• 39:15
  SPEAKER_03: Two at a time, switch out as much as you want, blah blah blah blah.
• 39:18
  SPEAKER_03: And then they just let and I'm like, that makes me feel distant.
• 39:22
  SPEAKER_03: It makes me feel, you know, a certain type of way.
• 39:25
  SPEAKER_03: And it is it the end of the world, no, it's not.
• 39:28
  SPEAKER_03: It's you know, there's all avenues.
• 39:30
  SPEAKER_03: I guess everybody feels that way, but I am paid, I'm I'm going to my job, so I can deal with it.
• 39:36
  SPEAKER_03: It's the patients and the families, you know.
• 39:38
  SPEAKER_03: But at the end of the day, if you or your loved one is receiving medical care and you feel dismissed for whatever reason, for whatever thing, you just keep on escalating, advocating.
• 39:49
  SPEAKER_03: We're in your corner.
• 39:50
  SPEAKER_03: That's what we're gonna do the best we can.
• 39:52
  SPEAKER_03: And don't let anybody make you feel like your needs are not important.
• 39:58
  SPEAKER_01: Because we don't know everything.
• 39:59
  SPEAKER_01: We don't.
• 40:00
  SPEAKER_01: And don't let names, titles of people, facilities m make you think that they have it all.
• 40:10
  SPEAKER_01: Like if you feel something's off, say it.
• 40:13
  SPEAKER_01: I did pull some like phrases that patients could use.
• 40:18
  SPEAKER_01: So we can maybe talk a little bit about how we feel.
• 40:23
  SPEAKER_01: So um one of the things that I pulled was I don't feel like my concern is being addressed.
• 40:29
  SPEAKER_01: And I think saying it like that in a good tone could uh could really open it up.
• 40:35
  SPEAKER_01: And I would even take it a step further.
• 40:37
  SPEAKER_01: I don't feel my concern about X is being addressed, like be specific.
• 40:42
  SPEAKER_01: Be specific.
• 40:42
  SPEAKER_01: Um be specific when you open up that conversation.
• 40:46
  SPEAKER_01: This goes into some of my communication uh studies of like it's an I statement, so it's not an attacking statement.
• 40:56
  SPEAKER_01: It's not you aren't addressing my concern, it is I, and then it is a feeling.
• 41:02
  SPEAKER_01: I don't feel like my my concern about X is being addressed in or say an actual feeling.
• 41:09
  SPEAKER_02: I feel sad, I feel frustrated.
• 41:13
  SPEAKER_02: Yeah, I feel frustrated, you know.
• 41:16
  SPEAKER_01: I feel frustrated that I still have stomach pains every day.
• 41:20
  SPEAKER_01: And I feel like my concern is not being addressed.
• 41:24
  SPEAKER_01: That is going to one make me empathize right away, like, oh gosh, okay, um, this is really impacting your life as opposed to you aren't doing this.
• 41:36
  SPEAKER_02: Yeah, it's just you're gonna get you're gonna get away.
• 41:38
  SPEAKER_02: You're not laying more with I statements.
• 41:40
  SPEAKER_03: Yeah, and I think probably we all are like us three in our lives, we know we know how to make it sound good.
• 41:50
  SPEAKER_03: We know how to use an I statement.
• 41:53
  SPEAKER_03: As much as sometimes I don't want to.
• 41:54
  SPEAKER_03: But yeah, I think that's a great like script, just something like you can say if you don't know how else to say it.
• 41:59
  SPEAKER_03: I love that.
• 42:00
  SPEAKER_01: Another thing it's if you have opened that and they kind of give you some big medical jargon, you can be like, can you please help me understand why we're not addressing X or some people really are timid about having that basically translated for lack of better words, from medical terminology to standard jargon.
• 42:22
  SPEAKER_02: You know, it's just like the layperson, how they can understand.
• 42:25
  SPEAKER_02: They just say, Okay, okay, okay.
• 42:27
  SPEAKER_02: And then sometimes in that moment, you don't know what to ask.
• 42:30
  SPEAKER_02: So even when your nurse provider of any sort come in and you have you you're kind of flooded with a bunch of information, keep something with you, whether it's the notes app on your phone or a pad and a paper, and write your questions down because you're probably gonna have questions afterwards.
• 42:47
  SPEAKER_02: And you know, we always, as nurses, love to be able to translate what physicians or mid-levels are um talking about, but sometimes even we talked to you and it doesn't make sense.
• 43:00
  SPEAKER_02: So always clarify like you're allowed to ask questions.
• 43:03
  SPEAKER_02: This is not a our way thing, this is your body, and you deserve to understand what's going on.
• 43:09
  SPEAKER_01: And then the other one that I came up with is if you are angry, if you are having big feelings, and I don't mean to like I realize that was kind of big.
• 43:21
  SPEAKER_02: That's what you do, that's what you do though.
• 43:25
  SPEAKER_01: If you are angry, if you are having big feelings, you can in the moment say, can we revisit this conversation in X amount of time?
• 43:34
  SPEAKER_01: Or if you just remove yourself and come back and say, I would really like us to revisit our conversation from earlier regarding X.
• 43:43
  SPEAKER_03: I think we're in couple therapy.
• 43:46
  SPEAKER_03: That's what I feel like.
• 43:48
  SPEAKER_03: We're teaching people how to do couple therapy.
• 43:52
  SPEAKER_02: But it's important whether it's your spouse or your partner or your, you know, your um friend and family member.
• 44:00
  SPEAKER_02: No matter who you're speaking to, your medical provider, it's just a good standard.
• 44:04
  SPEAKER_02: Uh Abby, the examples that you're giving are great examples of how to just speak.
• 44:09
  SPEAKER_01: I mean, it kinda is I mean, it is a uh it can be a very tense coupleship though between healthcare workers and the patient.
• 44:20
  SPEAKER_03: So I mean it can they'll say, like, I don't understand.
• 44:23
  SPEAKER_03: I'm like, okay, do you not understand like the actual words or do you not understand the concept?
• 44:28
  SPEAKER_03: Like, help break it down for me, what don't you understand?
• 44:30
  SPEAKER_02: Because some people have a fifth grade education.
• 44:33
  SPEAKER_02: Some people don't like where we live, you know, which I'm sure is really everywhere, but and um where we live, there are people that just don't know how to read and write, and they understand a lot more than obviously they can actually write.
• 44:47
  SPEAKER_02: But you really have to speak differently depending on your patient's education level, your patients, you know, if there's any disabilities, there's so many things to take into consideration.
• 44:57
  SPEAKER_02: So, like you're saying, Kaylee, to go back in and really clarify what it is that they don't understand is so important.
• 45:03
  SPEAKER_01: It is, and it's also my doctorate's coming through my studies.
• 45:10
  SPEAKER_01: Uh it is also like us having to switch how we talk so much, it's hard.
• 45:15
  SPEAKER_01: And it's hard if you aren't aware that you have to do it and train and practice it.
• 45:21
  SPEAKER_01: So even as a nurse, they will go from talking to a patient at their level, step outside of the room and start talking to me.
• 45:28
  SPEAKER_01: And then I want them, don't talk to me like I'm a fifth grader, talk to me like I'm a master's prepared nurse practitioner that's been doing this eight years.
• 45:37
  SPEAKER_01: Um, but I have in my studies become aware that that is hard, that is a skill that we're not taught, and it is a skill that we need.
• 45:46
  SPEAKER_01: And so sometimes we do need to be reminded like you are talking way up here, and I need you down here.
• 45:52
  SPEAKER_01: Like you're talking at your doctorate level, and I need you.
• 45:56
  SPEAKER_01: And I have to say that even to my physicians sometimes.
• 45:59
  SPEAKER_01: I'm like, you're saying that, like you're talking to for sure.
• 46:02
  SPEAKER_02: I'm like, we are on a cellular level, and I need to be on a gross level.
• 46:06
  SPEAKER_02: People want to sound really professional to their patients, and I totally get that.
• 46:11
  SPEAKER_03: I care less about you know you thinking that I know all of the big words than I care about you understanding what I'm saying.
• 46:18
  SPEAKER_02: But how do how do our patients honestly feel heard?
• 46:20
  SPEAKER_02: Think about the providers, some of the physicians, cardiologists that comes in there and they're talking, hey, hey, Mr.
• 46:28
  SPEAKER_02: Smith, uh tell me why you're here.
• 46:30
  SPEAKER_02: Oh yeah, oh yeah, where do you live?
• 46:32
  SPEAKER_02: Oh, yeah, you hunt too.
• 46:33
  SPEAKER_02: And that, you know, you just you just start getting that rapport with patients.
• 46:37
  SPEAKER_02: And I just remember one cardiologist, I think I know the late and the late and the great.
• 46:43
  SPEAKER_02: Great.
• 46:44
  SPEAKER_02: God bless, um, who I adored.
• 46:48
  SPEAKER_02: Um, but would just come in and just make these country folks feel so at ease.
• 46:55
  SPEAKER_02: And he would use sometimes he would throw those little, you know, STEMI or LED or you know, you gotta explain what that means.
• 47:02
  SPEAKER_02: But um, and we would translate, but they that man had patients that adored him, all because he related to them.
• 47:10
  SPEAKER_02: And so, as a provider, as a nurse, if you can just relate to your patients and help them feel comfortable, because we are strangers, like I said earlier, but just being able to speak on their level and meet them where they are.
• 47:23
  SPEAKER_01: I I know what one you're talking about, and he would be like, the heart's like you know, you know any plumbing, you know any plumbing.
• 47:31
  SPEAKER_02: Plumbing in the electrical session of the half.
• 47:33
  SPEAKER_02: You know the half?
• 47:34
  SPEAKER_02: You got your half, you got your electricity, and that's the heart.
• 47:38
  SPEAKER_01: So I'm gonna be fixing the plumbing.
• 47:43
  SPEAKER_03: That was great.
• 47:44
  SPEAKER_03: So I loved it.
• 47:46
  SPEAKER_03: He would draw a picture on the board.
• 47:47
  SPEAKER_03: That's so helpful.
• 47:48
  SPEAKER_02: Yeah, when some of the physicians come in and they grab the expo marker and they start drawing on the door or drawing, oh, or like after cath, and they have a picture and they have exactly what happened.
• 47:58
  SPEAKER_02: That stuff helps so much.
• 48:00
  SPEAKER_02: So physicians out there take that extra time.
• 48:03
  SPEAKER_02: I know you know it's hard to go see your patient right after cath, maybe you have one right after, but circle back afterwards and be able to speak to the family, be able to speak to the patient, really help them understand what's going on.
• 48:14
  SPEAKER_02: It's a huge and it makes a huge difference.
• 48:16
  SPEAKER_02: Yeah.
• 48:17
  SPEAKER_03: I agree.
• 48:18
  SPEAKER_03: Yeah.
• 48:18
  SPEAKER_03: I like having the statements out there disparate.
• 48:21
  SPEAKER_03: Yeah, it's always helpful.
• 48:23
  SPEAKER_01: And if anyone wants more scripts and to get my doctorate in it, I can help you.
• 48:28
  SPEAKER_03: Yeah.
• 48:29
  SPEAKER_03: Or maybe you have something.
• 48:30
  SPEAKER_03: And maybe you have to tell us what you think.
• 48:33
  SPEAKER_03: If you have stories, yeah.
• 48:35
  SPEAKER_03: If you've had an interaction as a patient or you know, with a loved one, give us your story.
• 48:42
  SPEAKER_02: How do you think one that like if there was something positive that happened or made you feel at ease, or maybe something that you didn't appreciate, both sides would be great to hear.
• 48:52
  SPEAKER_01: Yeah.
• 48:53
  SPEAKER_01: And how you addressed it, or how you might have used some of these things that we talked about.
• 48:58
  SPEAKER_01: And we hope he gives you a little bit more insight to kind of how these things affect us and our everyone's intentions in healthcare.
• 49:06
  SPEAKER_01: There are no malicious people, um, I believe in healthcare that join this to be bad.
• 49:13
  SPEAKER_01: Make sure you like, follow us.
• 49:15
  SPEAKER_01: We have our website up, banter at the bedside.com.
• 49:18
  SPEAKER_01: You can send us messages and leave us a review.
• 49:22
  SPEAKER_01: We really truly do want to hear from you.
• 49:24
  SPEAKER_01: And until next time from all of us shift talkers here at Banter at the Bedside.
• 49:29
  SPEAKER_01: Bye.
• 49:30
  SPEAKER_01: Toodaloo, yeah.
• 49:35
  SPEAKER_01: What is that?
• 49:39
  SPEAKER_01: I just felt it.
• 49:40
  SPEAKER_01: You felt it in your soul.
• 49:42
  SPEAKER_02: Yeah.
• 49:45
  SPEAKER_02: That's not the thing.
• 49:49
  SPEAKER_01: If this felt your kind of conversation, make sure you're following, leave us a review, and we'll see you back here soon.
• 49:56
  SPEAKER_01: Bye.
• 49:57
  SPEAKER_04: Step into the light where the stories come.