1 00:00:00,200 --> 00:00:05,440 Hey, what's up you guys. It is time for the final episode of 2 00:00:05,599 --> 00:00:12,039 season nine of Nursing Uncensored. This interview was recorded in June of twenty twenty 3 00:00:12,039 --> 00:00:16,679 two, and it's the last one that I recorded when Nursing Uncensored headquarters was 4 00:00:16,679 --> 00:00:21,839 still up in Minneapolis. I guess it's the perfect way to end the season. 5 00:00:22,839 --> 00:00:25,839 A lot can change in a year, and our guest for this episode, 6 00:00:25,879 --> 00:00:30,399 doctor Audrey Snyder, is a perfect example of that. At the time 7 00:00:30,440 --> 00:00:34,280 we recorded this, she was the Dean of Practice and Innovation for the College 8 00:00:34,399 --> 00:00:40,600 Nursing at the University of North Carolina, Greensboro, but she recently announced that 9 00:00:40,679 --> 00:00:46,560 she's now the Associate Dean for Community Engagement and Academic Partnerships at the same institution, 10 00:00:47,039 --> 00:00:51,439 so congratulations to her. We also talk about the new ENDCLX in this 11 00:00:51,520 --> 00:00:56,960 episode, but it was recorded before the new ENDCLX was being given, so 12 00:00:57,079 --> 00:01:00,920 unfortunately we don't really have a lot of info about it. But this episode 13 00:01:00,000 --> 00:01:04,799 is still super engaging and entertaining, so don't let that tetoria. We're already 14 00:01:04,799 --> 00:01:10,200 working on season ten of the Nursing on Sunsored podcast, and if you're a 15 00:01:10,200 --> 00:01:12,840 fan of the show, but you don't like ads, you should check out 16 00:01:12,879 --> 00:01:18,719 the Breakroom on Patreon. For five bucks a month. You can listen to 17 00:01:18,840 --> 00:01:23,359 the episodes about any commercials and enjoy some other cool perks too. You can 18 00:01:23,359 --> 00:01:29,319 even sign up now and listen to this episode ad free. Join at nu 19 00:01:29,519 --> 00:01:34,400 breakroom dot com And for those of you who like to continue to listen for 20 00:01:34,439 --> 00:01:44,680 free, just sit back, relax and enjoy. Welcome to Nursing on sunsored. 21 00:01:44,879 --> 00:01:49,200 It's me Adrian back again and today we are going to have a discussion 22 00:01:49,359 --> 00:01:53,439 about nursing education. I know that a lot of you listening are nursing students 23 00:01:55,239 --> 00:01:59,159 about to graduate. Maybe you know this is the spring season, so maybe 24 00:01:59,159 --> 00:02:01,840 the mclex is coming up for you, or maybe you're just thinking about getting 25 00:02:01,840 --> 00:02:06,680 into nursing. But in any case, this discussion is going to be very 26 00:02:06,760 --> 00:02:10,560 valuable. Today I have with me Audrey Snyder. She is the Associate Dean 27 00:02:10,639 --> 00:02:16,599 for Experiential Learning and Innovation at the University of North Carolina at Greensboro. Audrey, 28 00:02:16,639 --> 00:02:20,639 welcome, it's good to see you today. Thank you, Adrian, 29 00:02:20,919 --> 00:02:23,280 and how are you. I am well, glad to hear it, glad 30 00:02:23,319 --> 00:02:27,639 to hear it. Well. Before we jump into things, would you like 31 00:02:27,719 --> 00:02:30,280 to tell us a little bit about yourself and how you came to be in 32 00:02:30,319 --> 00:02:37,000 the role that you're in now. So my background as a nurse spans many 33 00:02:37,080 --> 00:02:40,000 different areas. When I was growing up, I actually wanted to be a 34 00:02:40,000 --> 00:02:46,599 paramedic, not a nurse, but growing up in a very rural area where 35 00:02:46,439 --> 00:02:54,159 it was felt that the role in prehospital care that by gender being a female, 36 00:02:54,199 --> 00:03:00,280 that that was not an appropriate career option to look at or even being 37 00:03:00,280 --> 00:03:05,759 allowed to take an EMT class or volunteer. So I decided I would go 38 00:03:05,759 --> 00:03:10,000 into nursing. And my grandmother was my first teacher. She was at home 39 00:03:10,039 --> 00:03:15,360 with us, actually in a hospital bed for nine years, being cared for 40 00:03:15,479 --> 00:03:21,360 my family before she passed away, and I learned so much from her as 41 00:03:21,400 --> 00:03:25,960 a patient. She had always also been a lay midwife, and so I 42 00:03:27,080 --> 00:03:34,039 learned a lot about natural means of caring for people, herbs and things like 43 00:03:34,080 --> 00:03:40,240 that. And I feel like that that was my first nursing lessons were actually 44 00:03:40,319 --> 00:03:46,039 from her as my grandmother and as my patient as a family member helping to 45 00:03:46,120 --> 00:03:53,280 care for her. But I have spanned a critical care er flight nursing and 46 00:03:53,319 --> 00:03:58,240 then became a nurse practitioner, and soon after I became a nurse practitioner, 47 00:03:58,439 --> 00:04:03,800 was tapped in for a faculty position and have continued to merge being a nurse 48 00:04:03,840 --> 00:04:10,080 practitioner as well as a faculty member for many years. And I came to 49 00:04:10,120 --> 00:04:15,000 the University of North Carolina, Greensboro three years ago to a newly created role, 50 00:04:15,479 --> 00:04:20,079 and I love this role. It's the Associate Dean for Experiential Learning an 51 00:04:20,199 --> 00:04:28,680 innovation and it gives me a lot of freedom to explore things that perhaps faculty 52 00:04:29,240 --> 00:04:32,839 have these great ideas, but they might not have time in a busy academic 53 00:04:34,079 --> 00:04:41,439 semester to explore how we collaborate with community partners, how we find other opportunities 54 00:04:41,480 --> 00:04:45,759 for students, and so it's let me do a lot of work in that 55 00:04:45,839 --> 00:04:53,639 area. I also focus on opportunities for study abroad and looking at short term 56 00:04:53,759 --> 00:04:59,199 student experiences, for example in Appalachia. Of course, the pandemic has taken 57 00:04:59,199 --> 00:05:01,199 an impact on all of those things, so we've been able to focus on 58 00:05:01,240 --> 00:05:09,480 a few other community collaborations. In the meantime, the future of nursing and 59 00:05:10,759 --> 00:05:15,959 many other areas is now saying that we need to move from our traditional acute 60 00:05:16,040 --> 00:05:21,279 care focus and teachings, which is what the in collects our Nursing Board exam 61 00:05:21,439 --> 00:05:29,040 focuses on to have more of a community focus in our nursing education, and 62 00:05:29,079 --> 00:05:31,600 we're moving that way, which is really good to see. I think there's 63 00:05:31,600 --> 00:05:39,199 a lot of synergy happening to have the thoughts about how we move to more 64 00:05:39,279 --> 00:05:45,240 community and ensure that our students have opportunities in public health and community health. 65 00:05:46,560 --> 00:05:50,839 It's wonderful just hearing about the experiences that you had in your youth and in 66 00:05:50,839 --> 00:05:56,120 your home with your family. I mean, there's like a million questions I 67 00:05:56,120 --> 00:05:58,839 would love to talk about that, so I'm going to try really hard to 68 00:05:58,879 --> 00:06:03,240 stick to topic today. It sounds like you have such an interesting diverse and 69 00:06:04,120 --> 00:06:10,519 a background that maybe a lot of people haven't experienced, you know, especially 70 00:06:10,560 --> 00:06:14,720 in that region. I mean, I'm so fascinated at Appalachia in general and 71 00:06:15,560 --> 00:06:19,399 the history and healthcare in that area as well. I've only driven through, 72 00:06:19,560 --> 00:06:25,720 I've never actually visited the area, so I'll try not to digress too much. 73 00:06:25,759 --> 00:06:30,120 But suddenly all of the questions are firing off in my mind. But 74 00:06:30,240 --> 00:06:34,480 I do love hearing what you're saying about the community focus and public health because 75 00:06:34,920 --> 00:06:40,319 It's true more and more of the focus is not just on the treatment of 76 00:06:40,360 --> 00:06:44,160 things that have already happened and are happening acutely. But you know, people 77 00:06:44,199 --> 00:06:47,319 are sicker, people are having more and more chronic illness. So we need 78 00:06:47,360 --> 00:06:51,680 to look at what we can't keep up by just treating things that have already 79 00:06:51,720 --> 00:06:58,079 happened and are already happening, but looking at those systemic ways they're occurring, 80 00:06:58,199 --> 00:07:02,399 and how we can treat commune unities and populations instead of just the people that 81 00:07:02,439 --> 00:07:09,319 are coming into the hospital already very very ill. So so many things that 82 00:07:09,360 --> 00:07:12,600 I would love to talk about. I would love to first kind of talk 83 00:07:12,680 --> 00:07:19,079 about what you all experienced down there as kind of well, let's back it 84 00:07:19,160 --> 00:07:24,959 up even further. Would you kind of just describe for our listeners, you 85 00:07:24,959 --> 00:07:30,959 know, maybe what traditional nursing education looked like before COVID, And I know 86 00:07:31,000 --> 00:07:35,839 it differs from institution to institution and by region and by discipline. You know, 87 00:07:35,879 --> 00:07:41,439 we have undergraduate nursing, graduate nursing. There's different levels, but in 88 00:07:41,439 --> 00:07:46,040 general, I think there's kind of a formula or a format for nursing education. 89 00:07:46,279 --> 00:07:50,639 So can you maybe talk just a little bit about kind of the I'm 90 00:07:50,639 --> 00:07:55,000 going to call it the old way, even though it's not that old, 91 00:07:55,199 --> 00:08:00,160 but kind of the old way of nursing education, the pre COVID way, 92 00:08:00,160 --> 00:08:03,519 if you will, right, And I just want to say that, you 93 00:08:03,560 --> 00:08:07,519 know, nursing education from my global ry, as you say, template perspective 94 00:08:07,920 --> 00:08:13,519 hasn't really changed in the last twenty five to thirty years, but now a 95 00:08:13,560 --> 00:08:18,800 lot of forces are coming together to help us change that. Yes. So 96 00:08:20,639 --> 00:08:24,759 you know, traditionally and even in the day when I took my board, 97 00:08:24,079 --> 00:08:28,079 I did a diploma based school and then went back to get my bachelor's, 98 00:08:28,079 --> 00:08:35,600 my master's in p certificate, my PhD in nursing. So everyone whether they 99 00:08:35,879 --> 00:08:39,919 take an associated degree program, a diploma program, or a bachelor's program in 100 00:08:41,039 --> 00:08:46,320 nursing, they all take the same nursing Board exam, the kles. And 101 00:08:46,519 --> 00:08:48,200 you know, in the day when I took my exams, it was two 102 00:08:48,279 --> 00:08:52,639 days of testing, and it was four exams, and so you had a 103 00:08:52,679 --> 00:08:56,159 med surch exam that was four hours long, you had a psych exam that 104 00:08:56,200 --> 00:09:01,960 was four hours long, you had a women's health exam that was four hours 105 00:09:01,000 --> 00:09:05,200 long, and a pediatric exam that was four hours long. And of course 106 00:09:05,240 --> 00:09:11,480 today, you know, our graduates go in and it's computerized, and they 107 00:09:11,519 --> 00:09:15,480 log in and they get really anxious when they get cut off in the sixties 108 00:09:15,480 --> 00:09:20,399 on the numbers of questions because of how these computerized modeling works. As if 109 00:09:20,440 --> 00:09:22,639 they're doing really good on questions, you get harder questions if you continue to 110 00:09:22,639 --> 00:09:26,200 answer those. And that a point they say, yes, you know enough 111 00:09:26,240 --> 00:09:31,279 that you know, we can give you a certificate that you have passed this 112 00:09:31,399 --> 00:09:35,759 board exam so that you can then apply to your Board of Nursing to get 113 00:09:35,919 --> 00:09:43,360 licensed. And I think that what that means is that you end up with 114 00:09:43,480 --> 00:09:46,840 let's say you have a class of one hundred and twenty students. Forty of 115 00:09:46,840 --> 00:09:50,159 them want to go into OB and forty of them want to go into pediatrics, 116 00:09:50,159 --> 00:09:54,039 and another forty want to go into ICU, and there's not as many 117 00:09:54,120 --> 00:09:58,840 who want to go into medical surgical nursing, which is where the largest number 118 00:09:58,879 --> 00:10:03,559 of nursing positions are in a hospital. But let's talk about beyond that. 119 00:10:03,919 --> 00:10:09,519 The number of positions that may be out there in public health are in community 120 00:10:09,600 --> 00:10:13,519 based care. You know, one of my colleagues that graduated with me in 121 00:10:13,559 --> 00:10:20,679 the early eighties from a diploma program, has an amazing job working in a 122 00:10:20,799 --> 00:10:26,720 nurse run clinic. There's no physician in the clinic. It's a rural environment, 123 00:10:26,919 --> 00:10:31,279 and if by her assessment, this patient needs to be seen by the 124 00:10:31,320 --> 00:10:35,919 physician, and it's for people who are uninsured or underinsured. They also have 125 00:10:37,039 --> 00:10:41,879 mechanisms of doing the assessment to see what resources are available and how we could 126 00:10:41,879 --> 00:10:50,440 get these clients covered on care for medical, psych etc. And she uses 127 00:10:50,519 --> 00:10:56,559 telehealth to connect these clients in with a provider, you know. So she's 128 00:10:56,600 --> 00:11:01,320 the one who helps manages the equipment on the side with the patient and connects 129 00:11:01,360 --> 00:11:05,039 them in with that higher level of care. But there are many things that 130 00:11:05,200 --> 00:11:13,879 she does to help focus on diabetes management, on hypertension management. She has 131 00:11:13,879 --> 00:11:20,759 a lot of education with nutrition with clients and then helping clients find resources. 132 00:11:20,799 --> 00:11:28,320 Because we know that with the continuing escalation of I'm trying to think of the 133 00:11:28,399 --> 00:11:33,279 correct word here, but that the cost of living is increasing exponentially right now, 134 00:11:33,320 --> 00:11:37,279 you know, twelve point eight percent just in the last year. That 135 00:11:39,320 --> 00:11:43,919 people who are on a limited budget. That impacts how nutritious you know, 136 00:11:43,960 --> 00:11:48,519 what nutritious foods can they buy and how they might be able to cook, 137 00:11:48,559 --> 00:11:52,559 and it just has added stress for everyone. But to think about this nurse 138 00:11:52,600 --> 00:11:56,799 and how much autonomy she has in her role and what a difference she's making 139 00:11:56,840 --> 00:12:01,759 in the lives of the clients that she's worked with, it's just amazing. 140 00:12:01,799 --> 00:12:07,679 And I think globally we just have to think differently about what is a nurse's 141 00:12:07,759 --> 00:12:11,480 role. And you know, I think that because a lot of check the 142 00:12:11,559 --> 00:12:18,320 boxes in nursing school has focused traditionally on skills and skill building, but in 143 00:12:18,440 --> 00:12:22,279 reality, there's so many of those skills are maybe never done again when they 144 00:12:22,320 --> 00:12:28,639 get out of school, or done infrequently when a nursing student graduates and gets 145 00:12:28,639 --> 00:12:31,000 into a role. And yes, depending upon where you work, there may 146 00:12:31,000 --> 00:12:35,360 be really high tech skills you need in the ICU or you're working in the 147 00:12:35,399 --> 00:12:39,000 emergency room and you have to be able to run the rapid infuse or on 148 00:12:39,080 --> 00:12:43,039 a trauma things like that. But in the skills we're learning in nursing school, 149 00:12:43,279 --> 00:12:48,480 we really are changing how we teach those skills to focus more on critical 150 00:12:48,519 --> 00:12:54,559 decision making, on interpersonal communication to ensure that what you as a nurse, 151 00:12:54,960 --> 00:13:00,840 what you're seeing and what you're understanding with your patient is to eximinated to the 152 00:13:00,879 --> 00:13:05,720 rest of the healthcare team so that they understand. You know, one of 153 00:13:05,720 --> 00:13:09,399 the challenges I found when I have clinicals with students in an ACTE care environment. 154 00:13:09,759 --> 00:13:13,639 You know, there's just this disconnect with oh, I have to make 155 00:13:13,679 --> 00:13:18,759 a phone call and talk to the physician, And so I make sure that 156 00:13:18,799 --> 00:13:22,120 any of the patients we're working with that the students practice running through that call 157 00:13:22,240 --> 00:13:26,960 with me and then we make that call because we want them to feel comfortable 158 00:13:26,960 --> 00:13:31,440 with those conversations, to really share what they're seeing, because they are the 159 00:13:31,519 --> 00:13:35,720 eyes, the ears, the nose. You know, many nurses can walk 160 00:13:35,759 --> 00:13:41,120 into a room and go, I smell pseudomonas for example. So so you 161 00:13:41,159 --> 00:13:46,000 know, it's really important that our nurses feel comfortable with how to communicate, 162 00:13:46,200 --> 00:13:52,440 how to assess, critically, think, but how to communicate that information to 163 00:13:52,519 --> 00:13:56,720 the other part. The other part of the healthcare team and us really focus 164 00:13:56,799 --> 00:14:01,200 on integration of how we work together as a team because it's not a solo 165 00:14:01,279 --> 00:14:05,360 world out there, which also gets back to a lot of things that we've 166 00:14:05,360 --> 00:14:13,320 done in nursing school. Focus on an individual person and how that individual person 167 00:14:13,440 --> 00:14:20,240 performs, and so we're shifting like how does the team perform and really focus 168 00:14:20,320 --> 00:14:26,080 on what we're doing in simulation that there's a team approach to what we're doing, 169 00:14:26,519 --> 00:14:31,440 and let's work on those team building skills that they are going to need 170 00:14:31,519 --> 00:14:35,639 as they navigate the future of nursing. The other thing is is that nursing 171 00:14:35,759 --> 00:14:41,159 education in many ways globally has not kept pace with the changes that are happening 172 00:14:41,159 --> 00:14:48,200 in healthcare. And yes, and you mentioned the coronavirus pandemic and what's changed 173 00:14:48,240 --> 00:14:54,159 and what we've seen is, for example, telehealth telehealth has blossomed. Some 174 00:14:54,320 --> 00:15:00,919 of the challenges are the ability of our older population to util lies telehealth. 175 00:15:01,559 --> 00:15:05,799 And I saw this even with my mother and her having her cardiology visits via 176 00:15:05,919 --> 00:15:11,679 telehealth and sitting with her so that she could go through which buttons she has 177 00:15:11,720 --> 00:15:15,600 to push to make sure that even on her phone, that she can get 178 00:15:15,639 --> 00:15:20,440 to a video where the physician can see her and talk with her. And 179 00:15:20,480 --> 00:15:22,879 so, you know, one of the things that we do with some of 180 00:15:22,919 --> 00:15:28,879 our students is actually teaching the older population how to use technology, because that 181 00:15:30,159 --> 00:15:35,840 use of technology is what's going to be their avenue of more rapid access to 182 00:15:35,960 --> 00:15:43,159 a provider. You know, a big focus on teaching is so important. 183 00:15:43,240 --> 00:15:48,200 And you know, years ago in my nursing education, I had a completely 184 00:15:48,200 --> 00:15:52,519 separate class that was just on nutrition, and nutrition has been more integrated today 185 00:15:52,600 --> 00:15:58,799 into the nursing curriculum. But I just had an honor student complete a project, 186 00:15:58,399 --> 00:16:03,679 and this was a study that was funded by the American Heart Association with 187 00:16:03,799 --> 00:16:11,440 a local food bank, where it was an evaluation of a six week program 188 00:16:11,559 --> 00:16:22,279 for women who are under resourced on looking at teaching cooking techniques and nutrition and 189 00:16:22,440 --> 00:16:30,759 healthcare together and looking at whether we could decrease cardiovascular risk for those women. 190 00:16:30,600 --> 00:16:36,919 And out of the study, what she found, even though it was a 191 00:16:36,960 --> 00:16:45,000 small cohortive clients that participated, is that the nutrition education was what made the 192 00:16:45,039 --> 00:16:52,279 biggest difference. And so you know, there's a big wave now on nutritionist 193 00:16:52,320 --> 00:16:56,399 medicine, and so in nursing, we really need to think about what we're 194 00:16:56,440 --> 00:17:00,360 teaching to our clients and how we look at what we put into our bodies 195 00:17:00,360 --> 00:17:04,559 and how that impacts our health and well being, and that again being a 196 00:17:04,559 --> 00:17:12,119 big piece of what we as nurses do in education with our clients. I 197 00:17:12,160 --> 00:17:18,799 think that one of the things that you said that's so important is that this 198 00:17:18,880 --> 00:17:25,200 is how people gain access because so much of navigating the world, there's so 199 00:17:25,279 --> 00:17:30,720 much information out there, and so the way that nurses present this really gives 200 00:17:30,759 --> 00:17:36,160 people a path to understand how they can access what they truly need accessing, 201 00:17:36,200 --> 00:17:41,240 whether that be face to face interactions with a provider, knowing what is best 202 00:17:41,240 --> 00:17:45,680 for them in their bodies, their diet, with their medications, because just 203 00:17:45,720 --> 00:17:51,759 giving someone the option to google something can be overwhelming, and if they don't 204 00:17:51,799 --> 00:17:59,720 have a high level of basic literacy medical literacy, that can become problematic for 205 00:17:59,759 --> 00:18:03,400 people, people who then maybe feel so overwhelmed they just give up, and 206 00:18:03,440 --> 00:18:06,720 that does nothing to improve their quality of life, the quality of their health, 207 00:18:06,720 --> 00:18:10,200 the quality of their communities. Because we all know as a nurse, 208 00:18:10,240 --> 00:18:12,400 I think every one of us has had that family member, that friend, 209 00:18:12,759 --> 00:18:18,279 that neighbors say hey, you're a nurse, what would you do about this? 210 00:18:18,599 --> 00:18:21,839 Or hey, can you look at this patch of skin? Or what 211 00:18:21,960 --> 00:18:25,599 do you think about this medication that my doctor put me on. We've all 212 00:18:25,640 --> 00:18:30,200 had those questions asked of us, and you know, oftentimes we feel really 213 00:18:30,240 --> 00:18:34,240 glad when we're able to give information that's helpful and that actually improves. Someone 214 00:18:34,279 --> 00:18:37,039 says, hey, you know, that's really wonderful. I really needed that 215 00:18:37,119 --> 00:18:41,160 information or I acted upon that information you gave me, and now I have 216 00:18:41,279 --> 00:18:44,960 seen it. You know, I've taken this A, B, and C 217 00:18:45,160 --> 00:18:48,240 steps and it's really helped. It's you know, I'm seeing less swelling, 218 00:18:48,319 --> 00:18:53,279 I'm feeling more energetic, my medications are working better. Those things are tangible 219 00:18:53,359 --> 00:19:00,960 improvements in people's lives that all stem from nurses in the community, whether it 220 00:19:02,079 --> 00:19:06,799 be in our personal lives or in our professional capacity. And I think it's 221 00:19:06,839 --> 00:19:12,960 so important what you're talking about. That shift is even more critical now that 222 00:19:14,039 --> 00:19:19,279 we see that telehealth COVID is not entirely going away. I don't know what 223 00:19:19,319 --> 00:19:25,240 the future holds for us ever getting back to the state of normal that we 224 00:19:25,319 --> 00:19:29,680 remember, and so it's important that we keep these gateways open and that we 225 00:19:29,759 --> 00:19:34,319 make these paths for people more accessible. And it sounds like that's kind of 226 00:19:34,319 --> 00:19:41,519 the shift that is happening, and I think it's really inspiring, not only 227 00:19:41,599 --> 00:19:45,799 because we have the power to make this change, but also look at the 228 00:19:45,839 --> 00:19:49,599 opportunity this opens up. If you would have said telehealth to a nurse fifteen 229 00:19:49,680 --> 00:19:53,279 years ago, they would have thought, oh, telephone, you know, 230 00:19:53,319 --> 00:19:59,039 you call on the telephone and look at what it is now, you know, 231 00:19:59,240 --> 00:20:02,319 now that we're able well to face to face. I mean, I 232 00:20:02,440 --> 00:20:06,599 have a friend who's a nurse practitioner and she's been doing telehealth and she loves 233 00:20:06,640 --> 00:20:11,240 it because she can be at home in her you know, in her professional 234 00:20:11,240 --> 00:20:17,720 attire and take you know, take appointments with her patients. And then when 235 00:20:17,759 --> 00:20:21,079 her patients, you know, when her appointments are done, she goes into 236 00:20:21,079 --> 00:20:23,480 her kitchen, she makes her lunch, then she comes back, she does 237 00:20:23,480 --> 00:20:27,440 her charting and her notes and her assessments, and that's her work day. 238 00:20:27,920 --> 00:20:32,680 And so it's given her freedom. It's given her patients freedom to not have 239 00:20:32,799 --> 00:20:37,000 to trek across town, across county to go to see her for their basic 240 00:20:37,079 --> 00:20:41,119 care. So it's it's really, you know, it sounds dramatic to say 241 00:20:41,119 --> 00:20:47,160 it's transforming lives, but it is. It's a lot easier to be on 242 00:20:47,200 --> 00:20:49,880 time and compliant with your appointments when you just have to go to your phone 243 00:20:49,960 --> 00:20:53,640 or your computer. So I think that that really is beautiful, and you 244 00:20:55,000 --> 00:21:00,039 bring up really great and valid ways that these things are changed. So I 245 00:21:00,160 --> 00:21:06,599 think that so valuable, so valuable well, and I believe that especially in 246 00:21:06,640 --> 00:21:10,359 the rural environment. And I know one of the challenges in the rural environment 247 00:21:10,559 --> 00:21:17,359 is just the infrastructure for technology. And we've seen the government pass some legislation 248 00:21:17,440 --> 00:21:25,759 that's going to put significant amounts of money into being able to get Wi Fi 249 00:21:25,880 --> 00:21:33,000 accessibility more in our rural areas and interconnect those rural communities with our larger communities. 250 00:21:33,000 --> 00:21:37,720 From that perspective, but even today, when you think about one, 251 00:21:37,759 --> 00:21:41,160 does a person have a vehicle, you know, what are the challenges to 252 00:21:41,200 --> 00:21:44,759 get to an appointment do they have or can they just put themselves in their 253 00:21:44,799 --> 00:21:48,799 car and go, or do they have to rely on public transportation or are 254 00:21:48,839 --> 00:21:52,000 they relying on someone else in the family, our friend, to pick them 255 00:21:52,079 --> 00:21:56,920 up and take them to an appointment. And then today with gas prices, 256 00:21:56,240 --> 00:22:02,519 perhaps previously there was a community group or an agency that might provide those free 257 00:22:02,599 --> 00:22:06,119 rides, and now today they might be saying, sorry that we don't have 258 00:22:06,200 --> 00:22:11,319 the budget to do as many transports as we did before. And we know 259 00:22:11,400 --> 00:22:18,000 that only certain types of insurance will cover that transportation to an appointment for someone. 260 00:22:18,440 --> 00:22:22,359 So these are all, you know, things that tell ahealth is helping 261 00:22:22,400 --> 00:22:26,480 to change. And with COVID, you know, there was this fear of 262 00:22:26,519 --> 00:22:29,799 going into a doctor's office or a fear of going into the emergency room. 263 00:22:29,839 --> 00:22:34,160 And I saw physician colleagues and emergency medicine doing ads to say, if you're 264 00:22:34,200 --> 00:22:37,480 having chest pain, if you're having neurosymptoms, we still want you to come 265 00:22:37,519 --> 00:22:41,759 to the er. But that's because people were afraid of getting you know, 266 00:22:41,920 --> 00:22:45,680 COVID. Well, of course, now we have vaccines, not that everyone 267 00:22:45,720 --> 00:22:49,000 is vaccinated, but vaccines are really helping to mitigate some of that risk. 268 00:22:51,119 --> 00:22:55,039 And you know, if someone does get sick, hopefully it's a less severe 269 00:22:55,240 --> 00:22:59,759 illness as opposed to the early days of the pandemic. But what I've seen 270 00:22:59,839 --> 00:23:04,559 is growth. I have colleagues who actually started a nurse practitioner home health agency 271 00:23:04,680 --> 00:23:08,599 where they are on telemedicine and the nurses are in the home, but they're 272 00:23:08,640 --> 00:23:15,799 actually caring for patients that are at almost ICU phase in their homes with technology. 273 00:23:17,640 --> 00:23:23,000 And so what we're seeing is a completely different blossoming of telehealth and a 274 00:23:23,039 --> 00:23:30,799 decrease in cost to care for these patients. So again a means of trying 275 00:23:30,839 --> 00:23:37,039 to decrease healthcare costs, decrease expenditure for people, and just you know, 276 00:23:37,480 --> 00:23:40,759 I think one of the challenges has been that legislatively, there were a lot 277 00:23:40,799 --> 00:23:47,759 of waivers during the pandemic which allowed for telehealth to be covered or even crossing 278 00:23:47,799 --> 00:23:49,920 state lines, and some of that has gone away, So there's new legislation 279 00:23:51,000 --> 00:23:57,480 being enacted to try and keep that flexibility. You might say, with telehealth 280 00:23:57,559 --> 00:24:03,279 provider coverage, we still have really good coverage from a psychmental health perspective, 281 00:24:03,640 --> 00:24:07,640 but for a lot of other things we don't have as good of coverage. 282 00:24:07,759 --> 00:24:11,599 So unless someone's paying out a pocket, there may not be the same access. 283 00:24:11,640 --> 00:24:15,559 But we're hopeful for the future because there's a lot of studies that are 284 00:24:15,680 --> 00:24:21,640 looking at analysis of the impact of the use of telehealth jarring the coronavirus pandemic, 285 00:24:21,680 --> 00:24:23,960 and I think that will give us good data to go back to the 286 00:24:25,079 --> 00:24:30,000 legislators and say this really is working and this is the needs of the future. 287 00:24:30,039 --> 00:24:33,640 But that also means that in nursing education, our students need to graduate 288 00:24:33,680 --> 00:24:42,880 with compigencies in use of telehealth equipment and telehealth technology and comfortable in safety factors 289 00:24:42,920 --> 00:24:48,880 for going into people's homes. So there's a lot of nuance, as you 290 00:24:48,960 --> 00:24:53,519 might say, but that also is great opportunity. Absolutely, and I think 291 00:24:53,559 --> 00:25:00,799 that when we talk about telehealth, we can also talk about telecommuting or even 292 00:25:00,839 --> 00:25:04,839 as far as students go, like you know, online schooling. We saw 293 00:25:04,960 --> 00:25:11,079 a huge change. And I remember when I was at the time that the 294 00:25:11,119 --> 00:25:15,920 pandemic began. I was in Iowa City at the University of Iowa, and 295 00:25:15,000 --> 00:25:18,599 I remember that there, you know, I knew a lot of teaching assistants 296 00:25:18,640 --> 00:25:23,640 and teachers at the time that suddenly had to you know, modify their courses 297 00:25:23,680 --> 00:25:29,599 to be online. And so now we're at a place where the anticipation, 298 00:25:29,920 --> 00:25:33,839 you're the expectation is that a lot of courses are now just offered online. 299 00:25:34,240 --> 00:25:38,559 So we went from this place where it was kind of this scramble to make 300 00:25:38,599 --> 00:25:42,720 things online that had never been online before, and now I'm seeing a lot 301 00:25:42,759 --> 00:25:48,279 of folks that are opting to be online. So students that had had never 302 00:25:48,359 --> 00:25:52,200 taken an online class before were terrified of it are now. You know, 303 00:25:52,319 --> 00:25:57,799 some people still prefer, you know, a tangible book in a classroom space, 304 00:25:59,160 --> 00:26:03,039 but more and more I'm hearing from students that they love the freedom that 305 00:26:03,039 --> 00:26:07,039 that kind of classroom gives them. And so can you talk a little bit 306 00:26:07,079 --> 00:26:14,240 about the experiences and some of the things you've seen from both the educators standpoint 307 00:26:14,359 --> 00:26:22,279 and student feedback about how we've seen online school change over the course of the 308 00:26:22,400 --> 00:26:29,759 last almost three three years now. Basically, yeah, and so I think 309 00:26:29,799 --> 00:26:32,599 that you know, very early on in the pandemic, a lot of us 310 00:26:32,640 --> 00:26:37,599 had to revert to online courses. And if you had a smaller class of 311 00:26:37,680 --> 00:26:41,960 students and you were online, that worked really well because you you know, 312 00:26:42,240 --> 00:26:47,000 you can put everybody on the screen at one time. When it became difficult 313 00:26:47,200 --> 00:26:49,880 is when the class has one hundred and twenty students in it, and if 314 00:26:49,920 --> 00:26:53,400 you're in you know, an auditorium, you can see everybody, and as 315 00:26:53,440 --> 00:27:00,359 a faculty member, you can see the glazed over stair or the furrowed brow 316 00:27:00,480 --> 00:27:04,640 I'm not getting that information. And that would give you a way to say 317 00:27:04,640 --> 00:27:10,200 it a different way. Whereas in online learning, many times, if it 318 00:27:10,279 --> 00:27:14,920 was a modeled on a traditional classroom setting, you might have five screens of 319 00:27:15,000 --> 00:27:18,279 students and you can't see them all at once at the same time, because 320 00:27:19,079 --> 00:27:22,880 technology wasn't as advanced three years ago as it even as today, as far 321 00:27:22,880 --> 00:27:29,200 as Wi Fi connections and connectivity, and of course everybody was working from home 322 00:27:29,440 --> 00:27:33,000 and you know traditional K through twelve taking classes from home, and then of 323 00:27:33,000 --> 00:27:37,920 course students in college taking classes from home. That you know, we saw 324 00:27:38,000 --> 00:27:47,400 overwhelming the kind of like cable system connectivity and many times in order for students 325 00:27:47,440 --> 00:27:49,880 to stay on they had to take their picture off. So then again as 326 00:27:49,880 --> 00:27:55,920 a faculty, remember you're not seeing them, so you know, in these 327 00:27:56,039 --> 00:27:59,160 large classes, so I think you know, in smaller class sizes, yes, 328 00:27:59,240 --> 00:28:03,519 but also what we've seen as an evolution of some asynchronous learning that is 329 00:28:03,559 --> 00:28:11,359 occurring online, which is still getting to the key concepts and the key standards 330 00:28:11,359 --> 00:28:19,720 of learning outcomes. Simulation has taken a major shift with online as opposed to 331 00:28:19,720 --> 00:28:25,559 in person. So yes, we have these fancy simulation labs and you know, 332 00:28:25,759 --> 00:28:32,279 humanized models that can you know, talk and breathe and pee and put 333 00:28:32,319 --> 00:28:37,839 out you know, chest tube secretions and all of those things. And what 334 00:28:37,839 --> 00:28:42,039 we're going to see, I think for the future is more virtual reality simulations 335 00:28:42,319 --> 00:28:48,759 are augmented reality simulations, and so those could be done anywhere, and that 336 00:28:48,839 --> 00:28:53,039 may also be beneficial. At the same time, the ability, you know, 337 00:28:53,079 --> 00:29:00,079 when you set up something in a simulation lab, the time and the 338 00:29:00,160 --> 00:29:04,839 energy and the effort, and many times students can only go through something once 339 00:29:04,920 --> 00:29:11,000 or twice. But if you have it and it's virtual and you've got augmented 340 00:29:11,039 --> 00:29:14,960 reality, so the student does it one time, then you give them a 341 00:29:15,039 --> 00:29:18,160 chance to do it again, and maybe they pick up on things they did 342 00:29:18,200 --> 00:29:22,720 in the first time, you know, are they tune into a different aspect 343 00:29:22,799 --> 00:29:27,200 of the assessment or what they need to do, and so you know, 344 00:29:27,359 --> 00:29:33,720 the future is going to be competency based learning. And so again, if 345 00:29:33,759 --> 00:29:37,400 a student can demonstrate competency and we have the ability to evaluate that, then 346 00:29:37,440 --> 00:29:42,599 we don't spend time holding that student back from moving forward in other areas. 347 00:29:44,680 --> 00:29:48,759 So that's also a shift. I think that we're then we're at this you 348 00:29:48,759 --> 00:29:52,559 know, precipice of you know, diving into you know, how we truly 349 00:29:52,960 --> 00:29:59,359 can change curriculum to be competency based for the students. And I believe a 350 00:29:59,400 --> 00:30:03,599 lot of s elation is going to help us with that. How do you 351 00:30:03,680 --> 00:30:08,200 think preparation for the ENDCLEX has changed? Like I do know that the ENDCLEX 352 00:30:08,640 --> 00:30:14,599 has recently or is about to maybe I'm not quite sure. About the timeline. 353 00:30:15,079 --> 00:30:18,240 But I know there's a lot of talk about the new ENDCLX. Yeah, 354 00:30:18,279 --> 00:30:25,000 I know that's causing anxiety for some relief for others. So can you 355 00:30:25,039 --> 00:30:30,480 share your insights on that. Yeah, So next Gen, the next generation 356 00:30:30,640 --> 00:30:33,799 ENCLUX is about to come out, and I do not have the exact timing 357 00:30:33,799 --> 00:30:38,240 in my head either. But what that means is, you know, and 358 00:30:38,319 --> 00:30:45,440 again the goal is not to teach to an exam, but nursing education is 359 00:30:45,559 --> 00:30:49,839 very different from a student taking a chemistry class or a biology class or some 360 00:30:49,920 --> 00:30:56,720 other health sciences class because most programs do not have a board exam to pass 361 00:30:56,839 --> 00:31:04,319 in order to continue on in your career goals. So again looking at how 362 00:31:04,359 --> 00:31:08,319 the next gen curriculum is there, and I think you know, over the 363 00:31:08,359 --> 00:31:15,160 next year, most faculty, if they haven't already, we'll be doing crosswalks 364 00:31:15,200 --> 00:31:21,400 of their curriculums for next gen, for the Essentials of Nursing, for the 365 00:31:21,480 --> 00:31:26,440 new AACN guidelines, and so depending upon what program you're in. You know, 366 00:31:26,519 --> 00:31:33,119 even for the MPs, there's new guidance out for MP education and so 367 00:31:33,319 --> 00:31:41,400 crosswalking the curriculum amongst all of the different pieces of regulatory guidance as well as 368 00:31:41,480 --> 00:31:45,400 board exams. I know, previously I was the director of an MP program 369 00:31:45,480 --> 00:31:52,160 and we had five different bodies that we needed to ensure our curriculum adhered to 370 00:31:52,960 --> 00:31:56,839 guidance for And so, you know, lots of time students think, you 371 00:31:56,880 --> 00:32:00,279 know, oh, it's easy being a faculty member. In the hard it's 372 00:32:00,319 --> 00:32:04,079 the student, But in reality they need to know that, you know, 373 00:32:04,119 --> 00:32:10,240 we're constantly having to evolve based upon what's evolving out there around us, and 374 00:32:10,279 --> 00:32:16,200 so ensuring that what we're what we're giving students meets all of these guidance. 375 00:32:16,559 --> 00:32:22,039 But at the same time, in reality, what is the goal that a 376 00:32:22,200 --> 00:32:30,000 nurse can graduate with good assessment skills, critical thinking skills, good communication skills, 377 00:32:30,200 --> 00:32:35,240 and good documentation skills? In my mind, those are four areas that 378 00:32:35,319 --> 00:32:37,640 I think, you know, every nurse that comes out of a program needs 379 00:32:37,680 --> 00:32:45,039 to really be able to focus on. And it's not the technical skills necessarily, 380 00:32:45,440 --> 00:32:51,640 as to you know, the goal with us graduating good nurses, nurses 381 00:32:51,680 --> 00:32:52,880 that you say, yes, you can take care of me or you can 382 00:32:52,920 --> 00:32:58,079 take care of my family member when you graduate, and that will come out 383 00:32:58,160 --> 00:33:04,240 and be good stewards in being a nurse. And caring for individuals, for 384 00:33:04,319 --> 00:33:09,440 communities, for the whole population. See indeed, and I think I think 385 00:33:09,480 --> 00:33:15,440 that we we this might be a this might be a little bit of a 386 00:33:15,519 --> 00:33:19,559 controversial statement. It's coming from me, not from you. I think you 387 00:33:19,599 --> 00:33:24,680 can tell the difference between a nurse that has those skills and a nurse that 388 00:33:25,000 --> 00:33:31,400 just studied to pass the test. You can tell the difference between someone who 389 00:33:31,519 --> 00:33:38,759 has really kind of come from a program that really wants that comprehension to be 390 00:33:39,480 --> 00:33:46,720 well rounded, focused on the critical thinking, the assessment portion, knowing what 391 00:33:46,799 --> 00:33:52,279 to do with that information aside from just reason out what the right answer is 392 00:33:52,359 --> 00:33:58,640 from that question. I think that it's very and and I think that plays 393 00:33:58,640 --> 00:34:02,319 out in those simulations, whether it be in person, virtual online, whatever 394 00:34:02,359 --> 00:34:06,559 the case may be. You can walk into a room and you can know 395 00:34:06,640 --> 00:34:09,320 what it means and what the labs are and you know what this different thing 396 00:34:09,320 --> 00:34:14,199 indicates. But when you're looking at a person in front of you and they're 397 00:34:14,239 --> 00:34:17,079 having these symptoms and they're making these complaints, and you're seeing all of these 398 00:34:17,119 --> 00:34:22,519 different things that these bits of data coming at you, and knowing how to 399 00:34:22,559 --> 00:34:27,000 synthesize that and knowing what to do for that human being in front of you. 400 00:34:27,679 --> 00:34:31,280 It becomes very overwhelming, very quickly. And I think that nursing education 401 00:34:31,519 --> 00:34:38,599 needs to to do a service to our new nurses and our students. We 402 00:34:38,679 --> 00:34:43,280 need to be giving them the tools to take all of those little bits of 403 00:34:43,280 --> 00:34:46,559 information and be able to look at an entire situation. And as a nursing 404 00:34:46,599 --> 00:34:52,039 student, I hated case studies. I will be honest. I hated it 405 00:34:52,079 --> 00:34:53,559 when they gave you all of this and I thought, Oh, they're trying 406 00:34:53,559 --> 00:34:58,840 to trick me by throwing in this information and this information that I don't need. 407 00:34:59,320 --> 00:35:01,920 But really, now as a nurse, I see that it's not trying 408 00:35:01,960 --> 00:35:07,079 to trick you. It's giving you a whole person, giving you an entire 409 00:35:07,880 --> 00:35:13,000 life and body and situation to look at, and then deciding which of those 410 00:35:13,000 --> 00:35:16,599 things are relevant in that moment and what you're going to do with that information. 411 00:35:17,159 --> 00:35:22,280 And so on one hand, when I found out that there's this new 412 00:35:22,360 --> 00:35:24,840 gen end CLEX coming out, I thought, well, man, that makes 413 00:35:24,880 --> 00:35:29,840 me kind of irrelevant as a tutor because I will not be taking this new 414 00:35:29,920 --> 00:35:32,519 gen. So I was a little for selfish reasons, I was disappointed, 415 00:35:32,760 --> 00:35:37,760 but I also thought, this is actually a really good move because as a 416 00:35:37,760 --> 00:35:40,280 good test taker, even in my early days of nursing school, I was 417 00:35:40,320 --> 00:35:45,199 scoring really high one or practice exams, you know, predictor exams, because 418 00:35:45,639 --> 00:35:51,360 I was kind of good at the end clex style of question answering. But 419 00:35:51,440 --> 00:35:54,159 that didn't mean that I was competent to be a nurse after two semesters of 420 00:35:54,280 --> 00:35:59,320 nursing school. And so it makes me really glad to see that this evolution 421 00:35:59,480 --> 00:36:05,840 is occur and that we're guiding students through this curriculum of being able to work 422 00:36:05,920 --> 00:36:08,679 through this information and knowing what to do with all of this information and making 423 00:36:08,679 --> 00:36:15,760 them good critical thinkers and making them good team players. It makes me think 424 00:36:15,840 --> 00:36:22,480 of situations in my job today where just to play out a situation, just 425 00:36:22,599 --> 00:36:28,880 really briefly, I received an admission, a patient came to me. I 426 00:36:28,960 --> 00:36:30,440 work nightshift, so patient came to me in the middle of the night. 427 00:36:30,960 --> 00:36:35,239 The orders came in. I needed to start a hepprin drip and get labs 428 00:36:35,320 --> 00:36:37,840 drawn and start fluids, and there were all these things that needed to be 429 00:36:37,880 --> 00:36:43,039 executed and they were all very important. Now I'm a float nurse at a 430 00:36:43,119 --> 00:36:45,199 hospital I've been at for less than a year, so I'm always going to 431 00:36:45,239 --> 00:36:51,119 different units, and so you never it's not like being on a team where 432 00:36:51,119 --> 00:36:55,480 you say, Peggy's great with IVY sticks, and you know Martha knows how 433 00:36:55,519 --> 00:37:00,920 to find all the equipment and get all that like, you don't necessarily know 434 00:37:00,119 --> 00:37:06,000 who your great sources of different things are. But when I was on this 435 00:37:06,119 --> 00:37:08,199 unit and I admitted this person, I didn't even have to ask. And 436 00:37:08,400 --> 00:37:12,719 each of the nurses that were on with me that night, I turned and 437 00:37:12,760 --> 00:37:15,199 I said, hey, can you find me an extra IV pump? She 438 00:37:15,239 --> 00:37:19,360 had already gotten one, it was already in the room. Can you get 439 00:37:19,400 --> 00:37:21,639 me some IV tubing? She's like, oh yeah, I already primed the 440 00:37:21,719 --> 00:37:25,039 IV tubing. I'm going to get these fluids running. Someone else had already 441 00:37:25,039 --> 00:37:30,000 called the IVY team and they were on their way to get an IV started. 442 00:37:30,480 --> 00:37:34,679 And I was getting the hepron and getting looking over those orders and looking 443 00:37:34,679 --> 00:37:37,159 at the protocol so I could get the hepron going based on the labs they 444 00:37:37,679 --> 00:37:45,320 like. It all came together instead of me by myself scrambling to get all 445 00:37:45,360 --> 00:37:49,000 of these things and all of this equipment. And when that happens, it's 446 00:37:49,039 --> 00:37:53,039 not just yes, it was easier on me. But that patient's treatment fell 447 00:37:53,159 --> 00:37:58,760 into place so much faster. We got those labs drawn faster, he got 448 00:37:58,760 --> 00:38:02,559 his pain medication master, he got the answers the physician was called up quicker. 449 00:38:04,079 --> 00:38:07,199 It made a difference in the amount of time it took for that patient 450 00:38:07,239 --> 00:38:12,920 to receive the care that the physician ordered. And so these aren't just like 451 00:38:14,800 --> 00:38:17,480 paper what am I trying to say? These aren't just like benchmarks are trying 452 00:38:17,480 --> 00:38:22,960 to meet on paper. This translates into real life outcomes for our patients. 453 00:38:24,119 --> 00:38:28,440 And so I think that these things that we're talking about, even though we're 454 00:38:28,480 --> 00:38:34,800 talking about like oh, yes, like better attrition rates and better end clex 455 00:38:34,960 --> 00:38:38,039 pass rates. Yeah, but what does that look like in the at the 456 00:38:38,079 --> 00:38:44,280 bedside, in the home health you know, treating ICU level patients at home. 457 00:38:44,400 --> 00:38:51,840 This like literally has better quality outcomes for people. And so that's what's 458 00:38:51,880 --> 00:38:53,639 so exciting to me. That's why this topic interests me. Like, yes, 459 00:38:53,719 --> 00:38:57,760 we can talk about education, and some people find that really boring, 460 00:38:58,360 --> 00:39:02,639 but this is so exciting for the profession because of the implications it has for 461 00:39:02,719 --> 00:39:08,280 our future care. So what are some things that you see sticking around? 462 00:39:08,559 --> 00:39:14,800 Some things that you see that maybe like you, we've talked about virtual, 463 00:39:15,840 --> 00:39:21,440 virtual simulation, things like that. What are some things that have come out 464 00:39:21,440 --> 00:39:27,840 of this pandemic that you see as being improvements, if you will, for 465 00:39:28,000 --> 00:39:31,280 lack of a better term, things that maybe we might not have done had 466 00:39:31,320 --> 00:39:38,519 we not been forced into this quarantine life so to speak. Well, I 467 00:39:38,559 --> 00:39:47,039 do think as we discussed, you know, learning remotely, more simulation that's 468 00:39:47,239 --> 00:39:58,320 virtual, more focus on competency another thing that I think came out of the 469 00:39:58,320 --> 00:40:01,679 pandemic, at least for us here locally, even though I feel like prior 470 00:40:01,719 --> 00:40:09,440 to the pandemic we thought we had good wraparound services for students, and the 471 00:40:09,440 --> 00:40:15,960 pandemic showed us we didn't. And that I'm not familiar with that term wrap 472 00:40:15,960 --> 00:40:22,800 around. Yeah, So when you have students, so our university is ranked 473 00:40:22,239 --> 00:40:27,199 number one in the state for upward mobility, and so that means we get 474 00:40:27,239 --> 00:40:30,639 a lot of first generation college students. And so when you have someone who 475 00:40:30,719 --> 00:40:37,000 doesn't have someone in their family who's been to college, who knows what it's 476 00:40:37,199 --> 00:40:42,079 like to navigate doing a bachelor's program, or they have no one in their 477 00:40:42,119 --> 00:40:45,440 family who's a nurse, our healthcare provider, and so they don't have someone 478 00:40:45,480 --> 00:40:50,760 to go home and talk to about the case they had today and to get 479 00:40:50,800 --> 00:40:53,639 more gleanings of information, or just to have someone to vent to about you 480 00:40:53,679 --> 00:41:00,599 know, what's been happening. Many times, students who are generation may not 481 00:41:00,679 --> 00:41:06,159 have learned well how to study at a college level, for example, or 482 00:41:06,280 --> 00:41:14,199 they may not have good psychosocial support compared to someone who's not first gen for 483 00:41:14,280 --> 00:41:19,639 example, are someone who comes from an underserved background. And I know that 484 00:41:19,719 --> 00:41:27,960 during the pandemic, I had students who their parents were divorced and then remarried 485 00:41:28,320 --> 00:41:31,280 and they were kicked out of their dorm with COVID, and so then they're 486 00:41:31,320 --> 00:41:39,079 at home, and home means that their stepmother has a two year old in 487 00:41:39,159 --> 00:41:45,920 the house, and they're trying to attend classes with a two year old running 488 00:41:45,920 --> 00:41:50,039 around, And then they're trying to take their exams online, and so they're 489 00:41:50,079 --> 00:41:54,199 sitting in the bathroom with the door shut to take their exam because that's the 490 00:41:54,280 --> 00:42:00,800 only place that they could have enough quiet to be able to do their sam 491 00:42:00,000 --> 00:42:08,519 oh and other students who had no Wi Fi in their rural environment and who 492 00:42:09,039 --> 00:42:14,960 were driving to you know, coffee shops that hadn't turned their Wi Fi off 493 00:42:15,000 --> 00:42:19,559 and sitting in the parking lot of the coffee shop to do their class or 494 00:42:19,559 --> 00:42:24,800 to do their schoolwork online. And so you know, finding out that we 495 00:42:24,840 --> 00:42:30,639 needed to do Wi Fi hotspots for some students so that they would be able 496 00:42:30,679 --> 00:42:34,840 to be in class and be able to have enough time to do all their 497 00:42:34,880 --> 00:42:38,440 work. Supporting students, you know, with some technology, you know, 498 00:42:38,559 --> 00:42:45,880 some students did not have laptops. So again so thinking about and I know 499 00:42:45,039 --> 00:42:50,360 some colleges every student is mandated to have a laptop, or as a part 500 00:42:50,360 --> 00:42:52,760 of their student fees they get a laptop. You know, there's lots of 501 00:42:52,760 --> 00:42:58,920 different iterations of that sort of work being done. But we also you know, 502 00:42:59,079 --> 00:43:04,199 thinking about the mental health support for students who you know, we have 503 00:43:04,360 --> 00:43:08,440 not just your traditional age college student, if there is a traditional age anymore. 504 00:43:08,440 --> 00:43:12,800 But if you think about you know, most people finish high school, 505 00:43:12,840 --> 00:43:16,239 maybe take a year off and then go to college or go straight into college 506 00:43:16,239 --> 00:43:20,639 from high school. But you know, I have students who are in their 507 00:43:20,639 --> 00:43:22,840 fifties who are coming back to school to be a nurse. We have a 508 00:43:22,920 --> 00:43:30,000 veteran's Access program, so we have students who have significant lived experience who may 509 00:43:30,000 --> 00:43:34,800 have been Army vets for example, I mean army medics for example. There's 510 00:43:34,880 --> 00:43:40,599 lots of students who are not taking just a traditional pathway to an education in 511 00:43:40,719 --> 00:43:45,400 nursing. But to think about, you know, you have someone who has 512 00:43:45,960 --> 00:43:52,119 children at home and they're having to the parents. When students were in online 513 00:43:52,159 --> 00:43:57,519 schooling, the parents were responsible for ensuring their students were getting online and students 514 00:43:57,559 --> 00:44:00,599 were doing their school work while they're trying to be in school and do their 515 00:44:00,639 --> 00:44:07,400 schoolwork at the same time. And so you know, these significant challenges so 516 00:44:07,639 --> 00:44:12,719 psychosocial support for the students. And then again there's been this kind of I 517 00:44:12,840 --> 00:44:16,000 think historical tradition and nursing where well, if this is the way it was 518 00:44:16,039 --> 00:44:17,760 for me, this is the way it's going to be for the next one. 519 00:44:17,800 --> 00:44:23,880 And I completely disagree with that and this idea, especially in emergency medicine, 520 00:44:23,880 --> 00:44:28,159 which is where I spent a good part of my nursing career. You've 521 00:44:28,159 --> 00:44:31,119 got to be tough, and you know, you just step up to the 522 00:44:31,119 --> 00:44:34,800 plate and you do what has to be done and you kind of, you 523 00:44:34,800 --> 00:44:37,840 know, put your emotions on the back burner. And you know, now 524 00:44:37,920 --> 00:44:44,039 today having processes for debriefing and we're doing that with our students, is debriefing 525 00:44:44,079 --> 00:44:50,159 with our students, having processes where you find out what's happening in a student's 526 00:44:50,280 --> 00:44:54,679 life so that you really know what their challenges might be, and then looking 527 00:44:54,760 --> 00:45:00,400 at what resources we have as an institution that we can refer those students students 528 00:45:00,440 --> 00:45:05,960 too, just as we would in a medical environment with our patients. Where 529 00:45:05,960 --> 00:45:08,760 do we refer our patients to to get the resources in the support they need. 530 00:45:09,079 --> 00:45:14,400 We need to be doing that with our students. And so you know, 531 00:45:14,519 --> 00:45:19,000 tutoring, and we flipped tutoring to online. Of course tutoring had been 532 00:45:19,000 --> 00:45:22,639 in person, so we flipped to online during the pandemic. And I think 533 00:45:22,679 --> 00:45:25,440 we'll have a mixture of that going forward because for some things it's a whole 534 00:45:25,480 --> 00:45:30,679 lot easier in person if you can sit down and you know, write, 535 00:45:30,679 --> 00:45:36,000 I mean, their definitely you know whiteboards online that you can use, but 536 00:45:36,159 --> 00:45:40,039 still I think that's an area. But having that, you know, tutoring 537 00:45:40,039 --> 00:45:45,599 support, mental health support, and then just understanding the lived experience of the 538 00:45:45,679 --> 00:45:53,079 student during COVID and now post COVID and what are those challenges and how we 539 00:45:53,679 --> 00:46:00,239 can help them. I think that in a way the more that we help 540 00:46:00,280 --> 00:46:05,800 students figure out how to problem solve with patients, we can also help them 541 00:46:05,800 --> 00:46:10,199 figure out how to problem solves solve in their own lives. And students come 542 00:46:10,280 --> 00:46:15,880 with just like our patients, they come with a lot of baggage that they're 543 00:46:15,920 --> 00:46:22,760 working through. And so especially when you're if you deal with the that program, 544 00:46:22,800 --> 00:46:29,280 the Veterans Access program, you know, so again being sensitive to everyone 545 00:46:29,880 --> 00:46:35,360 and thinking about that concept of trauma informed care and how do we use trauma 546 00:46:35,400 --> 00:46:44,159 informed care with our students as faculty. And I've worked with veterans that are 547 00:46:44,159 --> 00:46:50,960 now amazing nurses that had medic and combat experience. I myself got my nursing 548 00:46:51,039 --> 00:46:55,079 degree or got my nursing license at thirty five years old. My most of 549 00:46:55,239 --> 00:46:59,639 my nursing class I did in the evening and week or a night and weekend 550 00:46:59,679 --> 00:47:05,239 program, and the majority of my class were in their thirties and forties. 551 00:47:05,679 --> 00:47:09,639 And so, while we definitely want to support our like you said, kind 552 00:47:09,639 --> 00:47:14,880 of the traditional right out of high school student, we have to expect that 553 00:47:15,360 --> 00:47:19,320 nursing is a wonderful profession. There's a lot of opportunity for lots of different 554 00:47:19,320 --> 00:47:25,119 people, and supporting that is wonderful. The thing that made it possible for 555 00:47:25,199 --> 00:47:30,920 me to continue I went to community college before doing an RN to BSN bridge 556 00:47:30,960 --> 00:47:37,559 program, and the thing that made my ability to go to school that much 557 00:47:37,639 --> 00:47:40,599 easier was the fact that I had a social worker at the college or an 558 00:47:40,599 --> 00:47:49,360 advisor that referred me to a mileage reimbursement program. Because my community college, 559 00:47:50,039 --> 00:47:55,000 the campus that had the nursing labs and the nursing program, was like thirty 560 00:47:55,039 --> 00:47:59,800 miles away from the city I was living in, and I was using some 561 00:48:00,039 --> 00:48:04,719 one else's vehicle to get to and from classes for two years, and so 562 00:48:05,360 --> 00:48:12,400 that that one program of mileage reimbursement was Without it, I probably wouldn't have 563 00:48:12,440 --> 00:48:17,039 been able to afford to get to and from so little things like that that 564 00:48:17,119 --> 00:48:22,280 if that person hadn't told me about it, I might have had a very 565 00:48:22,320 --> 00:48:28,920 different outcome. So that that social knowing the person's life, knowing what support 566 00:48:29,000 --> 00:48:35,199 they need outside of the academic is huge in people's lives, like I truly 567 00:48:35,400 --> 00:48:39,760 credit that hugely with my being able to be a nurse at all. And 568 00:48:39,840 --> 00:48:44,599 so it's really important that you talk about those things and that you recognize those 569 00:48:44,639 --> 00:48:47,840 things because that is such a that is such a huge component of it, 570 00:48:50,280 --> 00:48:53,400 and I think that that's a big thing. I another episode was with an 571 00:48:53,519 --> 00:49:00,400 LPN and we talked about how for her nursing was a way out of making 572 00:49:00,440 --> 00:49:04,960 a minimum wage job, and she loves it. It wasn't just a job 573 00:49:05,039 --> 00:49:08,719 for her, but it's it's not just about you know, I have a 574 00:49:08,840 --> 00:49:14,960 dream of being a nurse and it's been my lifelong calling. For some people, 575 00:49:15,679 --> 00:49:20,400 it is a means to a better life, and that is so important 576 00:49:20,840 --> 00:49:25,480 that we make it possible for people that don't have the traditional route of going 577 00:49:25,519 --> 00:49:30,519 to a for year college or a for your university. So it makes me 578 00:49:30,599 --> 00:49:37,440 happy that more and more institutions are picking up on that and are actively carrying 579 00:49:37,480 --> 00:49:42,519 through on that. So I think that's a lot of hope for a lot 580 00:49:42,519 --> 00:49:46,440 of students that otherwise might not might not pursue this in the state with the 581 00:49:47,119 --> 00:49:54,119 same sense of optimism, you know, right, and you know I have 582 00:49:54,239 --> 00:50:01,679 concerns that we have. That was a report it came out about ten days 583 00:50:01,679 --> 00:50:10,119 ago that said that our our exodus of nursing from nursing, the greatest numbers 584 00:50:10,119 --> 00:50:16,280 are now in that less than thirty five age groups, whereas traditionally it's been 585 00:50:16,320 --> 00:50:21,480 the older age group. So, you know, after working in the hospital 586 00:50:21,559 --> 00:50:25,320 for thirty years on concrete under you know, tile over, concrete floors and 587 00:50:25,880 --> 00:50:32,880 all of the lifting that nurses do. You know, changes in physical health 588 00:50:32,920 --> 00:50:37,079 you know, mean that people tend to they try to phase into a job 589 00:50:37,119 --> 00:50:40,159 that maybe is less physically demanding, but there are fewer of those in a 590 00:50:40,239 --> 00:50:45,800 hospital setting, etc. But we've seen, especially with COVID and the fact 591 00:50:45,800 --> 00:50:52,519 that COVID impacted older people more than younger people initially in the strains that we 592 00:50:52,639 --> 00:50:57,480 had, that there was a significant number of older nurses retiring, and so 593 00:50:57,599 --> 00:51:00,840 you would think that this would be the large number, but the strain and 594 00:51:00,880 --> 00:51:08,119 the stress on younger nurses has been significant, and so for many of them, 595 00:51:08,159 --> 00:51:13,559 they've made the decision nursing isn't where I want to be. And I 596 00:51:13,599 --> 00:51:19,800 feel like that if we did, globally in healthcare a better job of respecting, 597 00:51:20,199 --> 00:51:25,719 honoring, and understanding the needs of our nurses, that we will do 598 00:51:25,760 --> 00:51:30,679 a better job of retaining those nurses. And some of that, yes, 599 00:51:31,239 --> 00:51:36,880 and sometimes the going back to school is a means of getting re energized and 600 00:51:36,960 --> 00:51:40,119 focused and to find another avenue or you know, and there's times when I 601 00:51:40,199 --> 00:51:44,920 have nursing students that you know, in their junior year they're like, I'm 602 00:51:44,960 --> 00:51:47,199 going to be a CRNA or I'm going to be a nurse practitioner, and 603 00:51:47,239 --> 00:51:51,239 so you know, they've got those goals. But to get to those goals, 604 00:51:51,239 --> 00:51:54,199 they still have to practice, you know, and get that nursing foundational 605 00:51:54,400 --> 00:52:02,519 experience to build up on in a graduate program. So I do think that 606 00:52:05,079 --> 00:52:10,719 looking at ways that we help students be more resilient while they're in school, 607 00:52:10,840 --> 00:52:15,400 if we can help them with those tools, then when they graduate, I 608 00:52:15,480 --> 00:52:22,400 believe that they can carry that toolbox with them to help them when they encounter 609 00:52:22,880 --> 00:52:29,880 difficult situations as a new graduate nurse. And it sounds like, you know, 610 00:52:29,920 --> 00:52:32,800 the unit that you were talking to, where everybody came together to take 611 00:52:32,840 --> 00:52:37,559 care of that patient, that was amazing. I want to share a kind 612 00:52:37,599 --> 00:52:44,480 of just the opposite spectrum of having a friend recently who is older, who 613 00:52:44,559 --> 00:52:50,159 is a nurse. She had a knee replacement and you know, she's been 614 00:52:50,199 --> 00:52:52,960 a nurse for forty some years. She's still working as a nurse even though 615 00:52:53,039 --> 00:53:00,159 she's in her seventies, and she had her knee replacement. She had to 616 00:53:00,199 --> 00:53:06,880 spend a night in the hospital. She had an issue, whether the person 617 00:53:06,920 --> 00:53:10,079 didn't respond plus or not, or she had too much pain medicine on board, 618 00:53:10,320 --> 00:53:17,199 but she had an issue of incontinence and her dressing was wet, and 619 00:53:17,480 --> 00:53:21,760 she had pushed the call bell and waited and waited for someone to respond. 620 00:53:22,280 --> 00:53:27,280 Nurse comes in the room ten minutes before shift change and says she can't do 621 00:53:27,320 --> 00:53:30,760 anything about it because she has to go and give report. And this was 622 00:53:30,800 --> 00:53:37,119 a nurse who only had three months of experience as a nurse, so new 623 00:53:37,159 --> 00:53:42,880 grad apparently never reported off that it was an issue. She waited, she 624 00:53:42,960 --> 00:53:45,360 again pressed the call bell to try and get someone to help her. You 625 00:53:45,400 --> 00:53:51,559 know, this is you know, from six o'clock in the morning until nine 626 00:53:51,760 --> 00:53:59,559 thirty when the occupational therapist shows up to do her therapy, and the occupational 627 00:53:59,679 --> 00:54:05,400 therapy has changed her and helped her get into a clean bed and to get 628 00:54:05,440 --> 00:54:09,800 her dressing out of dressing changed. And so this was a nursing failure, 629 00:54:12,039 --> 00:54:20,800 complete nursing failure for her. And she was lived and of course they wanted 630 00:54:20,800 --> 00:54:23,199 her to stay another night in the hospital and she refused. She said, 631 00:54:23,239 --> 00:54:27,679 I'm going home. I will take care of me. My friends will take 632 00:54:27,719 --> 00:54:32,199 care of me. I will not stay another night. And so you know, 633 00:54:32,280 --> 00:54:37,599 we have to think about what's the endpoint. And again, how humiliating 634 00:54:37,000 --> 00:54:43,639 for someone who is continent, who's never had issues with incontinent and to have 635 00:54:43,840 --> 00:54:47,320 this situation. And then again, if you think about skin breakdown, the 636 00:54:47,440 --> 00:54:54,239 potential for additional wound section, yes, all of the complications that can occur, 637 00:54:54,840 --> 00:55:00,519 and so realize that you know, taking the time to do the right 638 00:55:00,559 --> 00:55:06,000 thing at the right time, are getting someone else to help do that, 639 00:55:06,079 --> 00:55:08,119 you know, And if everyone who was going off shift just coalesced and quickly 640 00:55:08,159 --> 00:55:12,920 came in and change the bed and got the dressing changed, that would have 641 00:55:12,920 --> 00:55:19,039 been such a different perspective for her. She was humiliated. And so to 642 00:55:19,119 --> 00:55:22,079 think about how does the patient feel, you know, how does this human 643 00:55:22,239 --> 00:55:28,880 being feel in this case? And so, you know, I want graduates 644 00:55:28,920 --> 00:55:34,320 to go out not only competent in their knowledge and in their skills, in 645 00:55:34,360 --> 00:55:39,280 their communication skills and their assessment skills and their documentation skills, but also in 646 00:55:39,360 --> 00:55:45,800 being able to rally and to meet the needs of those patients, because that's 647 00:55:45,840 --> 00:55:52,519 really important. But I also want them to be able to think about population 648 00:55:52,599 --> 00:55:55,800 health and public health, and for example, you know, what we're trying 649 00:55:55,840 --> 00:56:02,440 to do right now is collaborations with public health in our community because what we're 650 00:56:02,480 --> 00:56:10,639 seeing is, even especially after the pandemic, changes in morbidity and mortality and 651 00:56:10,880 --> 00:56:17,440 maternal child health in persons who are of color, and so trying to place 652 00:56:17,480 --> 00:56:23,840 a community focus on a community perspective on this. Recently in the media, 653 00:56:24,079 --> 00:56:30,599 issues with formula, the ability, accessibility, prices going up. What's that 654 00:56:30,760 --> 00:56:37,239 impact? And I can just remember being an ear nurse years ago when sometimes 655 00:56:37,280 --> 00:56:43,000 some of the challenges for the patients we took care of is that the problem 656 00:56:43,079 --> 00:56:49,800 was associated with parents not mixing formula to the specifications because they didn't have the 657 00:56:49,840 --> 00:56:55,239 ability to buy more formula, and so dilute formula that impacts the nutrition and 658 00:56:55,320 --> 00:57:00,519 the health of a child. And so there's so many things we can't just 659 00:57:00,599 --> 00:57:05,360 address the nursing care for the person in the hospital, and if we don't 660 00:57:05,440 --> 00:57:08,639 ask the questions, we don't know, you know, asking questions about how 661 00:57:08,679 --> 00:57:12,840 will this person take care of themselves when they get home, who's going to 662 00:57:12,880 --> 00:57:16,440 be their support financially, how are they going to be able to forward the 663 00:57:16,480 --> 00:57:21,360 supplies that they might need. You know, you find out interesting things if 664 00:57:21,400 --> 00:57:25,440 you ask simple questions like what's your biggest challenge going to be to get home? 665 00:57:27,239 --> 00:57:29,960 Because then you find out, well, they're living in their car, 666 00:57:30,119 --> 00:57:35,559 and their car is parked in the Walmart parking lot and they get their hygiene 667 00:57:35,599 --> 00:57:42,119 in the Walmart women's bathroom. You know, So finding out getting to know 668 00:57:42,360 --> 00:57:49,559 people, getting to know your patients their challenges by asking simple questions and spending 669 00:57:49,599 --> 00:57:55,039 that time with them is so important. And as nurses, we're going to 670 00:57:55,159 --> 00:58:00,920 know that information and rallying the healthcare team to find resources for that patient before 671 00:58:00,920 --> 00:58:05,920 we discharge them or once they're in the community. You know, knowing, 672 00:58:06,400 --> 00:58:09,800 for example, and a housing authority site that this patient's been discharged from the 673 00:58:09,880 --> 00:58:14,679 hospital, or how to visit to the er. Can the nurse from the 674 00:58:14,760 --> 00:58:19,599 center visit this patient at home and check in, do they understand their discharge 675 00:58:19,599 --> 00:58:23,360 instructions? Did they have the mechanism to get their prescriptions filled? You know, 676 00:58:23,880 --> 00:58:28,880 as this someone who used public transportation to get home and they didn't have 677 00:58:29,000 --> 00:58:32,840 the money to have them stop at a twenty four hour pharmacy that's ten miles 678 00:58:32,840 --> 00:58:38,079 away to get their prescription filled and then pay the waiting fees to then get 679 00:58:38,079 --> 00:58:42,079 them home. So, yes, they've come home, they have an infection, 680 00:58:42,280 --> 00:58:46,639 but they've never filled their antibiotics, you know. So really thinking about 681 00:58:46,760 --> 00:58:52,119 how we are that conduit of knowledge, that conduit of knowledge from the patient 682 00:58:52,159 --> 00:58:57,960 to the healthcare team, that conduit of knowledge to the patient about how to 683 00:58:58,079 --> 00:59:01,960 care for themselves and what are the most important things to help them in this 684 00:59:02,079 --> 00:59:07,000 journey back to health. And it's a two way street, you know. 685 00:59:07,559 --> 00:59:13,920 And I feel like we're kind of maybe that you know, hub that is 686 00:59:14,440 --> 00:59:19,639 sending information both ways as nurses and as much as our students and our new 687 00:59:19,719 --> 00:59:22,519 nurses you know, can learn how to do that and do that well, 688 00:59:23,199 --> 00:59:29,599 and it's making a difference. And I have a story that I heard for 689 00:59:29,639 --> 00:59:34,760 the first time as a new graduate at my very first Emergency Nurses Association conference, 690 00:59:35,559 --> 00:59:39,440 and it's the story of a girl who's at the seashore and the girl 691 00:59:39,599 --> 00:59:47,159 is walking the seashore and the seashore is scattered with starfish, and a gentleman 692 00:59:47,199 --> 00:59:52,440 comes up to her and he's he's watching her. He sees her throwing something 693 00:59:52,480 --> 00:59:55,320 in the ocean, and as he gets closer, he sees that she's stooping 694 00:59:55,360 --> 01:00:00,159 down and she's picking up the starfish, and she's throwing the starfish into the 695 01:00:00,159 --> 01:00:04,559 waves, and she keeps coming in. There's starfish everywhere, and he says 696 01:00:04,599 --> 01:00:07,679 to her, you can't possibly throw all the starfish back in the oshan, 697 01:00:07,679 --> 01:00:13,599 why are you even doing this? You know it's impossible. And her response 698 01:00:13,639 --> 01:00:17,679 to the gentleman is it made a difference for that one, as she's throwing 699 01:00:17,840 --> 01:00:22,880 one into the waves again. And I think as nurses, we need to 700 01:00:22,920 --> 01:00:27,760 realize that every day we make a nurse, do we make a difference for 701 01:00:27,920 --> 01:00:36,159 that one patient or that one population, and it exponentially grows. I am 702 01:00:36,199 --> 01:00:37,800 a little choked up. I wish it was here on my desk. I 703 01:00:37,880 --> 01:00:42,239 have a stark fish pin that was given to me when I was a new 704 01:00:42,360 --> 01:00:45,360 nurse, and I got that same story, and it brings tears to my 705 01:00:45,440 --> 01:00:51,400 eyes every time I hear it. That is true. You can't save the 706 01:00:51,400 --> 01:00:53,559 world, but you can help the person that's right in front of you. 707 01:00:54,280 --> 01:01:00,559 And I think that is a beautiful and profound message. So I can't throw 708 01:01:00,599 --> 01:01:02,840 all the starfish back in the water, but you can help the one that's 709 01:01:02,880 --> 01:01:08,760 in your hand. Absolutely, Audrey, it is wonderful talking to you. 710 01:01:09,760 --> 01:01:15,039 I could do this all day long. The information that you've shared is beautiful 711 01:01:15,199 --> 01:01:19,360 and wonderful, and I kind of want to end it there because I think 712 01:01:19,400 --> 01:01:24,320 that is such a beautiful and profound story, and I think that this message 713 01:01:24,320 --> 01:01:28,440 is important, and I hope all the students that are out there listening really 714 01:01:28,440 --> 01:01:32,320 take this to heart. Nursing education is difficult, but in the end, 715 01:01:32,840 --> 01:01:37,159 there is a lot that we can do and a lot of difference that we 716 01:01:37,199 --> 01:01:40,920 make. Before you go, will you tell people if they would like to 717 01:01:42,000 --> 01:01:45,480 learn more information about your program or I mean, if you have any way 718 01:01:45,679 --> 01:01:50,360 that people can learn more get in touch with you, any information, n 719 01:01:50,519 --> 01:01:53,079 links or anything that you have that you would like to share. Sure, 720 01:01:53,199 --> 01:01:59,159 So I'm on LinkedIn just with my name Audrey Snyder. You can find me 721 01:02:00,039 --> 01:02:07,599 on the UNCG dot edu website. My email is a E s N y 722 01:02:07,199 --> 01:02:13,800 D E and the number two And even though my name last name is Snyder, 723 01:02:13,840 --> 01:02:17,079 there's no R in there. So a E S N y D E 724 01:02:17,159 --> 01:02:22,639 two at UNCG dot EPU and I am happy to do whatever I can to 725 01:02:22,679 --> 01:02:29,119 help persons along disjourney in nursing because it is a journey, and I wish 726 01:02:29,159 --> 01:02:32,960 you all much success as a student are as a nurse in the area that 727 01:02:34,039 --> 01:02:37,519 you're in. Go out and make a difference. Thank you so much, 728 01:02:37,559 --> 01:02:42,800 and thank you for joining me on Nursing con Fencored and everyone. Thank you 729 01:02:42,840 --> 01:03:40,840 for listening, and I will catch you next time. The Nursing Uncensored podcast, 730 01:03:42,199 --> 01:03:45,960 like nursing itself, can be intense. We don't censor, but we 731 01:03:45,039 --> 01:03:50,679 do protect private health information has been changed and concealed to comply the type book. 732 01:03:50,840 --> 01:03:53,360 I'm not talking about your me, mom, your boss's wife, or 733 01:03:53,400 --> 01:03:58,320 anyone you might know. Also, we're real health professionals trying to give you 734 01:03:58,400 --> 01:04:02,280 factual information. However, you are responsible for doing your own research and not 735 01:04:02,400 --> 01:04:08,320 taking anything you day as medical advice. The opinions expressed here are the responsibility 736 01:04:08,320 --> 01:04:13,039 of the person expressing them and do not reflect those of our employers, educational 737 01:04:13,199 --> 01:04:16,880 or professional institutions. I hope you learned something, laughed a little, and 738 01:04:17,000 --> 01:04:17,800 that you'll come back