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Ep223: Let’s Change This Thing Called Nursing with Ben and Greg from Real Talk Nursing

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Wow . . . what a fun show today.  I was honored to sit down with Ben and Greg from the Real Talk Nursing Podcast.

We found through this discussion that we had a lot in common regarding our views of nursing and nursing education.

If you haven’t yet . . . subscribe to their show.

63 Must Know Lab ValuesQuick! Is this aPTT Count Dangerous? Hesitant? Never Feel Anxious About Lab Values Again...
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Podcast Transcription

Come into a class with some experience and you say, “Oh, well yeah, that’s how it looks in the book, but I’ve seen it this way” and you kind of get shot down.

John:                     What’s up everybody? Awesome episode today. Today, I am talking with Ben and Greg from the Real Talk School of Nursing podcast. If you guys haven’t listened to this podcast yet, it is a lot of fun. It’s Real Talk School of Nursing and Ben and Greg are EMTs who then went to nursing school and they share their stories. They talk very openly, very frankly about their journey in nursing. So once you’ve listened to this episode, head over to iTunes or Stitch or Google Play, wherever you’re at and just search Real Talk School of Nursing and make sure you subscribe. These guys are a lot of fun. They’re very awesome. You can also find them on Twitter, Facebook, anywhere on social media @RealTalkSchoolofNursing or @RealTalkNursing. So, be sure to check these guys out. It’s Ben and Greg with Real Talk Nursing.

Lastly, if you haven’t had a chance to try out the NRSNG academy, you can try it out for just one dollar for a three day trial. It included all of our courses, OBPs, med-surg labs, cardiac EKG, just so many things. It also includes tools. It includes our question base. It includes flashcards. It includes image database. There’s so much there if you go to nrsng.com/academy, you can get started for a three day trial for just one buck. All right guys, enjoy the show.

Ben:                       I’m Ben and this is Greg.

Greg:                     Greg.

Ben:                       We are a podcast called the Real Talk School of Nursing. I guess we just started this, like February.

Greg:                     Yeah, earlier this year.

Ben:                       Almost a year ago.

Greg:                     Yeah, we’re getting up there. We always have some hair brain schemes and this when we listen to podcasts a lot so we’re like, “Well, why don’t we start our own?” So, we’re hoping to grow with is because I’m still a nursing student. Ben is on his way out. He just graduated.

Ben:                       Yup.

Greg:                     The show is just gonna grow with us, hopefully, and we’re just gonna continue to record. Yeah, we just do a lot of complaining, usually, on the show.

John:                     You know, that’s actually why I liked your show. Because I don’t know, that’s kind of … We talked about this before we started recording and stuff but I have some definite strong sentiments about nursing school and the way it’s done and stuff. I appreciate, it’s obvious that you guys have a lot of experience in nursing and stuff too or in healthcare, I should say. It’s frustrating to go through that experience and see what you should be taught versus what you are being taught and stuff.

Greg:                     Yeah, I’m happy we finally got the chance to talk to you because the only thing we really knew of you was just looking at the iTunes top podcast list and your face being all over there.

John:                     Yeah we got like 3 million podcasts.

Ben:                       I know, trying to unseat the throne there.

Greg:                     You have an empire going.

John:                     It’s a podcast empire.

Ben:                       How did that all start?

John:                     That’s a good question. So, if you go back and listen to the first podcast, I think I recorded into my phone and I think I was just kind of ranting on something. I was like, “Let’s just try this.” I put it up there and people started listening. I was like, “Okay, there’s people that want to hear this stuff.” Started going and then the NRSNG podcast kind of started out growing what I was talking about. I started focusing on meds for a little bit and I was like, “Well, let’s do a pharmacology focused one.” Then I started talking about, a lot about lab values and so I kind of just started building a different podcast for each thing.

It really helped because, you know, podcasts can get overwhelmed if you start talking about just whatever. Then this NRSNG one has kind of become more kind of the motivational one and occasional A and P and stuff type episodes on here. Yeah, I think there’s a lot of people out there that struggle, like you guys did and like I did, with nursing school. I think the intimacy of podcasting really helps because you can listen when you’re jogging. You can listen when you’re … that’s what I used to do, I used to listen when I was driving to work and you felt like you know the person.

Ben:                       Exactly

John:                     I just love the intimacy of it. I think it’s more than YouTube, where it’s public comments. This just feels like you’re just having a conversation, I guess.

Ben:                       Yeah and that’s why, I mean, we kind of saw some of yours with the pharmacology ones and the lab value ones and sort of realized that you were kind of the … Yours were 5, 6 minutes, quick and dirty, you want to talk about this, talk about this med, talk about this lab value and that’s that. I know that if we did that same thing, I’m pretty sure we wouldn’t have the listenership.

John:                     It’s out there already. There’s a couple different-

Ben:                       Yeah, you’re out there and you know what I’m trying to say.

Greg:                     Yeah, we almost wanted to be like the, just like the casual, the leisure talk show, almost. We like doing interviews. I think that’s one of our favorite things about the show is talking to people. We’ve had a couple pretty interesting people on. We had a gentleman who, he’s starting his own company, Nurse Search, kind of putting private duty nurses in with the right people. We’ve talked to the creator and the CEO of the Squatty Potty which was-

John:                     Did you? I didn’t hear that.

Greg:                     Oh yeah, it’s a good one. Look back on there. It’s fun. We had him on for an interview and he was just a really cool dude. We’ve actually even told our patients that come into the ER, “Oh, hey, you’re having some constipation? Try this out.”

John:                     Try out the Squatty Potty.

Greg:                     Yeah, exactly. We should have maybe parlayed a coupon code or something.

Ben:                       Yeah, he should be paying us.

Greg:                     Real Talk Nursing, 15% off.

John:                     That’s hilarious

Greg:                     Yeah, so that’s what we kind of wanted to do. We also wanted to do a show that could grow with our careers as well, too. It’s gonna change a little bit but it’s still the same type of, same subject matter.

John:                     Oh for sure and there’s endless stuff to talk about. You look on Instagram or Facebook and there’s so many nurses out there talking about nursing, but there’s just so much to talk about with it. There’s so many spins to take like what you guys are doing, the two male nurses just chatting about the career. There’s a niche for that in nursing and it’s awesome.

Greg:                     It’s been fun, I mean our ER, well, you probably can attest to this too in the critical care areas. You’ve got probably more male nurses there than anywhere else in the nursing profession in terms of areas, nursing areas. We have some pretty great role models, I think, in the ER in terms of male nurses, which, I know I’m gonna definitely model some of my actions after them. We work with such a great group of people, just in general, that we’re super lucky to work there and then he’s super lucky to get a job there. Then, hopefully, coming up here in a few months, I’ll get a job there too because that’s where I want to grow, at least in the beginning.

John:                     I mean, I have my theories on it but why do you guys think it’s more males in ER ICU than anywhere else?

Ben:                       This is just what I think but I dislike when people say, when they ask where I work and I say I’m in the ER and they say, “You must be an adrenaline junkie.” I think we’ve talked about this before. It’s not that. I just think that … I just think a lot of the other … I gotta be delicate how I say this-

John:                     No, say it like you will.

Greg:                     Yeah, we’re never delicate.

Ben:                       That’s true, we are never delicate. I’ll talk about this obviously later too but floor nursing, I just knew floor nursing wasn’t for me. It’s not the kind of nursing I want to do. There is more excitement in the ER. I’m the kind of person that needs, I guess I need a lot of stimulation. I don’t know.

John:                     Do you have ADD?

Ben:                       I think I might.

John:                     Yeah, I think you do too.

Ben:                       I can’t sit still right now.

Greg:                     Yeah, I don’t know what the draw is. I don’t know if there’s one factor of the draw. I think it may come from, I think people do have that adrenaline thing too. There’s a lot going on and I also think it’s the independence. I think a lot of men enjoy being very independent and not having to rely on many things. You can do a lot in the ER or the ICU and you can almost make some of the, not the actual decisions, but you can think like a physician and then kindly suggest it to your attending as to what you think is the right next steps, maybe, in a patient’s care.

Ben:                       No, I think that’s why it fits me too. I mean, I like that too. I work nights and ICU and in the neuro ICU where none of the hospitalists ever wanted to go. They just hated it. I loved it. There could be, if things were going smooth, I wouldn’t even see a physician and I kind of liked that. I could just kind of run the ship and take care of everything and if things went down, I knew they were there but otherwise, it was just us, a few nurses kind of running the show.

Greg:                     Yeah, exactly. I like the doctors nearby. It’s not as a crutch and I don’t see it as a crutch. I don’t think any of our nurses see it as a crutch. It’s just really nice to be able to interface with them because sometimes you just get some random, if you’re in a big teaching hospital, some random resident that you’ll see sparingly because they’re worried about something else. You get to really see your ER attendings and your ICU attendings. You get to know them really well.

John:                     People with [inaudible 00:09:49] is Susan, she works in a big university emergency room and having her talk with us, who are ICU nurses or floor nurses, it’s a different ball game. Once you get in the elevators leaving the ER, everything changes in the rest of the hospital. She’s like, “You guys can’t do that? That’s crazy.” I thought I had a lot of independence but man, it’s nothing like what you get in the ER.

Greg:                     Yeah, that’s definitely true. There’s a lot of people that don’t even know how, it’s just funny seeing people come to our ER and they don’t even know where room 25 is. To us, that’s just like simple, oh it’s right there. They get lost all the time.

John:                     Yeah, I had my path I would stay going to the ER to get stuff because otherwise, I’d be totally … I have no clue what’s going on down there. I think they see us, I mean, they were mostly nice to us but I think they saw us as outsiders.

Greg:                     Yeah, we tag you immediately as an outsider.

John:                     Thanks, appreciate it.

Greg:                     Oh, anytime. It sets you apart though so we know you don’t get lost. We’re like, “Oh, there’s an ICU nurse. They’re lost.” We still rely a lot, there’s a lot of stuff we rely on from the ICU. There’s some silly things. The CoolGard catheter, post arrest, pop in one of those. An ICU nurse has to come down and set that up. It’s kind of strange where we still rely on the ICU for some … obviously the patient’s gonna go there.

John:                     Right but just getting things set up initially and-

Greg:                     Yeah. I always thought that I think it’d be a great idea to have them come down to the ER, if they’re gonna take a patient, and obviously we would help still transport the patient but a bedside report sometimes in the ER, I think would be very helpful.

John:                     Dude, that would, that’s a revolutionary idea and it’s so simple.

Greg:                     Yeah, exactly. I think most in healthcare, especially nursing, the simplest ideas can actually change the most and they could be the most beneficial.

John:                     How come I’ve never seen that done anywhere before?

Greg:                     Yeah, I don’t know. It’s something that I throw around. I have one of my best friends, he’s a cardiac ICU nurse. He actually just stopped, he’s gonna be going to CNRA school here in January but we have these conversations all the time. I’m just, we haven’t had him on the show yet and I always wanted to have him on. We just haven’t had him on but that’s one of the ones that we tossed around a lot. He takes a lot of patients from the OR, not the ER, and he even said he would love to go down there sometimes and take a report at the bedside, see if he notices anything he has a question on because once you start transporting a patient-

John:                     Anything can happen

Greg:                     All hell breaks loose.

John:                     Exactly, as soon as you move them. You turn an ARDS patient a little bit and they, you know you … So, yeah I’ve never seen that done and we’ve talked about it a lot on our show and on our blog and stuff that there’s this crazy animosity between ED and ICU nurses when it comes to report. You guys give report differently than we give and it fits what you do in your job. You tell us what matters to you but it’s not what we’re looking for. The easy fix for that is yeah, take the elevator down two floors, look at the patient, and then transfer it yourself.

Greg:                     Yeah, exactly. I don’t know, I think it’s just the change of scenery. If we come down, we come up to an ICU room and it is all set up correctly the way the ICU nurse likes it. Everything’s there and I feel like walking into those rooms, you touch one thing-

John:                     “What are you doing?”

Greg:                     Yes, exactly. So, I don’t know, maybe it’s just the scenery change. I’m pretty sure, do the ER nurses in your hospital, they come up with the patient?

John:                     Yeah, they’ll come up with one tech, drop them off, and like, “Here you go”. You start seeing the ICU nurses get in their little corner, the ED nurses get in their little corner and it’s like, this little like West Side Story or something.

Greg:                     Exactly. Somebody’s gonna start snapping.

John:                     Yeah, exactly. Pretty soon, fingers are snapping and people are tap dancing.

Greg:                     Yup.

Ben:                       Yeah and I think maybe it’d be such a radical change of scenery that that could help, but I also think that people just get pigeon holed into what they’re doing and there needs to be such a huge bridge between the ICU and the ER.

John:                     There really does.

Ben:                       That needs to be created and there’s some new units out there. I don’t know if you’ve ever seen, like the University of Michigan has a-

John:                     Oh really?

Ben:                       Yeah, they have a whole new unit that’s like an emergency critical care unit that-

John:                     Oh, that’s awesome.

Ben:                       Patients that still need, they still need to go to MRI, they still need a bunch of stential lines or an art line, they’re like sort of resuscitated but they’re not quite there yet to go to an ICU bed to be monitored. They actually even created a brand new residency and fellowship program too that kind of bridges the gap. It’s a, like an EM and critical care medicine fellowship.

John:                     Well that’s awesome because you guys start the neo or the levophed or whatever and then it’s like, I mean, you’re not used to managing it for six hours.

Ben:                       Nope.

John:                     So yeah, bring the nurse down because the MRI machine might be busy for the next two hours. Having somebody there that’s kind of used … Yeah, that’d be an awesome field to work in because you get that little bit of ED but you still get that, kind of, longer term management. You’re right, it’s a totally different ball game. It’s not bringing in that acute stroke and dropping him off in the ICU, it’s like, we gotta take care of him for four more hours or whatever.

Ben:                       Yeah, you know with that you’ve got all those checks. You dump a bunch of TPA in him and you’ve got all those checks you need to do.

John:                     There’s no ED nurse that can have that kind of time.

Ben:                       Exactly, yeah. It’s a bride the gap. It looks like, reading a bunch of articles on it, it looks like that’s gonna be, maybe not the trend, but more places going towards that trend. Especially with those large, inner-city hospitals that have the volume and that receive a ton of patients as well too whether it be EMS, brand new patients, or flown in from an outside facility. Sometimes those patients are an absolute disaster too when they land in the ICU because they came from a rural ED then boom, they’re coming right to an ICU bed.

John:                     That’s a, I love that idea man. I think that’d be incredible.

Ben:                       Hear it here folks.

John:                     So with … From what I’ve seen, we’ll talk a little more about this, I guess, but from what I’ve seen, EMTs and ED nurses have a really great relationship. I mean, is that-

Greg:                     For the most part, yeah. They’re-

John:                     You get to know your fire department and your buddies.

Greg:                     Yeah, you really do. I mean, those people, they become more than just, they’re definitely coworkers even though you don’t work in the same department. You just see them so much that they’re coworkers and then you also, I mean, we hang out with a lot of the medics too, after work. Our jobs are very similar. They parallel for a lot of time and then they, ours go off in a different direction than theirs do, but it’s nice to have that good working, professional relationship. Even the friend relationship too because, you kind of know, when someone comes in with a patient, you can kind of just look at them how they’re walking or acting and you know okay, this is a real shortness of breath, not just a, it got really cold out and bronchitis is acting up. You can kind of see that before you even assess the patient.

John:                     That’s awesome. So you guys both did the EMT thing before nursing school?

Ben:                       Yeah.

Greg:                     Yeah, for a short time. We pretty much realized the money and the fun is all in the hospital, in nursing.

Ben:                       They don’t get paid enough, which is sad, but-

Greg:                     Yeah, they don’t get paid enough.

John:                     No, no, no. Would you guys recommend that to people investigating healthcare or, I mean because EMT takes like 18 months or something too, doesn’t it?

Greg:                     Mine was pretty quick. I did an accelerated program and mine was three months in the summer.

John:                     Oh, wow.

Greg:                     It was pretty extensive.

John:                     A lot of your EMT stuff is on the job training, then.

Ben:                       Yeah. Well, paramedics, theirs is more like 18 months, maybe even longer.

Greg:                     Yeah they have a, theirs is definitely a much longer program. I definitely suggest it because I think the skills that you learn are, especially if you plan ongoing into nursing, because it’s all about the assessment. You’re doing an assessment, whether it be at the motor vehicle side or at the patient’s couch side or at the nursing home bedside. Those assessment techniques, if you can just hone those and you can adapt those and just see a ton of patients so you kind of know what the norms are, then if you bring that to nursing school, you’re gonna be above and beyond all of your peers because you’ve got that normal sound or that normal look.

John:                     Right.

Greg:                     That normal feel and touch before you even touch your first patient as a quote, unquote student nurse. I think there’s some valuable lessons to be learned out in the field but it’s very different. It makes it a little difficult though, sometimes in school, because you have your way of doing things and it’s going to change.

John:                     Right. Well, because you guys are kind of the lone rangers. I hadn’t really thought about that but you’re in people’s homes, doing your initial assessment or your focused assessment and that’s cool. You really see the part of healthcare that no one else gets to see, that home environment and everything or that COPD patient or heart failure patient.

Greg:                     Speaking of heart failure, you’re literally seeing what that patient’s eating so you can kind of know like, hey, okay this is probably CHF exacerbation because the Christmas ham over there is half eaten and it’s only December 19th. The living conditions, and I think a lot of our medics and EMTs are pretty good at conveying that social side too to us, at the bedside or at least the nurses at the bedside. I say us because we’re in the rooms pretty much right when they roll in too. They can convey that social side of it and you kind of can get a little bit extra of the history just by the condition of the house or so and so checks in on the patient but it turns out they haven’t been there for months. Kind of depressing sometimes, but you get a lot of back story information that you wouldn’t get otherwise. That may be lost in the report that we, that the nurse would give to the floor.

John:                     Oh yeah, and then you imagine the patient stays there two, three weeks and by the end of it, no one even, it’s not even the same person report to report. It’s a totally different patient and different background and every … it’s like the telephone game. Well, what questions do you guys have for me? I’ve kind of been drilling you about EMT stuff.

Greg:                     No, that’s cool, we love talking.

John:                     I love EMTs man, I really do.

Ben:                       We had some things we wanted to ask you regarding your podcast, actually. As you are, what we consider the innovator of nursing podcasts, do you think that the self-produced content is the best way to go for education for nurses or entertainment? I feel that it’s, these podcasts are taking the place of blogs now. They’re, because you can listen to them anywhere. You don’t have to sit down at your computer and read a blog.

John:                     I do. We’ve been doing this about two years or so now and what I’ve seen is you can get that person who’s still at the bedside, working with patients, seeing the innovations, seeing the real things going on. Then they’re able to come and tell you those stories and you’re able to listen to the story and be like, as a student, put yourself in that situation. What would I do? What was I just taught? You know, versus just the dry, formal classroom where it’s just 30 minutes of covering every cardiac disorder. Then you can come back and listen to ten different podcasts on angina, CHF, all kinds of different things that are focused and patient specific that you just can’t get that in a classroom.

Like we were talking about the intimacy of it, having these experienced nurses tell you stories and it feels like you’re there and walking you through the scenario. I wish that I had this when I was going through school. Somebody that felt like a mentor that was telling me what they would do and then telling me their struggles. I think, even like with, I love podcasting because you don’t have to see my face. You don’t have to see my writing style. I can just tell stories. You can be a little bit more raw and a little bit more honest.

I think sometimes people like to hide their vulnerabilities and their fears and stuff. I think everyone would be surprised if you found out how scared every other nursing student is but when you hear somebody who’s made it through, like you guys or like myself, telling you, “It sucked for me too” or “It was hard for me too”. I think it gives that little bit of courage. All right, it was hard for Ben and Greg and it was hard for John but they made it so I can do it too. You can’t get that from a teacher. They can’t tell you it sucks.

Greg:                     Yeah, they can’t.

Ben:                       Especially, I mean, I’ve kind of come to see this. I had a pharmacology course. They split it into two and they’re gonna change it again because it just, the way they set it up just hasn’t been working. You get this incredibly intelligent, very great, just incredible nurse that’s a DNP but they have their focus in genetics. They work in a neonatal ICU. They’re a huge, huge resource if you want to talk to them about genetics and neonatal ICU. I feel like sometimes the nursing instructors are too far removed, like we’re talking about, at the bedside, and they don’t understand the basics that need to be taught before they can go on to these really cool, high level thinking that they learned whenever they went to get their Master’s and then they went to go and get their DNP. It’s not saying that I want brand new nurses teaching nursing classes, but-

John:                     Guest lecturers, or-

Ben:                       Yeah.

John:                     Or podcasts.

Ben:                       Exactly, so I think that gap is filled by podcasting and is filled by even sometimes you follow people on Twitter. We follow a ton on Twitter and just reading their little blips and blurbs. You can learn a lot from just that.

Greg:                     Or YouTube. You know there’s other YouTube nursing celebrities like Michael Linares. You know him? And PowerRN, her.

John:                     Yeah and I think just you miss that. It’s hard to really have that real personal relationship with a professor too because their ultimate job is to judge you and pass or fail you. So there’s a little bit of animosity there, where you guys aren’t judging anyone with what you do and what you teach. We have courses and things like that, but in the end, I’m not judging. Our job, and we feel our job is to bridge that gap. Here’s what you were taught. Here’s what it actually means. No judgement, you know?

Greg:                     Exactly, yeah. That’s a huge part. I always feel it very silly whenever, we’ve both experienced this and we’ve probably talked about it on our podcast, where you come into a class with some experience and you say, “Oh, well that’s how it looks in the book but I’ve seen it this way.” You kind of get shot down pretty hardcore whenever you say those types of things in class.

Ben:                       I’ve learned to just be quiet.

John:                     That’s too bad.

Greg:                     Yeah and I think that stifles what could be brought to the table from people that maybe were CRNAs for a number of years or even and LPN for a number of years. They can bring a pretty valuable perspective to a lot of the concepts you learn in class but it’s this pretty, holy dictator in front of the room that has total control over everything. I understand where they’re coming from too because they get graded as well. At the end of the year, we fill out a survey, just about them, not about the course. That’s a whole different one so they have standards they have to meet. That’s sort of the way that the nursing profession has gone to are specific standards and the way [inaudible 00:26:19] even healthcare. You have numbers you need to make. You have zero this or 100% this and just kind of the way that it’s going where everybody is getting graded 24/7.

John:                     So we talked before we started recording too that you had been in business before this and that was my first major as well.

Greg:                     Yeah, we can tell.

John:                     It’s the bureaucracy crap that just pisses me off in everything. I lasted six months in my first business job, like, let me just do my job. Dang it! Then I went to nursing school and I had sit-downs with the deans and stuff all the time. Every time I sent an email, they were probably like, “Uh, it’s John again.” Like try and, hey, what about this? What you guys are experiencing, “Hey, actually what I saw when I was an EMT…” “Well, we don’t care about that.” Then when you’re on the floor too, it’s like, we’re gonna have zero CAUTIs this year. We’re gonna pull every catheter and it’s like hold on, I’ve got a diabetes insipidus patient who’s comatose, who’s lying in a bed, who’s putting out four liters of urine a day and you want me to remove a catheter. That’s gonna end up in a pressure ulcer. That’s gonna end up with the patient getting sepsis from bone infection. Let’s think. I get it, we don’t want a CAUTI but come on, isn’t that what nursing is? Using your judgement. Let’s use judgement. Just sound judgement to just improve the profession, you know?

Greg:                     Yeah. Hospital-based or even unit-based committees are great because you do learn the best practices based on people’s experiences but it’s the over arching blanket statements that really, I think, end up hurting in the end. We just went through a costumer service excellence thing that’s based … Make sure your patients smiling because you gave them a warm blanket type of deal. I did some background research and it turns out the company that our hospital system used to develop this program is the exact same one that was consulted whenever my previous job was looking to revamp their costumer service.

John:                     Yeah, so two different industries.

Greg:                     Yeah and it’s not developed just for healthcare. They just replaced certain words. They replaced-

John:                     Coffee with blanket.

Greg:                     Exactly. It ends up being taught by somebody at the corporate office that has always been on the human resources side of things or customer experience side. You hardly see somebody teaching those courses that’s coming in scrubs that just finished a 12-hour shift overnight.

Ben:                       You never will either.

Greg:                     Yeah, I don’t think you ever will.

John:                     I don’t know if you guys are familiar with the Show Me Your Stethoscope Facebook group and movement and everything but they’re pretty cool. They started with the whole, The View thing, where they talked about how nurses don’t use stethoscopes, whatever. They started this Facebook group but what they’re doing with that group, they’re actually trying to fix nurse-patient ratios and doing a lot of really good things is this non-profit group.

The director is Jalil Johnson. You guys, he would probably be more than happy to come talk with you guys too. He’s awesome. They’re really like, nurses, grass roots, floor practicing nurses that are trying to effect change. I really love that and I want their group to get more recognition because they’re pushing against these long-held things of like, we’re gonna let the CEO who has a business major dictate how we run things in the hospital. That just doesn’t make sense. In the end, it just doesn’t make sense.

Greg:                     Yeah and you have a chief nursing officer as well too, but I think they get immediately, as soon as that position is bestowed upon them, they get wrapped up into the business side of things.

Ben:                       You can’t help it.

Greg:                     Exactly. It’s none of their fault whatsoever. It’s just the way that the machine is built.

John:                     They even start talking different too, don’t they? They start talking like they’ve read every book on management. They just start talking to you, not like a person anymore, like, “What color is your parachute?” It’s unfortunate. When I was working the ICU, we had just this awesome floor nurse that got promoted to manager and you could see the struggle she was having because she was really good friends and we all loved, still love her a lot. Just awesome floor nurse but there was that fight that she had to kind of fight of this whole corporate side of zero cautis versus what do the nurses need to take care of the patients? It was really difficult for her and it was a huge struggle, you could tell, for about the whole year that I was there watching her go through this transition.

Greg:                     It’s such a thankless job too.

John:                     I mean a nurse manager would be the worst job in the world.

Ben:                       And no thanks, ever. I even say, I like super simple things. We have this app that is called Untapped and we love beer so we’ll go on there and put our beer on there and we’ll rate it. It’s like a 5-star rating system. I just want to have on there, thumbs up, I would buy again. Thumbs down, I’m not gonna buy it again. I feel like that’s almost the way healthcare should be. You come into the ER instead of getting your massive 35-point survey. Did you die, yes, or no?

Greg:                     Sounds like we did our job.

Ben:                       That be the standard. But it’s not the standard and it’s not gonna be the standard ever. It’s gonna constantly be how did they manage your pain? How did they make your family feel?

John:                     Did they bring you water? Did they respond to the call light? All that, yeah.

Ben:                       Exactly. Which, of course, are great things and I don’t know if the profession itself kind of moved away from those things. The basic, common, do this before you do this. Just give a warm blanket, a reposition, a light sound-

John:                     Let me ask you this. You guys work with a lot of nurses in the ED. The majority, do you feel, are doing the best for the patient, or no?

Greg:                     I mean, I think it’s very different in the ER than it is on the floor or the ICU.

John:                     Well yeah, yours is different. The best thing to do versus my different best thing to do.

Greg:                     Yeah, exactly.

John:                     I mean, I see the majority of nurses trying. I mean there’s one or two bad apples, but let’s not over complicate everything for everyone. Let’s fire the bad apples and move on.

Ben:                       Exactly and that, in this day and age, is not what happens. You see that in the police and citizen relationship now. You have some bad apples on there, but they somehow still have their jobs and you know, I don’t know if it’s the society we live in now, but that’s a whole different … That’d be like a 3-hour podcast we can do.

John:                     I’m listening to the last 20 minutes of us talking and I just want to like give a little caveat to all the people who are nursing students and haven’t worked in healthcare. I think all three of us love healthcare. We love nursing. That’s why we’re doing what we’re doing. It’s not that. This sounds very negative, but there are things and I think people that listen to either you or I understand this, that there’s things that need to be fixed. Closing a blind eye to it and pushing through isn’t gonna help. We need nurses that are confident in themselves and their skills and in what they’re doing. Just trust me that I’m gonna do the best thing for the patient. I’m not here for me. This is a terrible job to just be here for me.

Ben:                       And that is why we’re here because nursing school isn’t telling you this stuff. You’re not learning this stuff in nursing school. Unless you have a job where you’re learning it on your own, on a floor or whatever, you’re not learning this.

John:                     Not at all.

Greg:                     I think that’s what we’ve always wanted to bring to the … Get ready for this stuff. It’s not all bad. It’s kind of great when you don’t have a nursing school instructor breathing down your throat on a clinical. When you have your own patients, you can manage those patients how you want to manage them. You’re ticking all the boxes they want you to tick, but it’s your way of ticking them, not the nursing instructor’s way of ticking them, which you may be totally opposed to.

It’s an old profession. It’s a profession that’s been around forever. It’s highly evolving, as we speak, in terms of just even the education you that you can receive and still be considered a nurse. The medicine is constantly changing. It’s great that nursing is also changing with medicine, but there’s still those basic, base level things that you need to do and that you have to have in terms of foresight. As a nurse with a patient, you need to make sure you have the basics. If everybody was doing the basics, I think a lot of the ways that we grade hospital systems or doctors or nurses, it would be different. If we were all doing the base stuff, they wouldn’t have to have satisfaction surveys about, “Did you get a warm blanket while you were there?”

I think people also miss the mark whenever they, first off, come to the ER. They come for all sorts of stuff. That’s just the way that the healthcare system is now that access to healthcare is very difficult, especially in highly urban areas, where the ER is your clinic. That is your primary care physician. Sometimes those patients that come often, because they have nowhere else to go, they kind of get a little, “Oh, this person is here again?” You have some genuine frequent fliers that should not be in your ER every single week, but there are some that that’s the only way they’re able to do it. They’re not being captured by the system and said, “Okay, what can we do here?” Yeah, to help them. That just complicates the health system and health in general in the US. It just further complicated it.

John:                     Yeah, I’m sitting here nodding my head at everything you’re saying-

Ben:                       He went pretty deep there.

Greg:                     It happens.

John:                     You did. I don’t know that I can even address any of that, but I agree 100%. I think what we can do in our little circles, because you’re right, we’re not gonna be able to fix the system, but I think hopefully, we can fix the minds of some of the nurses. Get these nurses to have courage to ask the simple questions like, “Why doesn’t the ICU nurse come down here to take report?” That’s something that seems easy to fix. It’s difficult, obviously, because of the bureaucracy and stuff, but it’s something that we can push for. Sorry, what were you gonna say?

Ben:                       Oh no, I was just, I didn’t know how much time you had left. I wanted to get one more thing in for you.

John:                     Yeah man, ask whatever.

Ben:                       I just wanted to see what was next for your sort of brand and your website. Are you thinking about expanding into new and different mediums or are you just gonna grow what you have?

John:                     Yeah, so that’s actually what I was doing right before we called was just kind of looking over 2017 plan and what we’re gonna do. I mean, 2016 for us was far more than we expected would necessarily come of it. People really were very receptive to what we were offering and the story we were telling.

I think that, for the immediate, what we want to do it just kind of grow the community and grow the NRSNG family, is what we like to call it. We’re all in this together and the people that, I think, have gravitated to us, we’re all here for kind of the same reason. We think it can be done better and we want it to be done better and we know there’s better resources and things out there.

As far as the NRSNG brand itself, the biggest thing we just kind of launched and it was the beginning of December, just a couple weeks ago, is we launched a full-fledged nursing education academy. We now have courses in OB/peds, mental health, pharm, med-surg, cardiac, EKG labs, everything, and so it’s really to kind of keep growing that and making sure we’re offering the right thing for people. We kind of put it out there, hoping it would answer the big need that there is that there are the nclex prep companies alone that will prepare you for 3 weeks and then you never hear from them again. Then there are a lot of people offering stuff on YouTube and stuff like that. We really wanted to kind of bridge that even and say okay, from the moment you decide you want to be a nurse til the moment you retire, we want to have resources for you.

That’s obviously a huge goal, but we are starting to have a lot of tools and things available for people that they can come to us and kind of clarify all the junk and the mud that you’re hearing in class. Then when you’re on the floor and you have a question like, “Dang, what was Addison’s disease again?” We have resources, cheat sheets, tools, and stuff for you. That’s kind of the immediate plan. Long answer, I guess.

Greg:                     I sing your praises all the time to people in class that haven’t found you yet. A lot of people found you without me mentioning it. I think it’s that, you know you’re talking about the break down, you can just listen about this specific thing. This one lab value. I know you’re, especially the lab stuff helped on fluid and electrolytes whenever we took that test. That was huge. Just pairing it down to one lab value and just looking at that and looking at what the consequences of the being off is. That’s actually how we ended up getting testing. It was like, pretty much in line, which was really nice.

John:                     That’s awesome.

Greg:                     I love podcasts. I know Ben does too. He’s a big podcast guy. We love it and I think it’s definitely the next thing. It’s actually here already, I think.

John:                     Yeah, it’s only gonna grow. I just want to say one more thing about what you were saying. I think the reason I’ve broken everything down so simple is because I actually learn fairly slow. I even took a physics class with my wife, we were both looking at going to med school and stuff, and we took a physics course and we spent all the same amount of time studying, did all the same things to study. She’s making 99s on the test with no problem and I’m struggling to get a B. I realized this isn’t how I learn. When I went to nursing school, the guy that teaches the pharm course for us, he actually kind of showed me how he studies and it’s just breaking things down. If I don’t understand sodium, I can’t understand DI or these different pituitary type issues. I have to understand sodium itself before I can understand edema. That’s why I do it. If it takes me 40 minutes to understand what the heck sodium even is, so be it. I’m gonna do that. Then I’m gonna move on to the bigger.

So, podcasts. What podcast do you guys listen to outside of nursing? Curious. Best ones.

Greg:                     I think we cut our teeth on Joe Rogan. Yeah, he’s an interesting dude and I think the way he interviews and the different types of people he has on is, that’s why he’s almost a model for a lot of people, I think.

Ben:                       Yeah, because he has such a huge variety of guests. He’ll have on a comic, that’s his friend, and then the next week he’ll have on a neuroscientist. He’s blown away equally by both of them.

John:                     That’s cool.

Greg:                     Yeah, that’s a big one. I like Bill Burr. I like his Monday morning podcasts.

John:                     I was actually just looking at his the other day. I haven’t subscribed to it yet, but I saw the Monday morning. I thought it was a good idea.

Greg:                     Yeah, it’s good because it’s all extremely, extremely current because it is literally him in the corner of his house, just talking by himself. I think he’s just a funny dude. He’s got some good insights on a lot of stuff.

Ben:                       He’s basically saying what we’re thinking.

John:                     Again, just the intimacy of podcasts, it like, you can be in a crowded gym, running on the treadmill and it’s like you’re having a personal conversation.

Greg:                     Yup, absolutely.

Ben:                       I just had a four hour drive today. I put on a four hour podcast and I was here. What’s better than that?

Greg:                     I drove down to North Carolina and I was starting to doze off but as soon as I put on a podcast, I was like, I was in the room with them having this intellectual conversation.

John:                     Engaged.

Greg:                     Yeah, exactly. There it is. I was totally engaged. Before you knew it, you were at the beach house.

John:                     That’s cool. I’m kind of looking at the top podcasts right now. I’ve tried the How I Built This. It’s pretty cool. It’s a new one by NPR and they bring in like Mark Cuban was on and they talk about his journey through becoming Mark Cuban. It’s pretty cool.

Greg:                     Yeah, there’s this on that Slate puts on. It’s people in different professions. They talk about their profession.

Ben:                       Oh yeah.

Greg:                     What’s it called? Worked? I can’t remember what it is and we don’t have a executive producer over in the corner-

John:                     You have to have your producer look that up real quick, yeah.

Greg:                     Yeah, we haven’t thought of that point yet. Maybe in a couple years.

John:                     Got to start somewhere.

Greg:                     Ben’s son’s here. He’s been kind of running around so maybe in a couple years we’ll get him to produce the show.

John:                     There you go. He can do sound effects and stuff on the side.

Greg:                     Yeah, he’d probably know it all better than we do. It is the holiday season and I think this question has been going around a lot at work. I don’t know if you’ve been a part of these conversations, Ben. Talking about Christmas movies, and I think the big question is, Die Hard. Is it a Christmas movie or is it not Christmas movie?

John:                     I’m not even qualified, you know I haven’t even seen Die Hard.

Greg:                     Oh.

John:                     Wait, wait, don’t hang up. Don’t hang up.

Greg:                     Hang up, delete.

John:                     Yeah, screw it. You know, I don’t even watch that many movies. I didn’t even watch many movies until I got married. I don’t know what I did as a kid, growing up, because I didn’t watch TV and movies. I don’t know what I was doing.

Greg:                     You were probably doing the right thing. You were out scarping your knees and doing cool stuff outside.

John:                     Yeah and so my wife kind of introduced me to this thing called TV so I’m trying to catch up. We got the whole Roku thing now. We do Netflix. Got the Amazon video.

Greg:                     There you go.

John:                     So I can’t even answer that.

Greg:                     All right, do some research then. I have a feeling we’ll be talking again.

John:                     Come back to you.

Greg:                     Yeah, I have a feeling we’ll be talking again on the podcast so do some research for us and get back to us. I want at least 250 words.

John:                     Gotcha. Thanks, okay. APA.

Greg:                     We’re turning it over. You’re the one educating but now we’re gonna educate you.

John:                     Appreciate it.

So I hope you enjoyed that discussion with Ben and Greg with Real Talk Nursing. It was just a lot of fun to connect with these guys and to talk about so many aspects of nursing. I think that there’s so much more that we could talk about and it was just a ton of fun to connect with these guys. If you guys head over to Real Talk Nursing here on iTunes and Stitcher, anywhere. You also can head over to social media, Twitter, Facebook, anywhere and just look for Real Talk Nursing.

You guys, I really appreciate you being here. I appreciate you being a part of this NRSNG family. Everything that we do is for you guys and we just want you to succeed. We want you to have the tools, the confidence, everything you need to succeed in your journey as a nurse. Now with all that said, I want you to go out and be your best self today. Happy nursing.

Date Published - Jan 2, 2017
Date Modified - Dec 21, 2016

Jon Haws RN

Written by Jon Haws RN

Jon Haws RN began his nursing career at a Level I Trauma ICU in DFW working as a code team nurse, charge nurse, and preceptor. Frustrated with the nursing education process, Jon started NRSNG in 2014 with a desire to provide tools and confidence to nursing students around the globe. When he’s not busting out content for NRSNG, Jon enjoys spending time with his two kids and wife.