Nursing U's Podcast
Nursing U is a podcast co-hosted by Julie and Caleb. We embark on an educational journey to redefine nursing within the modern healthcare landscape.
Our mission is to foster an open and collaborative environment where learning knows no bounds, and every topic—no matter how taboo—is explored with depth and sincerity. We delve into the essence of nursing, examining the intimate and often complex relationships between nurses and their patients amidst suffering and death.
Through our discussions, we aim to highlight the psychological impacts of nursing and caregiving, not only on the caregivers themselves but also on the healthcare system at large.
Our goal is to spark conversations that pave the way for healing and innovation in healthcare, ensuring the well-being of future generations.
'Nursing U' serves as a platform for examining the state of modern civilization through the lens of nursing, tackling issues that range from violence, drugs, and sex to family, compassion and love. We will utilize philosophy, religion and science to provide context and deeper understanding to the topics we tackle.
By seamlessly weaving humor with seriousness, we create a unique tapestry of learning, drawing wisdom from the experiences of elders and the unique challenges faced in nursing today.
Join us at 'Nursing U,' where we cultivate a community eager to explore the transformative power of nursing, education, and conversation in shaping a more whole and healthier world."
Disclaimer:
The hosts of 'Nursing U', Julie Reif and Caleb Schraeder are registered nurses; however, the content provided in this podcast is for informational and educational purposes only. Nothing shared on this podcast should be considered medical advice nor should it be used to diagnose or treat any medical condition. Always seek the guidance of your doctor or other qualified health provider with any questions you may have regarding a medical condition or health concerns. The views expressed on this podcast are personal opinions and do not represent the views of our employers or our professional licensing bodies.
Nursing U's Podcast
Ep #024 PT 1 - Navigating End-of-Life Care with Heart and Spirit
Ever wondered how spiritual breathwork could redefine the essence of nursing? Join us as we promise to unlock the secrets of breath as the spirit of the earth, connecting you to ancient Hebrew wisdom and the transformative power of breathwork. Through personal experiences, we explore how this practice enriches the inner self, much like tilling soil for growth, inviting a deeper understanding of our place within the world. These insights lay the foundation for a new perspective on nursing, blending spirituality and holistic care.
We're thrilled to introduce Madison, a dedicated nurse who opens up about her journey from the hospital ward to hospice care. Since starting her career in 2018, her experiences with death and suffering have prompted a quest for deeper meaning, both personally and within the healthcare system. Madison's insights reveal the isolative nature of hospital deaths and underline the need for systemic change, especially as the baby boomer generation faces end-of-life care. Her story is a powerful reminder of the existential maturity required to embrace hospice services, highlighting the moral injuries faced by critical care nurses and the urgent demand for broader acceptance of hospice care.
Finally, Caleb and I reflect on our transitions from hospital to hospice settings, challenging common misconceptions and emphasizing the importance of self-care amidst the emotional toll of the job. We discuss the cultural reluctance to address death and the systemic issues that hinder open conversations about hospice. Through sharing our experiences of healing trauma and finding purpose, we underscore the potential for personal growth and the profound impact that compassionate end-of-life care can have on both caregivers and patients. Join us for a heartfelt exploration of the spirit of nursing, as we strive to create a more compassionate and understanding healthcare environment.
Check Out Madison's Podcast: Spiritually Human, a podcast inspired by the human experience - https://open.spotify.com/show/3iMSGIMVU0PLnjBivBc7bP?si=LXNUnhm0S7mYf3xDzrFHmg
Hi, I'm Julie.
Speaker 2:And I'm Caleb. Welcome to Nursing U, the podcast where we redefine nursing in today's healthcare landscape. Join Julie and I as we step outside the box on an unconventional healing journey.
Speaker 1:Together, we're diving deep into the heart of nursing, exploring the intricate relationships between caregivers and patients with sincerity and depth.
Speaker 2:Our mission is to create an open and collaborative experience where learning is expansive and fun.
Speaker 1:From the psychological impacts of nursing to the larger implications on the healthcare system. We're sparking conversations that lead to healing and innovation.
Speaker 2:We have serious experience and we won't pull our punches. But we'll also weave in some humor along the way, because we all know laughter is often the best medicine.
Speaker 1:It is, and we won't shy away from any topic, taboo or not, from violence and drugs to family and love, we're tackling it all.
Speaker 2:Our nursing knowledge is our base, but we will be bringing insights from philosophy, religion, science and art to deepen our understanding of the human experience.
Speaker 1:So, whether you're a nurse, a healthcare professional or just someone curious about the world of caregiving, this podcast is for you.
Speaker 2:One last thing, a quick disclaimer before we dive in. While we're both registered nurses, nothing we discuss here should be taken as medical advice. Always consult with your doctor or a qualified healthcare provider for any medical concerns you may have. The views expressed here are our own and don't necessarily reflect those of our employers or licensing bodies.
Speaker 1:So let's get started on this journey together. Welcome to Nursing U, where every conversation leads to a healthier world. Okay, we're on. Wow, yeah, I know.
Speaker 3:I feel like I can take on the world. Oh my gosh.
Speaker 1:It really clears space, almost like my vision, like debris leaving my body. Yeah, like toxic Toxins. Yeah, like clarity. It's just, it's, it's an experience. Now Caleb does that like over and over and over again, so he'll go right back into another one. I'm not that experienced with it to do that. You know I I've done a lot more just meditation than than that breathing meditation. But um, when I do do it multiple times, I literally have to lay down.
Speaker 3:Oh my God, I was getting really lightheaded.
Speaker 1:Yeah.
Speaker 3:Um Julie, I think you know this woman getting really lightheaded.
Speaker 1:Yeah, um Julie, I think you know this woman.
Speaker 3:Her name is wait, am I allowed to say? Her name is Melissa. She is a. She is wears several hats, but one of them is a breathwork facilitator and she did breathwork in the park throughout the entire summer and I was able to participate in some of those and that's where my breathwork kind of started. Um, that's when I, like you know, kind of experiment experience, that for like the first time officially breath work, and that was just same feelings, lightheadedness, but like this immense clarity.
Speaker 1:Yeah, yeah, it's we we should do. We should all three go to one of her ceremonies. Really is what it is. You kind of get into the flow of what's within you and through sound, sound bathing, the musical instruments and then just the breath, and it feels like a religious experience. But it's not religious, it's spiritual. And yeah, just allows you to go within your own mind. It's very.
Speaker 2:So in the very first podcast I mentioned kind of some of the Hebrew words that are associated with that I connect with breathwork, that are just intrinsically connected with breathwork.
Speaker 2:One of them is, well one, the idea that Adam, adam, like the original person in the Bible, adam and Adam are kind of connected, and Adam means earth, it's earth, and so Adam is earth.
Speaker 2:And then the word for breath has a couple of different meanings Ruach, it means spirit, so the breath is the spirit.
Speaker 2:And so connecting the idea that the wind, wind, the breath, is the spirit, and so connecting the idea that the wind and the breath are the spirit, and then connect that to adam, to adam, that the wind, the breath, is the spirit of the earth, like that we, like we are earth beings, like all of the elements, like, once our dna comes together and it starts emitting the signal, the beacon call out to the material world, you know, because once the two strands come together and form, it starts emitting. I need this element and I need it in this much quantity and I need this, and then, like, throughout the entire lifespan of that d sequence, it's emitting that signal. And so it is about the material, physical world, but that wind. So the idea is that the earth that is in here needs like nothing grows in ground that's not tilled. So when you breathe, you're moving. You're moving all of you're moving the earth within you and and getting getting that oxygen and that life in it, yeah, you know what I wish.
Speaker 3:I wish that cause like. Just seeing you talk about this is like. I love to see you light up like that. I wish that you could have these conversations with the average person, because if, if you're like you know, if you're talking to somebody who you know doesn't really talk about this, often they're like what the hell are you talking about? But like listening to you talk about it, this is what fuels my fire. Like this is the conversations that I want to have.
Speaker 3:And I just wish that more people were open to that, like just to talk about that kind of stuff. It's so.
Speaker 1:Yeah, it's. It's hard because each soul has to come to their knowing on their time, like on their own, and so when we, after we've done that and we are in touch and we have the knowing, all you want to do is tell people about it all you want to do is tell them like how good it can, kind of like when you get a new job and you go to this hospital in this unit, you're like you got it.
Speaker 1:It's amazing, yeah, but the thing about it is you have it's like a practice of being patient for them to come to it on their own. That waiting, and in and of itself is a spiritual practice. I feel, you know, it's like speaking a different language. They hear you, but they cannot comprehend what you are saying.
Speaker 2:Well, you can't make anybody wear the glasses, you know once, once you've put them on, you can't take them off like, and you can't make anybody put them, you know so yeah well, so that that kind of connects to everything that julia and I are doing and talking about, which is like just we've we've talked about it so many times um, just the idea that experiencing suffering and death creates a lack of meaning in life. And so then that creates people that are searching for meaning, meaning that we're all part of. The reason why we're in this conversation is because we've experienced so much suffering and death in our careers and the fact that there's an isolative factor in that that, because death and dying and suffering is siloed into the hospitals, no one else out in the community can relate to the experience that we're having, so we're isolated in that experience. So then when we get together, we're pinging off each other. You know having these existential observations.
Speaker 1:So we kind of got into it. But that can be our intro a little bit. We have a guest today. This is Madison. She's a nurse also and we worked her and I worked together at the hospital. She was just a new little baby nurse. I was Was that your first job? It was my first job.
Speaker 3:That's what I thought.
Speaker 1:Yeah, and what year was that? That was 2018. 2018. That's what I thought, yeah, yeah, and so you know, we're we're doing kind of a series of episodes introducing, talking about engaging with kind of information about hospice and hospice nursing, hospice care, what it means, where we're at now with it, where could it go, where we're at now with it, where could it go, and so the next couple episodes we're going to have different guests on talking about different aspects of it. And today we have Madison, who is going to share her story kind of how she got into nursing and how she got where she is now and you know a little bit about her journey.
Speaker 2:Because I think when we talk about our journeys, when we talk about our personal stories, it's really to relate, it's really to for us to process and for someone else to cling to to find hope in, to resonate with, and you know the shared, the shared storytelling from our ancestors is really, and death was so emergent and crisis-based and created so much trauma, and so watching how hospice services operate, watching death with dignity, and then learning that hospice services are increased, meaning there's a six-month benefit that is out there for everyone, but most people only enter into hospice within the last month of life, whereas they could be, uh to receive the information and reconcile their um, their mortality sooner, which is what this is. We're attempting to educate a populace that that should be thinking about these things, um that if, if we were successful in this, even in a small degree, it would, it would save so many nurses from so many moral injuries, because then they don't have to break every bone in Meemaw and Papaw's chest. So that's kind of the perspective that I'm coming at it. You know, julie and I's perspective. Our mission is to help nurses that are suffering and potentially suicidal.
Speaker 2:They've gotten to this point in their career where they can't reconcile what they've participated in and witnessed and seen, and they're isolated in that experience, and so my perspective in analyzing hospice is purely from the perspective of the critical care nurse, that I'm trying to help the critical care nurse by seeing, by seeing this problem and addressing it through the podcast and getting getting this educational piece out, because in some of my conversations it's not just education. You can educate someone that they need hospice services. You can educate them all day long, but if they don't reach the existential maturity that is needed to make the decision, it's all useless. And so you know, on the on the backside of of COVID, where, um, you know, people were really confronted with their mortality, I think that the ground is kind of uh, ripe for the conversation, um, especially with the baby boom generation.
Speaker 2:It's, it's a mountain of people that is getting ready to landslide onto the healthcare system that can't handle it. So to me, this is probably I mean, I do think that this is because because of the numbers, because of just the, the quantity of people that are going to be dying in the next 10 to 15 years 5, 10, 15 years and that nurses are peeling off, either going to upper level schools or they're just leaving the career or they're killing themselves. It's an inverted situation and it's untenable and it has to change. So by taking care of the nurses, I'm taking care of everyone, we are taking care of everyone.
Speaker 3:I wish I had this podcast when I was a nurse at the hospital because there were some dark times there and you said it. You said it when you were talking. It's trauma. It's. It created a whole world of trauma.
Speaker 2:Yeah, yeah, so tell us about you.
Speaker 3:Well, um, so I, I I mean, where where do I start? Um, I, I guess I graduated in 2018 and got my first job at the hospital actually the one where Julie was working and I started in a cardiac unit and it was funny because in nursing school, that was one of the things that I was like I'm never doing this. I don't like reading rhythms. This is not. I don't think I can do this. This is too hard and ended up being my first job and, um, I, I loved it and I also hated it and, um, but I mean, I, I needed it. I mean, I think it's what built the backbone of who I am as a nurse. Um, and then going going to hospice was just a total 180. I mean, it was a complete leap of faith. That's kind of I, I don't know what else to say. What. Where else? Um, I don't know what else to say. What, where else? What?
Speaker 1:what do you think? Why did you think you went to nursing school?
Speaker 3:What, what took you to nursing school? Um, okay, well, I feel like, okay. So my, my mom has multiple sclerosis and, um, so, growing up around that, you know, um, she, a point of time she had to get shots like every. It was either every week or every month or something, and seeing that was pretty I don't want to say it was traumatic, but it was like I couldn't quite understand why she was getting these shots and what they were for and why we were being taught to give them to if, if we ever needed to. But the I, you know, kind of being around that I, I wanted to, I wanted to do something like that. I knew I wanted to care for people in in that way, seeing my mom have, you know, deal with that, that was kind of. It was hard, but it was also, like, you know, I wanted to be there for her and it kind of made me feel like I wanted to be there for anybody else who had that.
Speaker 3:So when I went to college I was like I think I, I think I want to be a doctor, I want to help cure people, I want, I want to, you know, see what I can do to change the world and like every college student does. And so I I started at Park University. I was like I'm going to do this, I'm going to get a biology degree and be a doctor. But then I was like this is too much schooling, I don't want to do this. How how can I still care for people the way that I want to and not not go through you know 10, eight, 10 years of school?
Speaker 3:So I was like, okay, I guess you know, nursing seems to be the next best thing. And also I feel like doctors do not spend I mean, they just can't spend a lot of time with patients, and I feel like nurses are the ones who are really there a lot. So that's kind of how I fell into that. My older sister is a nurse too, so she was kind of an inspiration to me as well. So, um, she is an inspiration to me. So that's kind of how I I decided on nursing and then kind of took off from there.
Speaker 2:So how was the how was the transition from emergency-based medicine to hospice service medicine?
Speaker 3:It was very it was an awakening. I, when I was still at the hospital. So I worked there during COVID too. So I kind of had a traumatic experience with death in the hospital. There was this one incident that happened and I was just, I was terrified of death. I was terrified of being in the presence of a deceased person. I couldn't do it.
Speaker 3:I was like I think I even went PRN at the hospital because I was like I need to figure something else out. I either need to step away from the bedside, I need to change my career Totally. Um, I, I would have, you know, panic attacks just going, uh, into work. I, you know I would. I would medicate myself with Benadryl the nights before so that I could actually sleep, um to get ready for these shifts. I, it was horrible. So I came in, um I, I came in contact with a, with my sister's friend who worked in hospice, and I was telling her about, like, my experiences and what's been going on, and she was like you should really consider hospice because that's where I am right now. It's, you know, it's changed my life. And I was like I mean, I don't know, I, I just right now. It's, you know, it's changed my life and I was like I mean, I don't know, I just I.
Speaker 3:Hospice was also one of the things that I was like I don't know if I could ever do this. I don't know if I could ever support these people in the way that they needed to, like, what am I going to do? What am I going to say? And so going into the world of hospice was just a I mean, it was a complete 180. I mean, I, I actually went into this job conquering a fear. I, I, I needed to conquer this.
Speaker 3:It's really ironic, really, because I was when I went into this job initially, I was like gosh, I hope I don't, I hope I don't see a dead body, I hope I don't, I hope I don't experience death. So it was like really ironic Cause, like it was like why are you going into hospice then? So being being like totally immersed in that fear, I feel like was completely necessary for my growth, and we all know growth is uncomfortable. So I I I guess there's no, there's no better way to say it other than I went into hospice with a complete fear of death. And now it is something that I am regularly around and I regularly speak about it and I'm. I mean it's. It's wild to see that change of being so petrified of something and then having it be your weekly norm. Yeah.
Speaker 1:I mean, it's like it's just a dichotomy. It's like what you were most afraid of is what you needed to go through to be taught and how it. How would you ever know that and choose? But there was. So there was something in you that knew not maybe consciously, but unconsciously or subconsciously that it was a calling. That is you said it earlier before we started recording like magic. It's a divine situation that arises to allow us to move into that next level, you know, that next level of our journey here on earth to kind of uncover some of that stuff. Yes, so what did some of those first shifts look like for you?
Speaker 3:Oh man, I mean, I was the I still am, well, I was the youngest person working in the hospice agency and I it showed it definitely showed. Um, we, I was told I was going to get like three weeks of orientation or something and I was like I actually I think I'm going to need like at least a month maybe, and so, like it was funny because I actually ended up like getting a sprain in my ankle and had to be on crutches and it was this whole thing but like literally my first week of the job. So I was like is this a sign that this is not for me? Um, but I, I was trained for. I got that like month of orientation, which I definitely needed.
Speaker 3:Um, I, I was very timid. I was timid with the whole idea of hospice. I I probably looked like I had no idea what I was doing. I mean, just like we do with everything that we, you know, haven't experienced before. But I, I saw I started seeing a new, like a, a different nurse, madison, probably by like month five, because I was like I was looking at things that I was kind of comparing like myself to you know, at that time, versus when I first started this job and I was like, wait, maybe you do know what you're doing and maybe you do know the right things to say. So it really it didn't take long for me to start feeling comfortable with hospice, which is just so. It was like night and day, because, working at the hospital, I was like when am I going to feel? Okay, like when, when am I going to feel comfortable with this? Am I? You know, every day I constantly was just like, like it doesn't get better. I mean, is it going to get?
Speaker 1:better.
Speaker 3:And then, you know, being in that world of hospice was like this is where I'm supposed to be, so it was. It was a. I mean, the awakening is is really no, no better way to put it. I was yeah. The awakening is is really no, no better way to put it. I was yeah.
Speaker 2:How I so I like asking people this question with that have experienced suffering and death, and it's it's an interesting question to me because, as I've said before, so many like we are siloed we are, we are in the box where suffering and death happens and we're so intimately connected to it and so much of the outside world is so completely disconnected from it. It's just not part of the consciousness of of humanity in the ways that it was in previous times, because of all the advancements that we've made over the last hundred years. How has your exposure to suffering and death changed you and how has that impacted your relationships with people outside of that box?
Speaker 3:Wow, that's a. That's a big question, that's a. It's a loaded question, but I I mean it's a necessary question.
Speaker 3:Um man, there's so many answers um just so, being in that world of death and dying, I mean it really, when you come in contact with people who behave certain ways, it kind of makes me, it prompts me to kind of understand their core, like the why, like what have they been through for them to behave like this? Versus, wow, you're being such an asshole right now, like I feel like I like being around that that world of death and dying. It really kind of opens me up to the deep understanding of why and how. And I also feel like I have grown like just a huge amount of compassion for people, because I mean, when, when we are supporting these families through their loved ones deaths and you know, their end of life preparations, like we are having to essentially coach them on something that they've never been through before, like and I mean, you know, there there are so many instances where, like you know, losing, losing a mother like I I have not been through that before yet here I am giving them, you know, the emotional support of it and sometimes I'm like how, how am I doing this? But it like creates such a big like just just so much I just I feel like I find myself more compassionate overall.
Speaker 3:Um, I'm. I find myself more, um, more understanding of, of you know, taking taking the time more to be like I don't know. I guess I'm basing this off of like when, when somebody pissed me off in the past, I'm like, I'm like, whatever I'm, I don't care. But like now it's like what have you been through? Like what, what happened to you, and I just feel like I'm more. I don't know if that makes sense.
Speaker 2:Yeah, I mean, I think experiencing it gives us an objectivity of the experience of life that others don't really get, but to me I feel like it can cultivate. It definitely cultivates a higher degree of compassion and being able to see people where they are and also, as Julie and I have talked a lot about, it hardens you and hard stops on situations and people that are absolutely like. It gives you that, that objectivity to to put up boundaries that are just 10 inches deep, you know we're not taught that.
Speaker 1:We're not taught it. Nobody teaches them in nursing school. Nobody tells you in orientation how this is going to be, how you're going to feel, what you're going to need to do to prepare your mind, how you need to release emotions from that. We don't even recognize that we need to do that. We're just like going through the motion, just like with everything else, like you know, as if, as if it were like a policy and procedure thing. I mean, how many times did I pull out that care for the dying policy and procedure? You know, it's like we have to task it out and there's, there's no room or time to do any kind of processing within the moment, within the shift, and then, once you leave the hospital you know, to me that was a cut, like cut, I don't. You know it was all involuntary.
Speaker 1:All my thoughts after I left the hospital either came to me in dreams, came to me and just as I was trying to go to sleep, driving home but not purposeful, I didn't take time purposely to just say, ooh, let's debrief about that Like, how does that make you feel what? What did it bring inside of you? Where do you feel it in your body? Um, give yourself grace.
Speaker 1:That was a lot. Take a bath, take yourself, you know, take care, none of that and so, but your, your soul is screaming for that. But that comes out in bitchiness, short temper, yelling at the kids, pissiness with yourself. I've let myself down. I can't sleep. I weigh more than I've ever weighed. I'm drinking more than I ever drank. That's what it's coming out as that is it speaking, and we don't know that language, more than I ever drank, though. That's what it's coming out as that's what it's saying. That is it speaking, and we don't know that language. And so you have to put it somewhere, because you're experiencing that death, and a lot of times in the hospital it's, it's chaotic, and so now you have that energy wrapped up in what happened and the chaos and your mind. You don't know what to do with it. It, your body, does not know what to do with it, you know.
Speaker 2:And then we're, we're overstimulated. We leave the hospital and you get in your car and you got your favorite music going and you just immediately get distracted and you get. Then you get home, you get showered I mean, if you're lucky, you know you might watch a TV show. So you're distracted again, uh, and then you do it all over again.
Speaker 1:Oh, distraction, that's a good word. It is a lot of distracting.
Speaker 3:Yeah.
Speaker 1:Yeah.
Speaker 3:I also feel like, with, since being around so much death and dying, I like I look at things and I'm like, does this really matter as big? Like this is not as big of a deal as, as you know, if certain situations that happen and you you look at it and you're like you know if someone's behaving in a certain way about it and they're like freaking out, but like I feel I find myself taking time like does this really matter? Because, like you know, people are experiencing their worst days of their lives, you know, dealing with, with the passing of their loved one, and I I just feel like there's so many times I've been like this does not matter, like there are more important things.
Speaker 3:So, but I back to what you were saying like the distraction. I feel like I was constantly trying to distract myself and I feel like I'm almost like realizing that more now because I really didn't have time to process my experience at the hospital. I mean, you know, I had a really good um Jacqueline, I had a really good friend there that worked with all of us. That she, she, really she's still such a badass, she's just a badass nurse and she, she kind of she was a huge part in my comforting of working there.
Speaker 2:So Do you guys remember that uh game on the phone? I think it was called Temple Run.
Speaker 3:Oh yes, that was like a huge anxiety provoking game.
Speaker 2:Like that's what you, when you were describing your distractions that was the image that came into my mind was Temple Run, like we're like.
Speaker 3:like we've got all these things chasing us and we're just running ahead of them oh my gosh right, but even playing that game you're like like it's like a anxiety provoking game yeah, yeah, no, that's the nursing experience we're running from all the experience we've had, so temple run and nursing yeah yeah, it is so true.
Speaker 1:So another piece of this and kind of these episodes, I think you know I don't know what caleb thinks, but what you know walk us through like what your day looks like when you go to work as a hospice nurse okay, uh, well, I will say I don't have the typical hospice job.
Speaker 3:So I went into. When I started with hospice I was a case manager, so I had a set of patients that I followed until death. So I would see these patients on a weekly basis, you know, participate in their care plan meetings, participate in the IDT, the interdisciplinary team meetings. I did that until I think last June and then I'm still with the same hospice agency but my role has changed.
Speaker 3:So I'm with our on-call team now so I respond to the deaths, I respond to the emergencies, like if there's something going like a patient has had a significant change in condition, if they've had a fall and there's an injury, and then I do any admissions that you know need to be done or whatnot. So I kind of am. I guess you know I work seven days on and then I'm off seven days, so I'm kind of our night owl, if you will. I have to keep my phone on me throughout the night and sometimes I get a call and sometimes I don't. I mean, it's very rare that we don't get calls throughout the night. But yeah, I'm with our call team so I respond to visits rather than following those patients anymore.
Speaker 2:So yeah, I'm just thinking um, thinking of how, like, because again, my our, our purpose here is to help critical care nurses and I'm curious what your perspective is on having come from critical care. You know, I know the unit that you worked on, I have had plenty of traumatic experiences on that unit and and now working in hospice. I'm just curious how, how you kind of receive what I was saying about hospice being underutilized and what answers you have to the question of how we can increase the awareness of the service and its utilization. I'm curious what thoughts you have about that.
Speaker 3:Well, so I, just to start off, that I, I, critical care nurses in my mind are like famous to me. I see critical care nurses as just these, just amazing, like how are you doing this? I, I, I look at them like they are the I don't know, they just are the most amazing things. So I it's it's ironic me trying to, you know, give advice, I guess, to critical nurses, or that is not I. I don't feel comfortable doing that because it's like I advice, I guess, to critical nurses, or that is not. I don't feel comfortable doing that because it's like I, you guys are the, you guys are the cool ones I'm.
Speaker 3:I'm just kind of I feel like also working in hospice. I'm like it's almost like a little bit imposter syndrome, like I, you know, I, I am a nurse, I am a hospice nurse, so sometimes I get in my head a nurse, I am a hospice nurse. So sometimes I get in my head like I know nothing about critical care nursing to that extent. But I mean, I do. I have to remind myself that that's kind of essentially where I came from. I've been there. One thing that I would say to kind of you know, help that under utilization is within the hospital setting. I found that I just feel like nobody was talking about hospice.
Speaker 1:I I.
Speaker 3:I feel like it was something that was just completely foreign. It was like we, we weren't. It's almost like we weren't supposed to talk about it because, like we, you know we, we had to get the specialties in there. We had to get the specialist doctors to go see, to go see, you know, room two, because you know there, you know there's, there's more that we could do, and it, it, it. I hate to say this, but it's like a it comes back to like a money thing.
Speaker 3:It's like with with hospice you're, you're not seeking the specialists anymore, you're not getting on all the medications anymore. So you know pharmaceutical companies aren't getting those reimbursements for those medications anymore. You know it's, it's, it's almost like hospice was just, you know, hush, hush in the hospital because, wait, we can do more. So I feel like within the hospital setting, hospice needs to be talked about more. I think there needs. I would go as far to say that there needs to be, you know, meetings within units that touch on hospice that talk about, you know, if you're dealing with a patient who is critically ill and you know their prognosis is very hindered, we don't know where it's going to go. I mean, I don't think it would be a bad idea to, you know, consult the hospice physician or consult the hospice people, whatever that may look like and families. You know they're often they're in denial and they're not ready for that, but it's important to get that conversation started within the hospital setting. So I think that that could be something that could help this.
Speaker 3:You know, underutilized benefit. I mean it is, it's truly a benefit Like hospice is. People need to know more about it and I feel like within the last you know, couple decades or whatever. It's been very skewed, because when people talk about hospice they immediately think death, like that's and like why wouldn't you? You know, but we've had, we've had some hospice patients on for one and a half, two years because they continue to meet the requirements for the for the benefit. So they just have to keep recertifying and if Medicare believes that they're, you know, eligible, then they remain on that hospice benefit.
Speaker 2:So Well, that kind of brings up, uh, when you, when you mentioned um meetings in hospital units about hospice, it immediately brought up the um, the idea of death panels. And so, um, Kevorkian, dr Kevorkian, when he was doing his uh assisted suicide stuff, um, it sparked a lot of debate. I remember that, a lot of that debate happening, I remember. I just remember that time when they were working to put together panels to assess the appropriateness of, of of care and like critical care services and and discuss end of life care, it became politicized and they and I don't know which side of the political aisle it was that that demonized the idea. But it became death panels. That that was the politics, politicization of of this idea that we're talking about.
Speaker 2:So I think hospice got kind of steamrolled into that conceptually, that hot, you know people, uh, kvorkin was such a polarizing figure and and I don't remember all the details of what, what it was that he did, um, but I I just remember a lot of outrage over it and you know, that's obviously not what we're talking about. We, we think, we, we think life is precious and should be treasured. Um, but dying with dignity is something that is uh not talked about and uh, because suffering and death is siloed in the healthcare consciousness and the outside world just ignores it. Um, it's getting people to that, to that understanding of death with dignity, and how important it is, and how especially important it is in this time.
Speaker 3:I feel like also part of the issue is people aren't talking about hospice and death until they absolutely have to you know cause, whenever it's, whenever hospice is consulted. I mean and you said it best it's like they have, you know, six months, but people are coming into it with a month or less of of life.
Speaker 1:So and I think that's just just um, a product of our medical system. It didn't used to be that way. You know, when laura ingalls wilder days, or you know, back in the egyptians, it's like death was revered, like you know, if, if you were dying you, you were now in this, like next life, this whole next phase, that was sanctimonious, almost, like you know, just looked at with like honor, you know, and their body was treated as such and prepared as such and and it was very respected and respectful of it, and like it was integrated that you're going to die, we all die, but the process and getting to death and then dying was something that maybe you know, you didn't look forward to, but that you knew was going to happen. So it wasn't, it just wasn't a deal and and nowadays it's, it's like everybody's like whoa, you know, whoa, whoa, whoa, like dodging death, not getting clothed, don't talk about it, don't talk about it. You got, you know you got a. You got a diagnosis that the end is death. Okay, so what does that look like?
Speaker 2:You get that at birth.
Speaker 1:Oh my God, oh my God, yes, but I you know, how many times in the hospital did you know that the patient had a terminal diagnosis and the family was like we're not telling grandma, we're not going to tell her.
Speaker 2:Which which actually puts a trauma on the nurse. I think I've probably said this before, but the fact that we're carriers of knowledge meaning we know something that you don't know, and and and we have to interact with you as if, though, we don't know yeah, we can't let on that we know. It is a bizarre thing, and it is a special form of the trauma, like just a nuance of the thing that we're carrying.
Speaker 3:But that that reminds me. There are some hospice patients that I've had in the past where families don't allow us to use the word hospice, we aren't allowed to say hospice. So if we come in and see the patient, we can't say, oh hi, I'm Madison with so-and-so hospice. We have to say oh, I'm, you know, I'm your extra care nurse or whatever. Because you know, there's always I have found, there's always that one family member who isn't quite on board with everything and even though many of the other family members are on board, there's always that one person who's like wait, hold, hold up here. This is not where we're going, and I don't know.
Speaker 3:But back to what you were saying, julia. You know, just still to this day, there are some experiences that I've been through since working in hospice. I still can't explain today. It's, it's very, it's spiritual work. I mean it really is, it's necessary work. It is, I mean, and divine, I mean divine timing, divine, everything within the hospice. It's, it's, it's truly a, it's, it's a work of magic, it's, it's a where I'm supposed to be. So I, I don't know. I'm curious to know, Caleb, what have you had since working in hospice?
Speaker 2:Have you had any experiences where you're like, like, just like, almost like I guess I'm going to use the word supernatural like things that you really can experience while encountering someone who yet, you know, I've had one death so far I've only been doing it a few months and they've been extremely gracious with how they have integrated me into their system and allowed me to take relatively, you know, stable patients that that aren't really imminent and learn all the charting and get that whole, because that's the biggest piece of I mean, you know, once you have the critical care like ICU nursing skills, you know, being able to go anywhere and do anything just come like, really the limiting factor is understanding how to navigate the charting systems. So they've been very gracious to me and in letting me uh, learn that, uh, without throwing me too deeply in, but I mean, I've, I've, I've had a lot of very spiritual experiences in the ICU and the ER. I mean, that's where most of my time has been and I know that it's different. I know I'm certain that I will have those experiences and I really like it. I, you know I had a.
Speaker 2:I had a patient um, I might've talked about this last week, um but I had a patient that uh didn't didn't think that they were going to make it to 2025, and they were so tearful and and we just and they were so tearful and we had such a beautiful conversation about life and death and I walked away from that conversation going maybe this is what I'm able to have this conversation, and it feels so right, like it. It just is so it. You know, if I said this previously, it feels like I'm I. That particular conversation and a couple of others feels like I get to have the conversation with the patients that were that I that should have been having that conversation in the hospital. So there's like this having that conversation with people that are in that space is healing the part of me that was hurt and broken by the people that didn't get to have that conversation. So, um, that's been. I've been telling Julie she needs to come do it. I think she would love it.
Speaker 3:I think, julie, just who you are as a person, I mean you would thrive, but you're also so good at, you know, going into the fire, I mean, and by that I mean dealing with those situations where you know there's just panic. I mean you, you, you know how to be, that kind of support, I guess. But yeah, caleb, I can agree with you. There's been so many times where I've walked out of a patient visit and I'm like my cup is so full. I like this, this conversation I just had with this person. I it's almost like. It's almost like therapy. I feel better, like.
Speaker 3:I feel better so.
Speaker 2:I feel like I actually made a difference in somebody's life, which is like so much of why we choose to do the work that we do.
Speaker 3:Yeah, I love moments like that.
Speaker 1:Me too. Well, it is like a gift. It's like a gift being given back. I think, when we open ourselves up to to looking within, to what, doing inventories, what is in there, what have I held on to all these years through the experiences that I've gone through, and you kind of what is there. But as you open that up and let some of that out, it makes room for different and better experiences that are very nourishing.
Speaker 1:You know, we all have had so many experiences, especially within the hospital, that have been so damaging and so traumatic, and even nurses listening. It's not like one huge catastrophe after another. Sometimes it's like the little things. Like you know, my patient had to go an hour and 45 minutes before I could get in pain medicine because the pharmacy was something and I couldn't get the doctor to put the order in, and so they're laying in agony but you, your hands are tied, you can't do anything because you're just waiting.
Speaker 1:So even that is traumatizing and so if you do that over and over and those little things that come up, that you know maybe the cardiologist should have come and taken him to the cath lab and he didn't, and now until in the middle of the night. But now it's day shift. That's damaging, and so all of that damage that we have been exposed to. Once you are able to go within and open yourself up to the light that comes in, I think that's where we find these new things that we're doing, and we're able to heal some of that through these new experiences.
Speaker 3:Just as you talk about that, julie, I found myself kind of going through my memories within that hospital and like I can feel my heart racing, like because, like my nervous system has been activated, like wow, that actually was really traumatic and maybe I I mean, I don't, I don't think I have processed some of the things that I went through in that hospital as I should, and it I mean literally right now, like it is creating, you know, I mean panic, yeah Well, and I think I don't think we'll ever quit processing.
Speaker 1:So I don't think it's like, well, I process that and I'm done. No, not really. Right. Right, Something else will trigger it, something else will come up. Your reaction will lessen as you continue to process.
Speaker 1:But here's the thing I've found as you process and your triggers become less it it you, you can see deeper. So it's like you're scooping out and there's trauma all the way back. And you know, as we've kind of talked on this podcast, a lot of nurses become nurses due to childhood trauma, and so it's like a thread, something that you're kind of you cling to because it's familiar to you. And so, as you're processing and opening up to let some of that new stuff in your body then now knows it's a little safer. I feel okay with you, me, you taking care of me, so I'm going to bring this up now. So now you know like I quit drinking in 2017.
Speaker 1:You would have thought that that would have just been like over. Well, no, and I've done a lot of processing since and you would have thought, okay, you process through that. No, actually. So you know, the same triggers aren't as intense. It just kind of allows for new things to come in, and so I look at our lives as journeys of just learning and processing through and, and all of these experiences that we get to be a part of and that we're drawn to and feel magic are meant for us. You know, we're all meant to be where we are right now, doing what we're doing to learn something like as an excavation of our own selves, learning.
Speaker 3:I truly believe that you are met with certain people, certain events, certain jobs. For a reason, I mean I, I don't know it's. It's funny because whenever I went into hospice, people were like people that I worked with at the hospital were like aren't you afraid that you're going to get like bored? And like in my mind I'm like, oh, you mean being a safe, consistent environment where shit isn't hitting the fan all the time?
Speaker 2:no, I'm actually oh my gosh I love that.
Speaker 3:But that's the thing is like we're we're always constantly waiting for that next chaos, because when things are okay and things are calm, we're like what's wrong, what's a like what's about to happen. You know it's like we can't ever be in that sense of you know it's like okay, wait should wait. I need to make sure this isn't going to happen. I mean, it's just like well, it's a condition.
Speaker 1:It's the conditioning that we've been in and that almost all nurses are put in, especially those ones who work in hospitals, acute care settings, it. That's what we're conditioned to do is to always be looking for the word. And, kayla, what I've talked about this on the podcast too we, we are even out of the hospital. You, we scan the environment. Whether you're at an airport, on an airplane, at a baseball game, you're like, oh my God, like any of these people could go down at any moment.
Speaker 3:Oh my gosh, that is so funny that you say that, julie, because I feel like I I literally was at a dinner rehearsal somebody's dinner rehearsal, like this, was like maybe a year, two years ago and something happened, somebody fainted, and I had my phone, I dialed 911 and but I didn't press the call button. I had it ready because I like, if someone was going to, if this was someone that just coded or you know, stop, I was gonna press call, give it to cody, my husband, and go right in. Like I was like it's like wow, like, and then I'm like do people, do other people think this right?
Speaker 2:just us it's actually just us, yeah, no but I, I do, I, I, if I'm in a room of people, I scan it and I find the person that I think is the most likely to go down. I know and some of the things I think is that one right there I'm watching you I'm watching you.
Speaker 1:Yeah, you don't look good. Your skin is a weird gray color Like. Is that how you always look?
Speaker 3:What is your hemoglobin?
Speaker 2:Yeah, what is your hemoglobin, or Billy Rubin, or Billy Rubin.
Speaker 1:Yeah, oh God, it does.
Speaker 2:We hope you've enjoyed this week's episode.
Speaker 1:Remember, the conversation doesn't end here.
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Speaker 1:Together, let's continue to redefine nursing and shape a brighter future for those we care for. Until next time, take care, stay curious and keep nurturing those connections and don't forget to be kind to yourself.