How Nurses Are the Backbone of Patient Care

Welcome to Massachusetts College of Pharmacy and Health Sciences Podcast, the secret to Living to 200. My name is Jennifer Persons and I'm your host. In each episode of this series, we'll explore different aspects of health and the factors that allow us to live longer, healthier lives. With the help of a thought leader from the university this year, MCPHS is celebrating its 200th birthday, and what better way to kick off our bicentennial celebrations than with a podcast about longevity and wellbeing? Joining me in the studio today is Dr. Deborah McManus. She is associate dean and associate professor in the Thank you. Thank you for having me. If you had a time machine and could travel 200 years into the future or 200 years into the past, which would you pick and why? I think for me, I would want to travel 200 years into the past. I would like to see the journey of how we've come to be where we are. I think with my profession, with everyday life, and I'm very interested in a big antique fan, a collector. So I think the journey would be backwards for me. I've researched a bit about your career, but I want to start by getting some insight into why did you want to become a nurse and how did you pursue that career path? So because I'm of a certain age, it goes way back. My career spans decades more than four decades. So thinking back why I wanted to be a nurse, I became a candy striper and many people wonder, what is that? I was age 13, so we were volunteers and the hospital was in my town. So I was able to get there and feed patients, help them get out of bed and just sit and chat with them and get to know people. So that was where my career, I want to say really started. So the notion of being a nurse and back in the day for us women, the choices were a little bit limited. You would be a nurse, you'd be a social worker, you'd be what they called a secretary back then. So we didn't have these huge professional goals. You'd be married, you'd have children. So for me, being a nurse seemed like the right thing to do and my heart was in the right place. I really enjoyed working with the patients at the hospital and getting to know them. So I said, I'll become a nurse and here I am. And then when did you get to start to actually pursue it as a profession? So when I graduated from high school from my generation, many people didn't even go to college. They went right to the workforce. So I looked at a program called Licensed Practical Nursing, and we have many, they're called LPNs and they're kind of the precursor and the support to the rn. So I sent 'em a year long program. It's really clinically immersed to get a lot of clinical experience, a little bit of classroom, and I said, let's start there and see where that journey will lead. Me. What was your first job as an rn? Well, even as an L P N I was starting to take charge at the hospital I was working at was working at a hospital in Cambridge, and at that time they were really utilizing the lpn. So I was in a charge role at a really young age, but as an rn, my first job was on a palliative care floor and today we used to call it terminal care. Back then people were at their end of their life. So I'd worked on the palliative care floor probably five years as an rn. So it was really tough, really grueling. Where did you spend the most time in your career? Probably pediatric nursing, I would say before I came into my role as an educator, I was in pediatric nursing for two decades, so that was where the crux of my career has been. But I've done medical, surgical, nursing, home health care, really done it all. I've been a school nurse, a camp nurse, so I think there's not much, I haven't done a lot of med surg exposure. Yeah, that's a varied experience. Is that unique for nurses or do you see a lot of people who have touched a lot of different specialties? I think that's the beauty of nursing is that you can move around, especially now more than ever, you can really get out there and there's so many tracks to nursing and so many concentrations. So I think that's not a new thing. I think there's even more opportunity now because before when I was a young nurse, you were limited. You couldn't go right into pediatrics, you couldn't go right into obstetrics. What was your experience? But now there's opportunity and I think because my profession's in crisis and we're really looking to fill positions that there's opportunity. Sadly, about 30% of nurses today are leaving the profession, which is very concerning. What do you think is the catalyst for that? I think we've always been a little bit in a nursing shortage because of the burnout factor. Because what we do is we're there at the bedside day in and day out. You're exposed to some really challenging experiences. I think the pandemic has really driven it. I mean if you were to look at what it transpired during the whole pandemic and healthcare situation, nurses, we carried it on our backs. They were at the frontline. So imagine doing that. Not really sure what the end game was going to be because it was such a scary time, but nurses never left the bedside. They were there. And I think afterwards a lot of nurses have rethought, maybe this is just too much. Maybe I'll look into doing something else. And I think because there are so many opportunities for young women out there today that weren't around in my day, that a lot of young professionals choose a different track. And I so often hear, I'm just a nurse and I could talk to you all day about that because we're so much more, don't ever say you're just a nurse. We've come very far, but I think we still have some work to do and feeling that we have a voice at the table that we really matter. And in your role in education now, how are you empowering these young people to face those challenges? Stand up to the burnout and the stigma, and what kinds of things are you instilling in them enter this challenging profession? I think coming into nursing, younger generation of students today come in, they're not really sure what does nursing entail? So I think what we do in education, and I think my piece is really talk to our students about what it means to be a nurse. And it's not really what we do, it's who we are. So it's not just a job you leave. At the end of the day, it's really who we become to the core, which is a wonderful thing, but it's not for everyone. There's still the 12 hour shifts and really being there maybe end of life or through some challenging time for the people you care for. So I think as an educator, my job is to really be transparent in what they're looking for in their profession. And you have to come into nursing with some level of compassion and wanting to care for others. And that's not something we can give an education. That's something really is inherent I think, in the individuals coming into our program. And when you were mentioning all the options that nurses have, how do you help them figure out where they should end up? So I think that's a really great question because I feel like more now than ever, there are so many more opportunities, but it So we have to talk a little bit about to be a bedside nurse. You really understand the profession, you're there day in and day out. And some nurses, that's where they want to end their career. And I think what I really stress to students today, there are many other tracks you could pursue as well. You could go into leadership, you could become a nurse practitioner, which is very popular track today. It is. So this is a wonderful thing, and I think this has come really full circle now in 2023 with the options and the different tracks for that. And do you believe that every student still has to have that foundation of bedside care before they can branch off to specialize in something else? Yes, I do. I really believe that it all starts at the bedside. What is the nurse? What's our role? So if we're going to expand our role, we have to start at the beginning. So I think that's the message I always send to students and to really love the profession because it is something you have to feel passionate about if you want to care for others because it can be very grueling and you have to self-care. I do tell the young nurses today have to think about self-care, which is a whole new topic today. Really. We didn't really have self-care back in the day. And it's always about the patient. That hasn't changed, but sometimes you do have to step step back and see how can I care for myself so I can care for others? We're talking a lot about how much face time nurses have with patients, and in light of the shortage, do you think there's a way that nurses can be better utilized in the system? And from the public perspective as patients, what should we be turning to nurses to? What can we lean on them for? I think that's really a multifaceted kind of question. And I think Mass College of Pharmacy does a really good job at addressing healthcare and interprofessional practice. And the nurse is one piece of that. That's why I think this university is just so important to healthcare in general. And I think being a nurse is one piece of the team. So I think that the general public should see that, right? And there's many faces at the table and caring for the patient. But the nurses, I see us as the glue because we're at the bedside, we're there with the patients, nurses do so much. So I hope we can continue to spread that word and really pick up some real value of what we bring. Yeah. Why do you think the nurses are so central? You mentioned advocacy, but what kind of things are nurses dealing with and seeing that maybe other healthcare providers are not? So I think the whole, we are the eyes of the patient. We are at the bedside day in, day out, 12 hour shifts, maybe you're staying longer. So the providers come in and they may be saying to the nurse what's going on with the patient. We are the ones that really are giving the report on what's happening minute by minute sometimes. So it all starts with the nurse because other pieces of the healthcare team may come in, may come out of the room where the constant. So I think that's really the crux of our role. So if I were to for whatever reason, be admitted to the hospital for several days, what would your advice be to me about the things I should turn to my nurse for? First of all, you have to have a good relationship with your nurse. I mean, I always say to the students, they have to trust you. Patients have to trust you so you can get the best information from them. It may not always be a physical complaint as well. Maybe something emotional that they're experiencing, family issues, support issues, what do the patients need? So I think we're a little bit of the investigator at the bedside too, developing that relationship of back and forth. And we are collecting all the data, the assessments. We always talk about the nursing process, and that starts with assessment. So the minute you walk into the patient's room, you are making an assessment of needs. What is happening here? From the very first moment you meet your patient and all of this information is going to be beneficial at the end of the story when they're discharged, whatever needs to happen next. So I think for the patient, they have to realize who do you see when you come in, you see the nurse? So that's where it all begins. I want to turn the conversation a bit back to you because you are doing some really interesting research. Can you tell me a little bit about your work about people aging gracefully, mindfully? My journey really as a nurse and through the years looking at how we all age and even as myself where I am now compared to in my earlier days, I want to age gracefully. I know everyone does. So when I was a doctoral student at Catholic University, I'd come from my background. I was school nurse and I was an parochial school environment working for the archdiocese. So we had a convent there and I became a caretaker to all the sisters living in the convent. They would come to me for medical advice, show me their medications, this is happening, and really developed a relationship with them. So I started to look at the sisters and how they aged, and I noticed they were all aging very well, really aging gracefully. And I was like, the obvious reasons were coming to mind to me. We know that they may not have a spouse, people think they may not have financial issues, they're living in a community. So those are wonderful things, but I don't think that was the driving force of their aging. I wanted to look a little deeper. So they would talk to me about being caregivers to siblings, family members that Alzheimer's, had dementia. And I was thinking, wow, I know as a nurse that that's really a genetic connection there. Why aren't they experiencing the same thing? So I said here, I have so many of them, I could recruit into my study. So I'll do a small little qualitative study, which I did. I had 12 Roman Catholic sisters in my study. And I looked at their meditation practices, their and how that affected their aging journey to age successfully. So I looked at their cognitive engagement. Many of them were readers. They do crossword puzzles, somewhat TV that wasn't television and they were really up on the news. I feel like they were more into that. I think the most astounding piece was their daily practices of religion, meditation, and what spirituality meant to them. So to pray, a lot of times I would notice they would sit together and pray the rosary, and I would hear that, and it's almost like a chanting they would do. So it's a meditative practice. So I think the theme of the daily engagement in all of this was really beneficial to their aging. What age are we talking about? So I recruited them ages 75 and up, and we had them all into their nineties. I think the oldest one was probably like 98 and still really engaged and successfully aging. So really for their story of aging, I think meditation practices are hugely important. I looked at, even when I was doing my research, Buddhism practices like that, there's been some research done with Buddhist monks of really deep meditation and it really changes your brain, the whole structure. And later on your risk for Alzheimer's, you can overcome a genetic component. So I think there's a lot more work and value to be done there. For sure, for sure. But I think we need to think about our everyday practices that really are helpful to mitigating stress because there's lot of stress out there. So what kinds of things would you say that the average person, and when you talk about spirituality, you mean whatever kind of belief you have? Yeah, spirituality. I'd like to talk about it to make it so that everyone can understand. So I see spirituality is what the driver that really brings us happiness. And if it is meditational practice, that's wonderful too. If it's going for a walk every night, that's spirituality right there. You derive happiness from it. And I think if we're happy beings, we're going to age well I think. And if we have some practices that make us really happier beings, I think we can overcome a lot of anxiety and depression and things as simple as that. Bringing more into our lives that bring joy. If it doesn't spark joy, right, why do it? I think a key to that and these practices is doing them mindfully. How can we unplug from the digital, from the noises, from the stress in our life? Have you come across any tips or what do you tell students they can do to center themselves? Well see, that's an excellent question. I think sometimes nurses are so in the throes of something emergent happening. It's a fire happening. Your patient's, coding, patient's very sick. Things are very heavy. Sometimes it's just taking that five minutes to step back and to really tune the rest of the world out. However you can do that or accomplish that. And you've seen and dealt with patients all ages, literally from childhood through their nineties. When would you say is a good time for people to start incorporating these practices into their daily lives? I can say working as a school nurse, I used to see how children as young as like nursery school, kindergarten age, they were so stressed out in the classroom. So what they would say to them, go see the school nurse. And you know why that was? It wasn't so much that they were physically ill, they were just so overstimulated. Get them out of space, get them out of that environment and give them a safe space. Even if I kept them 15 minutes, 30 minutes, whatever they needed to check out of that rat race that was happening, all the stimulation in the classroom. So I think that it's really never too early to instill some kind of calm in your children. And would you say it's never too late to start? Yes, a hundred percent. I have to remind myself sometimes because I work a lot. I have to think about what I need for joy, too. Seeing everyone succeed and the students in the program do well gives me a lot of joy. But you have to remind yourself too sometimes. So my last question, and we've kind of touched on this, but I'm curious to see what the culminating answer is. If there's one thing that you would want people to know about nurses, what would it be? That we're compassionate. Compassion, really, you can't teach that. I mean, nurses just, we come in, we come in as compassionate people, really caring for others and empathy. We talk about empathy to putting yourself in someone else's place. That's what I tell the students. Think about it. If the roles were reversed, what would you want? You want someone who's compassionate? Deb, thank you so much for this conversation. I've really enjoyed it. Thank you for having me. We have come to a part of our show called Red's Rapid Fire. I'm going to ask you a short series of questions and the goal is to answer them as quickly as possible. Are you ready? I'm ready. What is your favorite color? Blue. Coffee or tea? Coffee. What is your most used emoji? Happy face. Are you left-handed or right-handed? Right. What was your dream job as a kid? To be a nurse? If you could travel anywhere in the world right now, where would you go? To Italy. What is your favorite holiday? Christmas. Who is your personal hero? Barack Obama. What is one thing you could talk about all day. Nursing. What's one piece of advice you would give to your younger self? Remember to stay kind. Thanks again, Deb. And thank you for listening to this episode of The Secret to Living to 200. We hope you'll join us next time. And as always, stay curious Cardinals.