Episode 11 - Clifton Joullian aka The Nurse Farmer - the importance of SPEAKING UP!

Thank you for joining me for another episode of the Nursing Strategies for Success podcast with this week's guest, Clifton Julian. Cliff has been a nurse for over 30 years. He's currently working in plasmapheresis, and he has over 20 years of home health case manager experience. Cliff is also known as the Nurse Farmer, where for the past 6 years he's been providing education on the benefits of growing your own fruits and vegetables for mind, body, and spirit. So let's welcome Cliff to the show. Welcome to the Nursing Strategies for Success podcast, brought to you by The Nurse Speak, a show where we rally some of our nation's greatest nurse leaders educators, experts, and advocates to tackle some of our greatest challenges that the nursing profession faces. My name is Damion Jenkins, and I'm your host for this show. So sit back, relax, and get ready to learn that nurses can do anything. Okay, Clifton, thank you so much for being on the Nursing Strategies for Success podcast. Why don't you just take a moment and introduce yourself to the listeners? Let them know a little bit about where you started in nursing and where you are today.

All right, well, thank you, Damion, and thanks for having me on the show. My name is Cliff. I'm a registered nurse. I'm also a farmer, and I'm known as the Nurse Farmer. I've been a nurse for, um, Gosh, I guess 30 years, just over 30 years. I started my nursing career as a licensed practical nurse and eventually became a registered nurse. I'd have to say most— the majority of my career has been as a home health nurse, though I'm no longer working as a home health nurse. That is my background. I was a home health case manager for, say, about 20 years or so.

Wow.

Um, the majority of that was in— yeah, the majority of that was in California. Um, my husband and I moved to California around 2001. Um, like I said, we lived there about 20 years, and that was where, you know, where I worked the majority of my career. And then in 2018 we decided to move back to Alabama, where we're from originally. We moved back with our, our sons and kind of, uh, started a farm here. At least we're— it's kind of a work in progress, but that's kind of where we're at right now. And right now I'm working at a plasma pheresis center. I left home health when I first came back here. I did work for a hospital for a very short time, a rural hospital, which I enjoyed, but I wanted something different, and so I found the job, um, working for a plasma company, and I've been there almost 2 years and love it. So in between the farm and, you know, the plasma center, I stay pretty busy.

Yeah, well, it also sounds like you have a husband to take care of and you have children to take care of, right? So you're—

yeah, well, let me tell you, the children are actually grown.

Okay. But that doesn't mean you don't stop caring for them, right? And stop worrying.

Right, right.

Awesome. So, so you're back in Alabama, you're doing the nurse farming thing, like farming thing. Is that full-time for you and you're working at the Plasma Center part-time, or how is your time split up?

No, so the thing is, um, the Plasma Center is my full-time job and Because we live so rural, where it takes almost an hour for me to get to work down in Mobile. So that it's a 40-hour-a-week job, but my 8-hour shifts are more like 10-hour shifts because it takes me an hour to get to work and an hour to get back.

Right.

As far as the Nurse Farmer, I mean, basically, that's my blog. And I'm, you know, I can only do what I can do. So I write and blog and I try to make videos too, but that can present some challenges in its own right. So yeah.

Well, I can attest that I've seen your videos, I've read your articles. I think that what you're doing with that component of your knowledge and expertise is so valuable. I'm an avid gardener. I wouldn't go as far as saying I'm a farmer because I haven't raised any kind of livestock or did large crops, But, you know, when I was in Baltimore for 16 years, I always had one of those city plots like the, you know, the little urban kind of plot where I could grow fruits and vegetables and herbs and things throughout the year. And I love it so much. I find it to be so therapeutic on so many different levels. So I know I can see the passion for wanting to, you know, spend a lot of time out with your hands and feet in the dirt. And then reaping the rewards of your labor, right? You get to plant all of these things and then watch them grow, and then you get to share that with your friends and family, which is wonderful. All right, so, you know, you have a lot of— you have a lot of experience. You've been kind of, um, in the home care arena, which I haven't had a lot of nurses on the show just yet in the home care arena. And I know just as we have problems in private clinics in, you know, hospital settings, long-term care settings, I'm sure a lot of the same issues that come through that, you know, challenge the nursing profession also present themselves in the home care arena, or maybe even in your current role. So let's talk about the one problem that you've kind of identified in nursing, and then we'll get to talking about the strategies that you're implementing or recommendations you may have for that issue.

It's speaking up. And that was one issue that I encountered. Yeah, well, I encountered, and I'm not saying this is everyone's experience, but what I would frequently run into is nurses would maybe gripe privately. Maybe I shouldn't use the word gripe. Let's say address issues privately amongst one another.

Mm-hmm.

But yet they're afraid to speak up to the management about the issue in question. I mean, and that could be a COVID issue. It could be maybe having an unsafe patient care load, not enough, you know, just being overworked, overburdened, or whatever. And my thing is, I mean, and I did work for, I was in a union environment too, so that further complicated it. Another issue was, why isn't the union doing anything about this? And I would always think, but we are the union. The union is not some external force that's going to just step in and take care of every single issue. We are the union, and we have to stick together. Or if you're afraid of bringing something up, let's go together. I mean, let's get 2 or 3 of us, and we'll just say we're speaking on behalf of everybody. Here's the issue. And here's our recommendation, our solution, or our solutions. And even though I'm no longer in a union environment and I'm no longer a union rep, I still kind of have that mentality even at my current place of employment. If there's an issue, let's just go together. I mean, are we all unanimous in this? Let's go to management and say, here, you know, this is what we're seeing and this is, you know, what we propose to to fix that problem.

Absolutely. So, you know, the problem that you've identified here is that nurses sometimes stick together and address the issues, but you're right, they're afraid to address leadership or management or their superiors. And, you know, a lot of the times it's out of fear of retaliation, a fear of being fired or being labeled as the complainer. Um, but yes, troublemaker, someone who's stirring the pot. Um, it's easy to expect people to just fall in line, accept the status quo, and just keep the money machine turning. But unfortunately, nurses have taken on a much larger responsibility for maintaining safe environment, you know, healthy workplace, you know, patient safety, our own safety. Whenever we're faced with these challenges, we can't just gripe amongst each other. We have to bring it to the individuals who can actually implement that change. People who have control over the staffing ratios, people who have control over ordering that new equipment that we need because we are using old equipment that may not be giving accurate readings or, or delivering safe patient care. So speaking up in groups, I think, is a wonderful strategy that really will help for individuals to kind of see past that, well, I don't want to be targeted. I don't want to have the spotlight on me. So, but if you can rally the troops and get your colleagues to go in with you to address these issues, I think that's a very helpful strategy because not every place has nursing unions. Most of my nursing career has been in Maryland, Baltimore, Maryland, and we don't have nursing unions there. So it's very difficult for, um, to have that representation outside of numbers. So I do think that's a very helpful strategy. So can you give, you know, one or two examples of how that's helped you in the past where you've identified a particular issue and then going in with groups of individuals? And you have some experience with unions as well. Can you share some of those strategies?

Sure. Well, the first thing that comes to mind, I mean, I just kind of said it a moment ago, is unsafe patient care loads, meaning maybe we were just given too many patients to see on a given day. And I don't know that I necessarily, I mean, if it were me personally, I didn't necessarily go get another nurse to go with me, but I would just go to the manager and say, look, I've got X number of patients today. Not only that, they're spread from this side one side of the county to the other. I'm not going to be able to finish this in an 8-hour shift. I would emphasize I don't want overtime because that was always their— well, that was sometimes their response. Well, I'll approve the overtime, just go ahead. But I'm like, no, I want to get off at 5 o'clock just like everybody else. And so here's what I'm going to propose. And then, then it just involves like triaging. For example, could this patient be moved from today? I mean, I take it upon myself to call them and say, hey, you know, are you okay with me moving visit to tomorrow, or maybe we could address— if they didn't have to be seen in person, maybe this is something we could just address over the phone. Just my point is, always have a solution available. Don't just dump it on the manager or another nurse or whatever. So that's— that was one, one example. Um, what was the second part of your question you were asking?

So the second part of the question was, you know, you have a lot of experience as, you know, being a union rep and working with unions, what are some of the strategies that you would implement from the perspective of a union in order to help empower nurses to be able to speak up and bring forth these issues in a tactical and professional manner?

Right. Okay. And so the thing is that in that case, speaking up collectively, because like I said a moment ago, sometimes I would just hear What is the union doing about this? And at the moment, I'm hard-pressed to think of a specific example. I know there was an issue once with contract violations. We were working like every fourth or every fifth weekend, and management unilaterally decided that they were going to force us into working every other weekend, which clearly went against what the contract specified. And the thing is, a lot of people would just talk individually, but not collectively. They would talk to one another, but nobody really wanted to go to management and address this. And in the end, that's ultimately what happened. It was like several people just had to speak up and go together. And, you know, this is clearly a violation. And, you know, we can't— you know, we're against this. The end result was kind of a compromise, I guess, because, I mean, management made a good point that we didn't have enough nurses and our patient load was increasing, meaning we were getting more referrals from the hospital for people who needed home health. So we ended up, instead of working every fifth, I mean, going from every, every fourth to every 2 weekends to like every 3rd weekend. So there was somewhat of a compromise.

Okay. So beyond the compromise— yeah, that's a great example. So again, collectively, you know, approaching the situation when leadership decides that they're going to kind of force us into doing things that we didn't even have a seat at the table initially to make those decisions or to say, yeah, that sounds great. Um, you know, that collective bargaining, which is what, you know, we don't really learn in nursing school, but sometimes we're kind of forced into learning on the fly when we're out there working and serving our communities. So, you know, my question though is, why does it always have to fall on the nurses to make the compromise? Why does it always have to fall on us? And so this is something that we know has always been the issue, that when, you know, the people that make the decisions when it comes to money You know, it's like they basically force us into agreeing eventually because they keep pushing down the hammer. So, you know, you guys were working every 5th weekend or something. I'm sure that was a really wonderful schedule for you and your family and for your colleagues. And now you're being forced to, you know, pick up more weekends because what— what didn't happen, right? So what— what— where did leadership perhaps dropped the ball in deciding that you guys had to work more weekends. And so to me, from my own experience, it's usually because they're not willing to hire more nurses. Um, they're not willing to pay that additional salary to get more, more nurses in there so that you can split up the workload, you know, more appropriately. It's not about the money. And so I know, I know you agree with this, many of us agree with it. It's not about the money, it's not about the overtime. Just like you said, I don't want the time. I want to be able to get off like a normal schedule, be with my family, take care of myself. I have a whole life that's outside of my profession that I would like to attend to, make sure that I'm healthy so that I can continue to keep doing this. But when you work us so much to where we're just completely exhausted and all of our internal resources are spent, it doesn't matter how much money you give us. Now you're gonna have some young, eager individuals out there taking full advantage of the high dollars, but that only lasts so long. Even the young vibrant ones get burned out pretty quickly, um, within a year or two of, of working so much. So you can't just throw extra overtime or extra bonuses at the nurses. You have to hire more people. You have to get more of those long-term resources in place. So that we don't have to continue to compromise for the sake of profit. Because that is kind of—

You know, you're right. Yeah. And that, that's true. And I'd have to say, too, given that scenario I was just telling you about, it's also the respect. I mean, one of the arguments that was brought up was why was this decided up here? We weren't given a seat at the table. There were no negotiations. And I don't necessarily mean contractual, but just let's come up with the committee and try to look for solutions. It was almost like— I hate to use the word adversarial, but that's almost how this, that whole scenario played out. And you know, there's a stereotype of nurses being self-sacrificing, that we put everybody else's needs above our own, but that includes management and the business as well. We're gonna put our needs aside and take care of you, meet your needs, your financial needs, your financial goals. And when that doesn't happen, they get angry about it. Yep.

And I've personally have been told, well, I thought your passion and commitment to patient excellence would, you know, get you to pick up that overtime or to stay later or to pick up those extra shifts. And I'm like, Excuse me, you mean you're leveraging my compassion for positive patient outcomes and patient care against me? That's what you're doing. You're trying to make me feel guilty for my mission.

You don't mind me asking, go ahead, say that. I'll ask you that. Was it another nurse that said this? A nurse who asked you this, was it a nurse?

Absolutely, absolutely. It was not a nurse. It was never a nurse who says these things to me. It's usually a staffing manager, or it's been like an administrator, or it's been, you know, a COO who does not have any nursing background at all. I have been told this time and time again. It's never been by a nurse. I don't think any nurse in their right mind would have the audacity to say something like that. However, I've heard it personally.

You'd be surprised.

Well, all I can say is if you get to that point in your career where you're, you're pivoting, you know, profits over the core values that nurses have, perhaps you should step out and go for the business side of things and stop worrying about the nursing side of things, right? Um, because once you put profit over patients or profit over profession, that becomes a big problem, right? But there's a— this is a whole separate podcast that we can get into profits and, and what nurses make and what we're worth. Is a whole nother topic. We should be getting more money, we should be more financially intelligent and savvy and be able to have a part in the decision-making for how funds are spent in healthcare organizations. But that's a whole separate topic. This is why nurses need to get into those COO positions, um, so that we can start implementing those changes. However, but yes, no, I've never had a nurse specifically tell me those things. It's always been someone outside of the nursing profession who said that to me. And I find it extremely offensive that you're trying to leverage my compassion for patient care against me. So, right.

Yeah. Yeah. I had a similar, a similar one. And basically it wasn't really directed at me personally, but it was a non-nurse administrator basically saying that there is absolutely no reason why a med-surg nurse cannot work in the emergency room and vice versa. Basically, the expectation was that nurses, registered nurses, would work both med-surg and rotate in and out of the emergency room back and forth. There's no reason why this can't happen.

And so let me ask you, was there any additional, uh, discussion about training before you would have to move from med-surg to ER to take patients?

Mm, I don't know if there was— it was an expectation, so no, there really was no discussion about it.

That's my— this— so this is my continuing point. And so anyone who's following this podcast or any of the things that I write and what I'm doing out in the world is that there's a lot of non-nursing specific things that plague nursing so greatly that if you just take a few steps back and just think about it and say, what's the real problem here? A lot of it is lack of communication, lack of collaboration, you know, nurses not being, you know, leveraged for our ability to provide excellent outcomes. Um, and so when decisions are being made by people who have no clue about the intricacies or complexities of actually delivering the care, Well, then we have these continued problems. And so sure, I do believe that a nurse from med surg can, can be successful in the emergency room with the appropriate education and the appropriate training. I do believe that because nurses all have the fundamental skill set that we need to provide safe and effective care, no matter what, no matter where that patient might be on the spectrum of healthcare. But there are some very specific, you know, treatments, medications, diagnostics, plans of care that are specialized for each different area. And so if you're going to expect nurses to cross-train or go between different specialties, then the institution needs to leverage their nurse educators and give them the appropriate training. I think a lot of nurses might enjoy working in a variety of settings so that it keeps it interesting and so they don't get burned out in one particular area. But not many hospitals or healthcare facilities are willing to put forth the necessary resources to get that training. And so that, again, it falls on us to make the compromise on whether we want this job or not. And so many of us have decided the job's not worth it. It's not worth it. And we leave and we go find things that better align with our mission and our values. So, you know, you, you were in, you know, case management for a while, and that was in California, you said?

Yeah, for the most part.

Okay.

Yeah.

And then when you came back to Alabama, you didn't want to go back into case management?

Well, when I lived in California, I lived in a— and worked in— I basically worked in a bubble. I'd have to say the straw that broke the camel's back was most home health nurses will know this, that we had to take call. That's after the agency closes. You had to be on call in case, you know, one of the home health patients has an issue, question, or whatever. Fortunately, we had a call center. So when we closed at 5 o'clock, we didn't have to take call because all home health calls were diverted to the call center and they got to speak with an advice nurse who could address their issues, send them to the emergency room or urgent care, you know, whatever the case. Case might be. That's not the case in the real world, and I knew when I came back to Alabama I would have to take call, and the expectation in the real world varies from agency to agency. Um, it may have changed a little bit, but when I was a case manager back in the '90s here in Alabama, the expectation was a lot of times if they want you to come out to the house, even though there may not be a real need to go to the patient's home. It's a pers— it may be a perceived need, but drop what you're doing and go out there. I mean, and this could be, you know, you may have to drive an hour to get to that patient's home to address whatever issue they might have, which could have been addressed over the phone. But the thing is, it was just an expectation, and I'm like, I don't want to deal with this or go through this again. So Yeah, I'm going to look for something different. Yeah, a rural hospital and work there until this new job presented itself. And like I said, I've been at the Plasma Center ever since.

Awesome. So, okay, so we talked about several things here, um, as far as issues and strategies, and I just want to summarize for the listeners. Nurses collectively seem to be hesitant to speak up when they see problems. And so instead of just kind of having that conversation amongst ourselves and continuing to support each other in that way, we need to support each other further by taking those issues and collectively presenting them to leadership. And so there's nothing that stops us from creating our own committees. And you're right, we should create committees if we don't have them established. We should create suggestion boxes. We should maybe send a weekly email to leadership to let them know of the issues that we're seeing on the units, um, in our workplace with patient care, whatever the case may be. I do see a big need for that camaraderie and collaboration amongst each other, which I know sometimes doesn't happen, and it often is because of role modeling or, or what the leadership is doing. And so sometimes it does start with leadership, the educators, the charge nurses, the nurse managers, to kind of role model that behavior that we want this open communication, that we shouldn't be keeping things to ourselves and we shouldn't be just hanging our head low and just going through the motions to collect our check and, and be done for the day. Because I don't know any nurse in current global healthcare climate that's 100% happy. With their, the situation. And so there's always room for improvement, and there's some organizations, um, and even regions that are doing really, really great work to try to improve the process. But again, if we don't know about it and if leadership don't know about it, and if they don't know this is truly an issue, they're not going to do anything about it. Because, you know, people who are interested in cutting checks and collecting coins, they want the, the the pathway of least resistance, right? So if we can make a bunch of money and not have to do a bunch of work for it, then that's what they want. However, just as we're held to a high standard of accountability for outcomes for patient care, which does bring in huge profits to organizations because without patient care they would be making no money, we need to leverage our skill set and let our administrators and leadership know that they are also being held accountable. And so if individuals in positions of power don't necessarily want to be held accountable, this is a warning for everyone in those types of positions. Nurses are done. We're over it. We're finished with, you know, being the ones who always get the short end of the deal, and you need us. Right. Everyone needs nurses more than anything else. And if we can't get the treatment that we deserve and the work environments that we need to thrive, then we're going to continue to leave your healthcare institutions and form our own patient care services because we can do that. That's the beautiful thing about nurses. Nurses really can do anything. And so, you know, I really appreciate that, Cliff, that, you know, bringing these issues to the individuals who can implement change is so important. Sharing this information amongst each other, coming together and making sure that we can bring these issues up and offer those recommendations for solution. Because again, a lot of the problems we see, in my opinion and from what I experience, have nothing to do with nursing specifically. Like, we're not, we're not having issues with how we're doing Foley care. Like, we're not having issues with preventing infection. I mean, those things happen, but really the issues at large are operational, administrative, those essential skills that aren't necessarily taught in nursing but we're expected to know, like conflict resolution, financial intelligence, emotional intelligence, these types of things that maybe some of our leaders get in training. They go to their conferences, they go to extra kind of, you know, leadership training. Nurses don't really get that until they get out into the world and they start going through those processes on their own. So why not hold our leaders accountable for helping us fix those problems so that we can focus on what we do best, and that's delivering that safe and effective care. So awesome. So Cliff, are there any other things that you want to mention before we wrap up today's show? I do just want you to just elaborate a little bit on the Nurse Farmer, because again, I think this is an excellent resource for individuals. I think it's great therapy as well, not only for building resilience, but also just kind of meeting that physical, emotional, and spiritual kind of well-being. So let's talk a little bit about that.

Yeah, absolutely. And so, and, and you pretty well hit the hit the nail on the head there when you said that. The thing is, when we're gardening, when we're growing our own fruits, vegetables, flowers, you know, whatever the case might be, we're, you know, it really hits all domains of physical, mental, and spiritual health. I mean, I could talk all day about the hows and the whys. I mean, gardening is a form of physical exercise. Working in the soil exposes us to bacteria that stimulates our brain to produce more serotonin. You know, that's another example of, of how and why gardening is good for us. I sometimes have a hard time articulating how and why working in the garden can benefit our spiritual health, and that's because spiritual health can mean different things to different people, you know, so I won't go into a whole lot of that. But basically, like I said, I have a blog, thenursefarmer.com. Trying to remember, I think I initiated or started the blog in about 2015. I can't remember exactly when I started it, but, and that's what I do. I just blog about how and why growing our own foods and even cooking. Like this month and last month, I didn't really talk a whole lot about growing, but I wrote about pumpkin, and November is going to be a continuation of everything about pumpkin, the health benefits of eating pumpkin, and even a few recipes. Speaking of which, I got to get finished because it's already November 1st. Another thing that I wanted to talk about was I co-created a health campaign called Healthy Green Thumbs. That was a couple of years ago with Susan. I don't know if you know Susan. Susan is the nature nurse. The nature nurse? Yeah, yeah. Susan, Susan Allison Dean. She is the nature nurse., and we co-created the campaign, and basically it consisted of both of us blogging and making videos and just providing information that emphasized nature in general, but also growing plants as a means of living a healthier life. So I encourage anybody and everybody like yourself, you know, you talked about having that little urban garden. So, I mean, there's all kinds of ways we can, you know, grow, grow fruits, vegetables, flowers. And it's not only beneficial to our own health, but it benefits It's the environment as well. And I know we're going to wrap up here, but I just want to point out, when we lived in California, we had a backyard farm. You know, California is not known for having huge yards. Ours, you know, was a fairly nice-sized yard. But I mean, we had backyard hens, citrus trees, of course. Can't live in California and not have citrus trees. But we also grew lettuce, tomatoes, pumpkin. I remember one year I got like well over 10 pumpkins off of one vine. Wow. So I encourage everybody, and if you want to learn more, just you can go to thenursefarmer.com and sign up for my free monthly newsletter.

Awesome. So I think that's a wonderful resource. And, and certainly, you know, I live in New York City now. I don't have any outdoor space. I miss it so terribly. I don't even have a balcony that I can put, you know, potted plants on. But I am planning on investing in some window pots that I can hang outside of the windows because I truly miss growing herbs and tomatoes. And I know all of those do really well in pots. I had a huge balcony garden even in Baltimore. And even though I had my urban plot that I could plant things into the ground, I still had tons of things growing in pots because I truly enjoy nurturing things. I mean, it's part of what nurses do. We're nurturers. But I found it on the spiritual side, you know, and I know sometimes it's hard to articulate this and it's different for everyone. But for me, I felt very connected with Mother Nature, right? I felt very connected with the earth when I was gardening, when I would kick my shoes off and put my feet in the dirt, I instantly would feel better. My body would feel better, my energy level would go up. I would kind of live in a light of gratitude. No matter what happened to me, I felt safe and taken care of. And so for me, that was very spiritual, um, and very healing to be able to get out there a few times a week and de-stress from working as a nurse or teaching or running my business or whatever I'm doing. Because I just found it incredibly nourishing for me, for, you know, mind, body, and spirit. So I highly recommend anyone, if you haven't tried gardening or if you do enjoy gardening, try to do it more often. There's tons of resources out there, and I think The Nurse Farmer is a great place to start. So thank you so much, Cliff, for being on The Nursing Strategies for Success podcast. I really appreciate you being with us today. And is there anywhere else that listeners can connect with you other than thenursefarmer.com?

Well, I am on social media, Facebook, Twitter, you know, The Nurse Farmer is on Facebook, Twitter. I've got the YouTube channel, LinkedIn. So I'm all over social media. And in closing, I have one other— I have one other shameless act of self-promotion. Damion Jenkins. Hey, no problem. Talking about how You're talking about having limited space. So I do have a video and blog on my website for growing sprouts in canning jars, in canning jars that you can do in the kitchen with essentially no lighting. You know, you might need a little bit of sunlight or even room light, but check that out. Give that a try.

Absolutely.

You can grow sprouts. Yep. Grow sprouts in canning jars. Add it to your salad, soups, burritos, whatever. They're good.

Yeah, sprouts have tons of health benefits. I do enjoy them myself. So, all right. So thank you so much for being on the show today. Really appreciate you. For all of the listeners, all of the ways to connect with Cliff will be in the show notes of this episode. I want to thank you for being with us and Cliff will be in touch soon. I have to pick your brain about a lot of ways to cook some fruits and vegetables. Now that I don't have my own garden, I have to be more selective when I go to the market. So we'll be in touch. Take care. I'll talk to you soon.

Thank you.

My pleasure. And that concludes episode 11 of the Nursing Strategies for Success podcast with this week's guest, Clifton Julian. We hope that all of the strategies we've shared for you in today's episode will help you develop strategies for career success. All of the ways to connect will be in the show notes of this episode. And as always, if you have any questions about anything we've covered, feel free to visit thenursespeak.com/contact and get in touch with me. I would love to have a conversation with you. So until next episode, take care, be well, and And remember that nurses can do anything.