How asking "Why?" can lead you to career alignment, purpose & satisfaction!

Thank you for joining me for another episode of 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 the greatest challenges that the nursing profession faces. My name is Damion Jenkins, and I'm your host for the show. So sit back, relax, and get ready to learn that nurses can do anything. All right, Maria, thank you so much for being on the Nursing Strategies for Success podcast. Why don't you take a moment and introduce yourself to the listeners? Let them know a little bit about who you are, where you started in nursing and where you are today.

Thank you, Damion Jenkins, for inviting me. I am super, super excited to be on your podcast today. Um, so as stated, my name is Maria Jesaniar. I started my nursing journey when I was about 15, 16 years old. I attended Clara Barton High School. Uh, my mother knew that I wanted to become a nurse, and she asked around, and they said, if you want to— if your daughter wants to become a nurse, let her go to Clara Barton High School. And I just I did just that. I graduated when I was like 17, well, more like 18 years old, finishing my high school credits. Yeah, finishing my high school credits and was eligible to take the LPN boards, which I passed. After that, I went straight to— thank you so much. After that, I went to Hunter College where I did my BSN while working on the weekends in a nursing home. After I graduated, I knew that women and children was my passion. So I waited for a job until I was able to work there, and that has been primarily what I did at the bedside, doing women and children. When an opportunity came for me to be an adjunct professor, I took that. And then after a while of doing it for a while, I said, you know what, I want to make sure that I'm proficient in this, that I'm using the correct tools to educate the nurses. And then I actually went back to school for a second master's. My first master's isn't Thank you. My first master's is in nurse midwifery because I was passionate, and I still am passionate about women's health. And then my second degree is in nursing education. So usually when people ask me to introduce myself, I tell them I'm a nurse educator, I'm a nurse midwife, I am an adjunct professor, and I am also a nurse freelance writer.

Amazing. Oh my God, Maria. So sounds like, I mean, other than the women's and children's specialty, right, that you grew up in, sounds like we have a very similar pathway. You know, I didn't know I wanted to be a nurse very young. I didn't go to a special school to prepare me for that, but kind of that transition for once I got into the profession, once I got my feet wet and I started to realize all of the different opportunities, I did similar thing. I got some clinical skills. Realized what I liked, what I didn't like, and I wanted to lean in more to the things I did like, which was really being the glue that holds things together. I loved being at the bedside and teaching my patients and the family members, empowering them, helping them get better at what they're doing. But what I realized is there wasn't a lot of that for the nurses struggling, and I was one of those nurses, new, struggling, and think— trying to figure it out. Coming in as a second career, understanding my communication skills, my corporate experience in the food and hospitality industry, a lot of transferable skills. But the nurses weren't being trained on how to use these skills. And I was like— and when I brought it up and tried to bring it to leadership's attention, I'm just a new nurse. I don't know what I'm talking about. Oh, you'll figure it out eventually. Ugh, we don't have time for that, right? And I was like, this cannot be how things are or will be forever. So something's got to change. And what I did is I lean into my strengths, and I say, you know what, let me go back to school for nursing education. And that's exactly what opened up a lot of doors for me at that point. So, you know, 4 years into nursing, I graduated my master's, and then I started teaching in a way that put me in the classroom at the universities, put me in the clinical educator roles within the facilities, put me in positions to where I could speak on the public stage, write articles, be a freelance writer and publish. So it opens up a lot of opportunities, and I'm so glad you kind of shared your whole trajectory up to now, because a lot of people listening to this are new grads figuring it out, professional nurses, nursing students, people who don't even know they want to be a nurse yet, but maybe a family member's a nurse and the title of the podcast caught their eye. So it's just really cool to hear how you've gone through to get to where you are now. But you know the premise of this podcast, right? The premise of the podcast is strategies for success. Well, clearly you learned a lot along the way and developed a lot of strategies. But before we get into those nuggets of wisdom, what's the thing, right? What is that thing that has bothered you or that you struggled with or that you see current nurses struggling with? And oftentimes this is an overarching theme that kind of follows us throughout our careers. What's the thing that bothered you? Let's talk about that first before we start getting into how we deal with it.

Yeah, I would say the thing that bothers me is that people don't ask why. Yeah, I don't know if that maybe that they are afraid to ask why. They just want to leave things the status quo, but they don't dig a little deeper. When I actually didn't even know nurse educators really existed, but I remember as a new nurse, I will ask the seasoned nurse like, okay, why are we doing it this way? And you know what they told me? This is the way we've always been doing it.

And isn't that the most dangerous thing that a nurse can say, or anyone for that matter, right? This is the way it's always been. And just to piggyback on that real quick, if that's the case, let's ruffle a few feathers real quick, raise some blood pressure, because that's what's going to happen. Maria, you and I would not be on this podcast right now if things were the way they always were, right? Absolutely. We wouldn't have the privilege to do this. We wouldn't have the technology. We wouldn't have the freedom to get to this level of education to represent how smart and talented we are because, you know, we of a certain creed, a certain race, a certain gender, right? We can't live in that mindset of this is the way it's always been. And it's so wild to me that a predominantly female, you know, um, profession who constantly has to fight for their rights at the table they just so easily fall for that. Yeah, it's wild to me. So let's shake people up and make them realize sometimes nursing's problem is nursing, and we have to— we have to break free from those, you know, old ways of thinking, right, and change it up. So yeah, people don't ask why. So let's get into that. What do you—

yeah, because I asked myself, I said, you know, healthcare is always changing. Yeah, there has to be more— there has to be reasons why we do certain things. And now when I look back, I think that's what really started my nursing education journey. Just being able to ask why. And even up to now, I still ask why, you know. But even if it's something that we're doing a new— I remember there was one assignment I actually got because I asked why, but it's okay. We had the new equipment that came to our department and to our hospital. And because of this new equipment, the nursing assessment was going to change. So you know what I asked? I asked why, which opened the opportunity for me to do research, which I didn't mind, and even contribute to editing, updating, actually, our policy, our GI policy.

Yeah.

So again, asking why definitely opens up opportunities for you for sure.

And, you know, again, to piggyback on your question is, I don't know why people don't ask why. Girl, you know, that's the reason. Sometimes it brings more work. Let's be honest, let's just call it for what it is. Sometimes asking why gives you more work.

Work.

However, that is true. If you are the person who wants to improve systems, if you want to improve assessments, if you want to improve your work, your working conditions, your workplace, your salary, the opportunities available to you, the opportunities available to your patients that you serve You have to ask why, because if you don't, the people who run the organizations who are counting the dollars in the bank account, they're not asking why. They're asking, how can we pay less and save more? More. And of course, sometimes when we come to the table and we say, hey, Administrator, or whatever the case may be, we need X, Y, and Z, not only because it's a regulatory requirement, but because it's also going to improve outcomes, retention, customer service reviews, 5-star metrics, like all of these things that start to speak their language. Now we're often met with a very large project to collect the data, do the work, and then bring it back to the table to see, is it worth the time, money, and effort, right? Fine.

Yeah.

If it's going to get to that positive outcome, folks like you and I will do the work.

Yeah, and also too, I would say asking why, even for your patients. Yeah, I've always, uh, disliked the terminology patient non-compliant. Well, what exactly does that mean? Are we assuming that our patients don't want to take their medications? They don't want to do their follow-ups? But as a bedside nurse, when you're asking your patient, well, why didn't you take your medication? Maybe it was so expensive. Maybe insurance didn't cover it. Maybe they didn't really understand their instructions. Maybe they're supposed to take their pill twice a day, but they want it to extend and last longer, so they decide to take it once a day. But if you're a nurse that asks your patients why, you will find out what are their barriers to maintaining their health. And with the knowledge of that, you can let the doctor know, maybe can they prescribe something, a generic medication that is as effective, maybe link them up with the social worker that may be able to— social worker or case manager that may be able to provide them services. But if we don't ask them questions, how will we know what will be going on with them socially? How will we know that maybe they're having a hard time getting to appointments, right? So only if we ask our patients why can we really serve them better.

Absolutely. So the, the power of why goes far beyond for our own knowledge and our own self-service, right? It's to really just understand the things around us, the people around us, the way things work, why they work that way. And then when we can identify the issues within that why, that's when we can really start to be the amazing, bright, talented contributor to ourselves, our profession, our patients, whatever. So we can start fixing some of the things that just don't seem to make sense, right?

Absolutely.

Now, you've been doing this long enough to know it is possible because we've done it. Right. I know how it feels for a lot of people in the trenches. Like, I know how it feels for the bedside nurse, the new grad nurse, the student nurse, the nurse transitioning into leadership, the nurse transitioning into becoming an educator. And with human nature comes past traumas.

Yeah.

Um, different situations that they've been exposed to that they might kind of project onto other people. We have micromanagers, we have people with attitude, we have people who just never say yes to anything. They're constantly pushing back no matter how amazing the evidence is to show that it's going to help them. You know, sometimes this is a lot of the challenge and the, the issues that people have with asking why, because I've been that nurse. I want to know, but I also know it's going to cause more work. I want to know, but I also know that the limitations of my workplace does not allow me to spend that much time at the bedside to not only collect the information, but if I'm a good nurse, I know once I identify a problem, I got to do something about it, right? So sometimes we want to put on the blinders and be like, I don't see that, to, to not only just keep moving through the tasks of seeing all of our patients or doing the things that need to be done, But really, there's a lack of structure oftentimes where when that bedside nurse wants to do something about it and they're overwhelmed with the sheer number of issues. And like, we're both in New York, so we know the population here is busy as fast. People are very short-tempered when it comes to waiting. They want it now.

Yeah.

And the hospitals, as we've seen with all those strikes and things like that going on, sometimes they overwhelm the staff. And so Sometimes the nurses might not want to ask why. Yeah, because they're in survival mode, right? So, you know, yes, the question stands: why don't more people ask why? And now this is an opportunity for us to look deeper, to dig deeper, and start finding out. Like, we have to, one at a time, one group at a time, one organization at a time, start asking.

Why.

That sounds like a really fun project that you can kind of like start doing, not even in your own organization, but just in general. Start doing surveys in the community, network with your nurse, you know, colleagues, um, people who work in other schools, departments, whatever. And just, we could just start asking that and collecting that data and, you know, kind of analyzing it and determine, you know, at the entry level, at the professional level, at the leadership level, like, what is the why for why they don't ask why? And I would, I would believe that a lot of it's going to come back to the limitations of our day-to-day responsibilities, that we are stretched so thin already to do the bare minimum, to just get by, that asking why is almost impossible to follow through. And unless we're provided, and unless we're provided with the flexibility and freedom to shift their priorities, to maybe get out of the classroom for a week or two so we can focus on these projects, or where we don't have to do orientation every other week, or where we don't have to do a specific rounding audit that can be really delegated to someone at a much lower level, like an administrative staff, right? If we could offload some of these responsibilities so we can actually spend the time to do that work. Imagine the amazing things that could happen. All right.

Yeah.

So you've identified a major problem. I agree, this is a big problem, and I know there's a lot of different angles. So what are some of the things that you've done to combat this? What are the things that you've kind of strategized around so that way you can, one, do more asking yourself, and two, help encourage others to also ask so it enlightens them, empowers them, and helps them go further in their career?

Yes, as far— I would say new nurses, nursing students, but definitely new nurses. I always ask them to ask why, especially if they see a medication that's ordered and they're not sure why the patient is getting it. They look it up on the resources that the hospital provides, they of course look what the patient's diagnosis is, and they are still unable to identify. I tell them that it's important that they ask the provider because Who knows, maybe the provider ordered it for the wrong patient.

Yeah.

And the truth of the matter is, if you as the nurse give it— gives it and something happens, it's going to fall back on you. It's not going to be the doctor who wrote the order. It's not going to be pharmacist who approved the medication. It's going to be the nurse because the nurse is what they say, the final check before administering it to the patient. So you really need to be knowledgeable on what you're doing. And ask why if you're not sure. Another thing too, I usually tell nurses, is same in alignment, is I do not like when nurses say, oh, I'm just following doctor's orders. I'm like, no, you're not just following nurse— doctor's orders. You're not just a nurse. You went through nursing school, you sat for boards, you are licensed to practice. If that was the case, they could just pick anybody off the street to administer medication. But you've been trained and you continue to receive training on Critical thinking, reasoning, tho— those are asking why questions.

Yeah.

So really, when you are asking why, especially for the bedside nurse, which I encourage them to always view themselves as a leader over who they're taking care of, you wanna make sure you're providing safe, holistic care for the patient. And that also too begins with asking why.

Exactly. Absolutely. So you're right. And again, you know, I like to play devil's advocate because I've seen it all. I've been in there, I've done it. I, um, you too. Some of the challenges that I see today, and you may or may not see this, um, challenge, especially with our new grad nurses. And of course, each program's a little different, you know, different professors. Some programs might be really, really good with a lot of hands-on clinical experience because they have really good connections with the, you know, um, affiliations out in the community. Maybe some programs are very theoretical but have zero hands-on experience. I see it all the time. I get brand new LPNs, I get brand new RNs, brand new CNAs, and I'm a little frightened at what I'm seeing, um, because they're not coming out with a lot of the encouragement to ask why. They're not really understanding the full scope of their practice. And I don't even mean like some of the legal and like leadership stuff that we get into later. I'm talking about basic stuff. Like basics, like they don't understand. They don't understand that a license is borrowed and not owned. Like they don't understand that. They don't understand that the DOH can take it in a, in a blink of an eye if they're unhappy with how you handle the situation. Um, they don't understand like a lot of the basic skills. Like some of the nurses are coming out, they don't know the difference between, you know, trans I mean, intradermal, subcutaneous, intramuscular. And I'm like, hold on, wait a minute. You don't know these basic terms? You don't know? No. And I'm like, you didn't practice it at least in a skills lab setting, like with real needles and like at least rubber, you know, injection pads, or aren't they? Like, no. I'm like, wait, you never spiked an actual IV bag, like a normal saline, nothing? No. They never made you put on or take off sterile gloves? The answer is No, I am mind blown. I've never seen anything like this, but this is the reality we have. So again, building onto that whole let's ask why, which is super important, and we need to drill this into every level of nursing. Yeah, it does start in the classroom, and I'm begging, begging, begging all of the educators that touch these people from day one, they need to drill it in right away.

Absolutely, absolutely.

Which I would say every school out there, that anyone who knows any educators in the area, please, please, I will train you. I will, I will come and volunteer my time in your school to help you learn how to deal with the student who pushes back, who doesn't seem interested. I'll teach you how to use the language to get through to these folks. Like, we just have to reestablish that standard and and, and reclaim our professionalism and reclaim the expectations for the profession. Because not only are we dealing with a lot of under-prepared knowledge base and hands-on skill base, but also professionalism. It's not good. It's not, it's not good. And again, this could be that the leaders aren't asking why. Maybe the people running the facilities are not asking why. From what I understand, based on all the research and historical facts and kind of understanding people who own schools, people who own hospitals, curriculum, the bylaws that determine curriculum approvals, all of this stuff— it's a business.

It's a business.

It's a business, right? So if it's a business and the hospitals and nursing homes pretty much dictate the curriculum, all the laws and the lobbying and the relationships and all this backdoor stuff that some of us will never see. Why aren't the facilities demanding more from the schools?

Yeah, yeah, that would need to happen.

Yeah, why isn't the DOH demanding more from the schools? Or the Department of Education, excuse me, because they're separate, right? They're technically separate entities, but the state You know, the people who govern it, why aren't they expecting more?

Yeah, I also think too, in that same thing, that there needs to be more collaboration between hospitals and schools, and not only in terms of clinical placement, but in terms of the people at the hospital, the educators who were seeing them, are able to speak to the schools and say, in order to prepare your students, they need to learn, you know, X, Y, and Z, and let that collaboration really enforce what the curriculum is, because the truth The matter is a lot of the people who are in academia full-time, they also don't— they don't have the pleasure of being in the hospital and really seeing what's going on. And that's how come I love my dual role of being an educator in the hospital and also being an adjunct professor at the colleges. Yeah, but a lot of them, they don't see it. So they're teaching curriculum that, yes, has been signed and a lot of people agree with, but are they really preparing our nurses? They're not. And the thing is, with a lot that's going on, uh, we have patients who are very complicated. They're sick by the time they come to the hospital. New York is very diverse. We have a lot of people who are underserved populations. So by the time they come, they're really sick.

Yeah.

And unfortunately, the new nurse is not able to quickly identify what is going on with the patients.

Yeah. And again, just with the sheer numbers of patient load, the doctors are stretched as well. The seasoned nurses are often not there anymore because they're like, I'm not doing this no more. I'm getting too old for this, right? And then it winds up becoming a lack of experienced, seasoned clinicians at the bedside with the new nurses. And now you have new nurses leading new nurses, and you have the, the educators sprinkled in there very thin, right? We're all spread thin. And it's like we're trying our very best to hold it down and to like educate and make sure that we're putting out fires and, and, and build up our staff as soon as possible. But sometimes You know, another issue that I see a lot is just how transient New York is. And so, you know, tenure for our staff is really not great in a lot of facilities. It's like by the time you finish one orientation and you're starting the next, half of those people you poured into are already gone.

Yes, it happens here too, right?

And there's so many reasons why that is. It's not just singular issue, but this has been the same since I've been a nurse for 16 years and nothing's changed. Maybe we should start digging a little bit deeper on that why.

Yeah, but I think it's actually getting worse.

Asking it though, this is my problem. Nursing should not be the only ones asking these questions. The people running these businesses should be asking these questions because I know they bleed their money. Yeah, I know they're tired of the same old same old. I know they want to grow and scale and maximize on profits and get more services so they could become gazillionaires. That's what we all want, right? But why aren't they speaking to the nurses? And yeah, to piggyback on you, what you said about the schools, I've been in New York now since 2020. I've been in an educator space the whole time, and I have not once had a school ask me, what should we be teaching? Now they might ask, can we come and do clinicals at your facility? And then they want to just drop them off with my staff and make my staff train them, which is an absolute no-no. No facility should ever allow that to happen. The clinical instructor needs to be with those students. I was a clinical instructor.

Absolutely.

Yes, you stay with your students. Your students do not go away from you. You take lunch together, you come together, you leave together. Like, you watch every invasive thing they do. Like, you sign them off for their competence. That's not happening either in a lot of places. And so it's like, we got, we got, we got to tighten this up a little bit, right? And we start by asking why. I love that. I love that. So Maria, do you have any publications, website, podcasts, resources, anything that people can come and connect with you, learn from you? Collaborate with you, any way that you would share how people can connect with you.

People can definitely connect with me on LinkedIn. My name is Maria Jasanya. There they'll be able to see some publications that I have done, some blogs in collaboration with other nursing organizations. So that's the best way to connect with me.

Amazing. And look, we in the same neighborhood practically. I mean, different boroughs, but whatever. Um, just a train ride away. We should definitely link up, put our heads together. There's so much work to be done. Um, our organizations, I know for a fact, are very blessed to have us. I hope that they see the value that we bring every single day, because honestly, without us, it would be nothing, nothing, nothing. So, but look, that's what we're here for. It's why we get paid. It's why we took the job. We here to work. And I'm ready to really start seeing things change in a much more positive and productive manner. I've done a lot of amazing work in my organization and within the community, starting to build these relationships and networks. I did it in Baltimore, I'mma do it here. So I'm ready. So it's exciting to have you on the show. Thank you so much for sharing your story, some little nuggets of wisdom. Don't forget, guys, you got to ask why. And I hope to see you soon. Thank you so much for being on the show.

Thank you so much.

My pleasure. Bye-bye.

Okay, bye.

And that concludes episode 11 of season 4 of the Nursing Strategies for Success Podcast with this week's guest, Maria Jasanya. We hope that everything that we shared for you in this episode will help remind you that asking why and finding the answers to that question will help lead you to the place of career alignment and success. All the ways to connect with Maria will be in the show notes of this episode. And as always, if there's anything that you would like to discuss regarding this episode, please feel free to visit thenursespeak.com and get in touch with me. I would love to have a conversation with you. So until next episode, take care, be well, and remember that nurses can do anything.