Nurses Creating the Change they WANT with Mindset Shift & Perspective! Episode 11 of Season 2: Tina M. Baxter

Thank you for joining me for another episode of the Nursing Strategies for Success podcast with this week's guest, Tina M. Baxter. Tina is an advanced practice registered nurse and board-certified gerontological nurse who resides in Anderson, Indiana. Miss Baxter has been a registered nurse for over 20 years and a nurse practitioner for the past 14 years. She is the owner of Baxter Professional Services, a consulting firm which provides legal nurse consulting services for attorneys and insurance professionals while also providing wellness and chronic disease management and customized educational and operational resources to healthcare organizations. Today, Tina is going to talk about mindset shift and perspective. So let's welcome Tina Baxter 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, Tina, thank you so much for being on the Nursing Strategies for Success podcast. Why don't you just take a moment to introduce yourself to the listeners? Let them know a little bit about yourself, where you started in nursing, and where you are today.

Well, first of all, thanks for having me. Um, I'm always excited when I get a chance to talk to nurses.

Yeah, my pleasure.

Ditto.

So I'm a nurse practitioner. My background, I started out as a volunteer in the nursing home. The rule in my mom's house was that if she volunteered somewhere, you were automatically a volunteer as well. So that became my love for older adults and nursing. So I started out as a CNA. Then I went to school and became a registered nurse and worked in long-term care and home care. And psychiatry, and that really developed my love for geriatric psychiatry. So I came back and became a nurse practitioner with a specialty in gerontology and a subspecialty in geropsych, and love it. And from there, opportunities just grew. People were asking me to help them launch their businesses. Nurses were saying, well, how do you do this? How do you do that? They knew I had a couple of businesses at the time, and they wanted to learn more. Branched out in other areas as a legal nurse consultant as well, and also helping people, helping nurses build their own businesses. So it's been a fun ride.

Yeah, it sounds like you've done some amazing work. And, um, for the audience, I know I say it in the intro, but how long have you been in nursing now?

I have been in healthcare for about 25 years and in nursing somewhere around 17, 18 years.

Yeah, maybe longer.

Yeah, I'm beginning to date myself.

That's— you know what, hey, look, it's okay. I thank you. I thank you for paving the way for some of us, you know. Um, I'm relatively a baby nurse compared to some of the other people I have in my network, and I'm okay with that, um, because I'm, I'm pushing, you know, 25-plus years of professional experience that, you know, it's transferable skills from my prior you know, work experience to becoming a nurse over 12 years ago. So, you know, we all can learn from each other and support one another along the way. And it sounds like you've done a lot of the same things I've done with the long-term care and the home care education. You know, I know you teach because one, you're a nurse practitioner, so you're in a space of teaching. Also, you help people create businesses, which is all teaching, you know, you're teaching them how to do that. So you must are an excellent, you know, content creator, you know, process creator. And this is really what nurses are the best at. We can create some amazing things. Awesome. So you've done a lot, you've seen a lot. I'm sure you've seen some, you know, issues that plague nursing or some challenges that affect the profession. So, you know, if you were to have to focus on one thing for today's, you know, podcast episode, what would be the one thing that you've identified as one of the major challenges that nurses face in our profession?

I think one of the biggest challenges is mindset.

Mm-hmm.

And I say that because we work in an environment where we don't have enough of, right? We don't have enough staff, we don't have enough supplies, we don't have enough of this. And a lot of times we tend to view the world that way, that we don't have enough. Right. And then we internalize that to say, I am not enough. Right. So you hear nurses say things like, well, I'm just a nurse.

Mm-hmm.

And that is taboo in my program. I'm like, we don't say that.

Yeah.

Because I firmly believe that nurses have skills and that you are a hero in your own profession. Every nurse, every nurse is a hero. And not talking about the hero that we think of, you know, with the nurse with the angel wings. Right. I'm talking about the fact that you are on your own epic journey with your career and you're the hero of your own story. Yes, and we need to fully embrace that.

Yes, I agree. So, you know, what do you think some of the, you know, causes of that mindset is? And you mentioned a few about, you know, being overwhelmed and stretched to the limits, maybe not have enough resources, not having enough staff. But, you know, based on your career, you've been doing this for a long time, so you've seen some things. You know what's really happening behind closed doors. What's the main issue? What's the biggest problem?

Nurses, for a lot of times, have been shut out of the boardroom.

Yes.

We've been sidelined, told that we're extra staff, warm bodies, anybody can do it. I actually heard a nurse tell me that the vice president of her institution said, well, what's the difference between an LPN and an RN?

Mm-hmm. Absolutely.

And people don't know and don't understand nursing. So they can sometimes trivialize the contributions that nurses can make. And also, there is that patriarchal hierarchy that we see in health care—

Yes.

—where the physician is at the top and everyone else is at the bottom. And changing that mindset to a team-based approach is going to be critical. Absolutely. And having nurses come to the forefront, and I'm glad to see that. I've seen so many nurses right now that are taking a stand. I wasn't able to join them for the march that they had in Washington, but I was able to watch some of it online and really applaud them for what they're doing. I just think that's wonderful.

Yeah, and this has been going on for as long as we've been nurses. It's been going on for generations before us. I mean, nursing really has come a long way, historically speaking, but yeah, there's still a lot of barriers that we need to break down. And I think I couldn't have said it any better. It really is that nurses are sidelined, that we're not included in the boardroom decisions. And it, I honestly, it's, it's because we're not represented in those boardrooms. We're not there. Right. A lot of us are not in those positions. You know, institutions have a DON, they have a CNO, but it's just one. Right. And oftentimes once they get to those positions, they're very focused on budget, bottom line, and they're less about the nursing care at that point. But instead, we need to have a lot more positions created beyond just nurses being middle management. We need more nurse executives.

I, I agree. And think about this, if you're the, the DON, the vice president of nursing, you are responsible for so much. There's only what— so so much that one person can do. And that's where we need other nurses to step up to the plate. I mean, how many times you've been asked to sit on a hospital committee and say, oh, I don't have time. I don't really want to do that. But yet realize that's important to have that voice. And so they keep getting those responses, I don't have time. I don't want to do that. I wouldn't be good enough for that. They're going to start to believe you. And so that's one of the reasons why I'm happy to support another organization on nurses on boards to make sure that nurses do get on boards. And I happen open to have board positions that I've gotten through that organization. I'm very grateful for that.

Yeah, that's amazing. So you're right. I mean, it's kind of the same thing when we get upset about who's in office, right? Who's running our local or, you know, state or, you know, federal government. We get upset when there's people in those positions, but yet we didn't go out and vote.

Well, that brings up another important thing. What about your professional nursing organizations?

Those individuals as well, the people who represent those organizations, right? Yes.

Do you, do you attend the meetings? Are you a participant? Do you even sign up and register? We in Indiana have been talking about nurse practitioners in the state of Indiana and how we don't have the majority of the nurse practitioners joining in our local organization where they go every year and they lobby for us to our legislature to help us in our practice. They keep an eye on what's happening with our practice and make sure that things aren't taken away from us or changes to our detriment. And so my question is, as a nurse, why aren't you participating? Why aren't you being a part of the solution? I mean, it's quite easy to say, oh, no one's listening. But if you're not even there at the table, how can they?

Absolutely. And we really come in numbers. And with numbers come power. And if we really do band together, which has been one my, you know, highest missions since I've started all of this and really saw a lot of the gaps is we could really make significant change. But we do— we have to educate all of our fellow colleagues. We have to kind of start at the beginning, start in nursing schools, and like really make sure that our new grads understand that they have the power to shape healthcare the way that they want, the way that they feel would be best for everyone. And if we lobby together, we can really make amazing things happen. And it's happening now. But we need more people. We need more people on board.

Let's go back to Flo, okay? Everybody likes to talk about Florence Nightingale, right?

We love Flo. We love Flo.

But think about the changes that happened to nursing practice because she went out and did it and then wrote the policies and talked to the powers that be and advocated for her patients and advocated for her role as a nurse. And we need to continue to do that and do it even more because, like I said, the lay public and the people that we elect don't understand what nurses do. Yep. And they don't understand— the doctors we work with don't understand half the time what nurses do. Yep. I just had this conversation with someone today who had to explain to a group of providers that, you know, the director of nursing at the nursing home is probably pulled in multiple different directions, so they might not know every little nuance about every resident in their building when they have 80 residents in the building. So yeah, they may have to look some stuff up, right? But I don't think we think of those things, um, necessarily unless you've walked a mile in that person's shoes, right?

Yeah, I mean, you know, even my own mother-in-law has asked some wild questions about our ability to make decisions and manage patient care and prioritize and delegate and advocate. And, you know, it's amazing when she goes to the hospital and she gets amazing nursing service, you know, the only real thing she has to say is, oh, the nurses were so they were so nice. But as far as any decision-making capacity or, or plan of care or outcomes, it's always focused on the physician. And I'm just like, but if it weren't for your nurses, the physician wouldn't have any of that assessment data to make those decisions. They wouldn't have the ability to make sure you get the treatment you need, you know. They wouldn't have those skills. The doctor can't possibly be there. They're not ready to be at the bedside as much as nurses are. So they need the nurses, and the nurses are highly trained to make sure that they're double-checking checking everything, keeping you safe, advocating for you, telling doctors no sometimes when doctors are ordering tests that are unnecessary.

So doctors, doctors kind of help you with the start of the healing process, but it's the nurses that keep you alive. That's it. I mean, the doctors go home. That's it. They're not there 24/7. It's the nurses that are at the bedside and they see the changes that happen. I mean, how many times have a nurse— have you taken one look at a patient, you walk in the room like something's not right. I may not know exactly what it is, but you're not right, and I need to go call the doctor and say, this is what I'm finding. We need to do something. And sure enough, something's happened. I mean, I've had a case where, as a staff nurse and supervisor, someone brought in a patient that I knew very well to our psychiatric unit and said he was psychotic. I took one look at him and said that he's not psychotic, he's delirious. He needs to go back to the ER. We sent him to the ER, he ended up in ICU in sepsis.

Yep, absolutely. How about that? As a nurse, right? Yes, as a nurse.

Exactly. As a manager, I could say, no, we're not taking him. Yeah, exactly.

Not on my psych unit. Like, sorry, this person needs medical care, not just psychiatric care. Exactly. Yeah. So, you know, for, for those of us who have walked the walk, we know that it's a matter of the difference between nurses and doctors as far as you know, a lot of the specialty training is the diagnostics, the laboratory results, you know, the being able to read images and understand how medications— the goals of the medications, and maybe a little bit of a deeper understanding of, you know, how they move throughout the body and what other drugs really shouldn't be mixed with them because they can cause problems. But if a nurse has been a nurse for more than a year or two and they're dealing with all of these types of things on a regular basis, like if you're on a busy med-surg unit, if you're in the ER, if you're on the ICU, you get to learn all of these things too. So yeah, we, we do know that the doctor is going to want an X-ray for a certain thing. We do know that the doctor is going to want to try this class of medication because this is the standard protocol. They're going to try this for this symptom and see if it works or not, unless there's another reason why they wouldn't do that. So we're all— but we're all on the same team, and it's the nurse's job to really make sure that all of the things that the physicians put in place are carried out safely and appropriately. And we're all human as well. So we're all at full potential to make mistakes.

And that's why having a team is important. I mean, how many times have I caught a medication error, potential error, because the order was written incorrectly? Or the pharmacy called and said, do you really want to mix those two drugs? We don't think so. So we need to have a team approach. And I don't understand this— this clash that we have in healthcare. When we understand and appreciate everyone's contribution and skills, I think things go a lot smoother.

Absolutely. I think it really does go back to, you know, some old-rooted, you know, habits, like, you know, things from the patriarchy, you know, nursing being primarily women, doctors being primarily men, the people who make all the financial decisions also being primarily men. And not just men, but let's call it for what it is, white men, right? Primarily. And so, and so all of these things, you know, it's just systemic problems that need to be changed. And so what's your solution? All of these, we know this is a problem, but what are you doing, or what strategies have you discovered or have created to try to help, you know, aid some of this?

Well, one of the things is that if you get the opportunity to serve on a board, do so. Yes. So I've had the opportunity to help with several nonprofit organizations, but also help in the hospitals as well, and healthcare agencies, sitting on review panels and helping them with some of the strategies that they have going forward. I've done the same for some nursing schools. I sat on the review panel for some nursing schools to help them, you know, change some of their policies and to evaluate their practices to help them grow and do better. Yes. We need to look for people that maybe don't always come from our same circle of friends and be open to something new. There's a lot of people out there with great ideas, and I think that opening up will also help us and strengthen us. I know we like to hire from within and promote people from within, and I'm all for that, right? But you also need to look at, are you developing your leaders? And how are you developing your leaders? I've seen a lot of places, particularly, and I'm going to pick on long-term care for a minute, because I see where they promote a nurse to be the D.O.N. or the charge nurse, however, with no leadership skills, no training. You've just been here the longest, so it's your turn to do the job. And I think we're doing them a disservice. I always say help, help develop your leaders, help them grow in their, uh, career path, and they'll tend to stay. And I have to say, I've had some great, uh, personal development from some wonderful leaders in my career, and I'm still in contact with two of my very first nursing mentors. Yeah, I mean, I completely agree with that.

Um, I've stuck around some places for long periods of time, and I can see the stagnation. I can see that things don't change because you're right, it stays from one perspective. And let's be honest, people don't want to rock the boat, you know, status quo, let's go. It becomes routine, it gets comfortable, and people just move forward with that. I can't tell you how many times in the 12 years I've been a nurse I heard, well, this is the way it's always been. And that's terrifying to me, and it's always been startling to me because we should always be evolving and growing and changing and improving despite the struggle that it may cause, because honestly, The struggle of the same problems every day with no resolve is much more challenging to me than the challenge of learning a new technique or a new way of doing things so that we have better outcomes.

Innovation is something we should all be striving for. I think of companies like Blockbuster, Kodak. Where are they now? Right? Because they were afraid to innovate. Kodak sold printers. I had a Kodak printer, loved the printer, affordable ink, beautiful colors, but they couldn't compete in the market with the Samsungs and the HPs. They didn't innovate quick enough. BlackBerry, loved my BlackBerry. Anybody remember BlackBerry? I remember BlackBerry. I loved my BlackBerry, but they didn't innovate. Right. And so iPhone took them over and has dominated the industry. Yep. And so that's, that's what's happening in healthcare in a lot of places. When you don't change, you don't adapt, you don't grow, you tend to wither and die. And that's what I'm seeing is that in some, some facilities and some healthcare organizations, because of that lack of innovation, they aren't able to do things and move forward. There's a lot of nurses that develop wonderful inventions. I just covered this last week. A group of nurses won this big award from Johnson Johnson for the innovations that they made in nursing. And I think that's wonderful. But where are the stories like that? Why aren't we talking about that? Those are things that should be celebrated. And other nurses need to hear those stories because maybe they have a great idea too.

Absolutely. And this is where the Nursing Strategies for Success podcast was born from. Because nurses can do anything. Nurses can stretch their skill set and knowledge to go beyond our vision of traditional nursing, right? We need nurses at the bedside. Absolutely. Our healthcare system would crumble without them. But, but we don't need nurses just at the bedside. We know we need nurses everywhere.

We're seeing an exodus of nurses, skilled nurses, experienced nurses leaving nursing. Yeah, we've also seen some young nurses, 1 or 2 years experience, saying, I'm done, I'm out. And I don't want to see that happen. That's one of the reasons why I started, um, the, the Fall Back in Love with Nursing Challenge that I did. And I did that because I want people to understand you don't have to leave nursing to be in business. Yes, you can be a nurse and a business owner. Yep. You can be a nurse and a podcaster. Yep. You could be a nurse and write articles and blog. Absolutely. There's so many different things that you can do in your nursing field. Wellness. I want people to know that you don't have to leave nursing.

You could be a certified nurse coach and see patients on your own time, your own practice. You don't need an NP, PA, or doctor to guide you in that practice. Exactly right. There's so many things that nurses can do. Awesome. So because nurses can do anything, you're— sounds like you have multiple businesses and revenue streams. It seems like you've tapped into your power as a nurse, which is amazing. And this is why we have this podcast, so people can understand that there's so many different opportunities out there. Um, and we are reshaping the definition of what the role of a nurse is, um, from a traditional sense to a much more in-your-face, hey public, this is what we do, just so you understand. Um, so are you a member of the National Nurses in Business Association?

Yes, I am. I've just completed my first year. I was a new member.

Awesome.

I started, I think, in the middle of last year, and I have attended a couple of online things that they've had, but it's been so busy with projects that's happened in the last few, few months that I haven't been able to get away to go to any, any trainings or anything like that. So I'm looking forward to some of that.

Yeah, well, we're going to be in Las Vegas this July, the weekend of the 24th. 1st. Um, so if you can make it to that, great. If not, we completely understand. Um, but definitely go to your members portal at the website nursesbusiness.com and then sign in and check out all of the amazing resources that we have. You know, even established business owners— the goal is to help, you know, aspiring business owners all the way through established business owners. Keep propelling forward. There's always something to learn. There's always new strategies. There's always new collaborations, different revenue streams. There's a lot of things that we can do. And, um, you know, it's just always exciting. You know, I've been in business since 2016 and I have 5 different revenue streams and I still have the ability to work full-time if I want to for another organization, which is amazing. Does it make me busy? Sure. Just as before we started this recording, we said the grind is real, the hustle is real, and it is because, you know, we got to stay busy in order to get our work out there, which is awesome. All right, Tina, so if people want to find you and see about some of the programs you have and some of the products or services you offer, where can they find you?

They can find me on LinkedIn. I'm on LinkedIn and I'm also on Facebook. I have two groups on Facebook. One's our Baxter Professional Services page, and then the other is our Nurse Shark Academy page. You can find us there. And what's great is that if you want to watch any of our news shows, we stream it to both pages. So you're able to catch some of our past, uh, shows. We've covered a lot of things from the Redonda Vaught case to the nurses strike in Massachusetts. So we try to stay on the forefront of what's happening in nursing.

Awesome, that sounds amazing. And do you have a website or anything like that yet?

Uh, yes, you can go to my website at baxterprofessionalservices.com. Awesome, thank you so much, Tina.

You have a wealth of knowledge, you have years of experience. I think anyone who connects with you is going to learn some amazing strategies, and I definitely am looking forward to collaborations for the future. Um, thanks for being on the Nursing Strategies for Success podcast, and I cannot wait to connect with you in the future. I hope you have a wonderful evening.

Thank you, and you have a great evening as well.

My pleasure. Take care.

And that concludes episode 11 of season 2 of the Nursing Strategies for Success podcast with this week's guest, Tina M. Baxter. We hope that everything that we've shared in today's episode will inspire you to lead the charge, join those nursing committees, and find your way into the nursing executive boardroom. All of the ways to connect with Tina will be in the show notes of this episode. And as always, if you have any questions about anything we covered, please 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 remember that nurses can do anything.