Season 2: Episode 16 - Dr. Nanette Nuessle - Stopping Bullies & Burnout by Learning & Implementing Personality Science!

Thank you for joining me for another episode of the Nursing Strategies for Success podcast with this week's guest, Dr. Nanette Nessl. Dr. Nan has led an exciting life as a frontline pediatrician providing excellent care to patients for over 30 years. She has spent the last half of her career giving back to rural areas that are short-staffed. Most recently, as a pediatric hospitalist, she has concentrated on her strengths which are stabilizations of critically ill infants and children, acute airway management, and attendance at high-risk deliveries. Dr. Nan also runs a coaching company named Beat Down Burnout, which utilizes a unique process of personality science to promote communication skills and relationship building, which allows healthcare organizations to improve staff retention increase patient safety, and reduce risk management. So let's welcome Dr. Nan 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, thank you so much, Dr. Nan, for being on the Nursing Strategies for Success podcast. Why don't you take a moment to introduce yourself for the listeners? Let them know a little bit about yourself, where you started in healthcare and where you are today.

Certainly. Thank you, Damion, and thank you for having me here.

My pleasure.

I am a pediatric hospitalist. I started out in central Illinois as just a traditional pediatrician at what is now the largest physician-owned multidisciplinary clinic in all of Illinois. Worked my way up to chairman of the Department of Pediatrics at the clinic and at the nearby hospital. And, um, it was not a good fit.

Mm-hmm.

Left there, had a solo practice briefly, and eventually became a locum physician.

Okay.

Along the way of being a locum physician, I had a couple of jobs where I was a pediatric hospitalist, where instead of being in the office all day, I was just in the hospital and dealing with the kids who were sicker, um, stamping out fires, uh, doing the higher acuity stuff. And I really, really liked that. That really fit better with my personality and I'm much happier there. And so now that's kind of what I specialize in. Nice. But along the way, starting at that big multidisciplinary clinic where I said it wasn't a great fit, mm-hmm. I saw burnout, and I saw that what was driving the burnout was bullying. Yeah, they bullied the pediatricians. Mm-hmm. We're the only department that had to be open both Saturday and Sunday and most federal holidays.

Wow.

We worked over 100 hours a week. When we were on call, it was not unusual for us to get called in 3 times a night. My kids actually asked me if other children's sick kids were more important to them— to me— than they were.

Wow.

Broke my heart.

Wow. So, so, all right, so this sounds very familiar with how, you know, nurses also feel the same way. But I think, you know, because nurses and doctors do spend a decent amount of time together, but we also spend a lot of time apart. And I think a lot of nurses in general, myself included, don't really know what's happening behind the scenes, like after you leave the nursing unit, give your orders, check on the patient, give the updates to the family, the patients, the nurses, and then leave to go do whatever it is you do, right? And so of course, those of us who have been nursing for a while, we've learned that there's a lot of things that you do after you leave the units. But to hear that the doctors are also being bullied is something that would probably be a shock to a lot of people who aren't doctors.

Yeah. Um, when I first started out, it was physicians bullying other physicians. Mm-hmm. And, um, that's most of what I've seen throughout my career. I have seen physicians bullying nurses, as I'm sure you have. Absolutely.

Um, nurses bullying nurses.

Oh. Mm-hmm.

Yeah. That happens.

Yeah. A lot. But things came to a head when I was working at a small rural hospital that had just reopened their labor and delivery department. And they specifically recruited for someone with my skills, someone who knew how to resuscitate newborns and stabilize them in case they needed to be transferred to a higher level of care. And when I first got there, it was great. I loved everybody I was working with. But then over the next couple of months, things changed. All those people that I started with were temporary. They were either traveling nurses or they had signed a temporary contract.

Yeah.

And they were leaving in 3 to 6 months. And when the permanent people came on, they had a very different attitude.

Mm-hmm.

Um, and I was left with a charge nurse who absolutely hated me. She argued every order I wrote. She argued policy with me. Um, I would spend a lot of my time educating. I educated the new moms, the new grandparents, and I spent a lot of my time educating the nurses because many of our nurses were only a year or two out of school, and I have 30 years experience.

Yeah.

And I wanted to share that with them. And she would go in behind me and just contradict everything I just said. Wow. Very frustrating.

Yeah.

Not only is it frustrating, but that's also— it could be potentially dangerous if the nurse is, you know, saying something that's opposite of what you're saying. And, you know, you're the specialist, you're the doctor with the inside scoop on, you know, not only disease management but medications and the whole care plan and everything. You know, that nurse sounds like she just wanted to do what she wanted to do at the expense of everyone else.

It was potentially dangerous, and it really drove the anxiety level in the unit sky high. Yeah, people were leaving the unit. I mean, labor and delivery is one of those places where people fight to get in and stay, right?

There's— that's the place where they stay. That's a dream job for a lot of nurses, and even, even doctors. It's a dream job to be in that space. Um, so yeah, I can imagine if this person was doing that to you, the doctor, she was also doing it to the other nursing staff.

I know for a fact that she was. Yeah, there were times when I would come in and I would be trying to find out information on a patient, and I would ask her point blank a specific question about a patient, and she would say, oh, that's not my patient today, when in fact She was training a nurse and they were sharing that patient, but she would not do anything on a patient until the nurse was actually at her breaking point. The nurse in training was actually— because she literally told me, well, I want to see where this nurse breaks. I want to find out what her breaking point is. What is the point of finding out someone's breaking point?

Yeah, we shouldn't, we shouldn't let it get to that point. We should be empowering them and supporting them and, and strengthening their skill set, not finding out where they're weak.

Yes, exactly. But that was, that was what she was doing, and we were having a very hard time keeping people.

Yeah.

And so this is—

so, you know, working with a lot of other people in this space and me being in the space myself, the question always comes to, to what point do hospital administrators, whether it's the nurse manager, the department head, the DON, the CNO, all of these individuals in charge of running the nursing staff. At what point do they realize that the person that says, "Yes, ma'am," and, "Yes, sir," even though they show up and do the work and the documentation's on point and they run a smooth unit, but everyone dislikes them and feels that they're not really part of the team, they're just dictating to everyone and they're bullying everyone, and they're actually causing more potential harm than good at what point do these individuals recognize this behavior and get rid of that person? Because it sounds like she probably was there for a long time.

The CNO was encouraging her.

So she had an inside friend.

During the time that we had that CNO— this was a 50-bed hospital— and during the time that we had that CNO, um, we had her for 13 to 15 months, and we lost 8 physicians.

Wow.

Encouraging the nursing staff to bully the physicians.

How is that even a thing? Like, I don't even understand how that would even be on anyone's radar to do that. It's, it's—

yeah, I don't understand how bullying would be on— it's not the right thing.

Well, you know, I, I've always been someone to give people the benefit of the doubt, and I think sometimes bullying behaviors come out of defense mechanisms. And in many cases, when it's that initial thing, it usually is a defense mechanism. And then you kind of say, all right, you know, the person's having a bad day, I'm not going to take it personal, let me see how I can help them. Um, but when it becomes cyclical and then you can identify it as intentional, now it's a whole nother story.

So yeah, these people were probably bullied when they were younger. Oh, and perhaps even in their own homes, right?

And I don't know how it was in your training in med school, but in nursing school we were bullied from day one. So it is a learned behavior. And so it's— I feel like it's people like you and I that identify this behavior, and we set a path to change it and to do things differently so that we're not just adding to the vicious cycle of the trauma and, you know, the hurt and the bullying behaviors, because it's easy to fall into the negativity and snap off at people and be abrasive and don't want to really collaborate because it's easier just get in there, do your work, and leave. But we know that that's not really going to help anything.

No, it's not. So go ahead.

No, go ahead.

So you got to the point to where—

got to the point with this nurse where I knew something had to be done, and if it was going to be fixed, I had to fix it. Mm-hmm. And I remembered a friend telling me about this Bank Method of Personality Science.

Yeah.

And I took a course and realized that the nurse was a blueprint personality and that I'm an action personality. These are opposite personality types. They literally butt heads.

Mm-hmm.

One thing that's different about personality types. I mean, there's a lot of 4 personality type systems and methods out there.

Sure.

This one focuses on people's core values and specifically the core values of the person sitting across from you, not just yours, but the person to whom you're speaking, the person with whom you're interacting.

Right.

I started speaking to this charge nurse in the language of her core values. And all of a sudden she had no traction with which to start an argument.

Right.

And in 3 days, the anxiety level on our unit went from a 10 out of 10 to a 3 out of 10. Wow. And people stopped leaving. In 3 weeks, nurses from around the hospital, nurse managers from other units began asking me to do conflict resolution in their units. Nurses, physicians came to me and asked me to help them with their contract negotiations. And I started doing lunch and learns around the hospital, and we reduced the anxiety level throughout the hospital. We got nurses to start collaborating from one team to another. People were more willing to float from one unit to another. All from just this simple methodology.

Right.

And so The Bank Method, I've heard of it. I've, I've looked at it before. I think it's a great resource. And I think a lot of people in probably our level of our career where we were setting out to try to implement this change, they may have heard about, like you mentioned, there's other methodologies out there that kind of touch on this. So how did you go about implementing this to where you can create that change where you're reducing the stress levels in the, in the facilities because one, I think it enhances communication tremendously, right?

It was so simple.

Yeah, so let's talk about how'd you do that.

We have people crack their codes. They can use these cards or they can just go to a URL, um, my.bankcode.com/beat-burnout. Okay, and they could crack their code. And we had, I would go through the hospital and have people crack, have nurses, RTs, the physicians crack their codes. And then what I did was I took stars from Walmart that you get in the school supply department.

Yeah.

And we would put it on the back of people's name tags, put their code in the colored stars on the back of their name tags. And so when people would get upset with one another, they'd reach over and they turn around somebody's name tag and see what the stars were, see what the bank code was in the colored stars.

Mm-hmm.

And they start speaking to the first 2 stars. Mm-hmm. The first 2 parts of that person's code. And what that does is that brings down the anxiety level. You're starting to speak to those 2 stars, the values of those first 2 codes. And you're speaking to who that person is and who they want to be, the values of that. Now, you cracked your code. You are an NKAB, which means you're nurturing, you value teamwork and community and relationships, and you back that up with research and expertise. And so I would talk to you on those values, right? When you're upset, you want to get things done and you want to get them done now. I'm going to speak to you that way, right? Because when you're upset, I want to move you toward relationships and teamwork, and that's going to calm you down and allow you to think about the information and the data so that we can come to a rational decision that's going to move things toward community and teamwork.

Yes, absolutely.

And that's how that works.

Yeah.

So I think being able to speak to people's personality types, you know, by having this very concise summary of their values is really powerful. Of course, it's not all-encompassing. Nothing is all-encompassing. But I think this is a really neat tool to use so that you can quickly identify the general, you know, motives of these individuals so that way you can address them in a certain way. Because you're right, I know, you know, from being a nurse for over 12 years, also an educator teaching adult learners for many, many years, that everyone has a different communication style. They want the information in different ways. One way does not fit all. And you have to, over time, learn these individuals' preferences. But this process gives you a great idea of how to do that without really having to spend a lot of time learning those individuals, which I think is really helpful.

How long did it take you to crack your code?

Oh, seconds.

Exactly.

It took me no time to fill that out.

It's the only methodology in the world scientifically validated to tell you your decision-making process in 90 seconds or less.

Yeah, it did not take very long, and it's really accurate for, for someone who's spent a lot of time reflecting and having internal dialogue and, and really kind of putting pen to paper about what my values are and what makes me thrive. That a lot of that came through entrepreneurship to make sure I'm aligning with what I'm doing. Also in my practice as a nurse and what I want to continue to do as a nurse. It's very on point. And I spent less time doing that than I've done all the years of journaling and inner dialogue. So this is really cool.

But this is the quick and dirty version.

Yeah.

If you want to do a deep dive with us, we have courses where we take this and we use this and apply it to emotional intelligence, spiritual intelligence, leadership skills, communication, relationship building. And those start at, um, 12-week courses. Yeah, I'm not talking a year. Yeah, we offer a year-long course, but we start with a 12-week course, and that's what we consider a deep dive. It's amazing what we can get done in 12 weeks or 90 days.

Yeah, so it sounds like this is a great tool for anyone to use, um, and so I'll definitely have in the show notes of this episode that URL that you shared with everyone so that they go and crack their code and get the little breakdown. Because guys, it's very accurate. I did it right before I started recording this show. And it is really accurate for who I am as a person and what I value. So that's really cool. So I have a question for you, Dr. Nan. Being, being that we know that a lot of the stress in healthcare comes from lack of resources, lack of time, lack of money, lack of investments by the C-suites. How are you getting into these spaces so that way they're investing in this, this opportunity to really change the way that teams communicate? Because communication, we know, is the number one breakdown in effective healthcare. And the biggest issue is, again, money. It always comes down to money and what the C-suite's willing to support. So how are you getting in that space?

It comes back to the personality types. Most people who— most of our healthcare workers are either NK or KN. Physicians are usually KN, your nurses and bedside people are usually NK, whereas most of your people in your C-suite are your B personality type. And when we teach you how to communicate with them, You're better able to, number one, set boundaries so that you're not overwhelmed, overworking, sustaining moral injury. But you're also able to write proposals and then able to get those proposals worked through the system.

Yeah. Get them actually in the hands of the people in the C-suites, which oftentimes feels impossible if you don't know the process of getting there.

I spent 25 years not knowing how to do it.

That makes me feel a lot better, being, you know, 12 years in healthcare and feeling like it's an impossible feat. And I've reached a few CCs, so I'm very proud of that work. But yeah, I think understanding how to reach them through speaking to their values is going to be way more beneficial than pitching, you know, creating a very crafted sales pitch. Um, because if I don't know their personality type and what they value, how am I going to reach them?

This is not manipulation. This is making a real genuine connection.

Absolutely.

There's a difference.

Yeah, I agree. I think that's amazing. So, you know, learning the different personality types in healthcare is tremendous, but this can work for any industry, right?

It does work for any industry. It was made for sales. It is the number one personality type for sales. In the world, not just the US, in the world. It's been around for 20 years. It's only been in the last 5 years that it's been branching out into other industries, right?

And that makes sense because every industry at the end of the day has some form of sales, right? It's all business, um, and we all have, you know, most of us have the same motives. We want to make good money. But we also want to do good, and we want to challenge ourselves, and we want to leverage our strengths and our skills and be creative and, you know, all of these good things about, you know, being in alignment with the career path of our choice. Um, so awesome. So where else can people find you, Dr. Nan, if they wanted to perhaps work with you and either have you come into facilities, do presentations, walk them through those, you know, 12-week courses, any of these things? How can they reach you?

Um, easiest place to reach me is on LinkedIn under Nanette Nussle. I have a company, the company is called Beat Down Burnout, so you can find me at beatdownburnout.com.

Nice.

And I have a Facebook page, Beat Down Burnout. So those are the places you can find me. I have Instagram, but, um, um, honestly, I don't spend a whole lot of time there. It's there, and I will messages there, but I spend much more time on LinkedIn than I do Instagram.

Sure. Yeah, LinkedIn is the, is the best place to go for those professional connections, as I always tell my clients. So awesome. So Dr. Nan, um, I really appreciate you coming on the Nursing Strategies for Success podcast today. Uh, burnout, bullying, these are all real issues, and I, I think since you've implemented this process, you would feel that you don't get bullied as much, right?

Um, I've learned not to.

Yeah, exactly. Now you know how to stop it in its tracks. This is not going to happen. These are the boundaries I'm setting. I'm pointing out the, the behavior. I'm not focusing so much on the emotion. We're going to call it for what it is and we're going to move forward. And this is, you know, a lot of what I teach also in my, um, transitioning into professional practice for new nurses, um, because, you know, We all get backed into a corner by people who we look up to, and we don't know how to respond when we're being bullied by people that we are trying to respect and learn from. So I think this would be a great thing for everyone. I'm definitely going to have that in the show notes and have all the ways people can connect with you.

Once you've been bullied once, you're more likely to get bullied again.

Absolutely, absolutely.

Learn how to Yup. Let me help you stop it.

Absolutely. Awesome. Well, I think that this is going to go really far. And for all of you listening to today's episode, definitely go check out Dr. Nan. She has lots of resources to help you. Thank you so much for being on the show, and I look forward to collaborating with you soon.

Thank you so much, Damion. I've really, really enjoyed this.

My pleasure. Take care. We'll talk soon.

Thank you.

And that concludes episode 16 of the Nursing Strategies for Success podcast with this week's guest, Dr. Nanette Nestle. We hope that everything that we've shared for you in today's episode will help you learn your personality type, help learn other individuals' personality types so that you can improve communication, collaboration, camaraderie and really align yourself with the ability to get what you need so that you can find satisfaction within your career. All of the ways to get in touch with Dr. Nan will be in the show notes of this episode. And as always, if you have any questions about anything that we shared, please 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 aligned healthcare professionals and nurses can do anything.