Episode Transcript
[00:00:01] Speaker A: Welcome back to the real estate and more show. I'm your host, Michael Hatfield, and I'm glad you tuned in. Our show today is centered around those professionals who help others, people who dedicate their life to the medical profession. You know, the angels among us who wear the wings of a registered nurse. I am acquainted with our first guest this morning, veteran registered nurse Dee, a lady who oversees a team of nurses at a major Bay area hospital and a person I admire greatly. She will share with us some of the ins and outs of caring for human beings who may be suffering an illness. Routine work for rns who do this each day in the hospital. Welcome to the show, nurse supervisor Dee.
[00:00:48] Speaker B: Thank you. Thank you very much for having me.
[00:00:50] Speaker A: First thing, I think a lot in airline terms, and then I apply it to everyday life. And we have talked before today, if a pilot leaves the cockpit, he expressly hands off the airplane to the copilot. The same type of handoff occurs in the medical profession. Can you give us a little insight on that? Nurse D. Please?
[00:01:13] Speaker B: Sure. Yes. So we do have a very formal handoff that occurs. There's different types of how this goes depending on whether or not you're handing off your patient assignment to the oncoming shift or you're handing off for a patient that's maybe going for a procedure or something like that, or you're just taking your lunch break and you're handing off to someone who's going to relieve you for 30 minutes. So there's different detail that goes into each of those reports. We call them an SBar, and that stands for situation, background, assessment and then recommendations. And that's just kind of the standard format that we give it in so that everybody is doing it the same way and that the same information is being passed along.
[00:01:55] Speaker A: Wow. Registered nurses are the angels that live amongst us. And just to know that you are there, most people can't get past taking care of themselves and hear you take care of yourself and then you take care of others. It's got to be a daunting task at times. I know it is. I can look you in the eye. I can see sometimes it's pretty heavy.
We were talking about the handoff, and one of my loved ones had surgery, and it was very well done the way that that occurred. And you knew who was in charge from one moment to the next, and you knew the appropriate information was transferred from one crew to the next. And I just thought it was very, very impressive to go through training. First of all, whatever drove you to take on this profession I think I.
[00:02:50] Speaker B: Was always kind of a caretaker. Even in my youth, I had siblings, and I kind of just took that on as my responsibility to help care for them. And if they ever hurt themselves or were sick, I was usually the one that wanted to be there and to help and give the medicine and put on the band aid and do these kind of things. So I think part of it was just who I am as a person. I think that's true for a lot of nurses. I also have some people in my family who work in the medical profession, and I feel like I always had just a lot of respect for them and what they do and how they are selfless and give their time and energy to other people. And it just was something I always wanted to do.
[00:03:30] Speaker A: I had a very good friend that we both recall from a number of years ago that was stricken with one of those terrible illnesses, and I was very impressed with your care, as well as the other nurses that attended to him. So there are people out there that are very grateful and thankful for what you do.
I think as part of the DNA makeup of a nurse, you have to be very tenacious and you have to be dedicated. If you're not, it just seemed like it wouldn't be a very good fit.
[00:04:05] Speaker B: Absolutely. Yeah. I feel like it takes a special person to be a nurse, and we have to adapt to a lot of changing circumstances and situations and be able to multitask and handle multiple things at one time and keep track of all of those things. And some people have a difficult time doing that.
But I think not only do we have to manage all of the tasks that we need to do, we have to do it with a level of empathy and compassion for these people who sometimes are suffering the worst news that they've heard in their lives. They're going through the worst times of their lives. And so it's a really difficult time for people.
[00:04:44] Speaker A: Oh, yes, for sure. Tell me about what training a person would have to go through in order to become a registered nurse.
[00:04:52] Speaker B: So a registered nurse degree takes about two years to become a registered nurse.
If you are wanting to take that a little further and have a bachelor's in nursing, the bachelor's of science takes about four years to complete the entire program and exit with a bachelor's degree. And that allows you to have a little more flexibility in the industry and be able to move up into maybe more managerial positions and leadership positions and things like that.
[00:05:20] Speaker A: Wow. Scarcity. I'm understanding that there's a real shortage of nurses in our society. Today. Is that a true and accurate statement?
[00:05:31] Speaker B: We kind of go in waves, I think, of having enough nurses where there's so many applicants that people are having to go other places for jobs and then times when we don't have enough applicants and there just isn't enough staff. I think right now we're having a difficult time because a lot of nurses are leaving the bedside.
It's a very difficult field to work in, and it is physically and emotionally draining. And I think if people don't have the proper resources to care for themselves, it makes it really hard to continue to work in that field and go into work every day and show the compassion that needs to be there to be a good nurse.
[00:06:09] Speaker A: I understand. I was speaking with a physician the other day, and he was saying that the traveling nurse tends to earn more than the resident nurse. Is that a true statement today? And does that cause some of the scarcity issues at hospitals and kind of slew things from right to left?
[00:06:30] Speaker B: Yeah, I mean, the travel nurses do tend to make more money than the stationed nurses who live here, but they have to have some sacrifice involved there. They're going from place to place. Their contract is usually only three months at a time. So kind of right when they're getting into a hospital and learning how everything works and getting comfortable there, where to find everything, who are their resources are. They're done with their contract and they're on to the next place to kind of do it all over again.
So it's a little bit different. I do think some nurses enjoy that, being able to travel and see different places. Lots of states have different laws and ratios when it comes to nursing, so California is one of the best. And I do think people enjoy coming and working here.
[00:07:17] Speaker A: I would imagine as a supervisor, you're kind of like a chief pilot. You're between the line pilots and the management. And so you're going to have to walk a line to try to take care of your fellow crew members. At the same time, you're carrying out the requirements of management. It just seemed like it would be a difficult line to walk, but I know you could maybe enlighten us a little bit on that.
[00:07:45] Speaker B: Yeah, that's a really good way to put it, because you are in the middle of two separate things here. You have your team that you work closely with on an everyday basis that you're in the trenches with. You're going through these hard, stressful moments with, and then you have the management above you that is bringing the things down that need to go out to the staff. And some of the things are, it's political things and paperwork things and stuff that is not really on the forefront of the mind of the nurse when it comes to patient care. The other legal things that have to be done and documentation and stuff like that that we have to talk about. And sometimes it's difficult to bring some of these new things that are coming out that we have to say, okay, this is the next thing that we're doing and we have to add this to our list of things that we're already doing. And when people feel overworked and it's hard to tell them that we need more from you.
[00:08:40] Speaker A: Doesn't a normal nurse schedule consist of like 12 hours each day, four days, five days?
[00:08:46] Speaker B: It's actually three days a week, 312 hours shifts, which is very nice to have that extra time off in between. A lot of nurses pick up extra shifts in between there, but I can tell you that twelve hour day is very long and you got nothing left when you get home from that day.
[00:09:04] Speaker A: Yeah, but I mean, that's by choice. Is that pretty much the general desire of the nurses or is it more of an interest to the management to have it like that?
[00:09:14] Speaker B: It's a little bit of both, I think. We've gone back and forth over the years with eight hour shifts versus twelve hour shifts and there's been studies done on both and which is more beneficial to the patient and to the staff.
It is nice to have. When you're handing off twelve hour shifts, you have one day shift nurse and one night shift nurse. And so it's a little bit easier to pass information. You're not going through a third person there in the middle. And I think the nurses have a really clear understanding of what's going on with their patient. You spend 12 hours a day with them and then you hand off, and then if you're back the next day, it's even better because you know exactly what's been going on and you're able to care for them better.
[00:09:52] Speaker A: Do you really enjoy your work now that you've been in it for several years? I mean, nobody knows who you are other than me. So got its ups and its downs and you love it, but then after the 11th hour in the day, you feel kind of. Yes, it's like being an airline captain. You're out there and after the first 10 hours, the fun meter pegs out and you get a little more tired.
[00:10:22] Speaker B: Yes.
As the hours go on, you do get a little burnt out. But I love being a nurse. I can't imagine myself doing anything else, but I do enjoy the little bits of change here and there. Going from a brand new nurse at the bedside and taking on different roles over the years, kind of the little bit of change helps to bring a new perspective and lighten it up a little bit rather than doing the same thing every day. But yes, definitely it does have its ups and downs. And there are some times when you pick up an extra shift and you're about 2 hours in thinking, oh, why did I do that?
[00:11:01] Speaker A: I understand. Well, just last night I personally received, I would say, unfavorable news about a loved one.
And to know that there are individuals like you that tend to them when someone like me has the, I don't have the tools you do, just to know that you're there is very heartwarming. And I've got to say, you have to receive that feeling that I used to get when I flew lifeguard flights, some of the first human heart organs. I flew some of the first premature babies that were two pounds when we had them in the airplane, and everything was lifeguard. So with that and just knowing how I felt at the end of the day, you have to get the enjoyment from that from time to time, just enough to keep that strong interest that you already have in something that is not easy.
But you feel that way, I imagine, all the time.
[00:12:08] Speaker B: Absolutely. Yes. We have situations like on a daily basis, even little things sometimes that happen, that just fulfill that you're doing the right thing. You're doing what you were meant to do. We have a lot of staff, seasoned nurses especially, can look at a patient and say, something's not right here. I don't know what it is, but we're going to figure it out. And to be able to then call a physician and say, hey, I'm looking at this patient and I've got this going through my head. What do you think? And, okay, well, let's order this, that test, and maybe you find something wrong and you prevented a serious situation from happening. That feels so good when you go home. And I really did a good job today, and I prevented somebody from maybe getting seriously more ill or even dying because of my attention to them as a person.
[00:12:55] Speaker A: Wow, that feels good. That's absolutely amazing. So in other words, you could say it another way.
You made it better.
[00:13:05] Speaker B: Yeah.
[00:13:06] Speaker A: And during the 911 segment and show that we did, everyone seemed to have that viewpoint. The firefighters, they were going to always be able to go in and make it better. But at 911, it was almost an impossible task with 2110 foot story buildings coming down. Almost an impossible task. But their intent is to go in and to make it better. The paramedics, the firefighters, they go in and make it better. And now you're saying kind of the same thing is that this is the seed of enthusiasm and motivation that you have is that you're taking a situation that is not optimum and you're making it better. And I find that just amazing and it's admirable in anyone to see.
Can you share what a routine day is at a hospital when you report to work? I mean, just, let's say just a normal nurse, he she reports to work.
[00:14:06] Speaker B: Okay? Yeah. So you come in in the morning, we start our shift at 07:00 a.m. You get your assignment and that can be anywhere from four to five patients, depending on the day and what's going on. You have a few minutes to kind of look everything up and take down some notes on what's going on. We do a quick safety huddle every morning at the start of the shift to kind of announce anything that maybe is going on on the unit or anything. We need to keep an eye out for, get everything ready for the day. And then the nurses go and get report from the offgoing shift. Usually takes about 30 to 40 minutes. And they do a bedside report where they go to each patient's room and they introduce the oncoming shift. And then we're going to give a quick report and they report off to each other using that s bar that we talked about.
And then once the nurses have gotten report, they kind of start their day. And then they're able to sit down and organize what they're going to do. They prioritize their care, which patient maybe needs to be seen first, depending on what you heard in report, what medications are due, and then they begin to round on their patients. They do their full assessments, they pass medications, they talk to them. We get to know who our patients are and what they need from us and what's going on with them. And then our most important job, I think besides the tasks that we do, is really that ongoing assessment of our patients. We're with them all day. We see them hour to hour. We can see when things are changing or something maybe doesn't look right. There's a change in vital signs. Or you walk in the room and just say, this patient doesn't look quite the same as they did 2 hours ago. What's going on here? And it's our job really to be the eyes and the ears for the doctors because they can't be at the bedside all day like we are.
And we call them and report off any information that we feel they need in order to do their job, and they rely on us for that. And so we monitor labs, we help patients to the bathroom. We hold their hand when they're upset. Maybe they just got really bad news of a diagnosis and the doctor had maybe ten minutes to spend with them and they leave and then the nurse goes in and it's our job then to hold their hand and to support it.
[00:16:17] Speaker A: Absolutely. So how many patients does normal day, does a nurse actually attend to? How many, well, normal operations.
[00:16:28] Speaker B: So in California, the ratios, we're allowed to have up to five patients, depending. If they have certain types of orders, the maximum would be four. But then we have discharges throughout the day. So sometimes if a nurse comes in the morning and she starts the day with five patients, she might discharge two of those patients and get two new patients. So she's then caring for seven patients in that twelve hour shift, which is a lot to discharge and then admit somebody. It takes a lot of time to do.
You know, it just depends on how busy the turnaround is. If they're discharging more, they might see more patients.
[00:17:07] Speaker A: Well, ladies and gentlemen, we're talking with nurse supervisor Dee. She works at a Bay area hospital and she takes care of many patients. So one question is with flying, we used to have twelve hour duty day, 12 hours of flight time. But if there was something irregular, then you could be in that cockpit for up to 16 hours. And I imagine it's same kind of emergency situation overriding umbrella that you will have. You'll be working your 12 hours. But if something happens, a major catastrophe or whatever, you have to be prepared to do what you can do until you can no longer do it.
[00:17:46] Speaker B: Yes, that's correct.
[00:17:48] Speaker A: When you do CPR, they say that once you start, you can't stop. That's true. It's kind of like attending to a patient in distress. I would imagine it's a lot the same way. Yes, but a lot of nurses, they have specialties.
They take care of certain type of illness that a patient may have and other ones take care of the other ones.
[00:18:14] Speaker B: Yes.
[00:18:15] Speaker A: Any enlightenment on that?
[00:18:16] Speaker B: There's multiple specialties that nurses can go into. We have different units in our hospital where we kind of segregate the different types of patients. We try to our best. So there's an orthopedic unit. Those nurses specialize in surgeries and these kind of things with the bones. We have nurses that work in oncology that specialize in cancer patients.
There's intensive care nurses that specialize in critically ill patients. And the list goes on. There's so many. You can be a labor and delivery and deal with some different, just very different types of nursing that happen in the ER versus in the inpatient units.
[00:18:52] Speaker A: What is your preferred specialty and why?
[00:18:56] Speaker B: My preferred specialty is oncology, and really, it is the patient population that we see.
Some of these patients are the bravest, toughest people you will ever meet. And I said before, they're going through some of the worst times in their lives, and you really develop a bond with them. You see them come in and out of the hospital over the course of their treatment and their disease process and the things that come up in between. You get to know them, you get to know their families. And I feel like that's just a special connection that you're able to make with your patients that you maybe don't get with a patient that's coming in for a hip surgery and then you never see them again.
[00:19:37] Speaker A: No. I imagine. How stressful can that be, though, for you personally? It just seems like that would be a real heavy weight at the end of the day. And how do you deal with that and how do you help other nurses deal with that?
[00:19:52] Speaker B: It is definitely, there are days that are harder than others. It's hard to try to compartmentalize your feelings. It's not about you. It's about them and trying to do your best that you can to help them deal with this process and move through the process. And at the end of the day, sometimes it really is, you're worn out emotionally. There's tears sometimes. We rely on each other a lot as nurses. We have a wonderful team, and we're there to support each other. When something happens, sometimes you just need to talk about it, and we'll do debriefing sessions. Sometimes if we've had a particularly difficult case, they'll have supportive people come in to sit down, and nurses can come in and talk about how it went, how they feel, and kind of get that off their chest. And that definitely helps to ease that stress a little bit.
[00:20:44] Speaker A: So everything you do is being shared with your team. So you're making your team better every day by the sharing of that information.
[00:20:55] Speaker B: Yes.
[00:20:56] Speaker A: And that is, I keep going back to this airline thing. I apologize, but it's a really good place for me to come from because there's been a lot of learning and a lot of truth in my life that has evolved out of that.
The guys that share are the guys, and I mean women, too. The women that share, those are the important ones in my life. In fact, after retiring some 20 years ago, I still have those people in my life. I talk with them incessantly, and we still connect because we share and we try to make things better. We talk about procedures, we talk about how we deal with stressful situations. And that's an important thing in order to keep your psyche, right? Dealing with high stress situations.
[00:21:51] Speaker B: Well, it's a very special bond, I think, that you make with people in this field, and it sounds very similar to what you're talking about.
A lot of us are very close outside of work, as we are at work, and we rely on each other so much. When things happen with one person's patient, it becomes everybody's job then to help. And people will come by and say, I see that you're really busy. What can I do for you? What do you need?
What's going on? Or if we're in a code situation, everyone knows what their job is, and they are there to do that job. And it's like a well oiled machine, and it gets done.
[00:22:27] Speaker A: And that's very rewarding, isn't it? It is, absolutely. It's like a flight well done, because nothing is ever the same from one day to the next. I mean, you construct your flight plan, you have your outline of how the day is supposed to go, and you get into the flight and they reroute you through North America somewhere. It's crazy. And today we have so many new advancements in medicine. I had a doctor on, he was talking about this pulse type of ablation that is coming out. It used to be six and a half hours to do an ablation, and then it came down to 2 hours with energy, cold energy. And now they've got this new one coming out that's down to less than 1 hour. It's involving a pulse type of procedure, which I don't know. But with these advancements in medicine, what has surprised you lately the most?
[00:23:17] Speaker B: I think what I'm most surprised, well, maybe not surprised, but impressed with is the new targeted therapies that are coming out specifically to treat cancer. I know everyone knows the term chemotherapy, and we hear that, and it sounds like such a negative word.
Chemotherapy is very intense, and it's really hard on your body. And the reason for that is the drugs that they use target cancer cells, but they also target your healthy cells. And so that's when people say they just feel terrible their body is going through something really difficult. And over the years there's been new developments. They're constantly coming out of targeted therapies, which they focus on specific proteins within or on cancer cells. And so it's less toxic to the body because they're killing just those cells and not the cells in the entire body. And I just think it's amazing that they're able to isolate that and then develop a drug that is specific to that.
[00:24:13] Speaker A: That's amazing.
Is that the same thing as a proton beam therapy that they use now for prostate cancer or do you know?
[00:24:21] Speaker B: No. So that's more of a radiation therapy. That is a targeted therapy in a sense as well. They're focusing on a specific area, but these are systemic medications that you take in either the form of a pill or an iv medication that go into your body and then seek out those specific targets and attach to them and then kill those cells.
[00:24:39] Speaker A: That's amazing. Do you have a heartwarming story you would like to share or something comes to mind?
[00:24:47] Speaker B: I have so many. Just one.
Okay, this story. We had a very young patient. She was in her early thirty s and she had a terminal illness that was very unexpected. She was in the hospital and being told that she probably only had six months to a year to live and just imagine being in your life is ahead of you. She was newly engaged and her fiance was there with her every day at the bedside.
And the staff, actually in partnership with the fiance, set up a plan. I'm getting goosebumps just talking about it. To provide a wedding at the hospital for this couple so that they could get married because we weren't sure if she would ever be able to leave the hospital. And it was so lovely to see the team all come together. We had flowers, we had decorations, we had cake, she had a dress. And people that got involved were people that didn't even work on our unit that came to our unit to be supportive and to watch her walk down the so called aisle.
Things like that that happen. That's just a miracle thing. That is. I mean, that must have meant so much to both of them in that time.
[00:26:01] Speaker A: Nurse D, I really thank you for being an angel among us, being a registered nurse and a supervisor on top of that, for sharing some of what it takes to be an angel to others even more. It has to be such a daunting task to manage other rns on the floor of a major Bay area hospital. Yet this angel embraces the challenge without hesitation. Nurse Dee, thank you for being on the show.
[00:26:29] Speaker B: Thank you for having me.
[00:26:31] Speaker A: You've been listening to real estate and more interesting people, topics of the day and of course, real estate. Tune in next Saturday morning at 09:00 a.m. On KGO a 10:00 a.m. And have a most wonderful week.
[00:26:45] Speaker C: The views and opinions expressed are based on current economic and market conditions and are subject to change. Information on the show provided for illustrator purposes only and does not constitute professional or legal advice. Information from sources deemed reliable, but accuracy and completeness not guaranteed. Michael Hatfield and the Michael Hatfield Remax team have no liability for information discussed on the show. Consult with qualified professionals prior to taking action.
[00:27:15] Speaker D: We at the Michael Hatfield Remax team enjoy representing our valued clients. If you or someone you know is interested in buying or selling and wishes to schedule a complimentary appointment with the Michael Hatfield Remax team, call us at 925-32-2775 that's 925-32-2775 or go to our website, michaelhatfieldhomes.com.
[00:27:38] Speaker A: I'm Michael Hatfield. Thank you for listening today. Join us next Saturday at 09:00 a.m. For the next real estate and more when we again sharpen our focus on house the market.
[00:27:49] Speaker D: Join us next Saturday morning at nine and have a wonderful week. Best wishes and blessings to you.
Dr. E 01493.
