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Hi Success NP, your host here Sandra, and today I am joined by
Tina Vasant. She is a registered nurse with a
BSN from Lincoln, Lincoln Memorial University and an MSN
in acute care coordination. She has experience in both
progressive and cardiovascular intensive care units and she's
currently working with an insurance company working with
chart review and occasionally works as a transfer coordinator
nurse on the side. I don't know how she has time
for all these things. He's also the host of the
podcast Good Nurse, Bad Nurse, which explores the realities of
nursing through compelling stories and discussions.
The podcast covers both the positive and the negative
aspects of nursing using real life scenarios and sometimes
involves true crime. Da, da, da to illustrate these
points. Welcome to the podcast, Tina.
We're so happy to have you on. Let's get started on kind of
what you're into these days. The good nurse, bad nurse.
You're blending the true crime with the nursing ethics.
What inspired you to start this podcast and how has it been
evolving over time? Well.
So way back then, it feels like forever ago.
It was 2018. I had been a nurse for about 3
years at a time. I remember I had reached a point
that I was feeling very confident in my nursing and I
had turned a corner where I was actually enjoying nursing.
I remember just kind of having this epiphany moment just like,
well, because when I first started, I was horrified.
I was just like, what have I done to myself?
I put myself through this awful, terrifying experience that
called nursing school. And now I just, I really wasn't
sure it was what I wanted to do. I wasn't sure if I liked it.
I didn't know if I was any good at it.
Were you in the ICU or you were just like Med surg?
I started out on PCU. I actually started out on a step
down, cardiac step down floor and I was only there for a
couple months. Just not good there.
And then I transferred to a level 1 trauma trauma center on
their PCU, still quite overwhelming.
And I just felt overwhelmed for probably about, I would say
about a year and then a year, maybe two years in, about a year
later, I was feeling OK. And then probably two to three
years in was when I really started to feel like I'm
actually enjoying this. It did.
I didn't. It's not like it happened
overnight. I just I realized it one day.
I was looking forward to going to work as opposed.
To. Dreading it with like crying,
I'm at my home or like thinking about everything you did, you
know, did I do everything correctly?
Did I, you know, do something to hurt someone?
Did I miss something? And it was just all of that
stuff, that self doubt that creeps in, that imposter
imposter syndrome that everyone goes, goes through or seems to
go through. And so when I, I discovered
podcasting, I was listening to a lot of podcasts and I thought I
would love to have a place to just like talk about my
experience and, and let other people know that when you feel
that way at the beginning, that's OK.
You, you can, you can feel that way and you will get through it.
You will get through that time. It's different for everyone.
Not everyone feels that way. There are people I know that
just are very confident in themselves and for whatever
reason they don't experience that.
That's OK too. I think the vast majority of
people go through it though and and have that period of time.
That's probably different for everyone where you feel so
unsure of yourself. And I wanted to just talk about
it. And and I found that when I,
when I did start it, that's I started hearing from people
saying things like, Oh, thank you so much for talking about
this. This makes me feel so good.
I'm a new nurse and I'm, I'm scared to death.
And I thought it was the only one that felt this way.
And I'm just like, oh, OK, that's why I did this.
This is. Good.
Yeah, Yeah, this is this is the purpose.
And so you start off kind of talking about your experience
and then you change it to this true crime.
Let's breakdown what's happening with the good and the bad in
nursing and, and, and talking and creating stories around
this. When did that kind of start?
And then how did you really start to kind of grow momentum
with that? Because that is, that's a
different beast in and of itself.
It really is. And when I first started, I
actually started doing that from the beginning.
I did, I I sat down and thought about the what I wanted to talk
about. I at the time I liked listening
to true crime podcast. I kind of have grown out of that
now at this point for my, my just as a personal preference.
But at the time I was listening to a lot of true crime podcasts.
I think I realized it was kind of like causing some mental
health issues for myself. And I realized that's probably
not the smartest thing you start, yeah, you have to be
listening to that stuff all the time, but back away from that.
But because of the time I was, I wanted a way to, could I
incorporate this somehow like nursing, you know, there?
And I start looking at, you know, these stories online and
realized, wow, there are actually a lot of stories out
there about not just nurses, but other health professionals too.
You know, there are bad people out there and they get into
healthcare, unfortunately. So I was just like, you know,
this could not, this could be a good thing to use these stories
as a way to highlight the good and the bad and.
Educate. Educate people about the the
types of people who you could be working right alongside in a
hospital. The importance of advocating for
all patients on your floor, not just yours.
The ones that you're assigned for because you see someone, a
colleague or Co worker doing something that is questionable
importance of sticking up and advocating for all of those
people. Those are human beings at the
end of the day. You know, they're, they're not
just like, oh, it's not my patient, not my problem.
No, it's, it's, it's a human being.
It is your problem if you suspect something is going on.
And I was like, wow, I could definitely use this to advocate
people. Yeah, because when I was
listening to your podcast, I was finding that from the patient
perspective too. I was kind of thinking like
patients need to know that you've got these people in here
because you'll be feeling a certain way and you won't be
validated because the system won't really like let you
believe like, no, this can't be going on.
No, this, there's no way. And then you start to realize
like then one episode with one of the Pas that came on and he
was talking about like providers and how they have this authority
over you and how you think they always have your best interest
and you they must. And most of us do, right?
It's the, the rare zebra that doesn't.
But when you encounter a zebra, you need to know like, Oh no,
no, this is not a normal situation.
And I just thought it was very informational from so many
different perspectives, not just from the nurse perspective or
even during that episode, the provider that you had on that
was kind of describing that his perspective on the stories that
you guys were sharing about providers that were abusing
their authority and hurting people for money.
When the guy had like a Lamborghini or some Maserati or
something like that. And it was just kind of like,
what is going on? You know, that's so scary.
You don't think it's happening. And until you hear it happening,
how is your perspective on the profession change through the
stories that you've been sharing and you research for the show?
Because I feel like it'd be kind of hard, kind of like what you
said, I'm listening to this stuff all the time.
Like it kind of is super dark for your soul.
Was it hard to keep perspective? And maybe that's what led you
away from the bedside? And I that maybe to ask that
question like where, where has this taken you in your own
journey with nursing through this side of storytelling?
Well, fortunately I did, you know, I am a end on a good note
kind of person anyway, I do like to keep things positive, even
though I I'm also a realist, so I want to keep things real.
So I do balance it out with a good nurse story.
So for every horrible story that I read about or talk about,
there's always a good one to end in on.
And so you those are endless. And the good thing is when I do
the research, looking for these stories, the good, the quote,
good nurse stories are the stories about, you know, people
doing amazing things out there helping people sometimes just
like great, you know, nurses or healthcare professionals living
their life and out in the world. And then something happens or
sometimes things that they do while they're at work, sometimes
creating entire jobs that that in order to advocate for, for
cause or, or a certain group of people, just so many things.
Those are just endless and they're ongoing all the time.
And so these other stories, while yes, there are a lot of
them, many of them because I've been doing this since 2018 and
unfortunately, nobody, these people are not apparently
listening to me because I keep telling them you're going to get
caught if you do this stuff there.
Those are out there and they are ongoing as well, but they're far
outnumbered by all of the amazing, wonderful things.
So I think that's helped keep my perspective in the right place
as far as just the the the quality of the people in
healthcare. I do think the vast majority of
people that go into healthcare do it for the right reasons and
are there to help and navigate for for people.
Yeah. And I think too, what you're,
what you're echoing and you're kind of confirming is that
there's a reason why nursing is the most trusted profession,
right? Like we're in the most trusted
profession in, you know, when they compare US against anyone
we just beat out, right? Like you trust your nurse and
it's, they're going to be hundreds and thousands of more
stories of a nurse looking out for you than a nurse taking
advantage of you. So I think that's a really great
perspective because that's the truth, right?
Just like you're saying I'm a realist.
The truth is the stories that you describe are very, very,
very rare, but that we need to, you know, it's still interesting
to talk about, dissect, even keep our eye out awareness for
when we're in practice, even as nurse practitioners, you know,
we do see people and I've, I've seen it in my practice that you
just think like, how did he do that?
Why did that doctor just, you know, make that call?
That was not the right call. That's not the call the other
doctors would have made. And you just wonder, like, where
is this doctor at? What is he trying to do?
And I think when you work in a private setting, that's
different than, you know, a hospital setting because it's
not as money driven as when you're trying to like generate
your own revenue with a private practice.
But it's definitely something to think about.
So one of the things I kind of want to shift to is a kind of a
nurse practitioner focus, right? Because that's what our podcast
here is mostly about. How do you find that the
portrayal of nurses and MPs in the media affect, especially in
regards to true crime, affect public's perception?
So like we said, most trusted profession, but do you feel like
there's a shift or a change at all?
Well, I think that, you know, media in general is just more
accessible. Obviously these days, just this
past what, 10 years or so, there's just, it's everywhere.
And so that's affected lots of areas of our lives.
Nursing is no different. I think it's just shown a light
on things that are the reality of what goes on.
And that's not a bad thing. I don't think that's a bad
thing. I do think that there, you know,
there's some media that can it can be frustrating for us as
nurses and nurse practitioners both because there are
stereotypes that play into the way we're treated when we're
working or, you know, we're doing our jobs, that we are
somehow the handmaidens for positions or that, you know,
we're supposed to be, you know, we're seen as sex objects.
You know, while we're doing our job, we're in our our workplace
and we're trying to do our job taking care of people.
And we're, you know, you walk into a room and the even family
members sometimes they, and I know they probably mean well,
that saying things like, Oh, you have a pretty nurse or, you
know, just little making little hot on for that.
And you just want to just be like, you know, you can't just
stop and educate every single person every time they say
something like that, because unfortunately it's pretty
prevalent. And I do think media plays a
role in that. I also think that media has done
a pretty good job lately. I think it's gotten better.
There are some, you know, cases of we were talking before the
show Virgin River. I, when I started watching that,
I did not even realize it was about a nurse practitioner.
And I started watching it. And that one like first episode
or so where the physician, she's she's supposed to to be coming
to help in that physician's office.
And there's this, you know, push back from the physician.
It was just like, wait, what? Are you kidding me that I was so
excited and I started, I just got hooked into that.
I'm so happy that there was a show that was really showing
what a nurse practitioner does, their role, the importance, the
autonomy. Oh man, I loved that.
I think Paul the midwife, Oh my goodness, that is show.
Just an amazing show, Yes. No, it is.
No, it's beautiful. It is beautiful.
And it just shows what midwives do.
It's again, the autonomy, the how, how much they advocate for
their patients. Also, you know, Nurse Jackie and
I know that's a little bit controversial with some people.
I loved that show. I thought it was very raw and
but it did show like the, you know, the action that goes on in
an emergency department with the nurses and what they're doing
and that things that they're doing hands on.
Yeah, I agree to, you know, take care of patients.
Scrubs a good one. Meet the parents.
I love the movie Meet the Parents because it is a movie
where he's a nurse. Ben Stiller characters a nurse.
And I love that, you know, Robert De Niro, the dad of the
of his fiance, just couldn't stand that he was that he was a
nurse. Like why didn't you go to
medical school? Fucker.
Yeah, yeah, yeah, that. Conversation is amazing.
That's amazing that such a popular movie had this
conversation about and he said I didn't want to he even got into
medical school. He, you know, did great on the
MCAT and he and I can't. Remember host reasons he wanted
to be. Because, you know, that's what I
think people think you, you, you go into nursing because you
didn't want to have to go, you know, spend 10 years in, in
becoming a doctor. And no, nursing is a different
profession. Even a nurse practitioner is
it's diagnosing, it's prescribing, it's treating, but
it's still a, it's the, it's a level of nursing.
It's like the complete picture of nursing and.
No, I love when they ask you as a nurse practitioner.
Oh, so you're a nurse practitioner.
Are you going to go to medical school at some point?
It's like you're just like I did.
No, no, no. This is this is where we where
we stop. You haven't.
I've completed you know my and I know there you know, there are
doctorate programs and but. Yeah, yeah.
Yeah. You're, you know, you're working
at the highest level of your profession.
And so it I I love seeing examples, you know, in the media
where they're actually portraying it accurately.
I love it. Yeah, no, I do too.
There's. Plenty of shows.
I mean, I could list the obvious Grey's Anatomy.
I like, yeah, yeah, yeah. I just feel like, yeah, those
are such melodramas that they're just, they take so away from the
medicine part. Yeah, yeah, yeah, they're not
yeah. But I felt like The Pit, I
recently watched an episode of The Pit and it was pretty like
raw and I felt like it was very accurate to like the roles of
they don't really have nurse practitioners on there, which
like, yeah, maybe they will. But I just kind of felt like I
don't know the nurse and the physician like dynamic.
When I worked in the ER, I felt like that was very accurately
portrayed and the in the drama, the crime issues that are in
that too. I mean, because some people come
on drugs and there's ethical issues that they feel like we
don't want to treat them or people that aren't vaccinated.
Different concepts were so well portrayed, I thought, and very
accurately portrayed the, you know, the frustrated provisions
that healthcare providers have. I thought it was very good.
So in your experience and the stories you've covered, what
unique ethical dilemmas do NP's face that might differ from
those of the RN from your experience that you've been able
to pull up and go, yeah, this is a, this is a nurse practitioner
solo issue that RN's really don't have.
Well, obviously RN's do not prescribe medications.
And one thing that I will tell you from, from doing the podcast
is that nurse practitioners, any of you that are listening, I say
this all the time on my podcast, you have got to be careful about
prescribing controlled substances because you have a
target on your back. And I've done stories about
nurse practitioners who have done it intentionally.
Unfortunately, those people exist.
People are going to, you're going to always find people who
are out to make a buck, you know.
And so yes, they're working in pill mills or whatever you call
them. But I've also done stories that
will horrify you. Maybe the hairs on the back of
your neck stand up. About one in particular I'm
thinking of is a nurse practitioner who's working in a
legitimate pain clinic that is trying to help people with
chronic pain doing everything right.
She was doing everything right and she they literally became
barging in guns aimed ripped her documentation off the wall of
her nurse practitioner license and everything and lives like
you know get on the ground and she went through so much it
took. I don't remember now the
details. It's been a couple of years
story, but went through so much to prove if it she did.
She was able to prove that she did everything accurately.
But when when the federal government gets their sights on
you and you could you really get into a lot of trouble once they
have their, once they are looking at you because they
suspect that you are over prescribing medication.
Yeah, they could get you in a lot of trouble.
And even if you're doing everything right, you're going
to have it's good. You're it's going to you're
going to go through a lot to try to clear your name.
And this person was able to do that.
But, and I'm not trying to scare you at this, but the same time
it's a reality. It is just a reality.
So. You know what, and I'm just, I'm
going to kind of stir the pot here because I think it's kind
of interesting for nurse practitioners when we get that,
you know, it's such a balance for us to get that prescribed
substance, controlled substance, you know, legality approval.
It's always a big state issue. Should we we give them a limited
scope? I mean, all this everything, you
know, what's fine? Very interesting physicians have
were the ones prescribing this stuff the whole time creating
the problem, right? Like I feel like doctors created
the problem. Now there's a big hubbub about
giving nurse practitioners the the access to these drugs.
And what I find very interesting is they don't really acknowledge
the fact that I'm like, we didn't have it.
And y'all created the problem. Now you're worried about us
getting access to these drugs. And by the way, I was a nurse on
the floor and I saw what was happening with the narcotic
thing. And it was very uncomfortable
for me to administer these drugs as a nurse to patients that were
completely not in pain, sitting on the phone talking.
And I was told the pain is where the patient says it is.
No matter what they say, you give the drugs, you don't ask
any questions. And that was coming from the
top, right. I don't know if you remember
that, but I remember that as a baby nurse pain and I remember.
Being vital sign or whatever they.
Yes, it was the 5th vital sign. And if you're in pain, I had, I
could not question and I would come out and just be like this
guy's in there sleeping. He woke me up.
He called me out of a dead sleep to come in and bring more pain
medicine like that does not feel like good care.
Like this is this is a psychosocial thing.
There's something going on. It's like logically with this
guy, he's depressed, whatever, whatever.
And it wasn't that I didn't want to take care of the patient,
that wasn't it. But I knew that something else
was going on. And so I just find it very
interesting that this is the hill that some people die on
with nurse practitioners. And I'm like, we didn't cause a
problem. Like in fact, most of us.
And personally, I can speak for myself, I don't want access to
controlled substances. So I could apply for a DEA with
my current job. They're of course pushing me
like please, please, please. And I actually refused because
of of the ethical issues I saw as a nurse.
I don't even want to have the the ability to prescribe them
because I saw how much of a mess it was.
And you know, you said something earlier about Nurse Jackie, but
it from a true crime perspective, nurses do get
addicted to these things like, and I like that they showed that
aspect in that show because a lot of nurses do struggle with,
you know, taking substances from patients.
And I remember, you know, in the the Florida bylaws, like you're
able to fail after trying to get off the drugs.
They will still give you your license.
And I found that very interesting because I thought
then this really must be a problem, like if they're even
going to allow you to kind of relapse and then still try to
get your nursing license after it.
So I just feel like the problem is very complex.
I think that there is also like a huge, you know, psych mental
health problem associated with this, that we are not just
medicating patients pain. We are medicating, you know, an
emotional or spiritual, whatever you believe in pain in these
settings. And I don't think nurse
practitioners are the problem because we've had that problem
way before we ever even got the rights to prescribe them.
And in fact, you might find that NPS like me are a little more
like, I don't know, I think I'm going to need to get take a
Tylenol, take an ibuprofen and, you know, and have a little bit
of more of that regulation. Not that we don't believe what
the patients are saying, but that we know what can happen
when you take these drugs. They are there are side effects
from, you know, addiction with these medications.
Yeah, there are plenty of stories out there about
physicians doing the exact same things, about physicians
getting, you know, their clinic shut down, arrested, charged.
So it's not this is. And that's the way a lot of
these stories go. Like you can find stories about
nurse practitioners misdiagnosing something.
I mean I'm missing a diagnosis or?
Just. Diagnosing something completely
wrong and someone dies as a result.
There are stories like that they've been arrested because of
it. Neglect for some reason,
overlooking something or, you know, whatever the reason is.
But for all of those, you can also find plenty of physicians
doing the same thing. And I think that it's easy to
just like pluck those stories out and pick on nurse
practitioners and just say, see, see, we've given them too much.
And as they're, we've expanded their scope to the point that
no, that's it's because anything that you can say about a nurse
practitioner, whether they, you know, you can find examples of
nurse practitioners to, you know, just aren't good at their
job. They're just not that, you know,
for whatever reason, I've worked with some that are just you can
just tell like they're they're just they don't care about the
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They're overwhelmed Whatever. You can also find plenty of
examples of physicians that are in the exact same boat.
It is not about whether they are a nurse practitioner or PA
versus a physician you know in a medical doctor or DO.
It is not about that. It is about how much effort
they've put into their own knowledge base, their skill
level. Yes.
How much education have you, do you have how much experience,
how you know, how much mentorship have you had and
guidance? And I've, I've worked with nurse
practitioners that you know, in, in the CBICU that I would much
prefer having them taking care of my patients as far as like
knowing, understanding the disease process that's going on.
The pathophysiology, pharmacology, whichever.
Yeah, yeah, yeah. Exactly.
And I and then versus, you know, some physicians where you're
just like, I know they may understand it or they may not.
You know, some of them, they're just like, you can just be like,
Oh my goodness, we're gonna struggle to get through these 12
hours. Yeah, yeah, that's my dad, says
not every doctor made straight A's.
But it's true, and that is so true.
I've said that too. Somebody had to graduate at the
bottom of their class. Somebody graduated.
Yeah, yeah, yeah. Well, very.
I think that's just something else I wanted to talk about.
I thought was very interesting and I really appreciate you
bringing that up because I think again, like having those, just
realizing that it can happen to anyone, you know, just say that
nurse practitioner did everything right.
Like why did this happen? And just kind of being on guard
for those things. Have you ever noticed any
recurring themes or red flags and a bad nurse story that a
nurse practitioner should be aware of?
Anything that you've noticed? You know that you're like, this
is a common thread. I'm starting to see this.
I mean, I, I guess I probably, that's probably the one that I
would talk about the most is just the over prescribing.
Yeah. Awareness also being aware of
the fact that if you are in a state where you do have to have,
you know, a provider, a, you know, a physician over, that's
sort of like looking over your charts.
You know, some, not all states give nurse practitioners the
full property. And so being aware that you, you
know, where you fall, you know, in that if you're, if you have
someone that you're relying on to look at your charts and kind
of like be that person that's helping you make decisions or
whatever, just not just like taking that for granted.
And just that they're doing that because in one, in one case, a
particular work that I can think of, they that that doctor kind
of just threw them under the bus.
So, yeah, you know, being aware of that relationship, I wish all
states just would give full practice authority.
You know, I think that people are just afraid of it.
And I think, you know, we've hinted at some of the reasons
why and it's it's it's rooted in ignorance, really.
But yeah, we have to do a better job of educating people.
You know, when you were talking, you made me think about the
nurse that in California that had been calling herself doctor.
And then, you know, she was a doctorally prepared nurse
practitioner, but it did not matter in her state.
She was not supposed to be referring to herself as a
doctor. And she ended up, yeah, yeah,
she ended up getting, losing her ability to make, you know, her
practice in that state. She was going to get sued.
It was kind of a mess. And I remember, you know,
thinking the rules aren't the same everywhere.
And, you know, you have to make sure in each of your states, you
can refer to yourself this way. But I just feel like it's one of
those crimes that I don't really think is a crime.
Like, I'm so sorry. I'm just having a hard time
wrapping my mind around a nurse practitioner that's doctorally
prepared that spent the extra time.
She's not referring to herself as anything inappropriate, but
this is just going back to some type of scope reach
battleground. You're misrepresenting yourself.
And I don't think there's anything wrong with saying I'm
Doctor Pryor, I am a nurse practitioner.
I'm going to be seeing you today.
I don't think there's anything wrong with that.
I don't typically do that, but there's nothing innately wrong
with what I just said. That is an accurate statement.
Then I just feel like it's just one of those things where it's
like, why are we battling over this when we actually have
bigger problems? Like, we don't have enough
providers. Patients are waiting longer and
longer to see someone to write medications or just hear what it
is that they're going, you know, dealing with.
And so it's really, it's a really bad hill to die on,
especially as more professions are creating these doctoral
programs from, you know, you know, physical therapy,
pharmacology, like all these programs are coming out with
doctoral degrees, which I think is just great.
It's just more education and people are spending longer
learning. But it just seems so strange to
me that there's only one person in the whole hospital, 1° in the
whole hospital that can call themselves doctor.
So I just find it interesting that nurse practitioners are
having to pay attention to their individual state laws before
they can refer to the extra education that they got with
confidence. And I just, I hate that for us.
Like why make us feel more uncomfortable when it's already
tough to be an NP? We're not physicians, We're not
nurses. We're in this middle ground.
And yet it's like, Nope, can't do that.
Nope, can't prescribe, Nope, can't work alone.
Nope, Nope, Nope, Nope, Nope, Nope, Nope.
And then it's like we don't have enough providers, but we need
how? Do we solve them?
And we'll put you in an emergency room all by yourself
with no physician whatsoever. No training, just go do it.
Just figure it out. Throw you in there, Yeah.
Throw you in there, but don't you dare do these things.
And it's like these things aren't the problem.
Like these things are just minor issues.
When we actually have major problems, and we may not be, we
may not, we may actually be the ones to help fix this or to
bring a different perspective that could actually kind of
create a different environment around this.
Why this? I don't know.
What do you think? I agree.
Why are we focusing on why why, but it is you you you nailed it
though. It's it's all about ego.
It's all about you know that that worrying about soap free.
We're worrying that oh, they're they're honing in on my they're
coming in on my territory. I think a lot of there are, I
know that there are people who go into medicine because of the
prestige that goes along with, you know, just being called a
doctor, of being called a physician.
And I know not everyone is like, I know so many amazing
physicians. So not everyone has that.
Yeah, yeah. Yeah, this is not a blanket.
Yeah, yeah. Most people that I work with
don't don't act like that. Yeah, occasionally they come
across those people and, and a lot of them have a lot of power,
you know, they're so. And I do hope though, that this
is this problem is aging out. I think maybe some of the
younger, the people that are kind of in the younger
generations don't have that mindset as much, you know?
So I think that the, some of the residents that I worked
alongside when I worked at 11 one trauma center, they seem to
just have a much higher respect for bedside nurses and also
nurse practitioners. And they and I, working as a
transfer coordinator, I listen, that's literally my job is to
connect providers and let them talk.
And I literally sit there and listen to everything that they
say and document what they say. And so I think that most, most
physicians have high respect for nurse practitioners and they
talk to them like, you know, their colleagues, their
colleagues. Yeah, absolutely.
Yeah. I would agree.
It's horrible when it doesn't happen that way.
But I definitely think that most of the most people are
definitely very respectful. Yeah, I would agree.
And unfortunately, like you said, the people that have the
most pull or some of the most, you know, the highest authority
tend to have that mindset. And so it's unfortunate, but I
think it's I think it's it's important.
I think the younger generations are more focused on work life
balance. A lot of the physicians are more
focused in on I can't do it all. And they're wanting, they're,
they're liking the fact that an NP will take a level of that off
of them and that they can focus just on one thing.
And then they realize when they get back or whenever that NP is
gone and they have to go back and do that grunt work, they're
like, oh, she's vital for me to get this part done of my
practice so I don't have to do as much of that.
And, you know, each of us have our roles and there's more than
enough work to go around. And I think the younger
generations are seeing that it's like, no, if you get APA nurse
practitioner or Pennsylvania on your side, that just only
extends what you're able to do. You're, you know, by
collaborating with one of those providers, you are, especially
when you train them well, you train them well.
You have a hungry NP, you really spend some time training her.
That's just an extension of your brain.
That's all that you just did. And it's just such a beautiful,
when I've seen those relationships, the physician and
a nurse practitioner is such a beautiful collaboration and, you
know, synergism that they're all working off of, of like, yeah,
no, we're working together to get to the same thing.
And yeah, I think that's really good.
Any nurse stories on your show that have impacted you and how
you view your role in healthcare?
You've got to, you know, you got to tell me something like, hey,
Sandra, like this one really stuck out to me.
This one was really beautiful because you see enough of the
you know the bad ones that which one that stuck with you that
just makes you feel warm and fuzzy inside.
So as far as like, unfortunately some of the some of the good
nerd stories aren't necessarily happy ones, so.
We all, we all love the smudge, right?
We like, we like that, yeah. Well, they're, some of them are
just like, they're heroes for a reason, you know, Maybe they,
you know, died in the process of trying to help someone.
Oh my gosh. So some of those are and so, so
I, I try to end the show on a good, good note.
And yet at the same time, I'm just like, boy, I've just
depressed myself because I've had two really depressing
stories. But I wanted to highlight, you
know, the amazing thing that the nurse did.
And one of them that is just like it's I'll never forget it
is the story of a nurse. Her name was Tristan Kate Smith.
And she, she, and I don't know if you can do a trigger warning
or whatever, but she took her life and she was young.
She was in her 20s, young nurse and she was an ER nurse and she,
she took her life. But before she did, at some
point, she had written a letter to her abuser and it was to the
hospital. Oh my goodness.
It will just rip your it just absolutely gutted me.
And after that happened, or our father found on her laptop this
letter that she had written to her abuser.
It's so just beautiful. It's it was just so raw and so
real. And you could just see the
damage that it had done to her. And I really wondered at the
time, I remember just thinking there was a hole that her father
has just worked tirelessly ever since that happened to bring
awareness to staffing ratios he's gone around.
I actually went up to Columbus, OH, where she was in the state
of Ohio. So you're trying to get laws
passed to regulate staffing ratios?
Yeah. In her using her memory, using
her story. And so I actually went up there
and I spoke at a rally there at the Capitol where they were
supposed to be voting on I. Saw that you were involved in
that, yeah. And so, yeah, I saw you on the
podium. I did.
I talked about her as a good nurse for one of my episodes and
because, you know, she, she is look at what she's done, you
know, posthumously. She look, look at the what her
father is doing in her name. And even though it's very
painful and difficult to talk about, it's also very important
to talk about because for, for even though her story is, has
gotten a lot of media attention and it's very high profile and
lots of people are talking about it.
There are so many people that have, have have succumbed to
mental health, you know, issues and stemmed from all of the
stress of working that side of work, you know, and just feeling
inadequate. That, that feeling when you
leave work at the end of the day and you feel like you just
didn't do enough to help your patients, you feel inadequate.
And really what's at this? The root of that problem was
the, you know, the, the root cause.
If you really go back and look at it, it's because there was
just not enough resources for you to.
Yeah, the system is failing. Yeah, the system is the problem.
It's not the individuals. Yeah.
So even though it's not a necessarily warm and fuzzy
story, it's definitely probably, of all the good nerd stories
I've done, it's definitely the one that's just like, stuck the
most, the most. Yeah, yeah.
That's just really like raw and real, and I think it's
emblematic of the systemic issues that we have in nursing
and it's why people are leaving nursing and going into the nurse
practitioner role, hoping to get away from a level of that only
finding as a nurse practitioner. They're their own mountains that
you have to climb. You're the they're their own,
you know, issues that you're having to navigate in your
career. You know, one of the things I
was thinking what you were talking, you know, you've had
three million downloads of your podcast.
I mean, you've you're doing phenomenal.
It's incredible work, but you've also had on if you.
Like either you one of the I think it was another podcaster
recently had on Redonda Vaunt. What was her is that her name?
Is that her Redondo? Redondo Vaught is her name.
Yeah, and she was a nurse that, you know, had the homicide issue
with. She had, you know, and I
actually had a conversation with her as well.
And I was so interested to hear the system failures that were
going on with her job and how she's on the chopping block
right there. I think they denied her her
license back, right? I believe that she was not
allowed to get her license back again.
And yeah, I just found it very interesting that again, here's
another system problem. She was able to override the
computer. She made.
You know, something happened. And they're not bad people.
This is not a bad person. This is this is a system, you
know, either overstaffed, distracted, it's a lot of
different things that end up causing these tragic events.
But again, I do think it's good that you focus in on, you know,
what she sacrificed by sharing what it was that she was going
through on the floor as a nurse. And so many nurses feel that
way. A lot of nurse practitioners
struggle. And you know, you go from being
a nurse crying in your car to being an MP crying in your car.
The only difference is that you're $250,000 more than when
you are the nurse. So there's that same balance,
that same issues that you're noticing, you know, I've noticed
in both roles. And I think, you know, doing our
best to change the system really is the focus and then doing our
part to focus in on what we can do that day.
And that's the most that we can do.
And we got to let the rest of it go is something for both the
nurse practitioner and the NP. Like we can only do what we can
do in that space. The system is broken.
And find your way in that system is the best thing that you can
do for yourself. And I think, yeah, I think
that's I think that's good advice for the nurse and the NP
for sure. Absolutely.
And if you had to find and describe the perfect good nurse
and maybe the bad nurse, what would you say?
How would you describe them? How would you give that
definition? Whenever you're telling your
podcast stories, this is the good nurse and this is the bad
nurse. How do you make those
definitions? Yeah, So what I always tell
people, you know, there's, there's certain things, you
know, I was a preceptor also and, and, and trained people.
So there's certain things, you know, making good habits, you
know, certain things that you, there are things that you will
have to sacrifice. You cannot.
And this is one of the things I talked about with the Redondo
bot story. You cannot follow every policy
to the letter because they, the hospitals are going to put all
these policies in place to cover their butt when something goes
wrong and then come back to you and say, what?
Wait, the policy is this, this and this, and you did that.
And the fact of the matter is that if you followed every
single one of those policies, you would never be able to take
care of the patient. You would be, you know, stuck in
the minutiae of all of these different steps, trying to get
yourself to where you're actually taking care of your
patient. And so you have to pick and
choose the things that you're going to go.
I'm not doing that one. And but when it comes to safety,
you cannot. Just going to say safety is when
you just. Safety is just something you
just can't, you know, you've got to do those rights, you've got
to check those fibrites, you've got to check the armband, you've
got to, you know, monitor. You can't override the system.
You can't tell it pull the drug out anyway, but you can't do.
Those things, Sandra, you have to do that if you're working in
an ICU. And this is something that I
think a lot of people don't understand is that I remember
when I worked in PCU, my preceptor, she was so good and
she taught me not to ever, don't ever hit override.
You can't hit override. Well, when I transferred to ICU,
I still had that mindset. And they were just all like,
you're going to have to get over that.
And yeah, you really do. Because as an ICU nurse, you do
have a lot more autonomy. You are allowed, and it is
actually written in the policy that you do have.
There is a level of in which you can make decisions that you know
is reasonable if you feel like your patient's life is in
danger, knowing that you're also at the same time going to be
getting in touch with the provider.
And it's so you kind of an understanding this is there's
very Gray lines here. So you have a patient who is not
on a pressor, but they're you're in an ICU for a reason.
You all of a sudden their blood pressure starts to drop.
Are you going to seriously go? I'm not going to go.
Wait for a pharmacy. There is.
No, Yeah, pharmacy has not seen it.
A doctor has not, or a nurse practitioner or a PA has not put
in an order for it yet. No, you're going to go get the
levo, pull it out, come in while you're hanging it, call, you
know, call Sandra MP and, and tell her I'm hanging this levo
now and put the order in, you know, and so you, you're all of
these things are happening at the same time.
If you didn't do that, people would die.
And that's just a reality in an ICU and in an ER.
And I think it probably happens more in an in an ICU than it
does in an ER because you in an ER, I feel like they're the
physicians and nurse practitioners illegally.
They're right there. Yeah, they're all working
together in tandem, but in the ICU, the doctor someplace else.
Yeah, you're right. Else and so you really do have
to make those decisions. It doesn't happen all the time,
but it happens enough that it's just, it's just a reality of
life that yes, you will be hitting override a lot.
And it's yeah, that's scary. And that's one thing that I, you
know, it was literally a reason why I chose to leave the bedside
because. I was hoping you were going to
talk about that. Yeah, I mean, I did.
I chose to leave the bedside because when when Redondo was
arrested, I saw that story and I was just like, wait, what?
And I just knew that there had to be something that she did
wrong, that, that there was some egregious mistake that was just
unforgivable. That and and I went and bred the
whole CMS report that literally just step by step told
everything that she did and I was just like she made a
mistake. She made several mistakes that
are probably because of the culture in which she was working
and that's the problem. So in a just culture you in that
situation, what should have happened is this horrible thing
happened and a patient died because of it.
And now we need to go back and look at this and figure out what
do we need to change in our processes that can keep this
from happening again. 100% agree.
Arresting punish. Yeah exactly.
This is how I feel as well. And then so she's arrested and
immediately drove to Nashville to be there for the hearing.
And I just could not believe that not only did you know she
did everything she was, she did everything right in terms of
like filling out her incident report, telling everything that
happened. Just I will say.
Honest disclosure, she wasn't trying to like, hide anything.
Honest, one thing she didn't, she did wrong that she she
didn't know and nobody I think would know is not asking for an
attorney. And if you do something that
very obviously leads to a patient's death, please ask for
an attorney. She didn't know to do that.
I think a lot of people would not know to do that at the time.
I wouldn't have known. Do not trust the hospital and
don't talk to their attorney. They're working in their their
best interest. You need to just close your
mouth. It obviously if a patient's life
is at stake in that moment, you have to stick up and say
whatever you need to say to help the patient.
But yes, when all is said and done and you're kind of like
looking at, oh, what just happened, you really do need to
close your mouth and ask for an attorney and then decide how to
take next steps or you're going to, you could get get in serious
trouble because that's what happened with her.
She was just so honest and just trying.
And then for some reason this case came across the desk of an
investigator, a TBI investigator.
And that TBI investigator decided, OK, I need to look at
this and started doing some investigating.
And then based on some answers that they got from somebody
working at a hospital, let's don't name names, but, you know,
whatever hospital it happened to be, somehow that investigator
got the impression that they needed to then present that case
to the prosecutor. And the prosecutor took that
information and went, yeah, it's a good idea.
Let's go arrest this nurse. And that's exactly what
happened. And then not only that, but two
years later, they a jury of 12 people of her peers convicted of
her. So yeah, that's why, that's why
I walked away. I was just like, I can't live, I
can't work in this environment. I am going.
It's too dangerous. We don't have enough staffing.
I'm working in a CVICU where I'm handed three patients, very very
sick patients, and I'm leaving as an experienced nurse.
I'm leaving crying because I was scared to death like what just
happened. And no, I can't work in that
environment knowing that if I make a mistake that leads to
someone dying, I could literally be arrested and lose my freedom,
lose me away from my. Family livelihood.
Yeah. No, exactly.
Yeah. Wow.
Well, I want to end on a positive note, just like you do
on your podcast, taking a page out of your own book.
So what is some maybe a humorous moment from your podcasting on
good nurse, bad nurse that may be stuck with you that you're
just like, all right, this one's kind of funny.
This one's kind of silly. Let's turn this thing around
from going to jail. Let's turn it into laughter.
Where what you got for me? OK, so I, I, I laugh all the
time, all the way through my, even though the dark subject
matter, I definitely am a person that laughs at inappropriate
times. I am horrible at funerals.
You don't want me ever coming to a funeral because I just once
something strikes me, I would just like start smiling
ridiculously. Yeah, I'm horrible.
I'm just like, oh, please don't, please don't.
It's not funny. Nothing's funny.
And the more I try to do that, so I I try.
To stop laughing The more you're laughing, yeah.
But one thing that it made me think of is like that I would
say the podcasting has connected me with so many just wonderful
people. And I went on the Nurse Lake
cruise, I guess it's been a little over a year ago now.
And while I was there, I met all these amazing people.
Like I just meet people that would just be like, I listen to
your podcast and then. Yeah.
And there's just different nurses, all kinds of other
influencers, the people that call those influencers.
And yeah, we were just all like, we decided we wanted to do
karaoke and we went like to, we called it kiddie pool karaoke.
And we went up to this, like, area like people, there are no
children on the nurse plate crew.
Yeah, yeah. No kids, but we're in the kiddie
pools. We went to the kiddie pool.
There was nobody there. And we somebody brought like
their beats, like. Speaker you know, and they yeah.
Playing portable. Speaker yes.
Portable. Speaker We pull up music on
that. And then we literally stood
there and played and did did karaoke and it was so much fun,
man. We had a that was like the most
fun cruise ever. So yes, single, like
unfortunately, you know, when you have little ones, it's just
like can't go on the fun, you know, Nurse Blake Cruise.
But it sounds like it's definitely checking out when
you're into single, single space.
No kids get out there, check it out.
That sounds like a good time. Well, we're, you know, Tina, I
absolutely love your podcast. I love your conversational
style. Just it's very relaxed.
It's such a great show to listen to.
So everyone check out Good Nurse, Bad Nurse, wherever you
get your your podcasts, we'll link them in the show notes.
Where can people find you? Give a shameless plug for what
it is that you're growing there. And it really is just a good
nurse, bad nurse. They gave me.
If you look up good nurse, bad nurse, it's pretty much just me.
Nobody else is going to call them crazy enough to call
themselves Best. Yeah, you'll find me if you just
Google good nurse, bad nurse or look it up on any of this, you
know, social media platforms or wherever you get, you know, like
you said, get your podcasts. Yeah, and we do a rapid fire at
the end. Are you ready, Tina?
For rapid fire? Are you?
Probably not. OK, Yeah, you're not.
Let's just go for it anyway. So tell me, what is your
favorite color? That was quick.
That was super quick. Are you like a solid Navy blue?
Are you like a royal blue? Are you like?
All colors of blue. Any blue.
Lighter, yeah. Okay, a lighter blue okay, okay
and then favorite dessert. If you have to pick a dessert,
no matter where you are, you're at least trying it because you
just love this thing so much. What's what it.
Is I'm from the South, yeah. Yeah, yeah.
I think I saw Tennessee, right? Yes, yeah, yeah, yeah.
And then, OK, so because this is the Success NP podcast, I want
to know, how do you find Tina? How does Tina defined success
for your life? This is not a rapid fire.
This is a little bit deeper, but I think it's important to hear
how you and your career and your life are chasing success,
chasing that thing. That's a great question.
I think that for me, and I've had lots of different roles as a
nurse and just, I'm, I'm constantly evolving and
challenging myself. So I feel like whenever I, as
long as I'm being challenged as like if I feel challenged in the
position that I'm, I'm in, I'll stay there.
And once I feel like, you know, I'm feeling stagnant, I'm going
to want to, I want to move forward.
So then, you know, but whatever I'm doing, I want to get the
certifications. When I was, when I was on PC, I
got my PCCN. When I was, when I moved to ICU,
I got my CCRN. I'm just always wanting to just
kind of like work at that highest level that I can.
And then when I feel like, you know, I'm, I'm feeling a little
bit, you know, like I got this, I'm ready to move on and
challenge myself. So to me, that's success.
Yeah, it's always, I think it goes back to the very first
story you told about how you finally kind of got settled as a
nurse at like 1-2 year mark, and that's when you decided to
launch the podcast. And so I think for any nurse or
nurse practitioner that is thinking like, all right, I'm at
this place like I'm feeling like what Tina did or, you know,
whichever, whatever that story is, for you to just launch
something new, go into something unexpected because you never
know what doors it's going to open.
You never know what conversations you're going to be
having and what stories you're going to be diving into to share
on your your no next episode. So thank you so much, Tina, for
coming on. It was so nice to meet you and
to sit here and have this conversation.
Absolutely. Thank you for having me.
Yeah, guys, thanks for hanging out be well, thanks for tuning
into another episode of success and P We hope today's discussion
has shed some light on the diverse career options or taught
you how to improve your clinical practice as a nurse
practitioner. Remember, whether you're
considering a specialization, pursuing advanced certifications
or exploring non traditional roles, there's a wealth of
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