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digital clinical resources. Hi welcome Success NP.
We have another episode of our podcast today with the amazing,
the illustrious, my dear friend Sarah Lorenzini.
She's a passionate rapid response nurse, an educator who
brings energy and expertise to the nursing community.
She's the host of the rapid response podcast, which I've
been on. She is so captivating as she
tells real life emergency stories from her over 20 years
of nursing experience in the ICU, cardiac ICUER and being the
head of the rapid response team. She tells all these complex,
beautiful, written applicable stories that you can then learn
the pathophys, pharmacology, anything that the nurse needs to
understand their role, especially in the acute care
setting in healthcare. She breaks it down for you.
She actually also has the Rapid Response Academy, which I think
she's phasing out for summer, but probably coming back at some
point, where she's teaching rapid response nurses how to be
the best that they can. She holds a master's degree in
nursing as well as her CCRN and her CEN certification.
So she just loves to teach nurses.
She lives in the wonderful state of Florida, and she's got a
bunch of kids. How many do you have now?
Like, 455, 55 kids. And she is a passionate mom.
And yeah, she's just a friend. She's just a friend.
Welcome, Sarah to the podcast. I could cry.
I just love you so much. Sanji, thanks for having me on
your show. I'm kind of laughing.
You called me illustrious that. Just.
Scared me that. Just mouth.
I just let it. Thank you for having me.
It's always good to chat with you my friend.
Good to see your face. Today I really want to talk
about an interesting role of the rapid response nurse and how it
intersects with the role of the nurse practitioner at the
bedside. Because I think that's something
that not a lot of NPS know too much about.
And if they are maybe a new grad nurse that is just finished
acute care nursing is going to be kind of maybe in that setting
where you're working. Maybe this is her first time
interacting with that role. What does that look like for
her? Like for a nurse practitioner
that's just starting. Yeah.
So I think just to back it up, let's just level set describe
what is a rapid response nurse, because I think that might mean
something different at different facilities.
Let's do it. And so, gosh, back in 2004, they
decided, I think it was called the 100,000 Lives campaign, that
they were going to make all these standards of care, they're
going to save 100,000 lives. And one of the centers of care
is there needs to be some sort of rapid response team or team
that responds to emergency at the bedside.
And so every hospital gets to decide who's on that team, how
they structure that team. But there is a team of people
who is supposed to respond. Patients are crashing.
So it's not just left in the hand.
So say the one bedside nurse to manage this crashing patient.
And so some facilities have dedicated rapid response teams
where it's a nurse, that's all they do all day long is just
respond to and prevent emergencies.
And then some facilities, it's like the ICU charge nurse, let's
say, or the ER Chargers might leave their unit and go respond
to the emergency wherever it may be happening.
So kind of like the 911, but on the inpatient side.
So that is my role at my hospital.
We have a dedicated Rep response team.
So I just respond to emergencies all day long and often times as
interacting with the bedside nurse, with the patient, with
the family, with the physician, with the nurse practitioner,
with the consulting team. Like I interrupt with all those
people. I think the expertise that I
bring is not just my 20 years of critical care experience, but
also team leadership. And I think that's the part that
I would love to focus on today. It's just talking about how as a
nurse practitioner you go, it's a very quick transition from
you're a bedside nurse to bam, now you're in charge, You're the
one that's ordering the things, you're the one that everyone's
looking to for guidance. And I, I mean, I haven't been
through MP school, but I, from what I hear, there's not much
training about that particular aspect of your role.
Like you get really good at understanding which antibiotics
to order and the diagnostics and like all of that.
But like, what about when the patient's crashing and it's
chaos in the room and everyone's freaking out?
Like that skill set, managing that, that's, there's no class
for that in a peace school, unfortunately.
But that is something that I have taken years and years and
years to try to perfect in my own practice.
And so I love to come alongside my NP colleagues and like
support them in that, give their tools and resources and verbiage
really to do that very well. So I don't know if I answered
your question. Yeah, yeah, Yeah.
No, you didn't. And that's exactly how they
collaborate is in those situations where the nurse
practitioner is kind of leading. And what you're noticing in at
the bedside is that they're thrown in to these.
And again, that's just so classic NP sometimes is that
you're thrown into situation and you're like, OK, this is trial
by fire. I'm going to have to learn,
build the plane as I fly it, learn as I'm doing.
And it does make it kind of hard.
And there are ways that I wish. And that's part of the reason
why we created the booklets that we did was because there's just
so many instances where NPS are put in positions where it's
like, well, why isn't anyone giving us some quick notes on
like, what it is that we need to be doing here so that we look
more prepared? Nobody wants to be unprepared,
especially when you spent all this time in school, you spent
all this time in clinical, and now you're in another position
where you're like, unprepared. Like you don't want that
feeling. That feeling is terrible.
What are some tools that you think that NP's could bring to
the bedside as far as maybe communication?
And yeah, let's start with communication and dealing with
bedside inside emergencies. What have you noticed or some of
the things that you said this MP did this or this MP didn't do
this and this was a benefit or a hindrance?
OK, let me talk about an MP that I love so much that I think
totally does an amazing job when she shows up to emergencies.
And then we'll talk about something that I've seen that I
would recommend people not. To.
OK, so one thing she does is she shows up and introduced herself.
Hey, guys, I'm Sandra, the MP from Blah blah.
Tell what's going on. So start the instruction.
No one knows who you are. We're all wearing scrubs.
It's hard to say who's in charge of what, what the role is.
Introduce yourself. And your role seems pretty
obvious. I can't tell you how many people
just forget to do it. OK.
And then she kind of like, gathers information, and you can
see all the wheels turning in her head.
And then once she's kind of like, made a plan, she announces
it. All right, guys, so we're going
to do this, this, this and this. I'm looking for this.
I'm assuming this might be going on, but I'm not totally sure
once we get the results back from this that I'm going to do
this. So just like basically lays out
the plan of care for the whole room and for the patient to hear
as well. Wow.
Does anyone have any questions or did I miss anything?
And that's my favorite part that she asked with humility is did I
miss anything? Anything else I should know
before we move forward with this plan?
And every once in a while, someone has a little piece of
information that she wasn't pretty to yet.
And when she hears that, she's like, oh, good point.
OK, well, let's go ahead and add this lab.
Let's go ahead and read. Like she's so good at
communication. And so she lays it all out
because everyone a chance to contribute.
And then she says, is there any questions?
All right, well, let me know about this and I'll circle back
in about this. Like she just closes the loop
every time. And everyone in the room is
like, like, we got this, like we know the plan, we can move
forward. I know what I'm looking for.
She she also thanks everyone for their contribution.
That also feels really good to the whole team.
And I think the bedside nurse, the family, the patient all feel
like, OK, this is being managed 12.
So this is for like an emergency that doesn't end in like a code
blue, right? That's a whole different
situation. But a lot of his rap responses,
it's just all the pieces of psychocardic.
We have to manage this tech Guardia.
Oh, they're hypotensive, but to fix hypotension, it's something
that we can fix, right? It's not like they're not about
to die, but that's something we need to address.
As for those situations, she she addresses the thing she talks
about what the plan is, what to look for it, it goes so smooth.
OK, so that's the that's the ideal nerve practitioner, right?
Beautiful. I love it.
It's. Beautiful.
Yeah, she's amazing. Everyone loves her, right?
Of course, because they feel safe whenever she is present.
But let me type. That's not good.
So here, Here's my most hated question.
Whenever OK, tensions are high, everyone's stressed out,
something's happening with the patient, and then the provider
or MP or whoever shows up and says why'd you call a rapid?
Interesting. OK, it's studying a different
SO. Yeah, I also want to know why
they called a rapid. But something about asking why
did you do this immediately puts people on the defensive.
It would put me on the defensive.
Right now I'm questioning, wait, should I have it?
Is it inappropriate that I called it?
I'm, I'm sorry, like like it actually makes you think like
you have to defend yourself. Well, I can't wrap it because of
this. And they get people, you can
feel it in the room. People get more stressed because
they have to defend their decision to have called the
rapid response. There's so many other ways that
you could ask why did you call the rapid except for that
particular question. And I get it that I also want
that answer, but I'm not asking it that way.
I'm starting with, hey, guys, I'm Sarah from rap response.
Who's the primary nurse, Sue? Hey Sue, time by your patient.
What should I know? There's so many other ways you
can ask what's going on with this patient.
Besides, why don't you call the Rep?
OK, so that's thing #1 don't do that.
And then you do not need to start like, listen, people with
questions, give them a second to like get it out of their their
chest. You know, you don't have to be
like, what's the blood pressure? What's the beds?
What's the history? They will get to it.
Just give them a second. It gets, it's really frustrating
when you have a fish in your head and you're trying to get it
out at what you think to be an organized fashion and someone's
asking these random questions from all over the place.
The other thing too is they were like, what's the blood pressure?
I'm like, OK, listen, just look on the dark screen right there.
The model of the machine is right there.
Just look at it, you know, like, what's the patient's name?
OK. It's literally written on the
white board right behind you. Like that some of these
questions, like you're just adding to the chaos.
Just like take a minute, take it all in.
Sometimes like the lack of emotional intelligence and
reading the room, you know, like as an MP, as a rapid response
nurse, when I show up to emergency, I actually act
different every time I show up. I read the room.
Sometimes I'm like funny cracking jokes.
Sometimes that's totally inappropriate.
Sometimes I'm like had to be very firm because the patient's
kind of wild out. Other times, no need for
firmness. This patient's scared and they
need someone to be maybe for me or like nurturing or consoling,
right? My tone of voice changes.
I'm not the same proper response nurse every time I show up.
And I think, as MP said, to be aware of that too.
Sometimes you show up with humor.
Sometimes you should not be busted out the humor.
Sometimes you show up with this kind, compassionate, nurturing
voice. And sometimes that would seem
kind of like you're making the patient feel like they're dumb,
right? Yeah.
They do condescending. Kind of change.
You have to change your tone based on the patient's needs.
OK, So we don't say why did you call the rapid.
We have to be aware of the room, kind of respond to the room and
then don't ask a gazillion questions.
Give a second to get it out. And then if they didn't answer
what you wanted to know, then of course ask the question, right?
But what I have found is most of the time people do eventually
get to all the things that I'm that I'm wanting to know.
And then acting like people are dumb for not knowing the thing
that you wanted to know. It actually doesn't help
anything. In fact, I would say it's going
to harm future patients because if they are afraid to speak up
and share concerns and let you know about the patient declining
because of fear that all the condescending MPs and I feel
dumb, they won't call you. They'll wait until the patient's
really, really bad to let you know.
And so that means future patients are going to get your
care delayed. And so I would rather even if in
my head I'm thinking, how do you not know this are like, I'd
never say it out loud. I'd never say with my facial
expressions. My tone is always thank you so
much for letting us know. Like thank you so much for
advocating for your patient. Even if you don't have all the
information, even have all the answers.
You recognize something was up. So thanks for letting us know
even times when like this is not even an emergency, this
patient's fine. You know, maybe someone said the
nurse is overreacting. They're not overreacting.
They're just reacting to whatever triggered them for this
patient. And that's fine.
So I say thank you so much for letting us know.
I actually feel OK about this patient's presentation right now
because and then explain yourself, provide some teaching,
right? But to say like this is an
emergency, Why did you call this rapid?
This patient's fine. All of that condescending stuff,
it doesn't help anybody. It makes it makes you look like
a jerk is what it does. And then the whole room is going
to be questioning the future. Should I actually call Sarah
because last time she was really rude.
And so the energy you bring to the room, it just makes a
difference, not just for this particular emergency we're
managing, but every future one, how people are going to interact
with you. So sure, super important.
I think that like everything you've just said is important
just for any interaction you have with anyone.
I'm like sitting here, like kind of flabbergasted at just how
you've broken down what communication should look like
for the MP at the bedside, in the office, in the clinic.
Like no matter where we are, everything that you just said is
so critical to how we should be interacting with each other on a
team. And so when I present to the
physician or when I am curbsiding something with one of
the other and, you know, nurses or whichever, these are little
tips and morsels that can play out anywhere and be very
effective at kind of creating that collaboration in a team.
And Sarah, one of the things I admire so much about you is that
you do just have such a servant leadership heart that when you
walk into the room, your mission is to serve the patient, serve
the team. And that's why you're the leader
of the rapid response team at your job, because you really do
walk in with that energy everywhere you go.
It's so inspirational. And it's one of those things
that as you were talking, I was thinking, how did you get these
skills? Because these are just not
skills you're born with. These are skills you cultivate.
These are skills you grow. And yes, part of it is from your
20 years of experience, but has there been anything else that a
nurse that's like, listen, our nurse practitioner is
struggling? Like I don't really have those
skills. This is really hard for me to do
when I'm under the gun or under stress to be able to immediately
go into that mode. What would you say to that nurse
or nurse practitioner? Yeah.
So again, these are things that I didn't learn the nursing
school either, but I think that I'm a person that likes to
reflect and debrief and I've learned a lot from that as well.
So like on my drive to work, I'm jamming out to music, I'm
listening to your podcast. Like I'm like getting in the
zone, right? My drive home from work is
almost always in silence and that's very intentional.
I want to reflect on my day and think about not just like the
patients I served and like the nurses I interacted with, but
also like, how did I perform? Like how is that received in
this particular situation? How how did people respond to
the way that I managed that room or how did that interaction go
with my colleague? And I'm like dissecting all of
it, Like what went well, what was not so good?
I think about other people and how they behaved.
I was like, oh, I really liked how Joanne handled that
situation. I'm going to, I'm going to try
that's good verbage. But how she explained that to
the family, I'm going to like, I'm going to capture that and
hold that in my brain or like, Oh my gosh, that one doctor, the
way he handled that conversation about goals of care was
horrible. I will, I'll never do that.
So I'm constantly like creating this filing cabinet in my brain
of what I aspire to be and what I'd never want to do.
And so that when it happens to me, when I get the opportunity
to access those tools or resources that I filed away,
that then I get to. And so the nurse that I am today
behaves very different than the nurse that started out in 2004,
right? I was one, only 19 years old
when I became a nurse. And so I was like the baby of
the unit and it was very obvious.
I was like 100 lbs in this little time.
I don't know, I'm still surprised they hired me,
honestly. But the way I behaved back then,
it's I'm, I'm very different now.
I've, it's been a lot of practice and mistakes and
failures and like, OK, we'll do that again.
I'm going to try this way next time.
I've, I've slowly learned how to do that and just like paying
close attention to my mentors and people I look up to and
trying to like clean how they, how they handle things.
I remember there's this church that I looked up to so much,
Jack. He was a nurse for like 30 years
prior to me becoming a nurse. So he had been doing this for a
while and just watching him in a code, he was just so calm.
He didn't freak out. His like voice didn't really,
like, fluctuate. He was just so I felt so much
like, OK, we've got this. Like Jack says, we got this.
I can tell from his body language, from his tone, OK,
this isn't scary stuff. We can totally handle this
versus this other nurse. Carol.
Oh, my gosh, your hair is on fire.
She's like yelling at everybody, freaking out.
And I remember thinking, Oh my gosh, this is not going well.
And it was probably the same exact situation as what Jack
managed. It's just that what he brought
to the room was so different. And so definitely the way he
behave is important. And I and I take note, OK, Carol
acts like this. I don't want to do that.
Jack does this. I want to aspire to be that.
So silly, find that away. And then I've just read so many
books and listen to so many podcasts about team leadership
and communication and trying to adapt those communication styles
to how it sounds like in Sarah's words, right?
I'm not Jack, I'm not going to talk just like him.
So like, what does that sound like from Sarah?
And eventually you kind of developed your own like script
and responses and things that you then you can pull out
easily. And you know, there's all the
times where I've interacted with the doctor and it didn't go well
or says with the patient that was not well received.
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Then I'm like, OK, so next time I'm going to do this
differently. I learned from mistakes.
Like I wish I would have said this, OK, next time I'm going to
try to say this today. And actually I've collected all
these things that I want to use and that I get to use at the
bedside. But it does take time and I
think intentional practice it just, it may come a little bit
naturally to some people, but it is a skill set to cultivate and
to to hone and work on. This sounds like the debriefing
that you do is a, a personal thing, but some places do this
as a group, like after an event occurs, they all kind of sit
around and talk about what went well, what didn't go well.
And I I think that like some hospitals, I don't know if your
hospital setting does this. Oh yes, we do.
After events, you kind of have this debriefing of what went
well, what didn't, and would you say the hospital culture plays a
really big role in how much of this kind of breakdown of what
can we do better, how can I change, how can I grow plays a
big role in the nurse NP relationship during critical
events. I think so.
I'm really lucky that our hospital culture is a pretty
safe culture in that when people make a mistake, they're not like
penalized, rather it's just a teaching opportunity.
There is that culture of life. Let's learn together.
Let's grow together. The whole debriefing process.
I remember when I first started the RAP response team and I
said, let's debrief. You're like, oh, no, like what
did we do wrong? Oh, no, no, no.
The goal of the debrief is actually to celebrate our wins,
to point out the good things. So we keep doing those things.
And if there's things we can learn from it, OK, let's do that
too. This is a great opportunity to
learn, but it's never the vibe of like, all right, Joe sucks at
compressions. And, you know, Tamisha didn't
document very good. Like, no, we're not.
We're not bashing each other. We were talking about how can we
grow as a team. And so once people started
realizing the culture was shifting, this is not punitive
that the goal is to celebrate. The goal is the kudos, right?
People love that. People love kudos.
And so I'm like, hey guys, what I usually say is I'm going to
give this patient ICU. I'm going to come back.
I wanted to talk to you guys about some things I saw that
went really well. And so like, oh, I can't wait to
hear like what went really well. Like, oh, am I one of the ones
that she wants to mention? And so I come back for the
debrief and I'd start with the good.
I'm sure you've heard of the sandwich method, right?
Yep, that teacher didn't. Peace goal.
Bad. Good.
Yeah, yeah, yeah, yeah, you. Start with Hey, guys.
What? But, well, I noticed this.
I saw this. Yeah, you're right.
They did do that. Really.
So kudos, kudos, kudos. As many as you can get out
there. Right.
And then you move into. All right, I agree.
That was awesome. There are some things we could
do better. What did you guys see that could
have gone better? It's not what do we do wrong?
What's the mistakes we made? It's just what what are the
opportunities that we can learn from?
Talk about those and never point at one person.
You know, like let's say Joe was bad at CPR.
I'm not going to say Joe sucked at CPR.
I would say and notice the compressors were getting tired.
Let's make sure that we're swapping out compressors more
frequently next time. Or I noticed that Sarah was
struggling with compressions because y'all, she's short.
We need to make sure we have that stool available for future
emergencies, like we need to have a home base for that stool
so it's easy to access or whatever The thing is, right?
So pointing it out, not like saying this one person sucks,
but as a team, as a system processes, how can we improve?
And then I always end the debrief with, all right, thank
you for this strong work on this.
Great job on this. How can we support each other
moving forward? Do you need to help get this
patient settled on 35 Can I help you clean that you want to pass
measure How can we support each other and that vibe feels very
different than all right. You shouldn't have this you
shouldn't have this you stuck to this and you stuck to this
questions. You must intend that that kind
of debriefed and so I think debriefing yourself in the same
way what I do well today. Who did I help today?
Who did I connect with today? Anything I could have done
differently today that would have made a better impact or
connected more with people or made more sense or more been
more clear, whatever The thing is.
And then OK, like kind of giving yourself some like gratitude,
like, OK, like great job Sarah, who does on this.
You didn't get on this. So deeper thing yourself is just
as important as deeper with the team.
Yeah, and I think that each NP for their just daily interaction
again, no matter what setting that they're in, this is
applicable, right. So going through and I do this
with my own self when I go to work, I think like, oh, you
know, when you become a mom and you're busy, it's it's kind of
hard to sit in silence. There's really not a lot of
moments of silence. But like you said.
Finding home. Finding those little pockets of
time when you're just like, all right, I'm here.
What went well today? What didn't go well?
I talk a lot about that in one of the booklets that we created,
because I think that being able to reflect on how you're growing
or not growing or what areas that you need to get better at
is tantamount to improving yourself over time.
I just think that's so applicable to any MP listening
today. And then how do you see, so you,
you've interacted with rapid response nurse practitioners on
the field live. And I know there's some that
have come on your podcast that you just think are fabulous
people. You've described them to me as
just, they're just so capable and, and they impress you a lot
whenever you describe some of them that you've met.
So what would you give to a new NP that's thinking about
becoming a rapid response nerf practitioner or being a part of
those teams that you're saying, hey, listen, like this is just
something that I've seen as a thread in each of them that
distinguishes them as great or cut above all the other ones
that I've interacted with. So I think that the transition
from being a bedside nurse to ANP, I'm sure it's difficult.
I haven't experienced a person, but I've watched so many of my
colleagues go through it. I know one of my good friends
right now, she just finished her DNP and she's starting next
month as a nurse practitioner in the ICU.
And during her clinical time, she said the big struggle, I
think they kept having to like correct her on is she still used
to jumping in and doing the thing, doing the test, let me
help out and give the Med, let me get the patient on the
monitor. Let me do because as nurses,
that's what we do and her preserver's like no, come back
over here to the computer. We need to review these labs and
figure out what to order. We need to look at the X-ray and
make sure that this is the right treatment for this patient.
Like take a step back. This is and it was so hard for
her to transition from like no, but I want to help.
I, I can help real quick, just like, and she said, but if she
did those things, then she's failing the team by not getting
to the bottom of the diagnostics, not treating the
patient appropriately. So that was a hard transition.
I mean, I'm sure she's figured out now, but that was like the
constant thing that came up in her clinicals was like, no, I
know you can do that. I know you're, you're so used to
doing that, you're good at it. But right now your transition to
a different role in healthcare. And so I think reminding my NP
colleagues of like, I don't expect you to give the meds.
I don't expect you to, you know, you don't have, you're not
documented. Like you're what I need you to
focus on is your expertise, which is diagnostics, assess the
patient, do the diagnostics. I will cover the basic stuff,
right? You don't have to remember.
Oh, it's been 3 minutes, it's time for epinephrine.
Oh, we need to pause and check a post.
I got you on that. I've been doing ACLS for 20
years, right? I will cover that.
Get out that ultrasound, figure out what's wrong with the
patient, review the labs, talk to the family, do what you got
to do, use your intelligent MP brain to figure out what's wrong
with the patient. And I will keep the recess
going. And I think that's such a hard
transition when you're used to being the one that's giving the
meds and you're used to being the one that's scooting the
patient up in bed. I mean, if you have time shirt,
you can help with those things. That's I think that's great for
morale, but I don't actually expect you to do those things.
To me, that's not what makes you a good MP or not.
I think it's your you do need to you do have to take some time to
like transition your role towards first diagnostics.
So I would say the the message to you is know that as a rapper
sponsors, I am capable of managing this room of keeping
the recess going. I want to give you space to
focus on the diagnostics. So how however, I can help with
that. If you need to do like some
cognitive offloading, like, hey, make sure that we get X-ray
coming. Make sure that you're using
closely communication. So you you want to hear me say
back, I'll call X-ray or if you say when you get an EKG, wait
till someone says back, I'll call for the EKG.
We need to get AI don't know an H&H and a lactate.
Make sure someone repeats back. That is being done because you
can't. I mean, you can say it all you
want into the abyss, but unless someone's actually doing the
thing, it's not going to get done.
So I making sure that closing the loop is happening, that's a
really important skill set. But I don't expect you to be a
bedside nurse. You've transitioned to a new
role, you have a new expertise and I'm relying on you to do
that well. And you just have to trust that
I will manage the other stuff as well.
Yeah, again, like I'm saying, it's so applicable to other
settings. Even this week at work, I had a
situation where the nurse had brought something to me.
And again, like you said, it's my job to be able to assess
what's going on, figure out if the more tests need to be
ordered, like different things like that with the patient.
And I had to reach, I reached out to a nurse and I said, could
you get all this information, like, you know, whatever.
And I waited for him to kind of follow back up and he never did.
And kind of like what you're saying, you've got to go close
the loop. That's my job.
Like. And again, it's not an acute
care thing. So I don't have the pressure of
right then and there, but you bet your bottom dollar the next
day I did. We call her.
Did we follow up? Did we make sure that these
things got done? And I was like, yeah, yeah,
yeah. I'm like, is the documentation
in the chart like following up with those things that's
applicable in the acute care setting, in the outpatient
chiller, not acute care setting? Because again, that's our new
role and it's not my job to necessarily do that thing, but
I'm still responsible for it. And so kind of like what you're
saying, you've got to kind of get that team approach work on
closing the loop. Did we do that?
Yes, we did great. Did we do this?
Did we follow up? Great.
And so I can close that up. And you've got to do that in any
setting as the NP. And then it's just interesting
to hear that that is the transition glitch.
That's the tough part for the for the nurse going to the NP is
just you've got to step back from the bedside and you've got
to get in their side of the computer and figure out what's
going on. And and that's hard.
That's really tough. And yeah, I think that's really
great advice. Sarah, where do you see the
future of rapid response going for the NP collab?
Like, what is stuff that you say, you know, where does this
go when you extrapolate? This is where I see the team
moving. This is where the vision of what
I have for the the most synchronous relationship between
the nurse and the practitioner at the bedside.
What would you say? I think we have a good mix right
now. My ideal rapid response to you
would be a bedside nurse with critical care experience, a
nurse practitioner with critical care experience, and a
respiratory therapist. We could, we could change the
world. There's those 3 disciplines
showing up to emergencies. We that's literally all that you
need. We could totally handle any
emergency. I've asked her that at my
hospital, unfortunately we're teaching hospital and they're
like, no, the residents need practice and the first needs to
do so. I was not granted my wish, but
to me that would be ideal. So in my hospital, there is a
nurse practitioner that works in the ICU and residents and they
rotate every other emergency who responds.
And so I get, I get to respond with residents and I get to
respond with the MP. I'm sure you can imagine how the
vibe is very different with my buddy, the MP that's been in
critical care for 10 years shows up versus this resident.
The residents are great, honestly, I love working with
them, but they definitely are much more scared and timid and
maybe not as familiar with emergencies as say the MP that's
been doing this for a while. So that'd be my ideal.
Where it's going, I don't know where it's going.
I think that's going to be dependent on so many factors if
the hospital, the teaching hospital, you know, finances,
all those things. I will say though, it's been
really cool to work with all these nurse practitioners that
I've worked bedside with with the years.
And now they're working on specialty teams.
Like I have friends that work with oncology now they work on
the neuro team, they work on the stroke team, they work in
cardiology, they work in GI. And because they know me
already, sometimes I'll actually get like almost like a consult
from them. They'll call me like, Hey, Sarah
was consulted for this patients GI bleeding.
But let me tell you, there's a lot more going on than you
probably should come lay eyes on this patient like I am.
I do not feel good about them being on the Med search floor or
they'll be like, hey, they called me and I there's a
cardiology console, but I this patient's in septic shock.
You may want to come look. And I think it's just a reminder
that like, yes, they're focused on like their specialty.
They're really good at that. Now they've been doing that for
a while, but they still have Nurse Spidey senses.
They still know like something's up with this patient.
This is out of my realm as the consulting provider, but like,
I'm gonna need somebody to address this.
Sarah, can you? I get those calls, I kid you
not, two or three times a week from my NP friends who are now
working in specialties that are finding these patients from
consulting services that need a little bit more TLCA, little bit
more tweaking, a little bit more advocacy.
So I'm happy to come alongside those nurses and support the
patients that they're caring for.
And if it's not in a way that you know, is specific to their
practice or their specialty, now, yeah, we're here for that
too, so. You're so incredible, Sarah.
You really are just hearing you talk and hearing how your
perspective on things is just, again, like I said, that's why I
like you, like try to shake me and I always call you like, hey,
where are you, Sarah? I haven't seen you.
What are you doing? I just don't look through that.
And you're always like, I just, I just think you're so
inspirational. You're so cool.
You've just got such a great way of putting things and just
putting it in such a way that everyone can understand it,
Everyone can grasp what you're trying to say.
It's so nice, dear. You talk and I do agree with
you, I think that nurse practitioners at the bedside and
that stable role, I just think it's so important.
I think that there's so much education backing for the
resident that sometimes I get a little frustrated as the MP
because I'm like, I'm going to be here for six years, seven
years. He's going to go in two or
three. Like they'll be gone.
And by the time you finally get them to where they are, you
know, that calm MD at the, at the bedside, they're gone.
You know, and that nurse practitioner that sometimes I
feel like the, the cosmic culture doesn't really want to
invest in maybe or, you know, the, the institution doesn't
really see is important. It's like, no, if you invest in
this NP and you let her grow, she can run the clinic or what,
run the office or what, or run the floor, whatever it is,
because she's had that continuity.
She knows what to expect. And so I think NPS kind of need
to hear like, you're super valuable.
The nurses see that you're valuable, The other staff, that
consistency that we are, I think goes a little undervalued
because it's just expected to be there.
And we don't think that we're that valuable because there's so
much energy put on. We have to get this person ready
to go out. And it's like, yeah, but I've
been here. So I think that's kind of an
interesting maybe topic or thing to kind of consider for the
future of what MPs are needing maybe to advocate a little
strongly. Like, OK, yeah, I understand he
needs the education. So do I like we both do both 0
This has been so much fun chatting with you.
I've had an absolute blast. Please tell me where people can
find you. And yeah, tell me all your
things. I've sure.
Yeah, so I ought to have a podcast called Rapid Response
or, and you can get it on any podcast player.
It's just for rapid response nurses.
Though. Really the goal is I want to
share every kind of a birds that you can think of when I share
the form of a story. So like, here's how I here's how
I found the patient. Here's what we knew in the
beginning, here's what we discovered kind of like
unfolding the story. And I think from the case study
is the easiest way to break down the pathophysiology, the
pharmacology, the nurse's role, even like the N PS role in
managing this particular emergency.
So if you want to hear literally 130 different stories, case
studies and how to respond to them, that is my podcast.
And I, I, I love telling stories.
I love teaching complex concepts.
There's probably a podcast on whatever crazy person you can
imagine that you might encounter in your workplace.
So I hope that that serves the nursing community, whether
bedside nurses or in peas. There's also like promises to
listen to my podcast and physicians and like, yes, a lot
of the residents in my hospital, they're like, oh, Sarah, that
last episode you did on serotonin syndrome.
That was so good. Like they I'm honored that the
residents also saw my podcast too.
But yeah, it's there just for healthcare professionals that
want to feel more confident responding to emergencies.
And then if you are a visual person, I have an Instagram.
I'm the rapid sponsor on Instagram, not because I'm the
only one, but because whoever claimed rapid sponsor and before
me and I couldn't have just plain property sponsor.
And so I'm the the rapid response already.
Title is appropriate. I think the title is
appropriate. The Rapid.
I love it. And what were you going to say?
I cut you off. I think that's it.
There's a podcast. I mean I'm I'm on Facebook, I'm
on TikTok but I I never actually post anything there.
I think the last thing I post on TikTok was like 3 years ago.
But if you really want to find that TikTok you can find me
there. Instagram is where I'm most
active for sure. I actually listened to your
podcast for that exact reason that the residents do because
I'm in the outpatient set. I never see any of this stuff.
And so I like to listen to your podcast because I'm like, Oh my
gosh, like I didn't even know this was something that I mean,
one of the ones I listened to, I love your story on the Foley
that got kicked. And the guy was having there was
something refreshed my memory. So he had a Foley got kinked and
he started developing some syndrome and I can't remember
what it was. Oh something with his blood
pressure went down and. Well, dude, now I can't think of
it. Hold on.
It's where patients who are paraplegics and they have.
Yes. No, I.
Can't remember what it was, but it was so just.
Took me a second. I listened to that episode.
I loved it. And so again, even though I
can't remember the term, I do remember just being like, you
were like, I just repositioned the catheter and like he started
feeling a little bit better. And I was like.
But right now, like like just you're genius and when you're in
flow and you're doing your job is just so cool and then you
share it. I just love it.
So we do rapid response. We do rapid fire questions, not
rapid response questions, but we'll call them rapid response
questions today because. Sure.
All right. I love Rapid.
Let's do it. So what is your favorite
beverage? Boba tea hands out.
Nervous about you? I love boba tea.
Oh my God, makes you so happy. It's such a fun drink.
Noted. OK.
And then what's your favorite season?
Fall. I feel like I was going to guess
all for you because I know you're just like, you're in me.
You're like, I don't know. Cozy man, I love cozy of fall.
All right. And then my last question is
because this is the Success NP podcast, I want to know what it
is for Sarah to feel like she's met the definition of success
for her life. What does that look like?
And I know this isn't a rapid response question, but it is one
that I feel like in in the vein of what you were talking about
earlier, like I just like to go deep.
And that's one of the things I like about you too, Sarah.
It's just that your depth of thought and your depth of
reflection, I think is emblematic of a lot of things
that you and I mutually agree on.
But I wanted to hear your perspective on this because I'm
like, if that's what we're chasing, if we're all chasing
success that looks individual. And what is that for Sarah?
I think it's hard to say is like one thing, but generally
speaking, I would say if I get to a point where I feel like the
way I spend my time and the way I spend my money, the way I
spend my thoughts is in alignment with my values, that
is success. So for example, if I value my
family, but I'm working my butt off and never get to see them,
well, that's not really in line with my values.
You know, if I value serving others, but I spend all my time
serving myself and focusing myself, that's not really in
alignment with my values. So if I can get my life to a
point where the things that I value is reflected and how I'm
spending my time and my money, my resources, my brain space, I
would say that is success has nothing to do with finances, has
nothing to do with things that I own.
All that stuff is, you know, pales in comparison to what I
value in life, which for me is time with people making an
impact on their lives, showing people love, like sharing
compassion. I want my, my purchases, my, my
thoughts base, my the last of my time to be in alignment with
with that I could go, I could go a lot deeper than that, but
that's like the over over that. So when I'm looking at my
finances, when I'm looking at my calendar, when I'm looking at
how I'm spending my life, I just want to, I want to make sure
that I'm tweaking it to actually line up with things that are
important to me. Yeah, that's deep.
That's deep. That's like, I know that's
superficial for you, but that was deep.
And thank you for sharing that because I I echo everything that
you just say. I agree with you 100%.
Yeah, it was beautifully said. Beautifully said.
All right. Well, guys, thanks for coming to
hang out with us at the Success and P podcast and catch you next
time. All right.
Adios. Adios Thanks for tuning into
another episode of Success and P.
We hope today's discussion has shed some light on the diverse
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