Hi there. My name is dr.
Presenta, and I'm the host of the doctor nurse podcast.
I'm an advanced nurse practitioner and I want to be
your guide into the world of nursing professions.
This podcast is a platform for nurses to share their Journeys
as they made their way in the diverse field of nursing as
either entrepreneurs, Academia private, practice or even the
corporate world. I think we should celebrate just
how diverse the field of nursing is through mentoring one.
Another, with the stories of our career.
Our Journeys, nothing is too mundane because each journey is
unique. This podcast will showcase
career options to encourage nurses to view their degrees
with a business mindset. After all we work in the
healthcare business and ultimately I hope I might
inspire you to make a change. If you're looking for something
different, I am motivated to see you live, your best, nursing
life and that looks different for everyone.
Thanks for joining me on today's podcast.
And let's get started with today's guests.
Hey, guys. Today we have the really unique
privilege of hearing from dr. Elizabeth winnings.
She is a board certified family, mental health, psychiatric nurse
practitioner, who completed both her undergraduate and graduate
education in nursing at the University of Florida.
She has an advanced training and plant-based nutrition and she
completed her doctoral internship in nutrition and
lifestyle medicine. At the True North Health Center
in Santa Rosa, California. And plant-based nutrition
certification through ecornell. She specializes in the
relationship between Diet lifestyle, and mental health and
works primarily with Children and Families.
She has experience as a surgical nurse and also working in the
Ed. She practices locally in the
Jacksonville area at the windings wellness and nationally
with the plant strong Retreat team.
She believes the power of healing through communication
restoring. Chips and living a healthy
lifestyle. Please enjoy the conversation
between my friend. Elizabeth and I, alrighty,
welcome. Elizabeth to the doctor nurse
podcast. So happy to have you on today.
Thank you. I'm glad to be here.
All right, let's dive in. So can you describe to our
listeners? What is your current job role in
title? Sure.
So my current job role is actually as the owner of
windings, wellness. It's an outpatient private,
practice for mental health, in Jacksonville, Florida.
And I am a Board certified, family psychiatric nurse
practitioner. So I specialize in medication
management, and therapy, and lifestyle medicine.
And my favorite populations to work with our children
adolescents and families. But I also do enjoy working with
adults. I just for my day-to-day work,
have more children and adolescents in my practice, is
there anything else that you're involved in outside of your
practice? Yes.
So, I also work with a national organization called plant-strong
and we have the privilege, Of Hosting five to seven day
Retreats for adults, who would like to make a lifestyle change
and we specialize in plant-based nutrition, and lifestyle
medicine and it's really fun. It's like an educational
vacation where you get to eat a lot of yummy food.
So, I am part of the medical team.
Overseeing participants during those Retreats.
Wow, that's really cool. So, how did you get to this
specific spot in your career? What was your journey?
So, I started as a Mr. Nurse at the Malcolm Randall VA and
Gainesville Florida after attending the University of
Florida and I was on a surgery floor and unfortunately there
were multiple veterans who had complications due to
uncontrolled diabetes and so they would have amputations and
it was really hard for me as a new nurse to have the same
patient come back for subsequent amputations.
So I may be their nurse for a toe being removed and then a
foot Then below the knee and it actually moves a little
traumatizing to see that the medical system continued to just
remove parts of the human body for a disease that I was under
the impression. We should be able to manage
through medication diet and lifestyle, so it kind of sent me
down a rabbit hole to better understand nutrition and
lifestyle medicine. And there was actually a
dietician on the floor who encouraged me to read the
Omnivore's Dilemma by Michael Paul.
Island. And then I watched Forks Over
Knives, which is a lovely documentary that highlights how
plant-based diet can improve your health.
In Reverse disease States like diabetes and I actually at the
time would contact one of my undergraduate nursing professors
and say, we really need to get nurses in here doing, you know,
their clinicals or doing a project to support patients.
After they've had an amputation to help them make these changes
and she would reply you Need to go back to school to be a
psychiatric nurse practitioner and I was like, no, no, that's
not me. I want to be in the acute care.
You know, I always wanted to be in the hospital so the more I do
of into the literature and the research the more I realized
that was a natural. Inclination for me to want to
know about, human behavior, and behavior change.
And my next job was actually in the emergency room at North
Florida Regional where Again, just seeing complications due to
either lifestyle, and, or disease states, that could be
mitigated by Behavior change or lifestyle change and that
solidified my decision to go into mental health.
I went back to school became board certified in family
psychiatric, mental health, and started practicing at the time.
I had already moved to Jacksonville, Florida, and I
started practicing in an outpatient clinic here and it
was great, you know, learning. About the role as much as soon
as great, it was also really challenging because there were
no other nurse practitioners at my clinic.
So it felt quite isolating to have to continually advocate for
either supervision or just the opportunity to have
collaboration with other. Prescribing providers, not just
therapist, and I worked with really supportive, Physicians
that did help me, it just wasn't a seamless transition.
So I think that was discouraging at the time but Ended up working
out. Okay.
But it was hard and isolating. And I think, you know, that's
part of where, when, when you sent this podcast idea to me I
was like, this is so important because I didn't have someone I
could turn to or I didn't know any other psychiatric nurse
practitioners besides those in my cohort or my professors, then
I did continue with my education after my masters and they got my
doctorate. And while I was doing my
doctorate, this plant-based nutrition piece of my life had
really become Important, not only to me but also to the way I
was practicing and it's very important that we're practicing
evidence-based interventions. And the evidence is there.
It's no longer a question is plant-based nutrition.
An important part of the medical conversation which is
encouraging, however, in 2014, 15 and 16, I think the
psychiatric professors didn't really want to hear about it.
And I had to petition my committee to do my doctoral
research project on nutrition. So as a graduate student in
Psychiatry pursuing my doctorate, I wanted to do my
project on the relationship between diet and lifestyle and
depression and ultimately I was able to do that but again it
took a lot of advocacy and back me continuing to say like I
would like to do this. So what was, what was their
rationale for pushing back? Oh, that we already know there's
a correlation between your lifestyle and mental illness.
So we cannot say that there's a causation, how New prove with a
dnp project or how can you do something that's a cue?
I intervention because the DMP is not a full research project
like the PHD level so you're trying to stay at a lower level
of the IRB approval so I think they were saying this is either
beyond the scope of the degree that you're getting and if you
want to do it you can get a PhD or just pick something else.
Wow. And this is what they said to
you. Oh, but I'll just show you like
how genius. What?
You were pursuing was because they were like in order to do
what you want to do. You have to go get a PhD like,
like if you just, you know, this sounds great, but you need to do
the work for it, which is, it is what it is.
I am grateful. You know, is able to string
something together that was meaningful met the criteria for
my degree but what I will say was the most pivotal experience
throughout that part of my journey is actually had the
privilege to do an internship at the True North Health Center in
Santa Rosa, California. So, with the dnp, you cannot do
additional clinical hours in your current specialty or where
you're working. Yes.
And so, right, and then it's like, are you kidding me?
I have to do more work and not get paid and needs to be
meaningful and enjoyable. So I spent five weeks and Santa
Rosa, and I had I think a total of five days off.
I mean, I worked for the whole time I was there and the True
North Health Center has been In practice since the 80s and what
they do is they actually bring people in for water only fasting
juice fasting as well as just to come in and you could have an
evaluation. And if you just wanted to eat
healthy and be a part of the community there, you can do
that. So this was a completely
different practice of medicine and it was really rewarding.
So that was just great because it Not only was clinicians using
evidence-based, practice for lifestyle medicine.
And, but it was the first time in my nursing career, I saw
people getting. Well, I mean, I could remember
like tears in my eyes like taking someone's blood pressure,
who had had, chronic hypertension and been told you
will never come off of your blood pressure medicine and we
had started titrating. And then we're day 3 of a normal
blood pressure. We are saying to them.
Hey I think we're going to stop your blood pressure medicine
today and it's a really moving experience to have that
privilege of being welcomed into such Such a vulnerable moment
with individuals and it's hard not to take that.
And then to continue pursuing it, you know what I mean to see
something. So, profound and then go out,
whatever. I'm just going to go back to my
job and keep doing what I'm doing.
So I think that was really, or like, I'm not crazy like this,
this is Meaningful stuff and more people should know about
it. So that is kind of, you know,
the journey for me from the bedside, all the A through my
doctorate and then I did have some very traditional roles as a
psychiatric nurse practitioner. I worked at a local children's
hospital and was on the inpatient pediatric psychiatric
unit. I've also been carrying out
patient clients since 2014 right after I graduated.
And so, I definitely have immersed myself in the medical
model and kind of our standards of practice for Behavioral
Health Care and psychiatric care.
However, /. It's married with lifestyle
medicine and looking at the whole person which I think on a
couple of episodes I've already heard on your podcast, you know,
really the nursing model is that's formative to our training
looking at the person and what is their lived experience.
And so, I think that also is just foundational to my
practice. I'm like, smiling ear to ear
because listening to you talk, I'm like, she gets it like she
does. She's looking at the total
person, she's not just saying like, oh, Sister Sam ads, you'll
be fine. Let's just cut a total.
Let's cut the foot off. Liquor looking at the total
person and that really is what we're taught in our training to
do as nurses and I just think it's so beautiful.
How you've married your medical training as a nurse practitioner
in psychiatric medicine with nutrition and lifestyle changes
and how you are, you found an area that needed a nurse to step
in and bridge that Gap and you stepped in and did it and you're
doing it and that's what more nurses need to do because we are
so, So close to the bed side, we have the opportunity to see
what's missing, we have the opportunity to be annoyed at how
something is not really great for the patient's overall, even
though it might get them out of the hospital today or tomorrow,
it doesn't affect their longevity or their life, right?
And I think that was as a new nurse, the biggest challenge
because I would see something. And I would go to the surgeon
and say, hey, who talks to the patient about the fact that Sad
that they used to have two feet and now they only have one and
the surgeons would just kind of look at me, perp a perplexed and
say, I don't know, we can put in a consult, you know, they're
healing, great, their wounds are not infected, they're going to
be discharged within however many days.
So I think that's also a barrier.
When you're new, you don't understand the system or who to
go to and it's so fragmented but you as the nurse are stuck in
the room with the patient after everyone else.
Leaves. And so then it's that very
palpable Gap. Like what you're saying, like
some of the moments where you're just feeling annoyed or
frustrated or confused but you're like, I don't know how to
implement the change. I'm amazed at what you've done.
I'm amazed at how you've built your career.
I think that you provide such an incredible service and then your
wellness company that you own. Tell us a little bit about that.
I am practicing in Jacksonville, Florida right now, I'm just in
clinic three days weekly. So I'm working too.
Wednesday, Thursday, and their full Clinic days.
I have outpatient Behavioral Health clients.
So, I'm doing therapy and medication management, and then
it's out of network. So, everything is not built to
insurance, which as much as I would love to be able to open up
and have more access to families, who need to see
someone on their insurance. Again, the system is incredibly
broken and that is so incredibly cumbersome as a solo provider,
but I'm full. So I mean, I and in January of
this year and I've had for the month of May, I'll have 90 total
visits give or take, who wants to come in this week, that's not
on my schedule, but it's busy and we need more mental health
providers. So, you know, I'm grateful for
the work that I do. It's been a hard year for
everyone. Our kids are feeling it or
parents are feeling it. And so, a lot of what I'm doing
right now is therapy and then medication management when
indicated. And I know it's different, not
part of my own practice, but I did get The go for our lifestyle
medicine, Retreats for this coming fall.
So our team is gearing up for those events that will be in
September and October of this year.
So that's also on my radar which I'm excited about what
throughout this process. Would you identify as a big
success? Something that you think this
was really a turning point or this was really a moment that I
think back was a high in my career.
I would say choosing to go to True.
North Health was a huge risk. It was undefined to my program,
to my current place of work. I took 6 weeks of unpaid leave
to travel and to do that and it was a huge risk, but it was one
of the things that I would do again, if I could.
So I'm really, really grateful for that.
And it led to so many wonderful relationships and opportunities,
and also education that I'm really thankful for.
And then I would also say another SAS is learning how to
advocate for myself and leave positions that were no longer in
alignment with my values, whether that's personally or
professionally and that's really scary.
I have done that two times in my career, where I've chosen to
leave an organization where I might really value people on my
team or my direct supervisor, but the organization did not
either value nurse practitioners or facilitate growth.
Unity's. I think those were hard
decisions, but they were huge successes because out of them
came opportunities. I couldn't have scripted.
And so, when you're standing on one side of a decision, you
can't really see the other side, that's just scary, but I'm
grateful to have been able to have enough opportunities that
I've just taken the risk and seen it worked out, okay or
better. That was so well said and then I
was thinking like that's also one of your biggest challenges
which is another question that I typically ask, but you kind of
answered. Both of them is just having to
For yourself, ended up leading to you overcoming jobs that were
going to hold you back from being able to apply for
autonomous practice. I mean to give you that ability
to advocate for yourself is the biggest reward and now you're
actually an autonomous provider. Can you tell us a little bit
about that process? Oh for sure.
So in the State of Florida if you have been out of school for
a longer than five years, you need to out of graduate school.
You will need to do. I believe it's 40 hours.
Hours of continuing education and psycho Farm.
Nope, you're not all Psych, sorry in Pharmacology.
So 40 hours of pharmacology and then 40 hours of a differential
diagnosis and there are enough continuing education providers
out there now that are ancc certified or the equivalent so
that graduate level certification for continuing
education. So those are the two biggest
hurdles as far as things that require time and energy and then
you have to have been in practice I believe it. 3000,
supervised hours and you have to have your own malpractice
insurance. So I mean it's not cumbersome
and and no egregious acts with the Board of Nursing or the
state like, your license has to be in good standing.
So the criteria is actually quite simple and you just submit
everything to the Board of Nursing.
And it's there's no fee Associated.
You just have to apply. So I was really excited.
I was so nervous that I wouldn't get everything in and time
because it Passed early December.
And my last graduate course, where I had psycho Farm hours
that would go towards my license was in December of 2015.
Anyway. So I was like--figured cross
please please, please. So, anyways, everything went
through, they processed it relatively quickly, so, I was,
it was a good experience for me, that's great, and working for
yourself by yourself. How is that experience been?
It's great. I will say, I am a rather social
person I do enjoy interacting with others.
Given this current year with covid and how we're still coming
out of social distancing and all of these protocols that are
needed right now. It has been ideal.
So I have my own little Private Practice where I can sanitize
and make sure all those things are in place.
And I would say about 60 percent of my clients.
Do come in person and then 40%, I'm doing Telehealth with but
it's lovely. I can manage my own schedule.
I can give the clients that I'm seeing my time and I have a
great. Great EMR and billing platform.
It's all seamless. So all in all how if you don't
have administrative skills, you will need someone to help with
that. But other than that, I would say
it's really wonderful. If you are a clinician who
enjoys what you're doing, and you're competent and capable and
you have administrative skills, and you can get those things in
order. Then this is so cool and I'm so
happy that you're sharing your story for other nurses out there
to hear. Just that it's doable that it's
possible that it's not this crazy.
A labor-intensive process that you can do it.
That's really cool. And even towards anybody along,
the way that helped you get here that you'd like to shout out or
just say, like this was big for me to get me to where I am
today. I would say, my life has been
shaped by amazing mentors. So prior to nursing, but then in
nursing absolutely and you know, in school.
Definitely dr. Schneider was with somebody who
was phenomenal and I've maintained a relationship with
post-graduation, some really grateful for her and then I
actually did something called The Valor program through the
VA, when I was an undergrad nursing student and Kathy,
Galvin was my nurse, and I worked with her for a full year,
and I think a lot of the courage that I had to do, what, the
patient needed, no matter what not to break rules, but right to
see the patient to advocate for the patient to go back to the
physician to speak up is because Did that?
And she, instilled, that in me. And so, I'm really grateful.
I think a lot of that, the kind of like core identity as a
nurse, was shaped by her. And my mother is also a nurse.
And so, I think, you know, there are ways that that is impacted
my life that I probably don't even know.
And I couldn't articulate, but I definitely know that that she
has been a wonderful guide and Mentor in my life.
And then my dad, I think one of the things that I'm so grateful
for is I've had a team of parents.
We're if I've wanted to take a risk and do something they'll
troubleshoot with me and then they're like, all right, go for
it, you know, and it's not that every single thing I've done has
been wonderful or succeeded by any means, I definitely have a
long line of failures and life lessons and times when I've
crashed and been frustrated, but I've had parents who I could
turn to and, and they've been, you know, phenomenal and I did
get married really young. So I actually got married when I
was As in nursing school as an undergrad and I don't know that
my husband's a mentor, but I would say he is the most
supportive like he's probably, you know, most supportive
biggest fan like, he helps me visualize my dreams and to have
a spouse who says, oh, this is this is super important to you.
I know, it's totally fine. If you need to take five weeks
and go like, do this grueling internship, I definitely
couldn't have taken all the risks that I have, or I wouldn't
be where I am. I am without his support.
So I definitely forgiven shoutouts.
We've got a shout out to Jordan whinings, because he's the most
patient, supportive person. And, and, I mean, I have a lot
of ideas Sandra, like all the time.
I'm like, oh, what about this? What about that?
And so Jordans really good at helping me.
Like, but something boil to the top and go with it, that's
amazing. Just to have support, which fun
fact. He was a paramedic firefighter
for quite a while and he is no nurse So we'll see where his
nursing Journey takes him, but that's cool.
You've probably inspired him watching your career and what
you were doing. That's really cool.
So, what advice do you have for a new nurse at starting off in
her career? That has got her piece of paper
certificate in hand, and she's standing there with the world in
front of her? What advice would you give her?
Oh, I would say, be brave. You need to try things.
You need to work and not like work hard but you need to figure
out what you like and what you don't like.
Like in nursing and there is no rush.
I think one of the biggest challenges throughout nursing
education. Is there is this sense of a Time
Clock? You've got to figure it out by a
certain time. You have to go back to school by
a certain time. It's just not true.
Every experience you have is going to build towards who you
are as a nurse, and who you are as a person.
And so I think it's really important for new nurses,
whether that means RN or APRN To take their time because we don't
we don't get that back and I think that is the biggest lesson
I've learned from my patients is to just be present and take your
time. Other things that I would tell
new nurses is ask for help, don't worry about, not knowing
what you're doing, you're not supposed to like you're supposed
to know the general rules and keep people safe and follow the
rules of your license, but ask for help sleep.
If if all of us could just prioritize sleep, I think the
world would be a nicer place. I think work would Be easier.
And I think our brains would be happier since I think nursing is
hard and exhausting. So if new nurses could
prioritize sleep, get Sunshine, eat your veggies and make
memories. I think one of the things that I
cherish the most, so I'm like my 10-year anniversary of
graduating with my undergraduate degree and I love looking back
on all of the environments. I've worked on, or the people
that I met, and it's just Cool. So you know if you're in a hurry
and you're rushing through everything, it's really hard to
savor it or make memories don't learn.
But I think if you're kind of looking at each part of your
career as an opportunity to grow and or just have fun, you're
going to make great memories and that's going to add up to pretty
wonderful career. So I think those are the things
that come to my mind. When I think about, I wish
someone would have told me those things when I was a nurse, not
just all of the be on time. Don't get stuck by a needle.
Make sure. Sure, you're wearing the right
shoes, that kind of stuff like, okay, we need to know that, but
what about me as a person and as a nurse and as a provider?
I think that got overlooked beautifully, said, beautifully
said and I agree. I agree.
And I think that's why the doctor nurse podcast has come
about is because I felt the same.
I felt that that slow down. Take your time saver what you're
in glean, like, in the moment knowledge, because it'll just
take. You so much further, I really
feel like that is so important and I didn't hear it enough,
what you said was so encouraging to the new to the new nurses.
And even the ones that are currently in their jobs and in
their roles to just say, like, just soak up what you've got
going on now, pay attention, make memories and take care of
yourself and I think the rest of it starts to fall in place when
you put those big things in the right frame of reference.
So alright the next part is the rapid fire questions so tell us
a book you're currently Reading. Whoo, maybe you should talk to
someone set. The title of the book, it's a
book written by a therapist, and it's about her experience, going
to therapy, and I had a few people recommend it to me.
So I started reading it. Very cool.
What do you got on your Netflix? Okay, hang on cuz there's a few.
Well if I could have something on repeat on Netflix right now,
it would be schitt's Creek, so good so good, give it a chance.
Crunchy. But it's so good and another
one. If there could be a movie actor
to play you in a movie who would play you, the Reese Witherspoon.
That one was easy. We are like soul mates.
Oh my gosh. I see it.
Now she would, I don't know if she would do your roll justice
but she can do it. I believe in reese.
Well, Elizabeth it has been such a joy chatting with you.
Your journey is incredible and super inspirational.
So keep doing you girl, think what?
Thanks so much. And I'm so grateful that you're
You're putting all of these episodes out there.
It's really meaningful. Well, this is the end of our
time together. I really hope you enjoyed the
chat. Please be sure to subscribe to
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I'll do my best to find them and as always thanks for listening.
And just a reminder the information in this podcast is
for educational purposes only and the information should not
be used in substitute for Professional Care by a medical
provider. The information in this podcast
does not represent medical or other professional advice.
Ice or services.