[00:00:00] Hello. Welcome back to another episode of the pulse check podcast. I’m hehe and I’m Mandy. And today we are diving into a very interesting topic. Mandy just got back from speaking at a national conference designed for nurses. Yay, Mandy. We’re so proud of you. I kept up with all of your funsies on your Instagram stories.

[00:00:20] And so many people were tagging you, people were saying how great your, your session was and you looked like you were having a ton of fun. However, when you got back here and you and I started to debrief. Womp womp. It kinda, it fucked you up real good is what you said. Those were the words you used. You were like, man, it fucked me up, but in a good way.

[00:00:42] And there were just so many parallels between bedside nursing and nursing within the hospital system that were mirrored. I mean, they were just so similar once you got to working with this national organization to be a speaker. Some of the things that popped out to me was really a lack of communication.

[00:01:03] We see that bedside and you experienced it being a speaker. Unpaid labor. I mean, that is like the whole MO of the hospital system, getting nurses to work for free and, or doing all of this unpaid labor. And that was similar in your speaking engagement as well. And then finally, just the smoke and mirrors of it.

[00:01:22] All things feel oftentimes very performative in the hospital system, especially from nurses, you know, it kind of comes down to past episodes that we’ve done of like, why did you gimme a rock with squiggly eyes when you literally could have given us all a $50 gift card and told us to do something nice for ourselves that smoke and mirrors idea or 

[00:01:42] Yeah, performative. 

[00:01:43] Right. Was part of this too. So let’s dive into it. I think a lot of nurses right now are in this pivotal place where they’re trying to leave bedside, maybe not all the way, but at least halfway. And they’re trying to find other streams of income. They’re trying to find other things that fulfill them and help them, you know, still use their nursing degree and reach people in a way that makes them feel happy.

[00:02:05] How do we do that? When everything in the nursing world seems really permeated with these ideas of no communication, unpaid labor, smoke and mirrors, performative performances. How did it fuck you up? Real good. 

[00:02:22] That sounds so silly now. Yeah. Yeah, it was, well, I knew it would. And you and I talked about it a little bit.

[00:02:28] I didn’t want to do this. I mean, I chose to do it and I’m happy I did. And it was an honor to be, you know, get accepted, you know, you have to apply to be a speaker or be a presenter at a conference. And even if you’re asked to by someone or like referred to as a speaker, you still have to send in your outlines, you have to send in a bunch of information.

[00:02:50] And so that was cool. It was very validating to be like, oh yeah, my shit is good. And it is aligned with nurses and it is at a national level and it is important and it is what people want to hear. That was really validating. But I had said no to speaking at this conference for years other friends had asked, let’s do it together. Other friends had gone and done it and said, I’ll be there speaking, why don’t you do it? I’ll help you with the process. And I said, hell no, am I gonna pay to play? Because I had just been doing that at the bedside. I had just been giving and giving and giving and giving and not getting paid a fair wage and not getting treated fairly, not having any sick days.

[00:03:30] Sick days, holidays were the same thing. That’s fucked up. That’s not okay. That’s unethical. It’s unethical to not be able to nurse your baby and provide milk for your baby while you’re growing your family as a nurse and then teaching other people how to do it. And Ugh, just so many things. I was, I am still recovering from that and I said, no, I’m not gonna pay to go.

[00:03:54] And you asked me that this morning, right. When we got on and I was like, Hey, push record. Because also like, maybe I wanna cut it because I’m not proud of the fact that I, I went and paid for my hotel room. It was reduced, but I had to pay to get in.

[00:04:10] What?

[00:04:11] I know. I didn’t wanna tell you 

[00:04:13] oh man.

[00:04:15] I know. And it’s not, I, I feel good that you feel bad. That’s not really what I mean, but you’re shocked because maybe you don’t see me as someone who would even do that. Right. I. I don’t think that that’s okay. You know, I have created a trauma informed business model in the years that I’ve left the bedside and developed an educational business from scratch. And I, I get excited when money moves through my business to other educators and parent educators and my team of women and gender expansive folks. I’m excited to grow in that way and to move money through and to be a conduit for good and change. And it is not on brand to be like, please, can I speak for you for free?

[00:05:06] And also here’s a partial ticket fee to get in and like go to all of the other presentations, which you don’t really do as a presenter, right? Yeah. You’re not really you’re. I felt like I could be one or the other. I could be an attendee or I could be a presenter, but it was really hard to switch my brain into learning and like being, I had two presentations.

[00:05:29] At the conference and it was hard to switch in between. So I, I would love to hear from listeners on Instagram, if you are presenting or want to incorporate that into your nursing resume. You’re like away from the hospital gig or grow your way from the hospital gig. I wanna hear about it and like where you’re going and how does it feel to be, to be asked to provide your own way there?

[00:06:00] When I bill for educational services, I include travel right? As do all physicians, all lawyers, all consultants, all coaches, they all do that. And it was a huge discussion within my team, the trauma-informed birth nurse team of, of like, this is how nurses are treated inside the hospital and outside the hospital.

[00:06:29] This is how people think it’s okay to treat nurses. I said, nowhere else do I do this? Nowhere else would I think it’s okay. And nowhere else would I expect anyone to come to me for something like this and pay their way, or they wouldn’t put that in the fees. And we had to really like wrap our heads around that and process through that because we also sell content to nurses.

[00:06:54] We also sell educational packages to nurses. We also sell whole unit packages of education to hospital systems and like quality collaborations within states, like health departments. And they also have a hard time wrapping their head around fair compensation for nurse education. They wanna send like a couple nurses to do it and then bring back the education for everyone else, which puts those nurses who are getting educated, which this happens at conferences also. I would meet nurses and they would be like, oh, they sent two of us. So those two now have a responsibility, not just of learning this information for themselves, but being able to learn it so well that in a few days they can regurgitate some of it to colleagues in like in like a professional way in like a, we’re gonna have a staff meeting and you’re gonna present this.

[00:07:49] Like, how is that learning? That’s not learning. That’s like an orientation where you’re like getting oriented and then you learn how to do it, and then you do it. And then you try to teach like pseudo teach your preceptor. This is how I would do it so that you can really begin to work through those like higher level learning of the process yourself as a learner, but that’s not, you don’t like learn it and then like take a student and then could fully be able to articulate everything. Like you just don’t have it integrated yet. Messy. It’s messy. 

[00:08:26] It’s just so indicative of how they view healthcare. I mean, Just hearing you say, you know, that they wanna use a fraction of their budget. Reminds me of one time. I was approached by the state of Massachusetts and they wanted to do this pilot program at one of our local hospitals and local being the, the hospital was about an hour away from our entire team. And I had sat down with them to create budget. So I knew what budget they were working with and I had drastically reduced our team’s price in order to be able to maximize the number of patients that we were gonna be able to utilize and serve through this program based on the budget that they had. And I ended up turning in a proposal for right at $800 per patient. And I was estimating that our team would spend about 30 hours per patient. Wow. For $800. So that breaks down to an hourly rate of about $26. Do you know that they came back to me and said, we need you to work for about $300 per patient bringing our hourly rate down to $10 an hour.

[00:09:42] And unfortunately that program wasn’t able to get kicked off, or at least not with our team, because there’s just no sustainable way that our team could work for $10 an hour. For all of these people, even if it was a pilot program, even if it was, you know, in hopes that more money would come down the pipeline, even if it was serving an underserved population, it doesn’t do any good for me to serve an underpopulated population at the expense of my team, because then we serve nobody.

[00:10:11] And it just reminds me of this is what do you think this organization’s budget was for this conference? Astronomical. It was huge. They probably have a ton of money to spend, and they wouldn’t even help their people who were speaking, putting this conference on, get out there mm-hmm they wouldn’t help them house themselves. That is crazy to me. And it’s just so indicative of how low on the totem pole valuing healthcare in our country really is. 

[00:10:42] What’s the word that is in Atlas of the heart. That is not guilt and it’s not shame, but it’s like being wronged by somebody else. That’s how I feel.

[00:10:54] Transgressions. I don’t think that’s the word. That’s not the word, but but transgressions against you for sure. 

[00:11:00] Yeah. I was done wrong, but I also accepted it and I also like agreed to it. And it also, still felt gross. But. Like you said, that program didn’t go forward because you know that you are teaching others how you are going to be treated in some ways.

[00:11:23] So you weren’t gonna say we can do it for 10 and then later have to say, but we’re only gonna do it for 10 until a hundred patient, you know? Yeah. 15 patients go through and then we’re gonna do it for 26 and then we’re gonna do it for 36 and then we’re gonna do it for 56. That’s just, that’s just not realistic.

[00:11:42] Like people aren’t going to respond well to that. And you are probably never gonna see that money. Mm-hmm so I, that was part of my like argument of not wanting to do this was like, I am saying it’s okay to present for this crazy like I’m, I’m okay to say I pay to play and I was not okay with that. And I did not wanna be that person, but we decided that it was beneficial in certain ways.

[00:12:10] And we were excited about it though I still feel like it was wrong and they shouldn’t have programs like that. They were exploiting. Yeah, the presenters, I hope they paid panelists that they invited cuz I went to a panel and I planned to ask because I, I want to continue that conversation with this program, but I hope they paid panelists who were there was a trans man who was talking about giving birth. There was a trans woman who was talking about transitioning and healthcare support. And then there was a physician who runs a Euro office, like they work with trans health and she was, I think, at a university, they were doing studies and collecting data. And she was a physician. I hope they were paid . I hope the money that they were gonna pay me, went to them because I, I don’t want them to be Out by teaching me what I learned at that conference. And I know nurses think that it’s done differently. The fact that you were surprised means that this is a secret , this is not well known and it should be well known because I don’t think nurses should stand for it, but that would’ve taken like 25 30 presenters to say, mm, you can go to hell.

[00:13:32] Right. And so I don’t have access to those 30 presenters. They don’t let us know who’s been accepted ahead of time, maybe so that we can’t talk and be like, what’d you get? But in my trauma informed business model, I think that that’s okay. It, we should be able to be transparent about that stuff because it should challenge me as the business owner to be ethical and fair. Isn’t the word I want, but fair, ethical and fair. And yeah, sometimes we need to be checked about that and also That usually promotes excitement. If folks are paid fairly and they should be excited about what they get paid. And that’s what I share with the folks that I pay is I want you to be excited.

[00:14:20] I don’t want you to be doing this and resent it. Just like you would’ve resented that program in Massachusetts. That resentment would’ve crossed it into your client care. Totally. Right. Just like just like biases do, like, we don’t want ’em to, they do mm-hmm so yeah.

[00:14:34] That was a downside, but I have a new perspective going in I’ve never had in a conference before and it’s so it’s, it’s fucked up. I mean, it’s cool to see like these different parts of it. Like, I was an attendee to conferences when I was a student. I think I went to like small ones, local ones when I was a nurse. And then. The pandemic was like a perspective shift for everyone. And now as a business owner, a trauma informed business model business owner, as I’m trying to be, I have made changes in my business that have not been modeled to me and done that with a team where we’ve had to like, figure it out and think like, how do we be transparent?

[00:15:21] How do we be ethical? How do we be fair? And I didn’t see a lot of that. But like, I went to go talk about trauma-informed care, so I shouldn’t have expected to see it. I just saw that there were missing pieces of information, like you said, communication. 

[00:15:39] And, there was no welcome committee. There was no meet and greet. There was no communication about where you should check in, who the other speakers were, there was no camaraderie around helping speakers actually meet other speakers. So all your speakers are your change makers in this industry. These are the people who have the goods. These are the people who are talking about these progressive subjects that we want to be on the loud speaker. Yet this organization being a national organization, having national reach didn’t take the opportunity to intentionally put all their change makers in a room and say, here’s your magic dust that we just sprinkled on. Go change the world. Right. Instead it almost seems. And who knows if this was, you know, really behind kind of their actions, but it almost seems intentionally they kept you apart. Maybe they didn’t want you to talk about who was getting paid, what maybe they didn’t want you to talk about X, Y, and Z. But in my opinion, a better approach would have been to put all of your change makers and your speakers in a room at least a couple times throughout this conference to say, You guys are the go-geters you guys are the golden child.

[00:16:52] You guys are the people who have the means and the resources and the willpower and the brains to do this and to move our industry forward. We gave you no agenda. We just wanted you to have three hours to talk amongst yourselves, to network, to get to together, to get to know one another. And that mark was really missed, I think, with this conference.

[00:17:14] Yeah, for sure. And the magic sprinkle is like food just feed us. Just, just like put some food there. That’s simple, real simple. And a show of respect and a show of appreciation, which would be very small. Yeah. And, and I’ll give that feedback, like, I’m happy to give that feedback. I expected it because I’ve seen it at other conferences, but maybe these conference leaders hadn’t been to other conferences outside of nursing.

[00:17:41] And I think that’s an important distinction. So if there are presenters that are listening that want to learn about conferences, go to a conference outside of nursing. Level up your standards so that we can all level up standards for each other inside of nursing, because I’m doing that. And now when I’m asked to present, I ask what’s your anti-racism plan for your company, and what’s the required education that everyone has to take. Who’s teaching inclusivity and gender expansive language in your company. Who’s in charge of marketing and who am I gonna be talking to about my intellectual property.

[00:18:17] Right? I have to be aware of that. A business owner and an online face, an online business, I have to be aware of like, how are you using my intellectual property? Who’s gonna see the video. Where is it going? How long do you have access? I want someone to read the contracts with me so that I know because you have to have your own back.

[00:18:35] So I think it’s interesting to see it from all perspectives and very, very helpful, and also helps me in my business and moving forward with other presenters business leaders, it was all very, very helpful. I got to see posters of folks that I wish I could meet in person. I was like, where are these people?

[00:18:54] I want them to be like, I wanna talk to you. Yeah. So there’s some email follow up that’s gonna happen. It was cool. It was cool to share space and to share energy with other people that was really cool and different. We haven’t seen it. We were all masked.

[00:19:09] We didn’t get COVID. There was very little COVID spread within the whole conference, which I was very impressed with. Okay. And we didn’t like eat together which is probably why. Yeah. I would’ve done love to have done more of that. 

[00:19:26] Give me, COVID let me eat with these people. 

[00:19:28] Oh, I don’t want COVID. I do want like, yeah. I like the round table places that I could be in where I could speak to others one on one. So it was cool to be a presenter and nurses would come up and talk to me. Yeah. Even in the Starbucks line, they would come up and be like, thanks for your presentation. I was there. I was like, Hey, who are you?

[00:19:47] They’re like, oh, I’m a nurse educator. I live in Iowa. And I really liked your presentation. This is what I’m trying to do. And just like see each other and just be like, oh, that’s badass. Like, that’s so great. A nurse came up to me and said, after my presentation on stir ups are restraints, which was really fun.

[00:20:04] It doesn’t sound fun cuz it’s restraints but it was, it was fun. They came up and they said, I want to be an advocate for my patients. I teach them all of these things that you’re saying. I teach them all the information I have, what I have is for them. And you know, she was echoing all of the things that we had just talked about.

[00:20:26] Teaching them, listening to them, hearing their story, being open to where they’re at learning about their goals and advocating for what they want and really trying to center them in a system that just doesn’t do that. And it’s not modeled. You don’t see that. And I was like, that’s great. And she said, well, my frustration is that they still go along with whatever they’re told to do. And so I don’t tell them what to do. I ask what they wanna do. I give them options. I support their answers and I, you know, am with them for like, let’s, I don’t know, let’s try this new thing. Let’s try the, what do you think? And I give them opportunity and I was like, yes, that’s amazing do it.

[00:21:07] And she said, well, when a provider comes in, they get told and they say, this is my recommendation. We need to do this. Whether it’s manipulative or not, or like super direct, they just come in and they’re like, this is what we’re doing.

[00:21:22] And she said, the patients do it. And I’m like, no, no, you don’t have to do it. I’m here, like all this work and all this time and all this education and all this like patient centering that the nurse has done, she was like, it gets washed away. They just do what they’re told and she was upset about it. And she said, what do we do?

[00:21:46] And this was in my role play. Like we had a patient in my role play who finally just turned over and put her legs in stir ups. And I was like, yeah, I know that that happens. It happens all the time. And I tried to just open her perspective to, you know, one of the hardest parts about being a nurse is that we don’t get to see the outcome of our work.

[00:22:06] We don’t get to see what they go do at home. We don’t get to see that they educate their whole family on what we taught them. We don’t get to see what difference we made in their lives. We don’t get to see what happens later. We don’t get to see the end. And I said, what if you’re the first person to ever give them so many choices. They really felt in charge the whole time you were taking care of them, which could be 12 hours. Yeah. And she was like, yeah, that sucks. That’s what I wanna do. That’s who I wanna be. And I was like, yeah, but not the first one. We want this to be normal. We want this, we teaching our children to expect this right.

[00:22:40] To level up their expectations and what respect looks like. And she’s like, of course. And I said, Would you expect your child to then implement everything? You just taught them in one day, in one of the most difficult tests they’ve ever encountered. And she was like, oh, well, no. I mean, that’s really hard.

[00:23:05] And I said, it could be the first time that that patient feels it from you learns it from you. Gets modeled it because you get so many interactions with your patients, you get to be like, what do you think? I’m listening to you. Let’s do what you think. how’s your body feel? Let’s respond to that. You get so many opportunities for that.

[00:23:23] So it’s a lot of learning and a little bit of time over the lifespan. But then when someone in power, I was like, they’re wearing a coat. They’re the doctor. We’ve all been told to do what the doctor says. The family’s saying, do what your doctor says. The doctor’s saying, do what your doctor says. there’s only so much that we can do in the middle of that.

[00:23:42] I said your, their choice is not your responsibility, but what if they make that choice, they decide to go with what the doctor does. Cuz that’s what everyone’s saying. That’s what everyone’s saying. But inside it’s the first time that it feels really wrong and she’s like, oh, I hope so. But I don’t hope so.

[00:23:59] Right. And that is when things change in their life. And that beyond is when they say. I’m not gonna let someone talk to me like that, or I’m gonna listen to my gut because my gut told me that that was a weird decision. And then I did it and then it responded that was a bad decision. What if you listened earlier to yourself and they move forward, teaching their kids how to listen to their gut and how to listen to what their body is saying and how to ask questions and push back to authority or perceived authority in those situations. And she’s like, okay, that’s totally good enough for me. 

[00:24:37] It’s a lot, it’s a lot to think about overhauling, such a dysfunctional system, 

[00:24:43] right? It’s a socialization too. Yeah, it’s not a healthcare system issue. It’s socialization that everyone has told them that the doctor’s always right. And the doctor kind of takes that position of power and feels a responsibility to give answers and to give these are my professional opinions and, you know, you have these two choices that they can see.

[00:25:06] That are kind of subjective. They’re based on a lot of education and experience, but they’re also kind of subjective. You’re gonna get different answers with different physicians, right. And not every physician is like that. And not every provider is like that, but it is so common that that is the, that is the barrier that I get after presentations.

[00:25:21] Like this is like, they still choose what they’re told to do. I’m like, of course they do. They’ve done that for 25 years. Like we did that until we stop doing that. We still do that when we break or when we’re vulnerable or when we 

[00:25:39] in a new situation and you don’t know how to advocate for yourself.

[00:25:41] We’re thinking about our baby. We’re told these things kind of are manipulative or coercive. So it was a cool conversation. And one that I really valued having in person that was really cool. It was really cool. So I will be doing more conferences. I really like it. And the nurse conference loop is, needs work. Just like nurses.

[00:26:10] Nurse culture needs work just like healthcare system needs work. So yeah, I like that. I appreciate that you tied those together in a way that’s super understandable and makes me feel less like I really got taken. I really feel like I came out with a lot, but we did put a lot into it. Money, time, resources, all that.

[00:26:28] And it just goes to show how trauma informed foundational care trauma informed lifestyle education really is a powerful, like compass for how to be treated and how to treat others and how to just think about who are we prioritizing? Who are we centering and listening to? What could possibly be viewed by our actions? Instead of like our intent’s good.

[00:26:57] We, you know, everyone should be so thankful to be here. It just, it it’s, it’s everywhere. It’s mirrored in everything. And I see it everywhere. Even, even at that big fat conference that yeah. Yeah. We went to as a, and that new perspective was super cool. So I’d love to hear if others are thinking about taking their topic and going out to conferences and starting to apply, or even local conferences. There’s a bunch and you know, getting your feet wet in that new territory. I would love to talk about that on this podcast. So find our little form on pulse check dot podcast on Instagram, fill it out. And we’ll have you to talk about it. Have some coffee with you on our show. Thanks for this cool little Q and a hehe.

[00:27:47] Yeah, this was awesome. And look playing devil’s advocate. I think there’s a space of transition where. You know, it happens in every industry. You’ve gotta teach the world and the industry and the leaders of that industry. What is now expected of them as our world grows and continues and as kind of roles change.

[00:28:08] So nurses are leaving bedside. They aren’t gonna be able to speak at conferences for free because this is now their income. And I think there is this gray area where people like you, and I maybe do have to take a conference or two or a handful for free or low fee or for maybe like trades of goods and services type things until we can teach the industry what is the new norm and what now is expected of them to ensure that everybody has you know, Quality of life due to fair compensation, and that people are really being compensated for their expertise, because as much as the leaders of this national conference, probably think that they could all get online on stage and teach I think it’s very apparent that they need nurses from around the country and around the world to truly put this event on. And hopefully in the years to come, the people who are speaking will be compensated for their time and expertise. 

[00:29:06] Yeah, for sure. Equitable compensation. Right? That’s the word I was trying to think of that whole time equitable. That really feels good. Hehe and you’re right. Thanks. 

[00:29:15] yeah, this was fun. Oh my goodness. As always, you guys, if you have a story that you’d like to share with us, if you are a woman or gender expansive person in medicine, we would love to hear your story. Come on here and tell us about what it’s like working within the halls of an American hospital until next time. We’ll see you later. Bye. Bye..