Episode Transcript
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Speaker 1 (00:05):
Appogie production.
Speaker 2 (00:11):
Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
Speaker 1 (00:15):
Do you need to burn out to have those insights?
While I'm talking about it now, But you know, came
to educate the world about it.
Speaker 2 (00:22):
But I didn't want anyone to know that I was
so unwell.
Speaker 1 (00:26):
I don't know when it was ever okay to yell
or scream or abuse somebody.
Speaker 2 (00:32):
We need to have support and know where to look
for support, and know how to look after ourselves, not
just professionally, but personally as well. It was quite profound
and I learned a lot from that one action. I
particularly wanted to have you come on board because you
(00:54):
were one of the most influential people in my nursing career.
You were a mental to me when I first became
a Richter nurse, and I have watched you move up
through the ranks of nursing, and I know there are
times that's been really tough and other times, you know,
full of joy and that sort of stuff that nursing
(01:15):
is known for. But I wanted to have a chat
to you about where you've come from, what you did
to get to where you are, but also some of
the pearls of wisdom. You think you could impart on
younger nurses, older nurses as well in wanting to start
a nursing korea and looking after themselves well.
Speaker 1 (01:33):
From a little girl, I always wanted to be a nurse.
I consider nursing to be a vocation and that is
always a very controversial conversation these days, considering where the
profession has taken us now into this current times. Beginning
of my career, I start at ryal Brisbane Hospital, I
can now say in another century and when things were very,
very different the way that nursing is now grew up
(01:54):
in the marster and apprentice scenario there, so a nurses
was basically seen and not heard. We were student nurses
working in the woods from the day that we actually commenced.
In our career, I've worked inariety of facilities, both public
and private throughout Queensland, within the regional setting and also
within the metro areas as well too. Working within both
(02:14):
systems has provided me with a lot of opportunity to
really understand how the variations of nursing and how different
staff go through a variety of things. My initial background
in nursing at my major first club was theater nursing,
which is where I met you, Rebecca. I walked into
an operating theater back in nineteen seventy eight and I thought,
this is it. I'm home. I love the scrubs, I
(02:35):
love the masks, I love being in that environment where
I really took on that I was actually helping these people.
They came in with conditions and parts of their bodies
that weren't working, and we were able to make them better.
That career assigned me can take a variety of different ways.
Within the next number of years, I went into repping.
At one stage, I've set up and run day surgery facilities,
(02:56):
worked in a private hospital as a registered nurse. But
also within that process there looked at other things that
what actually affected myself in my own daily life and
what else could I do to give back to nursing
and back to the staff that I was working with.
I became a workplace self and safety officer. I also
became a BLS trainer. Took notice then of accreditation about
(03:16):
what was happening with in that space as well too,
because these things actually interested me. But was it over
and above what I was doing. But the stuff that
I wanted to know about that, I wanted to learn.
My pathway took me to various other areas to where
a point. Now I work not implivate anymore, but working
with a whole range of nurses in a very different
field to theaters, but certainly to still see the passion
(03:37):
and the compassion that is required and needed every day
for nurses to do what they do and to keep
coming back the next day.
Speaker 2 (03:43):
You've seen some huge changes, and you know, being at
the age of seventeen because I started at PA and
laying out people that have passed away, and you know
those little processes you do when someone passes just I think,
so you can cope to where nursing is now. It's
polar opposite snelly, isn't it?
Speaker 1 (04:02):
It is, Rebecca, But we still have some things that
are exactly the same. We still need to lay out
people when they've gone on to the next part of
their journey, adults and children's alike and everyone in between,
and that respect needs to be remaining within there. So
those basic fundamentals of nursing. What's within our remit What
can we do with nurses? What do we do with nurses?
We look after people, We care for them when they
(04:24):
aren't able to do so for themselves. We look after
them and we answer their questions as best we possibly
can to make sure that they have the understanding of
what is actually wrong with them, and we include them
in that to make sure that we know that they
know what's going on. Language is a big thing within nursing,
in all professions and all areas of life. In my opinion,
nurses have their own language. Patients don't know that language.
(04:46):
They don't understand what we actually saying. I heard a
funny story a number of years ago from someone who
told me that they contacted a family member who was
so upset because they were diagnosed with hypertension and they
actually thought that they were going to die. When it
was explained to them it was just a little bit
of blood pressure and they could take medication to be
able to sort that through. They fully understand that, but
that person for that length of time had a real
(05:09):
concern about their mortality and what was happening with them.
So understanding that we have our own language and that
people don't know our language is very very important for
us as well too. So those things haven't fundamentally changed
technology as we're seeing right here today. To be able
to reach out to everybody on this podcast is just extraordinary.
(05:29):
To be able to do that from where we are now,
that wasn't heard of, not even five or six years ago.
Per Sae. It was there, but not to the extent
that it is here now. COVID came and COVID still here,
but it changed how our technology is utilized, how we
see nursing and how we see each other, how we
now interact with each other, and to find that collegiality
(05:49):
and to maintain that connectedness that we need to do
with patients is really super important. I found that one
of the big things during COVID was the great barrier
to everything was having to wear a mask. So you
have people who are hard of hearing, you have people
who mumble. We have known curtains who do mumble. Rebecca,
(06:12):
it's almost best guess, but not what you're doing as
well too. But so for patients, different language backgrounds, those
types of things. So it was really difficult for nurses
as a whole to actually get through that. But then
how do we express ourselves while still wearing a mask.
It's in touch, it's in feel, it's in eye contact
and those things are vitally vitally important, and those things
(06:34):
have not changed.
Speaker 2 (06:35):
Now. One of my clients is a speech pathologist, and
the number of kids that were born during that time
that are coming through with serious speech issues and learning
how to talk. Because everyone was wearing masks, I didn't
think about that. I was like, oh, my god, of course,
you know, it makes sense. It was quite interesting. So
I can imagine someone hard of hearing, or sick in bed,
(06:56):
or just imagine how frightening it might have been for them,
especially with people who are in full ppe.
Speaker 1 (07:01):
Absolutely, it's all very sort of you know sci fi
travels As an area it was as.
Speaker 2 (07:06):
A nurse practitioner, it was fantastic having telehealth. I was
able to do vaccinations. I had lots of people having
consultations through telehealth that normally wouldn't have reached out to
me because I couldn't obviously do the cosmetic side of dermatology.
But it was awesome to have people bring up and go, oh,
my acne has fled up so badly, can you give
(07:26):
me a hand? Able to still see them over skype.
It gave you a purpose. It was really great to
be able to still help people, and especially when GPS
and that were so under the pump, it was pretty
cool to be a nurt practitioner and have that ability
to continue to help people outside of that hospital space
and keep people out of hospitals and doctor surgeries and
that sort of thing. It was pretty cool.
Speaker 1 (07:47):
And it's changed the way that we're going to see
health going forward into the future as well.
Speaker 2 (07:50):
I believe so, kath in your position, dealing and managing
with staff is paramount for you. What do you or
your organization do to keep your staff physically, emotionally, and psychologically.
Speaker 1 (08:08):
We'll start with the obvious one is occupational violence. Occupational
violence appears to me to have actually been on the
increase over the last number of years. I don't have
any understanding or reasoning why that would actually be. We
can see all the advertising now sort of you know,
we're just a human being, We're just like you. We've
got a job to do. Please don't abuse our staff.
(08:29):
It's everywhere you go to now, even in the shops.
You know, we don't accept any bad language, no yelling,
and those sort of bits and pieces. And I truly
do wonder about how our society has actually got to
that point, I don't know when it was ever okay
to yell or scream or abuse somebody. It's never was
in my lifetime to be I was never brought up
(08:50):
that way, So I don't know why now, just because
you're not getting your own way all some things aren't
going in your particular way that you feel or some
people do feel that it's okay to abuse the person
in front of you, and I can't understand where that's
actually come from. Occupational violence not just verbal, it's also
physical as well too. With our aging population, and we're
(09:10):
continuing to keep people alive for a lot longer to
see an increase in dementia patients. Having had my mother
go through dementia, she didn't know what she was saying
most of the time. I spent most of my time
apologizing to stuff because of my mother and the words
that she was saying. So we need to understand that
and probably separate that out from people who are choosing
to be verbally aggressive to people. It's up to individual areas, groups,
(09:33):
organizations to be able to find the best way to
support their staff by asking their stuff, what do they
really need? That alludes to the physical and also to
the psychological side of things and to the emotional we
have introduced quite recently. I to say the last couple
of years is a hot debrief after any major situation,
But should that go down to an end of day
debrief about making sure that staff are okay when they
(09:55):
do leave work and if there actually are okay when
they come to work. We carry emotional baggage no matter
how hard and how much we say, leave it at home.
You don't bring that stuff work, we can't help not to.
And then for each person it's very very individual. So
we found that the debriefs have been highly beneficial been
rolled out now in a variety of other situations and scenarios.
(10:17):
Though I said, I do believe that an end of
day debrief or I go home chat or whatever you
want to call it, or a team huddle is really
super important for people to be able to understand and
clarify and clear up anything that's occurred during the work hours.
That helped with the emotional side of things, but also
looking out for those warning signs and they are there
if we choose to see there lies a huge issue though,
(10:38):
so we could be looking glossing over what we're not
actually seeing Are they not engaging? If you are doing
a homebound huddle or something like that, who's not participating,
who's looking sideways, who's looking distracted? Do you have the
skills yourself or you have the ability to gain or
source the skills to be able to support that person
going forward? If I ask somebody truly, are somebody are
(11:01):
you okay today? And they say to me, well, actually,
cath no, I'm not. How am I going to respond
to that? Am I emotionally stay able to be able
to do that? Do I have the skills to be
able to do that? But how am I going to
respond to that? So it keeps that person safe, but
it also keeps me safe as well too.
Speaker 2 (11:18):
We are empathetic to everybody else except to other nurses often.
How do we change that dialogue?
Speaker 1 (11:24):
How do we.
Speaker 2 (11:25):
Encourage nurses to feel safe sharing that information and then
getting the support that's needed for them without every Tom,
Dick and Harry finding out and then blah blah blah,
and you know, the gossip chain starts.
Speaker 1 (11:38):
Absolutely. So the old adage is we eat our own.
I'm very very sad to say that that's still part
and parcel a major part of nursing. We ask people
to come into the profession, and then we turn around
and we treat them dreadfully. I think you have to
be fully aware and be honest with yourself how others
see you. You know, if you're truly honest with yourself,
what would your colleagues say about you? And understand that
(11:59):
and accept that? And if it's not what you want
it to be, we have to change. You have to
change that. I have to change that for myself. I
can't change anybody except for my own thoughts and feelings.
So I have to be truly reflective about my behavior,
about the way that I see things, and I speak
and express myself to staff and to my colleagues, no
(12:19):
matter who they are. Oftentimes I tell people, what are
your thoughts when you wake up at half past three
or half past four in the morning, it's just you
and the universe sitting there, how do you actually feel
about how your day work yesterday? What are your thoughts
and feelings in and around that we've always spoken about.
I was brought up to be kind and to be polite,
But what has been kind and polite mean to other people?
(12:41):
How does that actually look for each of us? That's
making time to be with people. That's making time to hear,
not just listen, but to actually hear what they are
saying and trying to say to you. My senior role,
by the title of it, alludes to they're a scary person,
and I've tried extraordinarily hard over my years in the
senior role to make that only an illusion, to give
(13:02):
them an understanding that whilst I am a senior nurse,
at the crux of it all, I'm Kathy Flannig and
I'm a registered nurse.
Speaker 2 (13:08):
So just like you, I mean me knowing you and
having worked with you and under you, having a huge
amount of respect for you, are other organizations as aware
as what you are?
Speaker 1 (13:22):
The empathy side of things, we speak about it an
awful lot how we enacted on a day to day basis.
I don't see that happening in an awful lot we
do say, and I hear it all the time from people.
I'm like that, But that's where I go back to that.
What's that true self reflection? How do others actually see you?
Do you accept and understand what feedback is being provided
(13:42):
to you. There's been a variety of different programs over
the time about trying to give feedback to people to
help them to understand how they are perceived by other people.
I can't change human nature, beck I'd love to in
a variety of areas, but there are some people who,
for what they've come from, for where they've been, they
find it very, very difficult to change any part of that,
(14:03):
and they've got themselves into, oftentimes a niche role where
to their power and importance is the most fundamental part
of their being. I will say the word dominance, but
their dominance over other staff.
Speaker 2 (14:16):
Working in the operating theaters. I found that to be
very prevalent in the theaters because it was such a
closed off area. There were power struggles over who was
going to scrub for who, And I mean god, I
remember back at PA when I first started working there
and I went to the theaters for the first time. I
remember nurses hiding instruments from other nurses and they would
(14:39):
get there early so that they'd have those instrumentations for
their surgeon. It's hard to comprehend that happened, but it did,
and they were doing it purely because they wanted, I suppose,
be the best nurse they could be for that particular
doctor and it saved instrumentation being thrown at them. Some
of those theater nurses. When I first started, I was
terrified of them, and I still loved it, and it
(15:01):
wasn't for everybody. And I do think you had to
be a certain type of to work in the theater's
long term.
Speaker 1 (15:07):
Absolutely, I've had the opportunities to present a variety of
people and around different things. One thing that I really
consider is that I think a lot of this power
struggle comes from people holding onto their own knowledge. They
think that their knowledge is their power. So therefore I
know everything and if I don't tell you, well, then
I'm going to be the top dog. I'm going to
be the top nurse because I haven't given you all
(15:29):
my knowledge. When you spell knowledge in the middle of there,
there's three little letters altogether. It's owl and that's L
and l's a very, very wise creature. So as far
as I'm concerned, within knowledge, there is wisdom that needs
to be provided to people. And who am I to
hang on to my knowledge? Because I want to make
every nurse to be the best nurse they possibly can,
(15:51):
to be fully empathetic and understanding for the simple fact
that I might be their patient one day, My family
will be their patient one day, and I want them
to be the best nurse that they can be so
they can actually look after me. Entirely selfish, Rebecca. But
if I don't give over my knowledge, what am I
going to do with it? I'm just going to sit
in a rocking chair a white postages. Why hang on
(16:14):
to the knowledge? Why not share it and give it
to other people? Because once I've been provided with that,
they can't unlearn that. It's a bit like paying forward.
If I give that knowledge to someone, I want them
and I tell them I want you to give your
knowledge to others as well too. You're here to be
the best nurse you can and to make other nurses
the best nurses they can because.
Speaker 2 (16:33):
It's interesting within the aesthetic space. I've always shared my information.
I've gone out and trained for galderma, happy to teach
because I think if you learn good processes and you
know the right way of doing things, you're going to
be a better cosmetic injector or nurse. And I've had
so many people that come up and go, I can't
believe you're sharing your intellectual property. Why would you do that?
(16:56):
You know then they'll come in and undercut and I
think it makes the whole industry profession so much better
if the nurses that are rear nurses share the knowledge
that they've got. I know, we say nursing is a profession,
but I think we really need to start really looking
at it as a standalone profession. I've done a fair
(17:16):
bit of conferences in the States and how they perceive nurses,
nurse practitioners, physicians, assistants. It's really respectful and I know
they've worked very, very hard to get into that position,
but they're really smashing it over there in the value
that they see nurses bring to the health system. And look,
(17:37):
it's an awful health system, but they really value what
nurses say. And the last conference I went to that
was run by a plastic surgeon. The majority of people
that were there and that spoke participated with nurse practitioners, physicians, assistants, nurses,
and there were a few doctors thrown in the mix.
And here was the plastic surgeon deferring to a nurse
(17:58):
practitioner about anatomy facial anatomy. I mean, it was mind
blowing for me sitting there to see that it made
me really proud to be a nurse and it gave
me hope that moving forward in Australia, that we can
look after our own and really nurture an amazing profession.
But I think we've got a little way to go
at the moment.
Speaker 1 (18:18):
I'd agree with that the growth of the nurse practitioners
and the senior nurses doing those types of roles and
other individualized roles within the profession is certainly growing. We
are still basically under the English way of doing things
so greatly or wrongly, but certainly we need to step
away from that. That the doctor isn't God. The doctor
is part of a healthcare team. We see allied health
(18:40):
people now undertaking advanced practice scenarios as well too, with
our physios and occupational therapists. Speech pathologists have been able
to actually prescribe some bits and pieces as well too,
so that whole allied health process has changed. We need
to look at our patients holistically and our care delivery holistically.
It's something that's always been spoken about, though we've never
(19:01):
truly done that. We tend to defer back to a
hospital based system, a hospital slash GP type system, and
that isn't working for us at all, because the hospitals
will get to a point and they are back at
that again there's just not enough beds. The best place
for treatments in your home in the hospital. Acute care
absolutely not an issue. I need to be on a respirator.
(19:21):
I need to have something very majorly, some major interveections
undertaken bit theater, b at ICU, be at a cardiac
intervention or whatever it may be. But the place I'm
going to recover is in my own home. Being in
a hospital, it's fully supported in and around, having all
the doctors and nurses there. You've got to go home
at some stage and that's when you begin to get better.
(19:42):
In my opinion, The health system in Australia, in my
opinion needs a major at shakeup, both publicly and privately
as well too. I think with the NDIS they begin
to see some of that, even though that system has
its major quirks in there as well too. But to
have all that out at health to keep those clients
in their homes to be able to maintain a lifestyle
(20:02):
that they want to be able to do. So that's
where we need to get.
Speaker 2 (20:05):
To community based care. Nurses, physios. I mean it goes
on and on, doesn't it.
Speaker 1 (20:11):
I do believe that the predictions are that in the
next number of years not too far away, and we're
going to be short one hundred thousand plus cares in
our society.
Speaker 2 (20:21):
Ndis those work, isn't it? They don't come under a
governing body.
Speaker 1 (20:25):
Unfortunately, no, they don't. So that's part and parcel of
left hand righting, you know, horse and cart sort of scenario.
What do we need to do to be able to
support those people? They're dealing with all of our societies
most vulnerable people. We need to make sure that we
can look after them appropriately, I think of them what's
actually needed.
Speaker 2 (20:43):
It's quite concerning that that's not a governed area, I think,
because I think it allows vulnerable people to be vulnerable
KAV Within the hospital setting where you work, if someone
approaches you, are there counseling services or they have to
go outside and you recommend things to them. What is
the scenario of someone says to you, look, I'm really
(21:04):
struggling at work. Do you send them to their GP?
Speaker 1 (21:07):
What do you do when that occurs? In both public
and private there are outsourced groups of people who can
come and support people, it depends on what the issue is,
but also for them to seek their own ways forward
as well too. I don't know about you, but I've
spoken to a variety of psychologists over the years for
a variety of reasons, and finding that right person who's
going to be the best one for me is always
(21:27):
a difficult journey to be able to work through. It's
very difficult to find that person who you connect with
but who also gives you the truth in a way
that you're ready to hear it and that you're able
to hear it and be able to do something with it.
But ask them what is it that you actually need
and they'll generally say I don't know what I need,
And then we'll have a conversation. Tell us what the
(21:49):
situation is, but break down that big elephant that they're
trying to jump over. Best way to eat an elephant
is one tea spoon at a time. Break it down
to something small. What can we deal with here and now?
What's the major concern? Is it your safety? How can
we help for you for you to have your safety
going forward from today? Do you have a safe place
to be? Do you have finances available? How are your family?
(22:11):
Are the dogs okay, are the cats okay? Those types
of things. So take it down in small chunks. The
small chunks makes it so much more easy for everyone
to be able to say, I can actually achieve that
there's a small win there. I've been able to achieve that.
I've done that. Okay, now I'm ready for the next thing.
But have that overall plan. It's all a jigsaw. Have
an overall plan, have that big picture, but use it
(22:33):
one pieces of time to fill it in. And that
bit of that jigsaw may not quite fit in there,
but it may certainly fit in the next pot you
go and try it into.
Speaker 2 (22:42):
I saw a counselor that just didn't work at all
for me. In fact, I got sicker after seeing her.
And then I actually went and saw a behavioral scientist
and that just perfect because there was the science side
of things and then there was I suppose behaviors, and
she just nailed it. I've been seeing her now for
the last twelve months, and I didn't even know behavior
(23:04):
science did that sort of stuff. So good. There are
other avenues other than counselors and psychologists. There are behavioral scientists,
and I actually have friends of mine that have seen
them for grief management and things like that, to just
to try and change those thought patterns and that sort
of thing. So there are so many different avenues you
can take to seek help. It's just knowing how to do.
Speaker 1 (23:27):
It, absolutely Becca, absolutely well. And I speak for myself.
We've been here in that dark hole as well too.
But I think for me, at the end of days,
at the start of day, the best step forward is
to put your feet over the edge of the bed
and say, right this is today, This is not yesterday,
this is not tomorrow. This is today, and I'm grateful
to be here, right here, right now, and I will
(23:49):
take things as they come. I will do what I
can do within my own ability to be able to
do so, and not step outside of that for a
while until I feel more confident and go and do
something that you can actually can do and do well.
In most days, it could be just geeding up and
having a shower and doing your hair, and it might
not be any more than that, but then you succeeded
in that, So what can I do a little bit
(24:10):
more tomorrow? And those types of things. Most of us
have such high expectations of what we're supposed to achieve
what we should be doing. Love that word shouldn't I
should be doing this, I should have done that. To
a point. It Stimey's people's creativity and the ability to
actually get out.
Speaker 2 (24:25):
And I read the book Atomic Habits, which was absolutely brilliant.
It's all about incremental changes, you know, just one little change.
So for me, it was going to Plartis. I would
get up and go to Plarties. But my reward was
because I did a great coffee, getting a coffee from
the place on the way back, and because I'm such
(24:46):
a coffee fiend. That totally motivated me. But I couldn't
think of doing anything else, you know, I wanted to exercise,
So that was my one thing every day was get up,
put my gym clothes on, go to Plartis and get
that coffee. It's not the big changes, it's the tiny
little changes that you consistently do. I know when I
(25:06):
was very sick with depression, it was just getting out
of bed, getting outside in the sun, playing with the
dog and that actually, Lola was a big thing. It
was that I have to take it down to the
park to play. That was hard to do. That sort
of stuff. You're right, you know, it's the little steps
that you take that help you with the bigger.
Speaker 1 (25:26):
Ones, absolutely, and also finding your happy space within that
as well too. So what's that happy space in there?
And that is often a reward to find that. If
it's a cup of coffee after you've done something, that's fantastic.
But is there something else that you don't have to
actually do?
Speaker 2 (25:42):
What for?
Speaker 1 (25:43):
But you know what actually makes a person happy to
be able to do? So find that, do that and
that will begin to change your life. And yes it is.
It's little, tiny, winny steps at a time. It's not
a huge massive change. I see it with an awful
lot of places. We've done a lot of clinical redesign
around a range of processes, work processes, so on and
so forth. And whilst the outcome can be monumental, the
(26:06):
actual steps to get to there are super tiny. Do
people know what their job is? Do people know how
to do that job? Do they have the knowledge and
skills to be able to do that job? And how
can we help for them to do that better? And
do they know what the outcome that we are expecting is?
And once you get down and cut down to all
those sort of things. All of a sudden you can
find out, Oh my gracious me, these people really are
(26:29):
unaware about what happens next. So by them doing this
activity here effect somewhere else.
Speaker 2 (26:35):
Now, I know you're super busy and clearly you're going
to have to come back on. I just want to
say thank you so much for supporting me in this
and the fact that you know that we need to
be a little bit tender with each other, and we
need to be tender to nurses and we need to
look after ourselves a bit better and the profession. And
I cannot thank you enough for coming on today.
Speaker 1 (26:55):
Look, I really do appreciate the opportunity to come and
have a chat about this. Is this one of my
true passions and one of the things I wanted to
leave everyone with, apart from what I've said or bad,
is that, what do you want your legacy to be
when you're no longer that nurse at the bedside or
the nurse somewhere else? What do you want your legacy
to be? I want mine to have people who are
(27:16):
able to look after me and my family and my
colleagues and everybody else. To be the best person, the
best nurse they possibly can be, and that's going to
be what I'm going to do till the day I
think that.
Speaker 2 (27:27):
You know, it'd be great if all of us had
that same aspiration. It's a pretty cool profession.