April 15, 2025 • 43 mins
In this Nurse Shift Change episode, Dr. Lendra and Dr. Roberto Roman discuss the critical issues surrounding diversity, equity, and inclusion in healthcare, particularly focusing on the LGBTQ+ community. Dr. Roman shares his personal journey as a closeted gay man and his advocacy for marginalized communities in healthcare. The conversation delves into the impact of political changes on healthcare access and research funding, the importance of community activism, and the need for systemic change in healthcare delivery. They emphasize the role of nurses in advocating for social justice and the necessity of addressing implicit biases in healthcare practices.
Join Us at the Health & Wealth Expo: Live Summit – Where Advocacy Meets Action!
The key takeaways from our recent podcast highlight urgent issues in healthcare—diversity, equity, inclusion, and systemic change—and these very themes will take center stage at the Health & Wealth Expo: Live Summit. Here’s why you need to be there:
🔹 Diversity & Inclusion in Healthcare – Learn how to bridge gaps in care for marginalized communities, including LGBTQ+ individuals, and why representation matters.
🔹 Advocacy in Action – Hear from nurses, activists, and policymakers on how personal experiences drive change—and how you can, too.
🔹 Policy & Politics – Understand how shifting political landscapes impact healthcare access and what we can do to protect vulnerable populations.
🔹 Innovative Solutions – Discover groundbreaking healthcare delivery models that prioritize equity and improve outcomes.
🔹 History as Our Guide – Explore past mistakes and successes to build a more just future in healthcare.
Nurses, advocates, researchers, and community leaders—this is your call to action. Systemic bias won’t dismantle itself. Real change requires education, collaboration, and relentless advocacy.
Don’t miss out! Register now for the Health & Wealth Expo: Live Summit and be part of the movement to reshape healthcare. Together, we can turn insights into impact.
Secure your spot today: healthandwealthexpolive.com
Subscribe & Follow:
- Podcast: Nurses With Voices
🔗 Subscribe to Apple : https://podcasts.apple.com/us/podcast/nurses-with-voices/id1762933167
🔗 Follow us on Spotify: https://open.spotify.com/show/7jczK5DCP0I44do5lp5vAp?si=fubkwatKTSiFomnVotf4IA&nd=1&dlsi=9e88b8ca549f4e5f
Join the Conversation:
Share your thoughts, experiences, and questions with us on social media using #NursesWithVoices! Let's empower each other and build a community of passionate nurses and nurse entrepreneurs.
Support the Podcast:
If you're enjoying the show, please leave us a review and share it with your fellow healthcare professionals. Your support helps us bring more inspiring content to our community!
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome back to another episode of Nurses with voices. I'm Dr. Lyndra, and
today I have Dr. Roberto Roman. Dr. Roman is
the Chief Innovation Officer for Vital Bridge Health.
And I am just, I'm so excited to have you here today. I'm really excited
to get into our conversation because we're going to talk about, like, some nitty gritties
that the conversation is really,
(00:22):
it needs to be had. Right. A lot of people are
being evasive on topics of discussion that we're
about to have, and let's just say it, diversity, equity, and inclusion.
So we're talking about inclusion, we're talking about nurses shifting change.
It's really time for us to stand up and have a voice and say something
with everything going on around, around us. And I want to
(00:44):
hear your thoughts. I'm so happy to have you here. I'm glad you came on.
So let's get into it. Tell us a little bit about you and go for
it. Absolutely. So thank you so much for having me on here. I know,
you know, mom raised us that you don't talk about three things, politics,
religion, and money. But this is. We're in a period that we
have to talk about all of it. Right. And, you know,
(01:07):
just a little bit of background about me. I am a registered
nurse, have been in healthcare for over 20 years.
Started as an associate degree nurse and then worked my way through
getting double doctorate. So a PhD in nursing from
University of Miami and the DNP from Johns Hopkins University.
Never thought I would do that. Never thought I would go that far. I was
(01:28):
not one to think that would make my life career
in work, like as a student in academics, and then getting into
academics myself and then just serving
multiple roles throughout my career, which has been very rewarding.
But everything has led me up to this point where,
you know, living my life as a closeted
(01:50):
gay man, living in the Bible belt of the U.S.
growing up in a military family, living in military
bases through the era of don't ask, don't tell,
I didn't feel safe or comfortable disclosing the
authentic me because there was so much
rhetoric and verbiage around how bad it is to be
(02:13):
gay. And, you know, and as a child, you know, that's
extremely impactful. So it wasn't until just a few years ago that I felt
compelled and just ready to live my authentic
life. And the University of Miami. Once I got into my
PhD, it really gave me that opportunity to kind of
reset myself personally and professionally and
(02:35):
focus and support a community that is
marginalized and My research focus in LGBT inclusive
healthcare. So serving as a registered
nurse, getting a doctorate, and then being able
to authentically step into spaces
to be a voice for a community that struggles
(02:56):
to fully represent themselves in
an area that we still deal with so much health
disparities within the LGBT community. And
not only just the lgbt. Once you start putting in other components
the intersectionality of being a minority, you
know, low economic status, we're just worsening
(03:18):
disparities within the LGBT community. And now the politics of everything
is making things worse within the community.
You've said so much, and everything is just so rich. We
need to unpack just what you said so far. So
the double doctorates, right? The being a closeted man,
(03:38):
right? And then you don't talk about politics. What is it? You don't talk about
religion, you don't talk about policy, you don't talk about these things. And you're right.
So let's start there because now we can't keep. Keep
quiet. Like, this is not the time to be quiet, because when you're quiet, people
feel like you're not doing anything. This is why we came together as nurse
ship change, because we felt like the nursing culture was.
(04:00):
Wasn't doing anything. And. But now we see there
are movements being made, there are shifts being made, but
we need more than the ship. We need more than statements. We need more. We
need action, and that's what people are looking for. So we have
to talk about the politics of it, because the politics is what's affecting
us. And you mentioned how the LGBTQ
(04:22):
community is being affected from a lot of the policies, from governmental
politics. Share. How. How is that being affected?
So I'm going to back it up just to. When I started my Ph
program, I was looking to see what I could do. So in
healthcare, I knew that one of the hospitals was going for Human
Rights Campaign, the Human Equality Index for being a
(04:45):
leader in LGBT healthcare. And one of the components of it is research. And
I realized within the department I worked at as a neuroscientist at the healthcare
system, there was no research specific to lgbt. And
the research studies that were going on did not collect social orientation or gender
identity. So this was a huge gap that. That
of information that we're missing. And so that's what prompted
(05:07):
me to start the PhD program. And when I went back to school
for the. I wanted to do something in LGBT
inclusive health care. So this was, you know, we're talking about
2020 pre Covid. This was before the pandemic
hit. And so I just said, okay, this is what I want
to do. Pandemic hit started at the University of
(05:29):
Miami and already knew what the topic
was that I wanted to do. And the University of Miami has a very strong
focus within the LGBT community as well. So it was a great match. Fast
forward just a year. You know, each year into the program, as I was
refreshing my literature search, looking at different
data, I saw how Florida was progressively
(05:51):
getting worse in regards to LGBT rights.
And it started, you know, one of the things was
the don't say gay law known as the parental rights in
education. And this was under the
preface that, you know, parents have a right to know
what's going on with their children. So when you read it, the law
(06:14):
is pro parent. But then when you break down what it
does, it essentially almost
requires teachers to out students that come to them looking
for guidance. And, you know, it's.
It's written in such a way that, you know, the teacher
needs to identify if it's safe to disclose to the parents about the
(06:36):
child either questioning their sexual orientation or gender identity. But
there wasn't any education going on or training
for teachers to know if it's safe to talk to the
parents about letting them know about their child, questioning
their. Their sexual orientation or gender identity, or just out of curiosity.
So it kind of snowballed. And this is when we started seeing
(06:59):
censorship of books that discussed LGBT
topics. I think one of the big books was two male penguins that
raised a baby penguin. That book was
censored and removed from libraries. And sex ed
was also censored throughout
multiple grade levels. So in my PhD program, at the very
(07:21):
beginning, I saw this starting to unravel.
And by the end of the PhD program,
when I was looking at the LGBT, there's a movement
map that you can look at to see how civil rights are, what the laws
are supporting or going against the LGBT community. And
unfortunately, like the map, it was like a heat map. And over
(07:43):
the months I was looking at that map, you could see Florida
getting redder and redder, more in the
negative regarding LGBT rights. So
by the time I finished the PhD program,
defended my study,
I realized just how important
(08:06):
it was to start this three years prior. And.
And, you know, I remember when I was awarded the
LGBT research or the researcher of the year by the LGBT Student
center, just, you know,
thankful that I went to a private university that was able to support
this topic when other universities, public
(08:28):
institutions in Florida were being censored, and, you
know, either told, you can't do this type of research. And
then fast forward to today. The research lab that I
worked at as a research assistant lost their grant
funding, and their grant funding specifically was
for LGBT community. And
(08:50):
I have colleagues, students that are losing their
F31 grants and that are
specifically in LGBT research.
And just. It's to the
point where the stigmatization, the
discrimination towards the LGBT community is just
(09:11):
out there rampant and open. And it's a small
percentage of the U.S. population. We're talking right now, about
9, almost 10% of the population identifies as LGBT. And it's
such a hot topic, it's such a buzzword, It's
a campaign trail. Like, this is what people are putting their campaigns
on and targeting for something
(09:34):
that is a small percentage in the grand scheme of things.
Does DOGE have anything to do with the cut in grant
funding or has that been happening before?
DOGE even. So this, this is definitely happening, this
administration. So when they're looking at the nih, which is
a huge funder of science, just
(09:56):
healthcare science, they started looking at things that had
specific buzzwords that were using, you know,
either things that we would look at as social justice
research would just get cut. And not even a
transition period, not even a warning, just saying that your
study no longer supports the direction that we're going
(10:17):
in. So I've seen colleagues on LinkedIn post
the letters that they've received from the NIH and
it's. It's painful. It's painful verbiage to
read. And when you see that happen on a
national, international level, because it's impacting studies all over the world
that are NIH funded, because there's a lot of partnerships
(10:39):
between universities here in the US with other
healthcare systems throughout the world.
When you see that type of verbiage, essentially you
can read it as the government is saying, you don't matter.
And when we look at the websites that have been pulled off
the Internet from the cdc,
(11:02):
verbiage education points, talking
points for providers and patients alike that talk
about hiv, that talk about STI prevention,
you know, your
putting the community in a public health
crisis. Abs, you are completely on point. And this is
(11:25):
why what we're doing with Nurships Change is
so important. We have the rally coming up on May 24, but
it's more than a rally, right? It's more than about attending the
rally. Yes, definitely. Come out. Come to your capitals. Look
at hands off, right? Look how they came out
in like the masses. There was thousands of people
(11:48):
who came out all across the. In support of a
cause, right? Hands off of My Social Security hands off of
my government job. And listen, some of those health and human services
jobs are right along in there. So I say this to say it's
painful to watch what's happening to this country. And this is
why we're going to have a movement, inertia, change
(12:10):
movement is more than a rally. This is something that's going to be ongoing
because we need ongoing education, we need ongoing support, and we need
to continue to continue to. To make a stand. Because
what's the saying, if you don't stand for something, you'll fall for anything? And right
now, just sitting back and being quiet is just not. It's
just not an option. And it's not about being, you know, oh, we can't be
(12:32):
aggressive or, oh, we can't approach it. We don't want to.
We have to do something right? Like, we have to. So what is your
community doing right now to really push
back on a lot of these changes? The loss of the grants? What is
the LGBTQ community doing to fight back? So, pretty much,
you know, it's. The Pride parades are still happening, you know, and
(12:55):
Pride. The Pride parade isn't just about, you know,
going out there in rainbow flags and rainbow gear. Pride
started from a riot. Look at the Stonewall
riot. This was a
LGBT movement that was initiated by the trans
community. They were tired of living in
(13:17):
secrecy. They were tired of having to go to these speakeasy
type bars or underground
locations to live their authentic life. And
it was this movement, the Stonewall riot, that really
said, we're here and we're not going anywhere.
So we're in a period now where people feel like
(13:39):
they're being. The rights are being stripped. They're worried
about what. What will remain. And we're not
going anywhere. You'll still see the community out in full
force in healthcare. You see the LGBT community. So
glma, the Gay and Lesbian Medical association,
is doing a lot for the community. You have
(14:00):
organizations such as Equity, one of them, Save
LGBT in Florida. You have different organizations that are
out there that are looking at what's happening. They're looking at
policy, they're looking at politics, and they're standing up for
the community. What I would love to see more of is,
you know, individual members, you know, beyond the
(14:23):
organizations. Contact their representatives, you know, let them
know who they are, that their constituents and their votes
matter, and that if they're voting against LGBT rights, guess
what? Then I'm not going to vote for you. You know, I'll help campaign for
someone else that does believe that my rights matter, you
know, and within the nursing community. And this is
(14:45):
one reason why I stand behind Nurse Shift Change.
You know, nurses are supposed to be the most. We are the most trusted
profession. We need to be the most inclusive, and
we need to stand up for the communities that don't have a voice.
So while my passion, you know, and my advocacy lives within
the LGBT space, you know, my push for
(15:08):
rights impacts everyone, you know, as we
move through. So nurse Shift Change and what.
What we're doing here, you know, standing for humanity,
ethics, science and social justice, you
know, is really getting nurses together
and unifying our voice, because we're also one
(15:30):
of the largest healthcare professions with
over 5 million nurses strong. When you bring together those
retired LPNs
allies, you look at all the opportunity we have. Our
voice is nowhere near as strong and powerful as it should be.
And Nurse Shift Change is really trying to bring that together
(15:53):
and break those silos of the different little specialties and different
organizations and say, look, we're all together in
this. Nursing has been about social justice since the
onset of nursing, and we need to make sure that we're still
advocating loudly for the communities we serve. I
can appreciate you mentioning the silos. I'm hosting an event
(16:15):
in May, and a nurse reached out to
me and she goes, is the event for LPNs as well? Yeah,
absolutely. Right. Like, because I think, yeah, you're a nurse. And her
response was, you know, you know, some people don't think LPNs are nurses.
And this is part of the problem with our. When you mentioned
silos, we want everyone to come out, we
(16:37):
all collectively, whether you're a doctor of nursing
practice, whether you're a PhD nurse, whether you're a
CNA, whether you're a registered nurse, LPN. Listen,
if you provide patient care, your voice matters,
right? Your voice matters. And that march that
you saw, that hands off march, there were people of all
(17:00):
walks. And I'm sure there weren't just people who got fired from the government
job. Right. They were people there in support of. And
that's what we need to come together as, not only
as each discipline, right? Not just nurses. We're calling
healthcare professionals. And this is how you shift change.
This is how, if you stand for humanities, if you stand for ethics, if you
(17:22):
stand for social justice, stand with us, because this is how we're
going to be able to make a change. And I. And I'm so happy to
be able to use this platform so that voices like yours
can be heard. Right? Or each community matters and
to me, we're all together, right? So whether it's the
LGBTQ community, you know, you have your Latino
(17:44):
communities, you know, I spoke with Adrian Espinoza,
was on air, was. Was on the podcast, and,
you know, we have our black community. We're all
feeling the hit of dei. We're all feeling, you
know, the needs of diversity because we know what it's like to have that need
for access, to be included or to be excluded.
(18:07):
Right. So when we talk about dei, this is so that
people can have access to environments where we don't
normally have access, so that we can have seats at tables that we don't normally
have seats. So when you look at the guise of how you mentioned,
of legislation being put in place so that it looks like
we're helping moms, but we know we're not the same thing with this whole
(18:29):
dei, Right. When we talk about dei, diversity,
equity, and inclusion, DEI is being weaponized, and it's
affecting all of us. And you're put.
Placing the guys like it's something wrong with dei,
forgetting why DEI was put into the place in the first place.
Right. Why it was put into effect. There was so much underrepresentation. And to your
(18:50):
point, there's an underrepresentation. There's only 10% of the
LGBTQ community that's underrepresented. That's an
underrepresented community that needs to have a seat at the table and needs to have
access to the same. The same
seats that those who don't believe in
dei. Yeah. And it's unfortunate, you know,
(19:12):
and people are saying they don't like DEI
and challenge them. When I hear that. What part
of DEI don't you like? What don't you like about diversity, equity, and
inclusion? We're talking about bringing all people to the
table. The weaponization
is towards minority communities, but
(19:33):
DEI itself has helped so many
communities. When we talk about access, accessibility,
we talk about even breastfeeding
rooms and malls in workplaces, all of this is
coming together because there was a lens
specifically put in place to look at other communities
(19:55):
and their needs and what we can do to improve it.
So it's interesting when people say they don't like dei, because
you're showing me a shade of yourself that you probably don't realize you're
showing. I'm so glad you said that. Note to anyone who's
watching, when you say, and you're right, when
someone has a problem with dei, it really shows who
(20:17):
you are. It really does. Because you can't tell me
all of these years, diversity, equity, inclusion has been around,
and now all of a sudden, you agree with an administration
who is clearly, it's clear, the writing's on the
wall, the gloves are off, right? So there's no more trying
to sugarcoat what's going on. The gloves are off, and
(20:39):
it's so evident. We're very educated. You know, listen, we
have double doctorate degrees. You know, we're very educated. So we see
the writing on the wall. We see what you're doing. And it's unfortunate that
we still live in a society where, you know, you want to believe the
rhetoric. And I don't know if it's that you. You
believe it or you want to believe it. My opinion is that
(21:02):
you want to believe the rhetoric because it makes you feel
good about the decisions that you're making and
why you feel that DEI should go away. History is
uncomfortable. History is uncomfortable. And, you know,
just even with the Smithsonian being told to look
at what they're presenting, the history that is in
(21:24):
their walls and saying if it's
appropriate or not, it's not for us to decide the history,
what was appropriate or not, you know, it happened. You can't change
it. You can hide it. And I don't know what the benefit of
hiding any of that is, because we're ended up reliving it. You know,
we need to know our history. We need to share our history so we can
(21:46):
grow and learn from it. But it's. It's crazy, you know, every time
I hear that about DEI and, you know that
it's. It should be about merit. It's always been about merit. You
know, it was to give us the opportunity to have people
with the experience and credentials to be able
to. To have the opportunity to get jobs that they
(22:08):
might have otherwise been overlooked. Right,
Exactly. Exactly. And you live in a state where
there's been a lot of removal of education from
the school books. Right. And from the libraries. And so depending
on what. What you look at or what you hear on the news, you know,
some of it, you' that none of our books are being censored. Officially,
(22:30):
maybe none of them have been censored, but I've seen. And I know
friends that are teachers, I've seen the headlines here
that, yeah, it might not be officially censored,
but when you have teachers that are just
more likely to remove their own personal libraries out of their
classroom for fear of being reported
(22:54):
or fear of saying that they have, you know, books that shouldn't be in
their library and just say, you know, What? I'll just let you know, the librarians
in the main library deal with that. Or when you have, you
know, schools that are short staffed, that might not have
librarians that are, you know, supposed to go through all
the books in the school to see if they meet what's
(23:15):
appropriate. Yeah, it might not be an actual book burning, but when you're
removing things and it's no longer accessible to students,
books that have been around for years, that we grew up reading in middle school
and high school, no longer accessible. Again,
maybe not officially banned, but not available.
You know, that part's extremely telling.
(23:37):
And when you see what's happening in academics in higher
ed here, we're seeing censorship. You know, I've
had colleagues that were called into the dean's office to find
out why they're teaching a particular topic when they were hired for
liberal studies to talk about those topics, you know, because someone
felt uncomfortable. And, you know, we're making it
(24:00):
okay to report things that go against what the government says we
should be doing. It's a scary time. And I know a
lot of people, you know, we used. Florida hosts a lot of
conferences. It's a beautiful state, great facilities to host it,
but people are pulling away and don't want to come to Florida because they either
don't feel safe, don't like what's happening. You know,
(24:22):
Florida has been home for over 20 years for me, and I'm not going anywhere.
You know, I'll be one of the last guys standing here fighting for what I
believe is right. And we need voices here.
So as long as I can stand on my, you know, stand on my own
and be the voice, I will continue to do what I
do. I've spoken at national conferences that said, you
(24:44):
know, they had pushback about hosting conferences in Florida.
And, you know, if we don't post it here
and help the people that want to make a change, we can't
leave them stranded. You know, you can't just like, leave us to the wayside here
in Florida. So we need to still have
this connection with
(25:05):
nationalizations. There need to be a conversation about
what's going on and how we're doing it, because people, in
essence are boycotting Florida for conferences, nursing
conferences. But there's information that needs to be shared, there's
networking that needs to happen, and that happens in
conferences. And also, you know, I challenge people when, when,
(25:27):
you know, people don't want to look at Florida, they need to look at Florida.
Florida is the canary in the coal mine. You know, we need
to understand what's going on here, what's happening in
politics here, because you do, especially in the south, you have a lot of copycat
states. You know, legislation will be pushed in one state,
people will see how it does to see what the talking points were against
(25:49):
it, and they'll massage it and reinvent it in a different state,
might give it a different name, but the same premise. So,
you know, I tell. And I was just in California a few weeks ago, and
I said to them, I was like, don't get comfortable. Do not get comfortable because
you live in California and you're a liberal state that
things cannot be undone. And I challenged him. I was like, look
(26:11):
at Florida, look at Texas. Look at different states around you. Look
at what's happening with your colleagues in nursing, in healthcare,
and don't get comfortable
with where you're at, because things can change quickly.
Absolutely. There was a nursing conference
(26:31):
recently. I understand at the conference, their
posters had to be submitted beforehand because they couldn't
have anything that was going to be about dei, which tells
me that there's. There's things that we need to look at within our
own community as well. And this is. And this is why we're asking
for change. Right. Because we need to change, have change, and make movements
(26:53):
in our own community so that we can remove those silos. Right.
To your point, when you talk about comfort, we're already uncomfortable because now I
have to submit my. My poster to you on what the
work that I've done to make sure that it doesn't have anything
about inclusivity or equity.
Like, yeah, and we're seeing that
(27:15):
everywhere. You know, a podcast that I just recorded not too long ago, same
thing, they said it needed to go for approval with their board. You know,
so it's. This is where we're at.
So these are all forms of censorship. You know, if we're
looking at, you know, oh, does this make someone uncomfortable? Is it a buzzword
that, you know, we can't say, are we going to lose funding? Because we've
(27:37):
mentioned DEI, you. When we talk about
organizations, especially 501c3, so nonprofit, not for
profit organizations, you know, have to be nonpartisan.
So people are afraid that if you use the wrong
word, you're going to be viewed as political. And at that
point, you can lose your tax breaks, you can lose your benefits of
(27:59):
being a 501c3 organization. And I think that
was kind of the hurdle that we saw very early on within this
administration was people were afraid about what they
can do or say because of the backlash that can
damage the organization. So there was a
lot of probably legal counseling that was going on trying to interpret what some
(28:22):
executive orders might have looked like, what was being impacted,
and what the organization is able to say within its
parameters and not be targeted. And this is why I'm
so glad that Nurses with Voices are. We're who we
are, right? And we don't have to rely on anyone. That's why we're not
censored over here. We're not censored because we don't have to rely on anyone. We
(28:45):
rely on us. This is a podcast that is for nurses
by nurses. And because we can't be censored,
we can't allow anyone to tell us what to say or
especially when the message is so important. Right? These are important
messages, and hence Nurses With Voices. We have to have a voice and
our voices need to be heard. I welcome you and others to come on the
(29:07):
podcast. If there is something that message that you want to get out there,
you will not be censored here on Nurses with Voices.
And again, hence the nurse shift change movement. And this is how you
shift change. It really is. You can't allow censorship. And
I do appreciate you bringing up that point though, because
no one wants to risk their
(29:29):
501C3s, and no one wants to risk
that or there are other funding. Right. In other areas. And I
totally, totally get it. But this is why it's important to have safe spaces
like this so that you are able to, you know, to voice your opinion
and say, get your important message out there.
So as the chief innovation officer that you do, as the chief
(29:52):
innovation officer. So when my husband and I started
Vital Bridge about two years ago, it was his passion
project to give back to the community. So he grew
up, you know, poor. He was in, you know,
the Medicare, Medicaid healthcare system. He saw the
challenges his family had receiving health care.
(30:15):
So, you know, we're both at a point in our careers where we're able to
give back to the community. So he started Vital Bridge Health
and our mission, you know, our silent mission, so
it's not on the mission statement, but ultimately is to disrupt healthcare.
And our mission is to provide health care to the
marginalized, underserved, uninsured community,
(30:36):
regardless of who you are, you know, we serve everyone
and, you know, do it in such a way that is affordable.
So as he's a PhD prepared nurse practitioner,
specialized, certified in adult and acute care.
So he wanted to, we both actually wanted to create
concierge Level care. So when you walk in it, you
(30:59):
know, the, the practice has kind of a spa vibe to it. We
have, you know, I created planters and have like
eucalyptus stocks in the lobby so it
doesn't feel like a sterile lab or
hospital or government office. And
we, we set it up in a way that the hours
(31:21):
are not 9 to 5, Monday through Friday. You know, we can set appointments that
will serve you, you know, blue collar workers, people who can't take time
off, you know. So a lot of times when you look at what
people say about healthcare is that, oh, you know, it's,
they're non compliant. You know, that's the word that we hear a
lot in healthcare, noncompliant. They're not paying attention, they don't want to do what they
(31:43):
want to do. Well, it's not that they're non compliant, but did anyone ask them
can they afford to take a couple hours off of work? You know, they're deciding
if they're going to pay rent or buy medications, if they're going to put food
on their table or pay
for lab tests. So we need to look at the
community and actually provide services that meets them where they're
(32:05):
at. We've had home health visits with some of the patients that might
not be able to come to the practice. We'll open up the practice on
a weekend for a few hours to see patients because if we
don't see them in the primary care practice, guess where
they're going to land? They're going to be in the er.
And then we wonder why our hospitals are overwhelmed and overburdened
(32:28):
and why people are coming in for things that look like should have been treated
weeks ago. Our healthcare system is not set up to
give fast, efficient care unless you have money. And even then it's a
challenge if you don't have the knowledge of how healthcare works. So
we do a lot of in house lab testing for those that need to have
immediate results so they can leave with the care plan or treatment
(32:50):
plan. And we do things
that most primary care practices don't do because
there's no benefit or what they see is not a good
return of investment for the business. So we flip
in and look, okay, what is the best in the best interest for the patient,
Right? So when you can come in and you can get blood work done, you
(33:12):
can have a sonogram done or an ultrasound done in office
and know what's going on within an hour or see if you need to go
to the ER immediately versus waiting to go to a
diagnostic center in a week, get tested, wait a couple more
days and figure out, oh, you need to be in the ER now because you're
even worse. So Vital Bridge Health
(33:32):
really was developed to disrupt
health care. And my role as an innovation officer, Chief Innovation
officer is to see what we can do to improve
health care. You know, essentially reimage it because it's
not. We have a ton of resources, the US has a
lot of technology, we spend more money than just
(33:54):
about any other, you know, like country on healthcare. But our results,
our outcomes are not any better than a lot of countries
that spend less than we do. So one of the things that we did very
early on, and I'll give an example here. So a
patient diagnosed with diabetes, what is typical treatment? Put them
on some oral medication, see if their A1C goes
(34:16):
down, wait about three months to see if the A1C goes down in three months.
You know, tell them to check their blood sugar, stick their finger a couple times
a day. But you don't feel
bad with diabetes, right? You, you don't. It's such a slow
transition of a decline in health that you don't
realize that when your blood sugars are 300 and you've been living there for a
(34:36):
while, you don't realize how bad you do feel until you finally get it
under control. And when you're getting it under control, you feel worse because
now your body doesn't know what to do when your blood sugars are
normal. So what we did, we
any patient that was diagnosed with diabetes was either pre
diabetic or yeah, was pre diabetic or has
(34:58):
uncontrolled diabetes, we would give them a continuous glucose
monitor. Insurances will not approve that until you
are, have been uncontrolled for a while or you're on a high
regimen of insulin and they're like, okay, we'll give you a continuous glucose monitor and
cover it. Well. We were able to have two different companies
donate continuous glucose monitors. And we also found
(35:20):
the coupons for the continuous glucose monitors. You're able to get like a two week
supply for 70 bucks discounted regular price is almost
$200. So the patients that can afford the $70 would pay
the $70 to get about two weeks worth of data. And
you talk about changing adult patterns, adult
behavior, give them a continuous glucose monitor where they can see in
(35:41):
lifetime how that big slurpee from
711 or the corn Flakes that you thought were healthy for
breakfast really spike your blood sugar. So when they
eat blood sugar spikes, they see it in real time.
They know to adjust their eating habits. So some of the patients
that paid, you know, the $70 to have that, that two week supply
(36:03):
will pay to stay on it even longer because
they see the change that they can make.
And you know, so when we look at healthcare, it's like, why aren't we using
these tools sooner with everyone
we know the progression of prediabetes, you tell someone they're pre diabetic,
okay, eat better, exercise, then they come back later
(36:26):
and it's not any better, okay, we're going to put you on, you know, some
sort of long acting insulin and we'll see how you do it progressively gets
worse. So let's flip the script, let's use our resources and let's
actually see how we can improve healthcare from the beginning. Let's not be
reactionary, let's be proactive. So this is what we're
doing at Vital Bridge to really just change up healthcare.
(36:46):
And with the DMP and the PhD, you know, my
DMP helps me translate research to the bedside. The
PhD helps me create new research. So I just use this
skill set to really look at what we have going on, assess what's happening.
Because as nurses, that's what we do, we know how to assess. And then we
need to go ahead and develop plans, implement and reassess to see what's going
(37:08):
on. So I've really, you know, it's been a fun journey because I've really been
able to dig into this and look at what's going on and
even, even look at, you know,
disparities and see how
systemic or implicit bias, I'll say, has
impacted healthcare. So I consult with the providers
(37:30):
and one of them is like, you know, I have this patient, African American,
black guy, blood sugar uncontrolled, you know, and textbook
tells you they're going to be on, you know, multiple medications
and still not getting controlled. There was nothing else to add to
it. And you know, I was just talking with a colleague and she's doing
research in tb and you know, we're seeing the
(37:52):
implicit bias. We're looking at how healthcare has essentially
been designed by cisgender white
men scientists. And that's
what is being taught in healthcare, has been taught for a long time. So
I just laughed. I was like, well, have you tried treating him like a white
guy? He's like, what do you mean? I was like, if you had someone just
(38:13):
newly diagnosed with hypertension, what would you do for a white male?
He's like, oh, we would do this this and this. Let's try it, see what
happens. Within a day, your blood pressure was under control,
you know, and this was someone that. His medications have just been
increased, increased, increased, increased over time. And it was to the point where,
(38:34):
okay, we're hitting stroke levels here and we need to do something. And I'll just
like, flip it. Go ahead and let's do this. Because textbook tells you that a
black person is going to need multiple medications to
get their blood pressure under control. And some of it, yes, a lot of people
do need multiple medications. But when it's not working,
let's look at what evidence shows us. And there's
(38:57):
a lot of literature that shows us that even diagnostic devices
for people of color don't work as well.
So we then need to then rethink how we're treating
people and see how we can
make it, how we can make healthcare better and
remove these systemic biases that have just kind of
(39:20):
permeated over the years through science and through
practice to improve community health.
This has been such an enriching
conversation. I really, really, really appreciate it. Thank you
so much for coming on, sharing your expertise, your knowledge,
(39:41):
dropping some gems, because
that's exactly what it is. I mean, if you
took away Anything of what Dr.
Roman has shared today, please, please, please listen
to that last piece about the systemic bias
and how it plays out into our community, how it just
(40:03):
really impact, the impact that it has
and ultimately why everything that's happening in the
government, everything that's being taken away, the research, the
grants, all of this, it all matters.
So. And if you look at how pieces of the government is being taken away
and how it's affecting, oh, well, this, this job is affecting this, and this job
(40:26):
is affecting health care, and this job is affecting the early childhood
development programs, and that's how it works with health care. So
everything that's happening has such a snowball effect. And you
just gave a great example of why
change movement matters, why healthcare matters, and why we need to make a
movement against what's happening right now in the government with the
(40:48):
administration. So thank you so much for coming on today. How can people
find you if they wanted to contact you? So I am on LinkedIn, so Roberto
Lewis, Roman Laporte or Roberto Roman Laporte,
you'll find me on there and, you know, just hit me up, slide into my
DMs and happy to talk with, you know, anyone that wants to have
a conversation around these topics or, you know, even finding out how we can move
(41:10):
forward. Because the one thing we didn't get to talk about. You know, I've
been able to advance through my career through really good mentorship and
having a circle of influence that really
supports me, people that see things in me that I might not have seen
in myself. So I'm always happy to pay it forward,
help mentor people or guide people. And the question I get a lot why? You
(41:32):
know, DMP versus PhD. I went for both. We can have that
conversation and then happy to guide you to, like, what would work
best for you. Absolutely. Be sure to make sure you guys check out the
nurse shift change movement. We have a LinkedIn page, Facebook,
Instagram. We are out here, so be
sure to find us there. And until next time, make
(41:54):
sure that you stay inspired, stay educated, and stay empowered.
Welcome back to another episode of Nurses with voices. I'm Dr. Lyndra, and
today I have Dr. Roberto Roman. Dr. Roman is
the Chief Innovation Officer for Vital Bridge Health.
And I am just, I'm so excited to have you here today. I'm really excited
to get into our conversation because we're going to talk about, like, some nitty gritties
that the conversation is really,
(00:22):
it needs to be had. Right. A lot of people are
being evasive on topics of discussion that we're
about to have, and let's just say it, diversity, equity, and inclusion.
So we're talking about inclusion, we're talking about nurses shifting change.
It's really time for us to stand up and have a voice and say something
with everything going on around, around us. And I want to
(00:44):
hear your thoughts. I'm so happy to have you here. I'm glad you came on.
So let's get into it. Tell us a little bit about you and go for
it. Absolutely. So thank you so much for having me on here. I know,
you know, mom raised us that you don't talk about three things, politics,
religion, and money. But this is. We're in a period that we
have to talk about all of it. Right. And, you know,
(01:07):
just a little bit of background about me. I am a registered
nurse, have been in healthcare for over 20 years.
Started as an associate degree nurse and then worked my way through
getting double doctorate. So a PhD in nursing from
University of Miami and the DNP from Johns Hopkins University.
Never thought I would do that. Never thought I would go that far. I was
(01:28):
not one to think that would make my life career
in work, like as a student in academics, and then getting into
academics myself and then just serving
multiple roles throughout my career, which has been very rewarding.
But everything has led me up to this point where,
you know, living my life as a closeted
(01:50):
gay man, living in the Bible belt of the U.S.
growing up in a military family, living in military
bases through the era of don't ask, don't tell,
I didn't feel safe or comfortable disclosing the
authentic me because there was so much
rhetoric and verbiage around how bad it is to be
(02:13):
gay. And, you know, and as a child, you know, that's
extremely impactful. So it wasn't until just a few years ago that I felt
compelled and just ready to live my authentic
life. And the University of Miami. Once I got into my
PhD, it really gave me that opportunity to kind of
reset myself personally and professionally and
(02:35):
focus and support a community that is
marginalized and My research focus in LGBT inclusive
healthcare. So serving as a registered
nurse, getting a doctorate, and then being able
to authentically step into spaces
to be a voice for a community that struggles
(02:56):
to fully represent themselves in
an area that we still deal with so much health
disparities within the LGBT community. And
not only just the lgbt. Once you start putting in other components
the intersectionality of being a minority, you
know, low economic status, we're just worsening
(03:18):
disparities within the LGBT community. And now the politics of everything
is making things worse within the community.
You've said so much, and everything is just so rich. We
need to unpack just what you said so far. So
the double doctorates, right? The being a closeted man,
(03:38):
right? And then you don't talk about politics. What is it? You don't talk about
religion, you don't talk about policy, you don't talk about these things. And you're right.
So let's start there because now we can't keep. Keep
quiet. Like, this is not the time to be quiet, because when you're quiet, people
feel like you're not doing anything. This is why we came together as nurse
ship change, because we felt like the nursing culture was.
(04:00):
Wasn't doing anything. And. But now we see there
are movements being made, there are shifts being made, but
we need more than the ship. We need more than statements. We need more. We
need action, and that's what people are looking for. So we have
to talk about the politics of it, because the politics is what's affecting
us. And you mentioned how the LGBTQ
(04:22):
community is being affected from a lot of the policies, from governmental
politics. Share. How. How is that being affected?
So I'm going to back it up just to. When I started my Ph
program, I was looking to see what I could do. So in
healthcare, I knew that one of the hospitals was going for Human
Rights Campaign, the Human Equality Index for being a
(04:45):
leader in LGBT healthcare. And one of the components of it is research. And
I realized within the department I worked at as a neuroscientist at the healthcare
system, there was no research specific to lgbt. And
the research studies that were going on did not collect social orientation or gender
identity. So this was a huge gap that. That
of information that we're missing. And so that's what prompted
(05:07):
me to start the PhD program. And when I went back to school
for the. I wanted to do something in LGBT
inclusive health care. So this was, you know, we're talking about
2020 pre Covid. This was before the pandemic
hit. And so I just said, okay, this is what I want
to do. Pandemic hit started at the University of
(05:29):
Miami and already knew what the topic
was that I wanted to do. And the University of Miami has a very strong
focus within the LGBT community as well. So it was a great match. Fast
forward just a year. You know, each year into the program, as I was
refreshing my literature search, looking at different
data, I saw how Florida was progressively
(05:51):
getting worse in regards to LGBT rights.
And it started, you know, one of the things was
the don't say gay law known as the parental rights in
education. And this was under the
preface that, you know, parents have a right to know
what's going on with their children. So when you read it, the law
(06:14):
is pro parent. But then when you break down what it
does, it essentially almost
requires teachers to out students that come to them looking
for guidance. And, you know, it's.
It's written in such a way that, you know, the teacher
needs to identify if it's safe to disclose to the parents about the
(06:36):
child either questioning their sexual orientation or gender identity. But
there wasn't any education going on or training
for teachers to know if it's safe to talk to the
parents about letting them know about their child, questioning
their. Their sexual orientation or gender identity, or just out of curiosity.
So it kind of snowballed. And this is when we started seeing
(06:59):
censorship of books that discussed LGBT
topics. I think one of the big books was two male penguins that
raised a baby penguin. That book was
censored and removed from libraries. And sex ed
was also censored throughout
multiple grade levels. So in my PhD program, at the very
(07:21):
beginning, I saw this starting to unravel.
And by the end of the PhD program,
when I was looking at the LGBT, there's a movement
map that you can look at to see how civil rights are, what the laws
are supporting or going against the LGBT community. And
unfortunately, like the map, it was like a heat map. And over
(07:43):
the months I was looking at that map, you could see Florida
getting redder and redder, more in the
negative regarding LGBT rights. So
by the time I finished the PhD program,
defended my study,
I realized just how important
(08:06):
it was to start this three years prior. And.
And, you know, I remember when I was awarded the
LGBT research or the researcher of the year by the LGBT Student
center, just, you know,
thankful that I went to a private university that was able to support
this topic when other universities, public
(08:28):
institutions in Florida were being censored, and, you
know, either told, you can't do this type of research. And
then fast forward to today. The research lab that I
worked at as a research assistant lost their grant
funding, and their grant funding specifically was
for LGBT community. And
(08:50):
I have colleagues, students that are losing their
F31 grants and that are
specifically in LGBT research.
And just. It's to the
point where the stigmatization, the
discrimination towards the LGBT community is just
(09:11):
out there rampant and open. And it's a small
percentage of the U.S. population. We're talking right now, about
9, almost 10% of the population identifies as LGBT. And it's
such a hot topic, it's such a buzzword, It's
a campaign trail. Like, this is what people are putting their campaigns
on and targeting for something
(09:34):
that is a small percentage in the grand scheme of things.
Does DOGE have anything to do with the cut in grant
funding or has that been happening before?
DOGE even. So this, this is definitely happening, this
administration. So when they're looking at the nih, which is
a huge funder of science, just
(09:56):
healthcare science, they started looking at things that had
specific buzzwords that were using, you know,
either things that we would look at as social justice
research would just get cut. And not even a
transition period, not even a warning, just saying that your
study no longer supports the direction that we're going
(10:17):
in. So I've seen colleagues on LinkedIn post
the letters that they've received from the NIH and
it's. It's painful. It's painful verbiage to
read. And when you see that happen on a
national, international level, because it's impacting studies all over the world
that are NIH funded, because there's a lot of partnerships
(10:39):
between universities here in the US with other
healthcare systems throughout the world.
When you see that type of verbiage, essentially you
can read it as the government is saying, you don't matter.
And when we look at the websites that have been pulled off
the Internet from the cdc,
(11:02):
verbiage education points, talking
points for providers and patients alike that talk
about hiv, that talk about STI prevention,
you know, your
putting the community in a public health
crisis. Abs, you are completely on point. And this is
(11:25):
why what we're doing with Nurships Change is
so important. We have the rally coming up on May 24, but
it's more than a rally, right? It's more than about attending the
rally. Yes, definitely. Come out. Come to your capitals. Look
at hands off, right? Look how they came out
in like the masses. There was thousands of people
(11:48):
who came out all across the. In support of a
cause, right? Hands off of My Social Security hands off of
my government job. And listen, some of those health and human services
jobs are right along in there. So I say this to say it's
painful to watch what's happening to this country. And this is
why we're going to have a movement, inertia, change
(12:10):
movement is more than a rally. This is something that's going to be ongoing
because we need ongoing education, we need ongoing support, and we need
to continue to continue to. To make a stand. Because
what's the saying, if you don't stand for something, you'll fall for anything? And right
now, just sitting back and being quiet is just not. It's
just not an option. And it's not about being, you know, oh, we can't be
(12:32):
aggressive or, oh, we can't approach it. We don't want to.
We have to do something right? Like, we have to. So what is your
community doing right now to really push
back on a lot of these changes? The loss of the grants? What is
the LGBTQ community doing to fight back? So, pretty much,
you know, it's. The Pride parades are still happening, you know, and
(12:55):
Pride. The Pride parade isn't just about, you know,
going out there in rainbow flags and rainbow gear. Pride
started from a riot. Look at the Stonewall
riot. This was a
LGBT movement that was initiated by the trans
community. They were tired of living in
(13:17):
secrecy. They were tired of having to go to these speakeasy
type bars or underground
locations to live their authentic life. And
it was this movement, the Stonewall riot, that really
said, we're here and we're not going anywhere.
So we're in a period now where people feel like
(13:39):
they're being. The rights are being stripped. They're worried
about what. What will remain. And we're not
going anywhere. You'll still see the community out in full
force in healthcare. You see the LGBT community. So
glma, the Gay and Lesbian Medical association,
is doing a lot for the community. You have
(14:00):
organizations such as Equity, one of them, Save
LGBT in Florida. You have different organizations that are
out there that are looking at what's happening. They're looking at
policy, they're looking at politics, and they're standing up for
the community. What I would love to see more of is,
you know, individual members, you know, beyond the
(14:23):
organizations. Contact their representatives, you know, let them
know who they are, that their constituents and their votes
matter, and that if they're voting against LGBT rights, guess
what? Then I'm not going to vote for you. You know, I'll help campaign for
someone else that does believe that my rights matter, you
know, and within the nursing community. And this is
(14:45):
one reason why I stand behind Nurse Shift Change.
You know, nurses are supposed to be the most. We are the most trusted
profession. We need to be the most inclusive, and
we need to stand up for the communities that don't have a voice.
So while my passion, you know, and my advocacy lives within
the LGBT space, you know, my push for
(15:08):
rights impacts everyone, you know, as we
move through. So nurse Shift Change and what.
What we're doing here, you know, standing for humanity,
ethics, science and social justice, you
know, is really getting nurses together
and unifying our voice, because we're also one
(15:30):
of the largest healthcare professions with
over 5 million nurses strong. When you bring together those
retired LPNs
allies, you look at all the opportunity we have. Our
voice is nowhere near as strong and powerful as it should be.
And Nurse Shift Change is really trying to bring that together
(15:53):
and break those silos of the different little specialties and different
organizations and say, look, we're all together in
this. Nursing has been about social justice since the
onset of nursing, and we need to make sure that we're still
advocating loudly for the communities we serve. I
can appreciate you mentioning the silos. I'm hosting an event
(16:15):
in May, and a nurse reached out to
me and she goes, is the event for LPNs as well? Yeah,
absolutely. Right. Like, because I think, yeah, you're a nurse. And her
response was, you know, you know, some people don't think LPNs are nurses.
And this is part of the problem with our. When you mentioned
silos, we want everyone to come out, we
(16:37):
all collectively, whether you're a doctor of nursing
practice, whether you're a PhD nurse, whether you're a
CNA, whether you're a registered nurse, LPN. Listen,
if you provide patient care, your voice matters,
right? Your voice matters. And that march that
you saw, that hands off march, there were people of all
(17:00):
walks. And I'm sure there weren't just people who got fired from the government
job. Right. They were people there in support of. And
that's what we need to come together as, not only
as each discipline, right? Not just nurses. We're calling
healthcare professionals. And this is how you shift change.
This is how, if you stand for humanities, if you stand for ethics, if you
(17:22):
stand for social justice, stand with us, because this is how we're
going to be able to make a change. And I. And I'm so happy to
be able to use this platform so that voices like yours
can be heard. Right? Or each community matters and
to me, we're all together, right? So whether it's the
LGBTQ community, you know, you have your Latino
(17:44):
communities, you know, I spoke with Adrian Espinoza,
was on air, was. Was on the podcast, and,
you know, we have our black community. We're all
feeling the hit of dei. We're all feeling, you
know, the needs of diversity because we know what it's like to have that need
for access, to be included or to be excluded.
(18:07):
Right. So when we talk about dei, this is so that
people can have access to environments where we don't
normally have access, so that we can have seats at tables that we don't normally
have seats. So when you look at the guise of how you mentioned,
of legislation being put in place so that it looks like
we're helping moms, but we know we're not the same thing with this whole
(18:29):
dei, Right. When we talk about dei, diversity,
equity, and inclusion, DEI is being weaponized, and it's
affecting all of us. And you're put.
Placing the guys like it's something wrong with dei,
forgetting why DEI was put into the place in the first place.
Right. Why it was put into effect. There was so much underrepresentation. And to your
(18:50):
point, there's an underrepresentation. There's only 10% of the
LGBTQ community that's underrepresented. That's an
underrepresented community that needs to have a seat at the table and needs to have
access to the same. The same
seats that those who don't believe in
dei. Yeah. And it's unfortunate, you know,
(19:12):
and people are saying they don't like DEI
and challenge them. When I hear that. What part
of DEI don't you like? What don't you like about diversity, equity, and
inclusion? We're talking about bringing all people to the
table. The weaponization
is towards minority communities, but
(19:33):
DEI itself has helped so many
communities. When we talk about access, accessibility,
we talk about even breastfeeding
rooms and malls in workplaces, all of this is
coming together because there was a lens
specifically put in place to look at other communities
(19:55):
and their needs and what we can do to improve it.
So it's interesting when people say they don't like dei, because
you're showing me a shade of yourself that you probably don't realize you're
showing. I'm so glad you said that. Note to anyone who's
watching, when you say, and you're right, when
someone has a problem with dei, it really shows who
(20:17):
you are. It really does. Because you can't tell me
all of these years, diversity, equity, inclusion has been around,
and now all of a sudden, you agree with an administration
who is clearly, it's clear, the writing's on the
wall, the gloves are off, right? So there's no more trying
to sugarcoat what's going on. The gloves are off, and
(20:39):
it's so evident. We're very educated. You know, listen, we
have double doctorate degrees. You know, we're very educated. So we see
the writing on the wall. We see what you're doing. And it's unfortunate that
we still live in a society where, you know, you want to believe the
rhetoric. And I don't know if it's that you. You
believe it or you want to believe it. My opinion is that
(21:02):
you want to believe the rhetoric because it makes you feel
good about the decisions that you're making and
why you feel that DEI should go away. History is
uncomfortable. History is uncomfortable. And, you know,
just even with the Smithsonian being told to look
at what they're presenting, the history that is in
(21:24):
their walls and saying if it's
appropriate or not, it's not for us to decide the history,
what was appropriate or not, you know, it happened. You can't change
it. You can hide it. And I don't know what the benefit of
hiding any of that is, because we're ended up reliving it. You know,
we need to know our history. We need to share our history so we can
(21:46):
grow and learn from it. But it's. It's crazy, you know, every time
I hear that about DEI and, you know that
it's. It should be about merit. It's always been about merit. You
know, it was to give us the opportunity to have people
with the experience and credentials to be able
to. To have the opportunity to get jobs that they
(22:08):
might have otherwise been overlooked. Right,
Exactly. Exactly. And you live in a state where
there's been a lot of removal of education from
the school books. Right. And from the libraries. And so depending
on what. What you look at or what you hear on the news, you know,
some of it, you' that none of our books are being censored. Officially,
(22:30):
maybe none of them have been censored, but I've seen. And I know
friends that are teachers, I've seen the headlines here
that, yeah, it might not be officially censored,
but when you have teachers that are just
more likely to remove their own personal libraries out of their
classroom for fear of being reported
(22:54):
or fear of saying that they have, you know, books that shouldn't be in
their library and just say, you know, What? I'll just let you know, the librarians
in the main library deal with that. Or when you have, you
know, schools that are short staffed, that might not have
librarians that are, you know, supposed to go through all
the books in the school to see if they meet what's
(23:15):
appropriate. Yeah, it might not be an actual book burning, but when you're
removing things and it's no longer accessible to students,
books that have been around for years, that we grew up reading in middle school
and high school, no longer accessible. Again,
maybe not officially banned, but not available.
You know, that part's extremely telling.
(23:37):
And when you see what's happening in academics in higher
ed here, we're seeing censorship. You know, I've
had colleagues that were called into the dean's office to find
out why they're teaching a particular topic when they were hired for
liberal studies to talk about those topics, you know, because someone
felt uncomfortable. And, you know, we're making it
(24:00):
okay to report things that go against what the government says we
should be doing. It's a scary time. And I know a
lot of people, you know, we used. Florida hosts a lot of
conferences. It's a beautiful state, great facilities to host it,
but people are pulling away and don't want to come to Florida because they either
don't feel safe, don't like what's happening. You know,
(24:22):
Florida has been home for over 20 years for me, and I'm not going anywhere.
You know, I'll be one of the last guys standing here fighting for what I
believe is right. And we need voices here.
So as long as I can stand on my, you know, stand on my own
and be the voice, I will continue to do what I
do. I've spoken at national conferences that said, you
(24:44):
know, they had pushback about hosting conferences in Florida.
And, you know, if we don't post it here
and help the people that want to make a change, we can't
leave them stranded. You know, you can't just like, leave us to the wayside here
in Florida. So we need to still have
this connection with
(25:05):
nationalizations. There need to be a conversation about
what's going on and how we're doing it, because people, in
essence are boycotting Florida for conferences, nursing
conferences. But there's information that needs to be shared, there's
networking that needs to happen, and that happens in
conferences. And also, you know, I challenge people when, when,
(25:27):
you know, people don't want to look at Florida, they need to look at Florida.
Florida is the canary in the coal mine. You know, we need
to understand what's going on here, what's happening in
politics here, because you do, especially in the south, you have a lot of copycat
states. You know, legislation will be pushed in one state,
people will see how it does to see what the talking points were against
(25:49):
it, and they'll massage it and reinvent it in a different state,
might give it a different name, but the same premise. So,
you know, I tell. And I was just in California a few weeks ago, and
I said to them, I was like, don't get comfortable. Do not get comfortable because
you live in California and you're a liberal state that
things cannot be undone. And I challenged him. I was like, look
(26:11):
at Florida, look at Texas. Look at different states around you. Look
at what's happening with your colleagues in nursing, in healthcare,
and don't get comfortable
with where you're at, because things can change quickly.
Absolutely. There was a nursing conference
(26:31):
recently. I understand at the conference, their
posters had to be submitted beforehand because they couldn't
have anything that was going to be about dei, which tells
me that there's. There's things that we need to look at within our
own community as well. And this is. And this is why we're asking
for change. Right. Because we need to change, have change, and make movements
(26:53):
in our own community so that we can remove those silos. Right.
To your point, when you talk about comfort, we're already uncomfortable because now I
have to submit my. My poster to you on what the
work that I've done to make sure that it doesn't have anything
about inclusivity or equity.
Like, yeah, and we're seeing that
(27:15):
everywhere. You know, a podcast that I just recorded not too long ago, same
thing, they said it needed to go for approval with their board. You know,
so it's. This is where we're at.
So these are all forms of censorship. You know, if we're
looking at, you know, oh, does this make someone uncomfortable? Is it a buzzword
that, you know, we can't say, are we going to lose funding? Because we've
(27:37):
mentioned DEI, you. When we talk about
organizations, especially 501c3, so nonprofit, not for
profit organizations, you know, have to be nonpartisan.
So people are afraid that if you use the wrong
word, you're going to be viewed as political. And at that
point, you can lose your tax breaks, you can lose your benefits of
(27:59):
being a 501c3 organization. And I think that
was kind of the hurdle that we saw very early on within this
administration was people were afraid about what they
can do or say because of the backlash that can
damage the organization. So there was a
lot of probably legal counseling that was going on trying to interpret what some
(28:22):
executive orders might have looked like, what was being impacted,
and what the organization is able to say within its
parameters and not be targeted. And this is why I'm
so glad that Nurses with Voices are. We're who we
are, right? And we don't have to rely on anyone. That's why we're not
censored over here. We're not censored because we don't have to rely on anyone. We
(28:45):
rely on us. This is a podcast that is for nurses
by nurses. And because we can't be censored,
we can't allow anyone to tell us what to say or
especially when the message is so important. Right? These are important
messages, and hence Nurses With Voices. We have to have a voice and
our voices need to be heard. I welcome you and others to come on the
(29:07):
podcast. If there is something that message that you want to get out there,
you will not be censored here on Nurses with Voices.
And again, hence the nurse shift change movement. And this is how you
shift change. It really is. You can't allow censorship. And
I do appreciate you bringing up that point though, because
no one wants to risk their
(29:29):
501C3s, and no one wants to risk
that or there are other funding. Right. In other areas. And I
totally, totally get it. But this is why it's important to have safe spaces
like this so that you are able to, you know, to voice your opinion
and say, get your important message out there.
So as the chief innovation officer that you do, as the chief
(29:52):
innovation officer. So when my husband and I started
Vital Bridge about two years ago, it was his passion
project to give back to the community. So he grew
up, you know, poor. He was in, you know,
the Medicare, Medicaid healthcare system. He saw the
challenges his family had receiving health care.
(30:15):
So, you know, we're both at a point in our careers where we're able to
give back to the community. So he started Vital Bridge Health
and our mission, you know, our silent mission, so
it's not on the mission statement, but ultimately is to disrupt healthcare.
And our mission is to provide health care to the
marginalized, underserved, uninsured community,
(30:36):
regardless of who you are, you know, we serve everyone
and, you know, do it in such a way that is affordable.
So as he's a PhD prepared nurse practitioner,
specialized, certified in adult and acute care.
So he wanted to, we both actually wanted to create
concierge Level care. So when you walk in it, you
(30:59):
know, the, the practice has kind of a spa vibe to it. We
have, you know, I created planters and have like
eucalyptus stocks in the lobby so it
doesn't feel like a sterile lab or
hospital or government office. And
we, we set it up in a way that the hours
(31:21):
are not 9 to 5, Monday through Friday. You know, we can set appointments that
will serve you, you know, blue collar workers, people who can't take time
off, you know. So a lot of times when you look at what
people say about healthcare is that, oh, you know, it's,
they're non compliant. You know, that's the word that we hear a
lot in healthcare, noncompliant. They're not paying attention, they don't want to do what they
(31:43):
want to do. Well, it's not that they're non compliant, but did anyone ask them
can they afford to take a couple hours off of work? You know, they're deciding
if they're going to pay rent or buy medications, if they're going to put food
on their table or pay
for lab tests. So we need to look at the
community and actually provide services that meets them where they're
(32:05):
at. We've had home health visits with some of the patients that might
not be able to come to the practice. We'll open up the practice on
a weekend for a few hours to see patients because if we
don't see them in the primary care practice, guess where
they're going to land? They're going to be in the er.
And then we wonder why our hospitals are overwhelmed and overburdened
(32:28):
and why people are coming in for things that look like should have been treated
weeks ago. Our healthcare system is not set up to
give fast, efficient care unless you have money. And even then it's a
challenge if you don't have the knowledge of how healthcare works. So
we do a lot of in house lab testing for those that need to have
immediate results so they can leave with the care plan or treatment
(32:50):
plan. And we do things
that most primary care practices don't do because
there's no benefit or what they see is not a good
return of investment for the business. So we flip
in and look, okay, what is the best in the best interest for the patient,
Right? So when you can come in and you can get blood work done, you
(33:12):
can have a sonogram done or an ultrasound done in office
and know what's going on within an hour or see if you need to go
to the ER immediately versus waiting to go to a
diagnostic center in a week, get tested, wait a couple more
days and figure out, oh, you need to be in the ER now because you're
even worse. So Vital Bridge Health
(33:32):
really was developed to disrupt
health care. And my role as an innovation officer, Chief Innovation
officer is to see what we can do to improve
health care. You know, essentially reimage it because it's
not. We have a ton of resources, the US has a
lot of technology, we spend more money than just
(33:54):
about any other, you know, like country on healthcare. But our results,
our outcomes are not any better than a lot of countries
that spend less than we do. So one of the things that we did very
early on, and I'll give an example here. So a
patient diagnosed with diabetes, what is typical treatment? Put them
on some oral medication, see if their A1C goes
(34:16):
down, wait about three months to see if the A1C goes down in three months.
You know, tell them to check their blood sugar, stick their finger a couple times
a day. But you don't feel
bad with diabetes, right? You, you don't. It's such a slow
transition of a decline in health that you don't
realize that when your blood sugars are 300 and you've been living there for a
(34:36):
while, you don't realize how bad you do feel until you finally get it
under control. And when you're getting it under control, you feel worse because
now your body doesn't know what to do when your blood sugars are
normal. So what we did, we
any patient that was diagnosed with diabetes was either pre
diabetic or yeah, was pre diabetic or has
(34:58):
uncontrolled diabetes, we would give them a continuous glucose
monitor. Insurances will not approve that until you
are, have been uncontrolled for a while or you're on a high
regimen of insulin and they're like, okay, we'll give you a continuous glucose monitor and
cover it. Well. We were able to have two different companies
donate continuous glucose monitors. And we also found
(35:20):
the coupons for the continuous glucose monitors. You're able to get like a two week
supply for 70 bucks discounted regular price is almost
$200. So the patients that can afford the $70 would pay
the $70 to get about two weeks worth of data. And
you talk about changing adult patterns, adult
behavior, give them a continuous glucose monitor where they can see in
(35:41):
lifetime how that big slurpee from
711 or the corn Flakes that you thought were healthy for
breakfast really spike your blood sugar. So when they
eat blood sugar spikes, they see it in real time.
They know to adjust their eating habits. So some of the patients
that paid, you know, the $70 to have that, that two week supply
(36:03):
will pay to stay on it even longer because
they see the change that they can make.
And you know, so when we look at healthcare, it's like, why aren't we using
these tools sooner with everyone
we know the progression of prediabetes, you tell someone they're pre diabetic,
okay, eat better, exercise, then they come back later
(36:26):
and it's not any better, okay, we're going to put you on, you know, some
sort of long acting insulin and we'll see how you do it progressively gets
worse. So let's flip the script, let's use our resources and let's
actually see how we can improve healthcare from the beginning. Let's not be
reactionary, let's be proactive. So this is what we're
doing at Vital Bridge to really just change up healthcare.
(36:46):
And with the DMP and the PhD, you know, my
DMP helps me translate research to the bedside. The
PhD helps me create new research. So I just use this
skill set to really look at what we have going on, assess what's happening.
Because as nurses, that's what we do, we know how to assess. And then we
need to go ahead and develop plans, implement and reassess to see what's going
(37:08):
on. So I've really, you know, it's been a fun journey because I've really been
able to dig into this and look at what's going on and
even, even look at, you know,
disparities and see how
systemic or implicit bias, I'll say, has
impacted healthcare. So I consult with the providers
(37:30):
and one of them is like, you know, I have this patient, African American,
black guy, blood sugar uncontrolled, you know, and textbook
tells you they're going to be on, you know, multiple medications
and still not getting controlled. There was nothing else to add to
it. And you know, I was just talking with a colleague and she's doing
research in tb and you know, we're seeing the
(37:52):
implicit bias. We're looking at how healthcare has essentially
been designed by cisgender white
men scientists. And that's
what is being taught in healthcare, has been taught for a long time. So
I just laughed. I was like, well, have you tried treating him like a white
guy? He's like, what do you mean? I was like, if you had someone just
(38:13):
newly diagnosed with hypertension, what would you do for a white male?
He's like, oh, we would do this this and this. Let's try it, see what
happens. Within a day, your blood pressure was under control,
you know, and this was someone that. His medications have just been
increased, increased, increased, increased over time. And it was to the point where,
(38:34):
okay, we're hitting stroke levels here and we need to do something. And I'll just
like, flip it. Go ahead and let's do this. Because textbook tells you that a
black person is going to need multiple medications to
get their blood pressure under control. And some of it, yes, a lot of people
do need multiple medications. But when it's not working,
let's look at what evidence shows us. And there's
(38:57):
a lot of literature that shows us that even diagnostic devices
for people of color don't work as well.
So we then need to then rethink how we're treating
people and see how we can
make it, how we can make healthcare better and
remove these systemic biases that have just kind of
(39:20):
permeated over the years through science and through
practice to improve community health.
This has been such an enriching
conversation. I really, really, really appreciate it. Thank you
so much for coming on, sharing your expertise, your knowledge,
(39:41):
dropping some gems, because
that's exactly what it is. I mean, if you
took away Anything of what Dr.
Roman has shared today, please, please, please listen
to that last piece about the systemic bias
and how it plays out into our community, how it just
(40:03):
really impact, the impact that it has
and ultimately why everything that's happening in the
government, everything that's being taken away, the research, the
grants, all of this, it all matters.
So. And if you look at how pieces of the government is being taken away
and how it's affecting, oh, well, this, this job is affecting this, and this job
(40:26):
is affecting health care, and this job is affecting the early childhood
development programs, and that's how it works with health care. So
everything that's happening has such a snowball effect. And you
just gave a great example of why
change movement matters, why healthcare matters, and why we need to make a
movement against what's happening right now in the government with the
(40:48):
administration. So thank you so much for coming on today. How can people
find you if they wanted to contact you? So I am on LinkedIn, so Roberto
Lewis, Roman Laporte or Roberto Roman Laporte,
you'll find me on there and, you know, just hit me up, slide into my
DMs and happy to talk with, you know, anyone that wants to have
a conversation around these topics or, you know, even finding out how we can move
(41:10):
forward. Because the one thing we didn't get to talk about. You know, I've
been able to advance through my career through really good mentorship and
having a circle of influence that really
supports me, people that see things in me that I might not have seen
in myself. So I'm always happy to pay it forward,
help mentor people or guide people. And the question I get a lot why? You
(41:32):
know, DMP versus PhD. I went for both. We can have that
conversation and then happy to guide you to, like, what would work
best for you. Absolutely. Be sure to make sure you guys check out the
nurse shift change movement. We have a LinkedIn page, Facebook,
Instagram. We are out here, so be
sure to find us there. And until next time, make
(41:54):
sure that you stay inspired, stay educated, and stay empowered.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.