November 3, 2025 • 35 mins
What if the most important part of your hospital stay happens after you leave? We sit down with a seasoned hospitalist who treats complex conditions on the floor and still argues that health is mostly made at home, at work, and in the community. From refeeding syndrome and new-onset renal failure to the familiar rhythms of CHF and COPD, she shows how the real challenge isn’t just diagnosing accurately, it’s designing a plan that survives insurance hurdles, pharmacy costs, transportation gaps, and the realities of daily life.
We'll step inside the team-based engine of inpatient care: bedside nurses who catch subtle changes, therapists who prevent setbacks with the right equipment and diet choices, and case managers who translate a great medical plan into something you can actually access. We talk plainly about burnout, the limits of what a prescription can fix, and why a policy lens helped convert her frustration into a Harvard degree.
Her career path wasn’t straight. She moved from neuroscience to psychiatry to internal medicine, rejected the ICU after listening to her body’s signals, and found a home in hospital medicine. That honesty becomes practical guidance for students: keep moving forward, define today’s answer, and trust resilience over perfection. We also spotlight her book, Prescription For Admission, a patient-first guide to navigating hospital stays, asking better questions, and preparing for a safe return home.
Finally, we tackle the chaos of health advice on social media. Learn how to decide who deserves your trust, what evidence literacy looks like, and how to align sources with your values without falling for trends. If you care about safer discharges, smarter care plans, and credible information in a noisy world, this conversation will change how you think about the hospital and about health itself.
To connect with Dr. Monique Nugent:
LinkedIn: moniquenugent-mdmph/
Instagram: the_happiest_hospitalist
TikTok: Mnugent-happiesthospitalist
Amazon: Prescription for Admission
Podcast: Prescription for Admission
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
Mock Interviews: shadowmenext.com/mock-interviews
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face, andwhat drives them in their
careers.
It's access you want andstories you need.
Whether you're a pre-healthstudent or simply curious about
the healthcare field, I inviteyou to join me as we take a
conversational and personal lookinto the lives and minds of
(00:43):
leaders in medicine.
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And follow us on Instagram andFacebook at Shadow Me Next,
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(01:03):
There are moments in medicinethat stay with you, not because
of the science, but because ofwhat they teach you about
people.
Dr.
Monique Nugent is a hospitalistwho has built her entire career
around those moments.
She reminds us that medicinedoesn't just happen inside
hospital walls, it happens inthe space between policy and
(01:23):
people, between what we canprescribe and what our patients
actually have access to.
We talk about how herfrustration with those gaps led
her to pursue a master's degreein public health at Harvard.
She also opens up about hernonlinear path into medicine,
the detours that shaped her, andwhat it really means to do
despite, despite fear, despitefrustration, and despite the
(01:48):
negative opinion of others.
This is an episode aboutresilience, about redefining
success, and about finding yourplace.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
(02:09):
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer, or company.
This is Shadow Me Next with Dr.
Monique Nugent.
Dr.
Nugent, thank you so much forjoining me on Shadow Me Next
today.
I we've already been chattingas we do, and this is just
you're an amazing person.
(02:30):
I I know your patients justadore you.
Dr. Monique Nugent (02:34):
I I hope.
I think the nature of what Ido, I know I have unhappy
customers as well.
Ashley (02:41):
You know, that would be a great conversation to have
because when you have an unhappycustomer at my office, they um
they they walk out 20 minuteslater.
You know, we have 20 minuteappointments, they're there,
then they leave.
Unfortunately, your customers,so to speak, your patients are
there a bit longer, right?
You are a hospitalist and umyour patients stick with you for
a bit.
Tell us a little bit about whatyou do, what your day looks
(03:02):
like on the regular.
Dr. Monique Nugent (03:03):
Yeah, so I am a hospitalist.
I love, love what I do.
Um, but it's not a field that alot of people know about until
they interact with us in ahospital.
So I'm a board certifiedinternist, but I only see
patients who are hospitalized.
Um, and so I practice thespecialties called hospital
medicine.
(03:23):
Um, people call it hospitalistmedicine, and I'm always like,
do you call it cardiologistmedicine?
No, it's cardiology, right?
So I the specialty is hospitalmedicine.
Um, and it's it's great becauseI get to see so many different
things.
Um, I remember when I firstgraduated residency and I was
talking to a friend who had justgraduated surgery residency,
(03:46):
and you know, we're together,we're new in attendings, and he
was like, man, you know, this isgreat.
This is what I want to do.
Um, you know, and it's goodbecause I'm I'm seeing things
that I'm used to.
Like I have a Lap Cole today.
And I said, I have the exactopposite.
I have a refeeding syndrome onmy list.
I've never treated a personwith anorexia who needed to be
refed.
Um, I have brand new renalfailure that no one knows why.
(04:09):
I, you know, I have yeah,things that I'm used to, like
COPD and CHF, but my list wasfull of things that I hadn't
seen, but I had the tools andthe skill set to work through
it.
And I continue to see thingsthat I haven't seen before, uh,
or iterations of it, you know,presentations that I haven't
(04:30):
seen before, uh, versions of howpeople uh interact with their
diagnoses.
And I love what I do because Icontinue to have the skill set
to work through it, but alsohelp my patients and their
families work through it.
But yeah, the average hospitalsay in this country is about
four to five days.
Um protracted hospital stayscan be due to people think just
(04:52):
medically, but there's a lot ofsocial reasons.
People are hospitalized forlike an extended period of time.
Right now, in my hospital, wehave a very lovely gentleman
with dementia who essentially isliving there because uh he
doesn't have in the financialmeans to be placed somewhere
else.
His family can't care for him.
And there are like little to noinpatient psychiatric dementia
(05:16):
beds run by the state.
So they're trying to figure outthe place to send him, and it's
been weeks and weeks and weeksthat the gentleman's been living
there, you know.
Um, but on average, you know,really active medical
interventions are about four tofive days or the amount of time
that I'm seeing my patients.
Ashley (05:32):
Thank you for describing that.
You've worked very hard in yourcareer to become a fantastic
physician, and you actually haveyour master's in public health
as well from Harvard University.
Is you're describing theseincredible treatments that you
offer and diseases that youdiagnose and really mysteries
that you solve, but you're alsodescribing um some things that
(05:54):
maybe we wouldn't think we wouldbe dealing with as a physician,
as a clinician.
Yeah.
Is that is that frustrating toyou?
Or is that do you just kind ofaccept that as part of your role
with serving and helpingpeople?
Dr. Monique Nugent (06:07):
So the reason I went to do my
non-clinical fellowship atHarvard, get my MPH, learn about
healthcare policy andmanagement was because I was
getting frustrated as a medstudent, as a resident, as a
young attending, and I didn'thave the language.
And I was speaking to someoneand I was like, you know, these
things that are happening tothese people outside the
hospital, and she said, Well,those are called social
(06:29):
determinants of health.
And I was like, no one has saidthose three words to me in that
order.
Tell me more.
Um, and that's where I startedto really learn that my
frustrations were warrantedbecause there are, if I say your
hospital has five days, right?
(06:49):
There are still 360 days of theyear.
You're not under my care.
You see patients for 20minutes.
I'm not gonna do the math tosay how many more minutes are
left in the year, you know, butessentially the things that
happen outside of your officethat happen outside of the walls
of the hospital really are thethings that determine a
(07:12):
patient's health, how wellpatients will do.
And when I started realizingthat my frustrations were
warranted, I, you know, Iremember being on the phone with
an insurance agency as asecond-year resident, trying to
convince them that tohospitalize a patient for
(07:32):
Lovinox, which is a bloodthinner, it's an injection blood
thinner.
And I'm old, it used to bereally expensive, so it's not
that expensive now, right?
Like I'm on the phone in theemergency department.
I'm like, this person doesn'tneed to be hospitalized.
We can just give them Lovinoxat home and do and they wouldn't
do it.
They were forcing this personto be hospitalized, which was
taking them out of um theirlife.
(07:54):
And they they were telling me,I'll have to leave because if I
don't work, I don't have money.
You know, um, and I it was justlike, wow, it is.
It's all this big machine thatwe've built that we give, we
think we give power to is notit.
Right?
The hospital, the clinic,that's not where health occurs.
(08:15):
It's not where health ismaintained.
It's outside of the walls andlearning how we can support
patients and ourselves in thelong run by changing the way we
think about healthcare, bychanging the way we understand
how legislature interacts withhealthcare, how you know, policy
everywhere from national tolocal to hospital-based
(08:38):
policies, you know, interactwith your healthcare um and your
ability to care for yourselfand your loved ones as you know
time goes on.
Uh, it really, I will say ithits everybody.
I haven't met a clinician worththeir salt who hasn't picked up
on this, right?
(08:58):
Who hasn't been like, I can'tprescribe you a better life, I
can't prescribe you betterinsurance.
This is the situation, and I'mfrustrated because I can't
prescribe you consistent food,like consistent safe housing,
clean water.
Ashley (09:14):
It's so challenging and it does, it does contribute to
burnout.
But I'm so grateful to hearthat you took that, what very
well could have contributed toyour burnout and you're stepping
away from medicine entirely.
And you said, you know what,let me let me seek more
education on this, and let mesee if perhaps I can contribute
to this solution for yourpatients.
(09:35):
I'd love to hear yournon-clinical fellowship actually
contributes to your care.
But before we talk about that,let's go back.
Um, you mentioned being on thephone with insurance companies
and it just it just thesomething inside of me died a
little bit yesterday.
But as a again, as a as aphysician, especially as a
hospitalist, I would imagine youwork with a team of people and
these social detriments ofhealth and and working with
(09:56):
clinical social workers, thingslike that.
Can you describe the team ofpeople that are surrounding you
every day when you go into work?
Dr. Monique Nugent (10:04):
Yeah.
So um hospital-based care isvery team-oriented.
Uh outside of your physician,your therapist, your physical
therapist, um, your speechtherapist, your occupational
therapist, big part of the team.
They really do help, again,determine how we can set you up
for success after you'rehospitalized.
(10:25):
Do you need to go to a rehab?
Do you need like a shower chairto be safe in your home?
You know, um, do you needdifferent, a different type of
texture to eat now that you'vehad a stroke?
You know, um, how can youcommunicate?
Right.
So these therapists, these areare really key to making sure
that we're we're keepingpatients safe, we're advancing
their care.
Uh, clearly the bedside nurseand her team of nursing
(10:48):
assistants.
Uh and and people just thinklike, oh, well, you know,
they're they're nurses, they'realways there, but but really
they're always in my ear aswell, telling me all the things
that are happening.
Um, and it doesn't just have tobe like, oh, you know, he's
bleeding, oh, this wound.
It's like when his sister showsup, you know, it there's a lot
of tension in the room and hegets very anxious.
(11:10):
And, you know, like, do we knowexactly the what's going on
there?
You know, like, oh, he says hehas a home, but actually his
brother showed up and was like,no, he got kicked out of his
halfway house.
So you have to talk to the, youknow, the social workers.
So they're keeping an ear outum and letting me know kind of
everything, the whole picturethat goes on.
Uh, and then there's myfavorite people who I dedicated
(11:30):
an episode to, which is casemanagement.
Um, some people call them caseworkers.
In some hospitals, they may bea mix of social workers as well.
Um, so I kind of put themtogether.
And their job really is tounderstand what your medical
needs are, what the social needsare, and where you can get all
(11:51):
of those things met through acombination of insurance
resources, community resources,um, and personal finance
resources.
And so I can cook up any plan,I can come up with anything
medically.
But if you don't have access tothat when you leave here, if
you're not going to be able tosee that specialist, you know,
if you can't access thatmedication, then I'm just over
(12:14):
here, you know, satisfying myown curiosity and feeling like
I'm doing a good job.
But really, the case managerskeep me in line and they're
like, his insurance won't coverthat.
Like, or like that cardiologistis outside of her network.
We've got to be we can getpeople the things that they need
to be successful after ahospital stay.
Ashley (12:35):
And the healthcare team, you know, it just reminds me of
the rather silly phrase, ittakes a village.
It really does take a villageto raise kids, it takes a
village in medicine.
And caseworkers really are uhthe heroes of the story a lot of
times.
You know, we need them, we needthem so much.
Dr.
Nugent, how long have you beenin medicine?
How many years?
Dr. Monique Nugent (12:55):
Oh gosh, 16 years.
Ashley (12:57):
16 years, 16, 17 years, yeah.
Absolutely incredible.
So I'm gonna ask you to stretchyour mind way back to 16, 17
years ago.
When you really first embarkedon this journey, is this is this
what you expected?
Is this what you wanted whenyou first realized, hey, I want
to go into medic?
Did you even want to go intomedicine in the first place?
(13:18):
Or did you were you kind ofjust did you fall into it?
Dr. Monique Nugent (13:21):
I had a lot of um, I don't know what you
would call them in the on theroad, but like detours where I
got off and then I got back onagain.
Um, so I went to college verymuch wanting to be pre-med and
thinking this was the thing Iwas gonna do.
I struggled a little bit myfirst year in college and then
picked up speed and then umdecided to drop all my pre-med
(13:44):
requirements.
I was not going to be aphysician anymore.
I um was really steeped inneuroscience research and I
wanted to be a clinicalpsychologist and do research.
So I was like, no, I'm notgonna take physics.
Physics was the last of thepre-med requirements that I had.
Um and you know, I'm sure myparents were will tell you now
(14:04):
that, like, oh, it's part of thepicture, but they were
unpleased at that point in time.
Uh and I haphazardly applied toa number of PhD programs and
realized that I didn't get inwhen everyone else got
interviews and I didn't even getlike no thank you emails.
Rude.
I was like, well, I guess PennState didn't want me.
(14:26):
Like, I guess I'm not gonnagive a PhD.
Um and I I did a post uhbaccalaureate research uh
position at the NIH again,focused uh in neuroscience.
I was at the NIMH,International Institute of
Mental Health, doing um fMRIresearch, and this was really
(14:48):
where I would thought I wantedto be, but got bitten by the
medicine bug again.
Um, and then picked up, gotback on track after college.
I took my my physics classes ata different institution, um,
you know, and applied to medicalschool.
And then, you know, went to medschool and I started medical
(15:12):
school.
I was like, I'm gonna be asurgeon.
I was like 100% gonna be asurgeon and realized really
quickly that there was no waythat I should be anybody's
surgeon.
Like when I got into the OR asa med student, a place that I
thought would be amazing, I Iwas petrified.
I was hot all the time.
I was like, why is it so brightin here?
(15:33):
And like you can't sit down,and it was stressful, and I was
like, Oh, I don't need to behere.
So um decided to do somethingelse and tried out a bunch of
things, and I actually startedresidency in psychiatry.
I was a psychiatrist,psychiatry resident for a year
(15:54):
at UC San Diego, where I loveSan Diego.
I love psychiatry, and I stillum have nothing but the utmost
respect for psychiatrists, whichis a totally different
conversation, but quicklyrealized that I wasn't going to
be the type of psychiatrist Ienvisioned myself being.
Um, re-entered the match.
Wow.
(16:16):
Did internal medicine.
And when I did internalmedicine, I thought I was going
to be an intensivist that I waslike, I'm gonna do ICU work.
And I love the ICU, and again,have nothing but the utmost
respect for my colleagues incritical care.
But every time I was on my ICUrotation, I lost weight.
(16:37):
Wow.
And I took that as a sign thatit was just not meant for me.
It was just very stressful.
I wasn't sleeping, I wasn'teating.
I thought I was enjoying theexperience, but it, you know, my
body was telling me somethingdifferent.
Um, and so I found my my loveof the hospital, and I just kept
doing hospital medicine, andit's been a great career.
(16:59):
So I tell my like random on-offstory because I want students
to hear that it doesn't have tobe linear.
Like I work with students fromTufts School of Medicine.
I spend all my time tellingthem you don't have to have the
answer today, you just have tohave today's answer.
That's it.
Ashley (17:16):
That's it, you know.
Dr. Monique Nugent (17:17):
It doesn't have to be linear.
You can get on, off, finddifferent ways, make the journey
your own.
Listen to your body, yourspirit, your, you know, listen
to what really is happening inyou when you are doing these
things, and you'll find theplace you need to be.
Ashley (17:33):
Absolutely.
Absolutely.
And it's it's so perfectlytimed because number the number
one question I get from studentshadows and students that I
speak with on college campusesis Ashley, am I behind?
Here's what I've done XYZ A BC.
I'm a sophomore in college.
Am I behind?
And I'm just so grateful foryour honesty and your
(17:58):
descriptions of why certainthings didn't work out for you.
Because it's not always, Imean, you didn't um you didn't
get a a D on your test andsurgery, and that's why you're
not a surgeon.
You it was an experiencing, youactually had to be there to
experience the fact that this isnot for me.
So um, no, I think we wouldboth tell these students, no,
(18:18):
you're not behind, you'reexactly where you need to be.
Yeah, yeah, it's just a matterof exploration.
Dr. Monique Nugent (18:24):
There's there's something about the
trajectory of going intomedicine, science, and academia
that makes you feel like youhave to have it like all lined
up, right?
But then you meet people whohave done all sorts of amazing
things and you think, wow, thatperson's amazing, they've done
all these amazing things, but inyour head, you have to be on
this line.
(18:44):
Yes, right.
So if you can acknowledge that,like, wow, someone has done
amazing things, and that amazingthing was on the other side of
the line, that amazing thingveered them off track a little
bit.
That amazing thing was inaddition to.
Why do you have to be on thestreet line?
And I get it because when I wasa med student and when I was in
college, I had the same exactfeeling.
(19:05):
I had the same exact so I dospend a lot of time with my
students and any student saying,like, as long as you have two
things, one forward trajectory,as long as you're doing
something.
The second you stop doingsomething, then that's a
different issue, right?
But as long as you're movingforward, I don't care where
you're moving forward, but aslong as you're moving forward,
(19:27):
you are good, right?
And as long as the second thingyou have um is the the joy to
be doing that, right?
Like it's not gonna be alwaysjoyful.
Like, don't think that likeyou're gonna wake up and be
like, I love med school, this isthe best.
Like, no, in no way, there'sgonna be times that you are just
(19:50):
like, I can't do this, I can'tI can't stand this, I'm in just
not a great place.
I don't want to be doing thisthing.
Um, get through that day, get agood night's sleep, right?
Like a good night's sleep, andwhen you wake up, if you can do
it again, then do it.
It's the morning that you wakeup and you're like, I really
(20:12):
can't.
Listen to yourself then, right?
Because there's lots of reasonswhy maybe you can't.
But as long as you're like, Igot beat down yesterday, I got
knocked down, but I took myshower, uh, you know, I had my
oatmeal, I had my sleep, and I'mready to try again, then do it.
(20:33):
As long as you're movingforward, that's all you need.
You don't have to have all theanswers.
You re I promise you, youreally don't.
I I'm 45 and I don't have anyanswers still, like ever.
Ashley (20:46):
Like no, you're just you're describing the beatdowns
and the wake-ups and try again.
I'm like, yeah, that's uhsounds like motherhood, first of
all.
And it sounds like working inmedicine, second of all, and
being a spouse and just life ingeneral, that's life, you know.
unknown (21:00):
Yeah.
Ashley (21:00):
Oh, that was so perfect.
While we're on the subject ofoffering good advice, we have a
segment on the show calledQuality Questions, which is
where we talk about interviewquestions that we've heard in
the past in hopes that it willhelp the person who is about to
sit for their own pre-healthinterview, whether it's med
school or PA school or nursingschool or a speech language
pathology program.
Dr.
Nugent, do you have aninterview question that is just
(21:23):
burned into your memory that youwould like to share with us?
Before we hear what Dr.
Nugent has to say, keep in mindthat there's more interview
prep, such as mock interviewsand personal statement review,
over on shadowme next.com.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Monique Nugent (21:42):
My first um med school interview, I ended
up, again, everyone's gonna belike, really?
Ended up crying in the bathroomand calling my mother because
um and the the interviewer askedme, why do you think you would
succeed here?
And I didn't have an answer forhim.
(22:06):
Um, and I was just like,Because I will try hard and I
will work hard.
And he said, You don't thinkeveryone is gonna do that?
And I was like, I didn't havean answer.
I just sat there in silenceafter he said, You don't think
everyone's gonna do that?
(22:28):
You know, um, and today, youknow, years later, I think I
would have told him, I think Iwell, I ended up not going to
that medical school, you know,but um the reason I succeeded in
medical school was because Icame back the next day and
because I did it despite beingscared, I did it despite being
(22:49):
mad, I did it despite being, I'mgetting choked up, being
feeling insulted.
I did it despite, right?
And not to spite people, butdespite of that, despite of all
the things, I still did it.
And if that can be you, likethat you you can you will do it
(23:13):
too.
I also think it's kind of likean an a-hole question to say to
somebody right?
I was thinking the same thing.
Like, you don't thinkeveryone's gonna do that?
I was like, he's right,everyone is gonna do that.
You know, um, but yeah, I thinkI would tell him I would be
(23:33):
successful because I'll do itdespite anything else.
Ashley (23:38):
No, and it's I'm so glad.
Thank you for sharing thatstory because um God, I would
have loved to have heard thesethings before I had some of
these interviews.
I had brutal, brutal interviewsand moments like that where you
hear, okay, um, this is aquestion people ask.
People are not always kind ininterviews, and um, and people
(24:00):
freeze, and you know what?
Then they become really amazingphysicians despite freezing in
one interview question.
You know, it's just and lookingback, yes, we would love to
give an elaborate answer as towhy, but I think I think what
makes things the best lookingback as clinicians and why we
talk to these students isbecause we are proud that we can
(24:23):
answer those interviewquestions now, you know.
I mean, the reflective natureof this of this show, and the
reason I love quality questionsis because these moments happen
all the time.
You know, we describe a hardinterview and say, you know
what?
Now I have a really greatanswer for that, because I've
been doing this for 10 years.
I've been doing this for 17years, and I'm proud of what I
do, and I'm proud of how I gothere.
(24:44):
And um, and that journey islong and it's grueling, and like
you said, you don't wake upwith rainbows and butterflies
coming out of your ears everyday.
But um, but we did it despiteA, despite B.
And um, and I it's just itmakes me so glad to be a part of
this community still.
Thank you for sharing thatquality question.
It's absolutely amazing.
Let's jump into um prescriptionfor admission.
(25:04):
And I want to talk about yourbook first.
And actually, I would like toread a little, a little clip.
It says, with the rightknowledge, your hospitalization
can be a positive experience,full of the comfort,
communication, and compassionyou deserve.
And this is you, the patient,right?
Dr.
Nugent, tell me why this bookwas necessary.
(25:26):
Why did you have to write thisbook?
Dr. Monique Nugent (25:29):
So I started writing this book during the
pandemic.
I was at the time the associatedirector for the division of
hospital medicine at myhospital.
And uh we had like 10,000meetings a day, if you can
imagine all the things we had todo to really pivot essentially
every practice that we had inthe hospital.
And one of the things thathappened was um we closed the
(25:53):
doors, right?
Family members could not comein as much as they were.
And people think that likedoctors and nurses don't want
families around wrong.
In the hospital, we love havingfamily and support systems
around our patients.
There are so many things thatfamilies and support systems
(26:14):
tell us our patients don't tellus.
For instance, I've never metNana ever in my life, and I may
think Nana looks great and she'schatting it up with me.
And someone else would be like,she's very confused because my
dad actually lives in Minnesota.
My dad no longer lives down thestreet, you know, things like
that.
Um, and so family members alsowant to talk to us.
(26:35):
And I was like, I'm gonna writea book teaching people how to
navigate the hospital duringCOVID.
And as I sat down to write thebook, what I found was I wasn't
saying anything particularlynew.
And it wasn't anythingparticularly COVID-based, it was
all hospital-based.
You know, I've practiced inacademic centers, VAs, I'm now
at a community hospital.
(26:56):
I also trained a little bit ata community hospital.
Like I have been in hospitalson the West Coast, on the East
Coast, almost every iteration oftype of hospital, other than
pediatric hospitals that youknow I've practiced in.
And it's always the sameproblems over and over and over.
So actually in the book, youwon't find the word COVID like
at all.
Wow.
Because it ended up being moreguide and manual for
(27:18):
hospitalizations in general.
And the reason that I reallythink people need it is because
um we're all gonna end up in thehospital.
Like nobody ever wants to talkabout it.
Um, because no one likestalking about being sick,
getting hurt, having a heartattack, finding out they had a
cancer, right?
But the hospital is like theDMB of healthcare, right?
(27:40):
At some point in time, you willend up there.
Even if it is to have a baby,at some point in time, you will
end up in the hospital.
And how you navigate that willdetermine the next thing that
happens, right?
Hospital states rarely makethings easier, they make things
different.
And you have to get to theversion of different that works
(28:03):
well for you.
And that's really what I wantpeople to get out of the book.
Ashley (28:07):
That's fabulous.
This book is available onAmazon.
Um, and it's such a greatresource, not just for patients
and their families, but for Ithink for young clinicians, for
students looking to medicine inthe first place.
I work in dermatology.
I I don't work in a hospital,but a lot of my patients have
just had hospital stays.
(28:28):
And you know what?
They come out sometimes reallythrilled with the new direction
that they're moving in, like yousaid, their different plan.
Sometimes they come outtraumatized.
And just to have a betterunderstanding of their
experience for me, I'm sograteful for this book and what
you have.
And not just this book, anincredible, incredible Instagram
account, which of course, afterspeaking with you, the handle
(28:50):
makes sense.
It is the happiest hospitalistwith underscores.
And uh, and the resources hereare incredible, Dr.
Nugent.
Thank you so much.
You talk about things like whydo patients really get admitted?
And uh, are you managing yourmeds safely?
Well, my God, I had a patientthe other day, they had about 20
meds on their list ofmedications.
And um, these are things thatthat maybe patients are afraid
(29:13):
to ask, or maybe people peopledon't know, or clinicians need
better tools in their belt forhow to discuss these things.
So um, this is this is anincredible resource.
Both, both of these, you'realso on TikTok.
Um talking about Instagram, andI actually, since you speak
with students so often, I wouldlove to chat with you about
this.
Let's talk a little bit aboutsocial media and medical content
consumption right now.
(29:34):
As a physician who's been doingthis for a really long time,
you've seen you've seen thegrowth of social media, you've
seen really this new generationof of students who are consuming
this content.
What's your what's your adviceto them when it comes to looking
at things on social media?
Dr. Monique Nugent (29:52):
Yeah.
I will admit that I'm kind ofrealizing I'm an old fuddy daddy
sometimes when I with myappearance.
Opinions about social media.
Because I've had several peoplesay to me, well, it's really
the medical institution's faultthat people look to social media
for health advice.
And I get it.
(30:13):
I do feel that there's a lot ofmistrust in the system, which
earned over time.
And hopefully we're working to,you know, earn back trust.
But like the thing that isreally strange to me is that
it's not a place where you haveto know things.
You really don't have to knowanything.
You just have to be there.
(30:34):
You just have to be on.
Um, and because of that, we'veseen really dangerous advice
given out.
Um, we've seen people, youknow, everything from trends,
you know, when kids were eatingTide Pods of like cups and like
cups, spoons of cinnamon andstuff, like years and years and
years ago, right?
(30:54):
Those trends are reallydangerous, to some of the health
advice that people put out thatcan be quite detrimental.
Um and so I always tell peopleit's fine to think that that is
doing your research, but thentake it and continue to do more
(31:17):
research.
Do more research on that personand figure out why you should
be listening to that person.
You know, people's values onwhy they should listen to people
are very different from otherpeople's values, right?
Some people value my master'sdegree from Harvard, my my uh
medical degree from Loma Linda,my leadership positions.
People, some people value thatand say that that is why I
(31:40):
should trust her because she'sdone the work.
Other people look at me andwould say, You're an insider,
and that that is why I don'ttrust you.
Right.
Precisely.
So, so you have to figure outyour value system to figure out
why you should be listening tothat person, but make sure that
you know why you are listeningto that person, right?
(32:02):
Make sure you know why you areseeking the information from
that person.
And I mean, like, I get suckedinto it too, right?
Like you see these like peopleon social media who have great
physiques, and they're like, II'm like, I get sucked into the
workout ones.
They're like, do this type ofsquat and like stand on your
head, and boom, and then myhusband finds me in the basement
(32:25):
trying to do these moves thatare just gonna end in injury,
you know.
And he's like, What are youdoing?
I'm like, this lady onInstagram said, I get it, I get
it, I get why we get pulled intoit, you know.
Um, but I I would always say,like, make sure you know why
you're listening to that personand why you trust that person.
People's values are all overthe place, but as long as it's
(32:48):
aligned with your values, that'sgonna be important.
And so I value what I considerto be high yield information
that's evidence-backed.
And so, therefore, I'm lookingfor people who have access to
that evidence, understand how tosynthesize that evidence and
(33:10):
can then feed it back to me in ahigh-yield way, right?
That those are the things thatI value.
And so you have to figure outwhy you value things and why
you're listening to that person.
Ashley (33:21):
That is the greatest advice that I have ever heard
about social media and medicine.
Thank you for sharing that.
It's so true.
You know, a lot of thesethings, a lot of these ideas
that we are hearing maybeinitially sound really, really
good.
But like you said, you need toyou need to find out where those
ideas came from.
And if it's a person, you needto know a little bit about that
(33:42):
person.
Um, and and it's not justtitles, like you said, it's it's
more than that.
It's their experience, it'stheir leadership, it's what is
driving them.
Um what is driving them?
It's not it's not hard to find,you know.
You know, it's not hard to findthat information out.
It just takes a little bit ofeffort, um, effort, which is
key.
Dr.
Nujan, this has been absolutelyincredible.
(34:02):
Such an amazing time.
I will tag how to um how to getin touch with you in the show
notes below.
But um, thank you.
Thank you for what you havedone, not just for patients, but
for students as well.
Um, the happiest hospitalist.
It the title, the title suitsyou.
It is absolutely amazing.
Dr. Monique Nugent (34:20):
Thank you.
It's thank you.
This is really, I was veryexcited to talk to you.
I'm excited to talk tostudents, you guys who are
listening, like it soundscheesy, but you're the future,
right?
You get to choose what thisinstitution of medicine looks
like as we go on.
And um, I'm excited to see howthey continue to shape medicine
(34:43):
so that medicine can really liveup to the practice and goals of
itself.
Ashley (34:48):
Absolutely.
Dr.
Nugent, thank you so much.
Thank you.
Dr. Monique Nugent (34:52):
Ashley, this has been great.
Ashley (34:54):
Thank you so very much for listening to this episode of
Shadow Me Next.
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for a friend, please subscribeand invite them to join us next
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Shadow Me Next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
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of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
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(00:22):
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(00:43):
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(01:03):
There are moments in medicinethat stay with you, not because
of the science, but because ofwhat they teach you about
people.
Dr.
Monique Nugent is a hospitalistwho has built her entire career
around those moments.
She reminds us that medicinedoesn't just happen inside
hospital walls, it happens inthe space between policy and
(01:23):
people, between what we canprescribe and what our patients
actually have access to.
We talk about how herfrustration with those gaps led
her to pursue a master's degreein public health at Harvard.
She also opens up about hernonlinear path into medicine,
the detours that shaped her, andwhat it really means to do
despite, despite fear, despitefrustration, and despite the
(01:48):
negative opinion of others.
This is an episode aboutresilience, about redefining
success, and about finding yourplace.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
(02:09):
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer, or company.
This is Shadow Me Next with Dr.
Monique Nugent.
Dr.
Nugent, thank you so much forjoining me on Shadow Me Next
today.
I we've already been chattingas we do, and this is just
you're an amazing person.
(02:30):
I I know your patients justadore you.
Dr. Monique Nugent (02:34):
I I hope.
I think the nature of what Ido, I know I have unhappy
customers as well.
Ashley (02:41):
You know, that would be a great conversation to have
because when you have an unhappycustomer at my office, they um
they they walk out 20 minuteslater.
You know, we have 20 minuteappointments, they're there,
then they leave.
Unfortunately, your customers,so to speak, your patients are
there a bit longer, right?
You are a hospitalist and umyour patients stick with you for
a bit.
Tell us a little bit about whatyou do, what your day looks
(03:02):
like on the regular.
Dr. Monique Nugent (03:03):
Yeah, so I am a hospitalist.
I love, love what I do.
Um, but it's not a field that alot of people know about until
they interact with us in ahospital.
So I'm a board certifiedinternist, but I only see
patients who are hospitalized.
Um, and so I practice thespecialties called hospital
medicine.
(03:23):
Um, people call it hospitalistmedicine, and I'm always like,
do you call it cardiologistmedicine?
No, it's cardiology, right?
So I the specialty is hospitalmedicine.
Um, and it's it's great becauseI get to see so many different
things.
Um, I remember when I firstgraduated residency and I was
talking to a friend who had justgraduated surgery residency,
(03:46):
and you know, we're together,we're new in attendings, and he
was like, man, you know, this isgreat.
This is what I want to do.
Um, you know, and it's goodbecause I'm I'm seeing things
that I'm used to.
Like I have a Lap Cole today.
And I said, I have the exactopposite.
I have a refeeding syndrome onmy list.
I've never treated a personwith anorexia who needed to be
refed.
Um, I have brand new renalfailure that no one knows why.
(04:09):
I, you know, I have yeah,things that I'm used to, like
COPD and CHF, but my list wasfull of things that I hadn't
seen, but I had the tools andthe skill set to work through
it.
And I continue to see thingsthat I haven't seen before, uh,
or iterations of it, you know,presentations that I haven't
(04:30):
seen before, uh, versions of howpeople uh interact with their
diagnoses.
And I love what I do because Icontinue to have the skill set
to work through it, but alsohelp my patients and their
families work through it.
But yeah, the average hospitalsay in this country is about
four to five days.
Um protracted hospital stayscan be due to people think just
(04:52):
medically, but there's a lot ofsocial reasons.
People are hospitalized forlike an extended period of time.
Right now, in my hospital, wehave a very lovely gentleman
with dementia who essentially isliving there because uh he
doesn't have in the financialmeans to be placed somewhere
else.
His family can't care for him.
And there are like little to noinpatient psychiatric dementia
(05:16):
beds run by the state.
So they're trying to figure outthe place to send him, and it's
been weeks and weeks and weeksthat the gentleman's been living
there, you know.
Um, but on average, you know,really active medical
interventions are about four tofive days or the amount of time
that I'm seeing my patients.
Ashley (05:32):
Thank you for describing that.
You've worked very hard in yourcareer to become a fantastic
physician, and you actually haveyour master's in public health
as well from Harvard University.
Is you're describing theseincredible treatments that you
offer and diseases that youdiagnose and really mysteries
that you solve, but you're alsodescribing um some things that
(05:54):
maybe we wouldn't think we wouldbe dealing with as a physician,
as a clinician.
Yeah.
Is that is that frustrating toyou?
Or is that do you just kind ofaccept that as part of your role
with serving and helpingpeople?
Dr. Monique Nugent (06:07):
So the reason I went to do my
non-clinical fellowship atHarvard, get my MPH, learn about
healthcare policy andmanagement was because I was
getting frustrated as a medstudent, as a resident, as a
young attending, and I didn'thave the language.
And I was speaking to someoneand I was like, you know, these
things that are happening tothese people outside the
hospital, and she said, Well,those are called social
(06:29):
determinants of health.
And I was like, no one has saidthose three words to me in that
order.
Tell me more.
Um, and that's where I startedto really learn that my
frustrations were warrantedbecause there are, if I say your
hospital has five days, right?
(06:49):
There are still 360 days of theyear.
You're not under my care.
You see patients for 20minutes.
I'm not gonna do the math tosay how many more minutes are
left in the year, you know, butessentially the things that
happen outside of your officethat happen outside of the walls
of the hospital really are thethings that determine a
(07:12):
patient's health, how wellpatients will do.
And when I started realizingthat my frustrations were
warranted, I, you know, Iremember being on the phone with
an insurance agency as asecond-year resident, trying to
convince them that tohospitalize a patient for
(07:32):
Lovinox, which is a bloodthinner, it's an injection blood
thinner.
And I'm old, it used to bereally expensive, so it's not
that expensive now, right?
Like I'm on the phone in theemergency department.
I'm like, this person doesn'tneed to be hospitalized.
We can just give them Lovinoxat home and do and they wouldn't
do it.
They were forcing this personto be hospitalized, which was
taking them out of um theirlife.
(07:54):
And they they were telling me,I'll have to leave because if I
don't work, I don't have money.
You know, um, and I it was justlike, wow, it is.
It's all this big machine thatwe've built that we give, we
think we give power to is notit.
Right?
The hospital, the clinic,that's not where health occurs.
(08:15):
It's not where health ismaintained.
It's outside of the walls andlearning how we can support
patients and ourselves in thelong run by changing the way we
think about healthcare, bychanging the way we understand
how legislature interacts withhealthcare, how you know, policy
everywhere from national tolocal to hospital-based
(08:38):
policies, you know, interactwith your healthcare um and your
ability to care for yourselfand your loved ones as you know
time goes on.
Uh, it really, I will say ithits everybody.
I haven't met a clinician worththeir salt who hasn't picked up
on this, right?
(08:58):
Who hasn't been like, I can'tprescribe you a better life, I
can't prescribe you betterinsurance.
This is the situation, and I'mfrustrated because I can't
prescribe you consistent food,like consistent safe housing,
clean water.
Ashley (09:14):
It's so challenging and it does, it does contribute to
burnout.
But I'm so grateful to hearthat you took that, what very
well could have contributed toyour burnout and you're stepping
away from medicine entirely.
And you said, you know what,let me let me seek more
education on this, and let mesee if perhaps I can contribute
to this solution for yourpatients.
(09:35):
I'd love to hear yournon-clinical fellowship actually
contributes to your care.
But before we talk about that,let's go back.
Um, you mentioned being on thephone with insurance companies
and it just it just thesomething inside of me died a
little bit yesterday.
But as a again, as a as aphysician, especially as a
hospitalist, I would imagine youwork with a team of people and
these social detriments ofhealth and and working with
(09:56):
clinical social workers, thingslike that.
Can you describe the team ofpeople that are surrounding you
every day when you go into work?
Dr. Monique Nugent (10:04):
Yeah.
So um hospital-based care isvery team-oriented.
Uh outside of your physician,your therapist, your physical
therapist, um, your speechtherapist, your occupational
therapist, big part of the team.
They really do help, again,determine how we can set you up
for success after you'rehospitalized.
(10:25):
Do you need to go to a rehab?
Do you need like a shower chairto be safe in your home?
You know, um, do you needdifferent, a different type of
texture to eat now that you'vehad a stroke?
You know, um, how can youcommunicate?
Right.
So these therapists, these areare really key to making sure
that we're we're keepingpatients safe, we're advancing
their care.
Uh, clearly the bedside nurseand her team of nursing
(10:48):
assistants.
Uh and and people just thinklike, oh, well, you know,
they're they're nurses, they'realways there, but but really
they're always in my ear aswell, telling me all the things
that are happening.
Um, and it doesn't just have tobe like, oh, you know, he's
bleeding, oh, this wound.
It's like when his sister showsup, you know, it there's a lot
of tension in the room and hegets very anxious.
(11:10):
And, you know, like, do we knowexactly the what's going on
there?
You know, like, oh, he says hehas a home, but actually his
brother showed up and was like,no, he got kicked out of his
halfway house.
So you have to talk to the, youknow, the social workers.
So they're keeping an ear outum and letting me know kind of
everything, the whole picturethat goes on.
Uh, and then there's myfavorite people who I dedicated
(11:30):
an episode to, which is casemanagement.
Um, some people call them caseworkers.
In some hospitals, they may bea mix of social workers as well.
Um, so I kind of put themtogether.
And their job really is tounderstand what your medical
needs are, what the social needsare, and where you can get all
(11:51):
of those things met through acombination of insurance
resources, community resources,um, and personal finance
resources.
And so I can cook up any plan,I can come up with anything
medically.
But if you don't have access tothat when you leave here, if
you're not going to be able tosee that specialist, you know,
if you can't access thatmedication, then I'm just over
(12:14):
here, you know, satisfying myown curiosity and feeling like
I'm doing a good job.
But really, the case managerskeep me in line and they're
like, his insurance won't coverthat.
Like, or like that cardiologistis outside of her network.
We've got to be we can getpeople the things that they need
to be successful after ahospital stay.
Ashley (12:35):
And the healthcare team, you know, it just reminds me of
the rather silly phrase, ittakes a village.
It really does take a villageto raise kids, it takes a
village in medicine.
And caseworkers really are uhthe heroes of the story a lot of
times.
You know, we need them, we needthem so much.
Dr.
Nugent, how long have you beenin medicine?
How many years?
Dr. Monique Nugent (12:55):
Oh gosh, 16 years.
Ashley (12:57):
16 years, 16, 17 years, yeah.
Absolutely incredible.
So I'm gonna ask you to stretchyour mind way back to 16, 17
years ago.
When you really first embarkedon this journey, is this is this
what you expected?
Is this what you wanted whenyou first realized, hey, I want
to go into medic?
Did you even want to go intomedicine in the first place?
(13:18):
Or did you were you kind ofjust did you fall into it?
Dr. Monique Nugent (13:21):
I had a lot of um, I don't know what you
would call them in the on theroad, but like detours where I
got off and then I got back onagain.
Um, so I went to college verymuch wanting to be pre-med and
thinking this was the thing Iwas gonna do.
I struggled a little bit myfirst year in college and then
picked up speed and then umdecided to drop all my pre-med
(13:44):
requirements.
I was not going to be aphysician anymore.
I um was really steeped inneuroscience research and I
wanted to be a clinicalpsychologist and do research.
So I was like, no, I'm notgonna take physics.
Physics was the last of thepre-med requirements that I had.
Um and you know, I'm sure myparents were will tell you now
(14:04):
that, like, oh, it's part of thepicture, but they were
unpleased at that point in time.
Uh and I haphazardly applied toa number of PhD programs and
realized that I didn't get inwhen everyone else got
interviews and I didn't even getlike no thank you emails.
Rude.
I was like, well, I guess PennState didn't want me.
(14:26):
Like, I guess I'm not gonnagive a PhD.
Um and I I did a post uhbaccalaureate research uh
position at the NIH again,focused uh in neuroscience.
I was at the NIMH,International Institute of
Mental Health, doing um fMRIresearch, and this was really
(14:48):
where I would thought I wantedto be, but got bitten by the
medicine bug again.
Um, and then picked up, gotback on track after college.
I took my my physics classes ata different institution, um,
you know, and applied to medicalschool.
And then, you know, went to medschool and I started medical
(15:12):
school.
I was like, I'm gonna be asurgeon.
I was like 100% gonna be asurgeon and realized really
quickly that there was no waythat I should be anybody's
surgeon.
Like when I got into the OR asa med student, a place that I
thought would be amazing, I Iwas petrified.
I was hot all the time.
I was like, why is it so brightin here?
(15:33):
And like you can't sit down,and it was stressful, and I was
like, Oh, I don't need to behere.
So um decided to do somethingelse and tried out a bunch of
things, and I actually startedresidency in psychiatry.
I was a psychiatrist,psychiatry resident for a year
(15:54):
at UC San Diego, where I loveSan Diego.
I love psychiatry, and I stillum have nothing but the utmost
respect for psychiatrists, whichis a totally different
conversation, but quicklyrealized that I wasn't going to
be the type of psychiatrist Ienvisioned myself being.
Um, re-entered the match.
Wow.
(16:16):
Did internal medicine.
And when I did internalmedicine, I thought I was going
to be an intensivist that I waslike, I'm gonna do ICU work.
And I love the ICU, and again,have nothing but the utmost
respect for my colleagues incritical care.
But every time I was on my ICUrotation, I lost weight.
(16:37):
Wow.
And I took that as a sign thatit was just not meant for me.
It was just very stressful.
I wasn't sleeping, I wasn'teating.
I thought I was enjoying theexperience, but it, you know, my
body was telling me somethingdifferent.
Um, and so I found my my loveof the hospital, and I just kept
doing hospital medicine, andit's been a great career.
(16:59):
So I tell my like random on-offstory because I want students
to hear that it doesn't have tobe linear.
Like I work with students fromTufts School of Medicine.
I spend all my time tellingthem you don't have to have the
answer today, you just have tohave today's answer.
That's it.
Ashley (17:16):
That's it, you know.
Dr. Monique Nugent (17:17):
It doesn't have to be linear.
You can get on, off, finddifferent ways, make the journey
your own.
Listen to your body, yourspirit, your, you know, listen
to what really is happening inyou when you are doing these
things, and you'll find theplace you need to be.
Ashley (17:33):
Absolutely.
Absolutely.
And it's it's so perfectlytimed because number the number
one question I get from studentshadows and students that I
speak with on college campusesis Ashley, am I behind?
Here's what I've done XYZ A BC.
I'm a sophomore in college.
Am I behind?
And I'm just so grateful foryour honesty and your
(17:58):
descriptions of why certainthings didn't work out for you.
Because it's not always, Imean, you didn't um you didn't
get a a D on your test andsurgery, and that's why you're
not a surgeon.
You it was an experiencing, youactually had to be there to
experience the fact that this isnot for me.
So um, no, I think we wouldboth tell these students, no,
(18:18):
you're not behind, you'reexactly where you need to be.
Yeah, yeah, it's just a matterof exploration.
Dr. Monique Nugent (18:24):
There's there's something about the
trajectory of going intomedicine, science, and academia
that makes you feel like youhave to have it like all lined
up, right?
But then you meet people whohave done all sorts of amazing
things and you think, wow, thatperson's amazing, they've done
all these amazing things, but inyour head, you have to be on
this line.
(18:44):
Yes, right.
So if you can acknowledge that,like, wow, someone has done
amazing things, and that amazingthing was on the other side of
the line, that amazing thingveered them off track a little
bit.
That amazing thing was inaddition to.
Why do you have to be on thestreet line?
And I get it because when I wasa med student and when I was in
college, I had the same exactfeeling.
(19:05):
I had the same exact so I dospend a lot of time with my
students and any student saying,like, as long as you have two
things, one forward trajectory,as long as you're doing
something.
The second you stop doingsomething, then that's a
different issue, right?
But as long as you're movingforward, I don't care where
you're moving forward, but aslong as you're moving forward,
(19:27):
you are good, right?
And as long as the second thingyou have um is the the joy to
be doing that, right?
Like it's not gonna be alwaysjoyful.
Like, don't think that likeyou're gonna wake up and be
like, I love med school, this isthe best.
Like, no, in no way, there'sgonna be times that you are just
(19:50):
like, I can't do this, I can'tI can't stand this, I'm in just
not a great place.
I don't want to be doing thisthing.
Um, get through that day, get agood night's sleep, right?
Like a good night's sleep, andwhen you wake up, if you can do
it again, then do it.
It's the morning that you wakeup and you're like, I really
(20:12):
can't.
Listen to yourself then, right?
Because there's lots of reasonswhy maybe you can't.
But as long as you're like, Igot beat down yesterday, I got
knocked down, but I took myshower, uh, you know, I had my
oatmeal, I had my sleep, and I'mready to try again, then do it.
(20:33):
As long as you're movingforward, that's all you need.
You don't have to have all theanswers.
You re I promise you, youreally don't.
I I'm 45 and I don't have anyanswers still, like ever.
Ashley (20:46):
Like no, you're just you're describing the beatdowns
and the wake-ups and try again.
I'm like, yeah, that's uhsounds like motherhood, first of
all.
And it sounds like working inmedicine, second of all, and
being a spouse and just life ingeneral, that's life, you know.
unknown (21:00):
Yeah.
Ashley (21:00):
Oh, that was so perfect.
While we're on the subject ofoffering good advice, we have a
segment on the show calledQuality Questions, which is
where we talk about interviewquestions that we've heard in
the past in hopes that it willhelp the person who is about to
sit for their own pre-healthinterview, whether it's med
school or PA school or nursingschool or a speech language
pathology program.
Dr.
Nugent, do you have aninterview question that is just
(21:23):
burned into your memory that youwould like to share with us?
Before we hear what Dr.
Nugent has to say, keep in mindthat there's more interview
prep, such as mock interviewsand personal statement review,
over on shadowme next.com.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Monique Nugent (21:42):
My first um med school interview, I ended
up, again, everyone's gonna belike, really?
Ended up crying in the bathroomand calling my mother because
um and the the interviewer askedme, why do you think you would
succeed here?
And I didn't have an answer forhim.
(22:06):
Um, and I was just like,Because I will try hard and I
will work hard.
And he said, You don't thinkeveryone is gonna do that?
And I was like, I didn't havean answer.
I just sat there in silenceafter he said, You don't think
everyone's gonna do that?
(22:28):
You know, um, and today, youknow, years later, I think I
would have told him, I think Iwell, I ended up not going to
that medical school, you know,but um the reason I succeeded in
medical school was because Icame back the next day and
because I did it despite beingscared, I did it despite being
(22:49):
mad, I did it despite being, I'mgetting choked up, being
feeling insulted.
I did it despite, right?
And not to spite people, butdespite of that, despite of all
the things, I still did it.
And if that can be you, likethat you you can you will do it
(23:13):
too.
I also think it's kind of likean an a-hole question to say to
somebody right?
I was thinking the same thing.
Like, you don't thinkeveryone's gonna do that?
I was like, he's right,everyone is gonna do that.
You know, um, but yeah, I thinkI would tell him I would be
(23:33):
successful because I'll do itdespite anything else.
Ashley (23:38):
No, and it's I'm so glad.
Thank you for sharing thatstory because um God, I would
have loved to have heard thesethings before I had some of
these interviews.
I had brutal, brutal interviewsand moments like that where you
hear, okay, um, this is aquestion people ask.
People are not always kind ininterviews, and um, and people
(24:00):
freeze, and you know what?
Then they become really amazingphysicians despite freezing in
one interview question.
You know, it's just and lookingback, yes, we would love to
give an elaborate answer as towhy, but I think I think what
makes things the best lookingback as clinicians and why we
talk to these students isbecause we are proud that we can
(24:23):
answer those interviewquestions now, you know.
I mean, the reflective natureof this of this show, and the
reason I love quality questionsis because these moments happen
all the time.
You know, we describe a hardinterview and say, you know
what?
Now I have a really greatanswer for that, because I've
been doing this for 10 years.
I've been doing this for 17years, and I'm proud of what I
do, and I'm proud of how I gothere.
(24:44):
And um, and that journey islong and it's grueling, and like
you said, you don't wake upwith rainbows and butterflies
coming out of your ears everyday.
But um, but we did it despiteA, despite B.
And um, and I it's just itmakes me so glad to be a part of
this community still.
Thank you for sharing thatquality question.
It's absolutely amazing.
Let's jump into um prescriptionfor admission.
(25:04):
And I want to talk about yourbook first.
And actually, I would like toread a little, a little clip.
It says, with the rightknowledge, your hospitalization
can be a positive experience,full of the comfort,
communication, and compassionyou deserve.
And this is you, the patient,right?
Dr.
Nugent, tell me why this bookwas necessary.
(25:26):
Why did you have to write thisbook?
Dr. Monique Nugent (25:29):
So I started writing this book during the
pandemic.
I was at the time the associatedirector for the division of
hospital medicine at myhospital.
And uh we had like 10,000meetings a day, if you can
imagine all the things we had todo to really pivot essentially
every practice that we had inthe hospital.
And one of the things thathappened was um we closed the
(25:53):
doors, right?
Family members could not comein as much as they were.
And people think that likedoctors and nurses don't want
families around wrong.
In the hospital, we love havingfamily and support systems
around our patients.
There are so many things thatfamilies and support systems
(26:14):
tell us our patients don't tellus.
For instance, I've never metNana ever in my life, and I may
think Nana looks great and she'schatting it up with me.
And someone else would be like,she's very confused because my
dad actually lives in Minnesota.
My dad no longer lives down thestreet, you know, things like
that.
Um, and so family members alsowant to talk to us.
(26:35):
And I was like, I'm gonna writea book teaching people how to
navigate the hospital duringCOVID.
And as I sat down to write thebook, what I found was I wasn't
saying anything particularlynew.
And it wasn't anythingparticularly COVID-based, it was
all hospital-based.
You know, I've practiced inacademic centers, VAs, I'm now
at a community hospital.
(26:56):
I also trained a little bit ata community hospital.
Like I have been in hospitalson the West Coast, on the East
Coast, almost every iteration oftype of hospital, other than
pediatric hospitals that youknow I've practiced in.
And it's always the sameproblems over and over and over.
So actually in the book, youwon't find the word COVID like
at all.
Wow.
Because it ended up being moreguide and manual for
(27:18):
hospitalizations in general.
And the reason that I reallythink people need it is because
um we're all gonna end up in thehospital.
Like nobody ever wants to talkabout it.
Um, because no one likestalking about being sick,
getting hurt, having a heartattack, finding out they had a
cancer, right?
But the hospital is like theDMB of healthcare, right?
(27:40):
At some point in time, you willend up there.
Even if it is to have a baby,at some point in time, you will
end up in the hospital.
And how you navigate that willdetermine the next thing that
happens, right?
Hospital states rarely makethings easier, they make things
different.
And you have to get to theversion of different that works
(28:03):
well for you.
And that's really what I wantpeople to get out of the book.
Ashley (28:07):
That's fabulous.
This book is available onAmazon.
Um, and it's such a greatresource, not just for patients
and their families, but for Ithink for young clinicians, for
students looking to medicine inthe first place.
I work in dermatology.
I I don't work in a hospital,but a lot of my patients have
just had hospital stays.
(28:28):
And you know what?
They come out sometimes reallythrilled with the new direction
that they're moving in, like yousaid, their different plan.
Sometimes they come outtraumatized.
And just to have a betterunderstanding of their
experience for me, I'm sograteful for this book and what
you have.
And not just this book, anincredible, incredible Instagram
account, which of course, afterspeaking with you, the handle
(28:50):
makes sense.
It is the happiest hospitalistwith underscores.
And uh, and the resources hereare incredible, Dr.
Nugent.
Thank you so much.
You talk about things like whydo patients really get admitted?
And uh, are you managing yourmeds safely?
Well, my God, I had a patientthe other day, they had about 20
meds on their list ofmedications.
And um, these are things thatthat maybe patients are afraid
(29:13):
to ask, or maybe people peopledon't know, or clinicians need
better tools in their belt forhow to discuss these things.
So um, this is this is anincredible resource.
Both, both of these, you'realso on TikTok.
Um talking about Instagram, andI actually, since you speak
with students so often, I wouldlove to chat with you about
this.
Let's talk a little bit aboutsocial media and medical content
consumption right now.
(29:34):
As a physician who's been doingthis for a really long time,
you've seen you've seen thegrowth of social media, you've
seen really this new generationof of students who are consuming
this content.
What's your what's your adviceto them when it comes to looking
at things on social media?
Dr. Monique Nugent (29:52):
Yeah.
I will admit that I'm kind ofrealizing I'm an old fuddy daddy
sometimes when I with myappearance.
Opinions about social media.
Because I've had several peoplesay to me, well, it's really
the medical institution's faultthat people look to social media
for health advice.
And I get it.
(30:13):
I do feel that there's a lot ofmistrust in the system, which
earned over time.
And hopefully we're working to,you know, earn back trust.
But like the thing that isreally strange to me is that
it's not a place where you haveto know things.
You really don't have to knowanything.
You just have to be there.
(30:34):
You just have to be on.
Um, and because of that, we'veseen really dangerous advice
given out.
Um, we've seen people, youknow, everything from trends,
you know, when kids were eatingTide Pods of like cups and like
cups, spoons of cinnamon andstuff, like years and years and
years ago, right?
(30:54):
Those trends are reallydangerous, to some of the health
advice that people put out thatcan be quite detrimental.
Um and so I always tell peopleit's fine to think that that is
doing your research, but thentake it and continue to do more
(31:17):
research.
Do more research on that personand figure out why you should
be listening to that person.
You know, people's values onwhy they should listen to people
are very different from otherpeople's values, right?
Some people value my master'sdegree from Harvard, my my uh
medical degree from Loma Linda,my leadership positions.
People, some people value thatand say that that is why I
(31:40):
should trust her because she'sdone the work.
Other people look at me andwould say, You're an insider,
and that that is why I don'ttrust you.
Right.
Precisely.
So, so you have to figure outyour value system to figure out
why you should be listening tothat person, but make sure that
you know why you are listeningto that person, right?
(32:02):
Make sure you know why you areseeking the information from
that person.
And I mean, like, I get suckedinto it too, right?
Like you see these like peopleon social media who have great
physiques, and they're like, II'm like, I get sucked into the
workout ones.
They're like, do this type ofsquat and like stand on your
head, and boom, and then myhusband finds me in the basement
(32:25):
trying to do these moves thatare just gonna end in injury,
you know.
And he's like, What are youdoing?
I'm like, this lady onInstagram said, I get it, I get
it, I get why we get pulled intoit, you know.
Um, but I I would always say,like, make sure you know why
you're listening to that personand why you trust that person.
People's values are all overthe place, but as long as it's
(32:48):
aligned with your values, that'sgonna be important.
And so I value what I considerto be high yield information
that's evidence-backed.
And so, therefore, I'm lookingfor people who have access to
that evidence, understand how tosynthesize that evidence and
(33:10):
can then feed it back to me in ahigh-yield way, right?
That those are the things thatI value.
And so you have to figure outwhy you value things and why
you're listening to that person.
Ashley (33:21):
That is the greatest advice that I have ever heard
about social media and medicine.
Thank you for sharing that.
It's so true.
You know, a lot of thesethings, a lot of these ideas
that we are hearing maybeinitially sound really, really
good.
But like you said, you need toyou need to find out where those
ideas came from.
And if it's a person, you needto know a little bit about that
(33:42):
person.
Um, and and it's not justtitles, like you said, it's it's
more than that.
It's their experience, it'stheir leadership, it's what is
driving them.
Um what is driving them?
It's not it's not hard to find,you know.
You know, it's not hard to findthat information out.
It just takes a little bit ofeffort, um, effort, which is
key.
Dr.
Nujan, this has been absolutelyincredible.
(34:02):
Such an amazing time.
I will tag how to um how to getin touch with you in the show
notes below.
But um, thank you.
Thank you for what you havedone, not just for patients, but
for students as well.
Um, the happiest hospitalist.
It the title, the title suitsyou.
It is absolutely amazing.
Dr. Monique Nugent (34:20):
Thank you.
It's thank you.
This is really, I was veryexcited to talk to you.
I'm excited to talk tostudents, you guys who are
listening, like it soundscheesy, but you're the future,
right?
You get to choose what thisinstitution of medicine looks
like as we go on.
And um, I'm excited to see howthey continue to shape medicine
(34:43):
so that medicine can really liveup to the practice and goals of
itself.
Ashley (34:48):
Absolutely.
Dr.
Nugent, thank you so much.
Thank you.
Dr. Monique Nugent (34:52):
Ashley, this has been great.
Ashley (34:54):
Thank you so very much for listening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday.
As always, if you have anyquestions, let me know on
Facebook or Instagram.
Access you want, stories youneed, you're always invited to
Shadow Me Next.
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