F087 — F091 [SERIES] Nurses: the hidden gem in healthcare
2020 is the year of the nurse and the midwife. What do nurses actually do and why are they still a hidden innovation treasure in healthcare?
World Health Assembly has designated 2020 to them, because “these are the people who devote their lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs. They are often, the first and only point of care in their communities.”
The world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030.
This podcast series features nurses that mostly do not work in clinical practice anymore, because they are using their knowledge gained in nursing to impact healthcare on a decision-making level where they help improve the system bit by bit.
When asked about the biggest untapped needs of nurses, their answer is respect, recognition. “The majority of people don’t really know what nurses are qualified to do. And while we’ve managed to raise the awareness about their clinical competence, we still have work to do to include them more in leadership and policymaking,” says Shawna Butler — Nurse Economist and EntrepreNURSE, currently the Host of See you now podcast, focused on sharing perspectives of nurses on healthcare. She is a member of the core team of the Exponential Medicine team at Singularity University.
In this series you will hear about:
What nurses actually do,
The changing role of nurses in healthcare,
Relationship nurses have with technology — IT systems, new innovations,
Why they should be at the policy making table.
F087 Nurses 1/4: Do you know what nurses do? (Shawna Butler, USA)
Shawna Butler.
Shawna Butler is Nurse Economist and EntrepreNURSE, currently the Host of See you now podcast, focused on sharing perspectives of nurses on healthcare. She is a member of the core team of the Exponential Medicine team at Singularity University. Her diverse portfolio of projects includes implementing an enterprise-wide digital radiology solution, creating an international emergency medicine training rotation between a US medical school and a New Zealand hospital system, producing a global competition for oncology-focused startups, and activating nurses as digital health leaders and innovators. Her clinical nursing experience includes emergency, cardiac, critical care, international medical flight transport, and workplace wellness.
In this discussion, Shawna Buttler, speaks about the current situation healthcare workers have found themselves in due to COVID-19, what she’s learning about nurses through hosting the See you now podcast, we also touched very human aspects of nursing we don’t hear about often, that is the needs and support in end of life care.
Some questions addressed:
It’s the year of the nurse and midwife. Does it matter, will it have any impact?
Two years ago we talked about why nurses are innovators, that first and foremost, they’re closest to the suffering and know probably better than other clinical workers, how patients feel and need. You mentioned that relationships in healthcare are changing and that nurses are getting increasingly heard when it comes to decision making, that the relationship in the clinical setting is turning from hierarchy to partnership between doctors, pharmacists and nurses. So in what position are nurses today, globally?
You recently became the host of See you now podcast where you give listeners the opportunity to hear from nurses at the forefront of healthcare and innovation; those developing new devices, processes, protocols, and ways to treat for infection prevention, infant health, maternal mortality, palliative care, and so much more. How are you enjoying the journey so far, what are you learning? Are discussions surprising you? What were the highlights for you so far?
Nurses are innovators and my impression is that that awareness is highest in the US where there are several organizations such as Sonsiel — “a global organization with the goal of positioning the nursing profession to participate in developing solutions and increasing Nursing’s influence as leaders of health care innovation.” You traveled a lot in your career, how much nursing innovation did you observe?
What is in your opinion today still the biggest untapped need of nurses?
You are among the Advisory Board Members of End Well objective is to address these issues as a multidisciplinary community, bringing together design, technology, health, policy and activist imagination and expertise in end of life care. Unfortunately, COVID-19 is leaving behind not only death but undignified, fast, and scary death, where patients die alone, without their families or loved ones, where families in some cases weren’t allowed to gather at funerals, where doctors will suffer from PTSD because of the wave of patients they saw die in these conditions and the wave of patients they could help in normal circumstances, but couldn’t because of the last of equipment, hospital beds and the sheer number of patients, which forced them to make the impossible decision as to which patient’s life is worth more. How did you observe all this as an advisory board member of End Well, as a nurse, who knows how it is to be at the bedside of sick patients?
How will doctors and nurses get out of this crisis? How can you recover from such stress, when you can’t really take normal time off, since medical resources are scarce, you can’t go on a normal holiday after the crisis since doctors and nurses work weekends, holidays, you can really move away from the trauma, because you have to go back to the workplace where unimaginable happened?
F088 Nurses 2/4: Making healthcare holistic (Sherezade Ruano, UK)
Sherezade Ruano.
Sherezade Ruano is an Arrhythmia Specialist Nurse at Imperial College NHS Trust, Founder of RhythmiaBreath Medical Well-being programme and Co-Founder, CEO of RB Hub Digital Therapeutics. Passionate about the importance of mental wellbeing, stress and trauma in cardiac patients, Sherezade works closely with a team of world-renowned Mental Health specialists and Cardiologists offering outstanding services.
In the interview she spoke about neurocardiology, struggles she came across as a nurse entrepreneur when looking for validators of her solution, she also commented the faster adoption of digital health in the UK because of COVID-19 and more.
Some questions addressed:
You have a private practice as a Stress management expert and Wellness Consultant in Central London. Can you tell us the background of your career path — how did you go from studying to become a nurse to take on all these roles?
How does your work look like when you’re there as an Arrhythmia Specialist?
In 2017 Rhythmiabreath was granted the credential of being the first method in the UK to combine modern medicine with holistic practices for the Prevention and Rehabilitation of Cardiovascular Diseases and Mental Wellbeing. That sounds like a huge achievement in redefining the frame of healthcare?
You deliver counseling sessions in the NHS for patients about to undergo invasive procedures or receive cardiac devices (ICD, CRT-D). How does this counseling look like and what are the needs these patients have from the emotional/mental health perspective?
Being in so many roles: how do you see the current position of nurses in general in the clinical environment hierarchy dynamic in which some claim is becoming more collaborative (nurses are increasingly seen as team members not doctor’s subordinates)?
As a part of an international medical team of holistic recovery, you act as a Mind-Body therapist, offering interventions with a focus on recovery from addictions, anxiety, mental distress, and depression. Two things: how does counseling and care for these patients differ from cardiovascular patients?
You co-authored several studies in preventive medicine and cardiovascular research. We are very well aware of how the mind or mindset in connected to stress and what strong effects that can have on the body. But where does the heart come in? Internationally you often talk about that; how the mind, the body and the heart are intimately connected.
You work very internationally — France, Spain, Kuwait, Switzerland, Florida. What kind of differences are you noticing in the way healthcare is delivered in these countries or how in wellbeing addressed?
F089 Nurses 3/4: “If you leave nurses out of your innovation process, you’re making a mistake”
Karmi Soder.
Karmi Soder started working as a pediatric clinical care nurse in 1992. Today she is a skilled communicator with over 25 years of healthcare experience in clinical, administrative and tech, which she gained by serving as Chief Administrative Officer at Sutter Health, leading pediatric department for Kaiser Permanente, worked at Google and co-founded NewboRN Solutions — a registered nursing corporation, which aimed at helping new parents get the best care and shared community after the birth of their newborn. Based in Israel Karmi now works as a consultant for program development and strategy, analyzes, designs and executes improved operations and workflows.
Some questions addressed:
You started you career as a critical care staff nurse in 1992. Can you describe your journey?
When you worked as a nurse in the nineties, what were the option for promotion/change of career for nurses then compared to now?
You have an impressive journey behind you: you became a Chief Administrative Officer at Sutter Health, Pediatric Department Lead in 2009 for Kaiser Permanente, in 2014 you co-founded NewboRN Solutions — a registered nursing corporation. You were never afraid of innovation, so I wonder how did it feel to work at Google?
What are your current experiences with Israel, innovation spirit and progressive healthcare?
What are the basic unmet needs nurses face according to your observation?
F090 Nurses 4/4: All the aspects of community care (Mary Lou Ackerman, Canada)
Mary Lou Ackerman.
Mary Lou Ackerman is Vice President of Innovation and Digital Health with SE Health. Mary Lou is a founding member of SONSIEL (Society of Nursing Scientist, Innovator, and Entrepreneur Leaders) and an active member of CHIEF (Canada’s Health Informatics Executive Forum) with Digital Health Canada. Her background is extensive — she has led the development and implementation of many business transformation projects, innovations and partnerships. Mary Lou joined Saint Elizabeth in 1987 as a visiting nurse, and she has augmented her clinical background with a graduate business degree and significant experience with health informatics and technologies. Mary Lou has a passion for community health care, combined with a desire to advance care, creating innovative service models supported by digital health technologies, to create a future that will provide a personalized, accessible, meaningful health experience for individuals, their families and the service providers that support them.
Some questions addressed:
You have an impressive background: you started your career as a visiting nurse, you later got a business degree and are now the vice president of innovation with Saint Elizabeth (SE) Health, which is a Canadian social enterprise impacting how people live and age well at home. Let’s start with your first years as a nurse: how did the work of a visiting nurse look like then, compared to how it looks like today?
What kind of comparison can you make in terms of the technology available or even required then compared to today? What kind of communication tools do nurses use, what kind of EHRs for home visits?
You have a strong passion for community healthcare. What are the biggest challenges in the field according to your observation? With the aging population, community care carries an increasingly important role. If we take into account how much later women decide to have families, this means that it will be increasingly more difficult for children to take care of their parents, because if we take an example of someone having children in their 40s, by the time their children are 30 with their own children and no time to provide care to their parents, unless they live in the same household. Does this mean that the role of community nurses is becoming even more important than before?
How do you see technology and innovation are contributing to coping with the rising needs for care for the elderly?
Are community healthcare and availability of visiting nurses decreasing the need for the elderly to move in retirement homes or go to hospitals?
When did you decide you wish to redefine your career as a nurse and got a business degree? What year was that and what was the attitude of the environment at the time towards such a decision? (For example, it seems that, at least in the US, nurses are becoming increasingly innovative and entrepreneurial and their potential in care is being recognized and valued in a whole new way.)
You were among the founding members of Sonsiel - a society of premier Nurse scientists, innovators, entrepreneurs, and leaders who are dedicated to advancing the transformation of healthcare. Let’s stop at the description of Sonsiel. Can you tell us more about the differentiation between nurses?
Given your involvement in Sonsiel, is it possible to assess the impact of nursing shortages in different countries? According to CNA, Canada is going to face a shortage of 60,000 nurses by the year 2022. How problematic or accurate are in your expert opinion these estimates given that care is reshaping - with telemedicine and decreasing number of hospitalization, healthcare needs for nurses are reshaping in a new way.
One of your specialties is innovation culture building. It is sometimes poorly understood that clinical practice carries very specific stress/pressure and that makes it hard to introduce new technologies and workflows. It’s not only about the culture but also about the specifics of the environment and hierarchy in healthcare institutions. Medical workers are increasingly becoming team members, but for a long time, the hierarchy between doctors and nurses was clear. Some saw doctors as the bosses of nurses. And as Shawna Butler mentioned in her interview, one of the biggest needs of nurses if to get recognition for the work they do, to get a seat at the table. Taking all this in consideration, I wonder how you look at how nurses can innovate in the clinical environment or how they can contribute to change, innovation, and adoption?
When it comes to innovation we often hear that vendors need to work with end-users, which in our case are nurses. During our introductory call, you said one very interesting thing, and that is that more vendors need to work with other vendors. Collabettion or coopetition is a trend we’re starting to see. Can you tell us more about your perspective and insight on these topics?