Holding the Leg for an Hour: Real Healthcare Teamwork

Ever held a leg for 60 minutes while a provider debrides a wound and the room goes silent except for scissors and suction? That’s the kind of unfiltered reality we explore with Daniel, a physician assistant who moved from vascular surgery to limb preservation and learned why the smallest choices—bed height, second hands, the right words—can change outcomes.

We dive into how careers evolve, why vascular work builds a wide medical base, and what bedside empathy looks like when amputations and infections aren’t abstract. Daniel opens up about surviving a COVID-era unit merger that fused teams, service lines, and stress, and the lesson he kept: rely on people. Find the seasoned nurse who can read a chest tube in seconds, the CNA whose instinct gets you running, and the resident who teaches the why behind orders. That theme of communication runs throughout: good pages offer signal, not noise; nurses deserve the rationale; and APPs need context to act fast.

There’s practical insight you can use on your next shift. We unpack when a post-VT EKG actually changes management, how accurate I&Os and standing-scale weights drive real dosing decisions in heart failure and post-op care, and why letting patients sleep at night reduces delirium and length of stay. We talk recognition—from Daisy awards to “Bee” shout-outs—and why celebrating the invisible labor of the team matters. We even touch tech upgrades like smarter EKG machines that auto-capture events and cut down on lost data.

If you care about nurse–APP dynamics, critical thinking, and the everyday habits that keep patients safer, this conversation brings both candor and actionable takeaways. Hit follow, share it with a teammate who makes your shift easier, and leave a review with one paging tip you wish every new clinician learned.

Transcript

Welcome And Today’s Focus

Christopher 0:00

Hello, and welcome back to Nursing Life 101. We're so excited to have you here as we dive into the world of nursing, sharing experiences, insights, and a little bit of fun along the way. I'm Christopher.

Colby 0:10

And I'm Colby. Together, we're here to bring you real stories, practical tips, and conversations that remind us all why we love this wild world of nursing.

Christopher 0:18

Today's episode is a special one. It's actually the first one we'll have in this entire series because we're not doing this alone.

Meet Daniel: Path To PA And Vascular Work

Colby 0:26

Nope. We've got a guest in the house, a great colleague, friend, and a phenomenal provider.

Christopher 0:31

Please welcome Daniel, physician assistant extraordinaire.

Colby 0:36

We're talking teamwork between nurses and APPs, sharing memorable cases, exploring how collaboration makes us all better.

Christopher 0:43

So let's get into it because this one's about respect, communication, and learning from each other.

Daniel 1:26

I am a physician assistant, PA. I think the AAPA is trying to change the name to Physician Associate, which I think is kind of silly. But I'm a PA. I have worked at the same medical center as Christopher and Colby for about seven years now. I started a little bit before Christopher, actually on the same unit as Christopher, and that's how we first met. That was in a vascular surgery step-down unit. And I worked there for a couple years, and in the for the past few years, I've been working in limb preservation, which is a lot of diabetic foot infections, still some foot wounds due to vascular disease and some trauma and ingrown toenails and all sorts of fun stuff.

Christopher 2:09

Do you remember like our first full conversation?

Daniel 2:14

Was it on the bus? Yeah. Yeah, yeah. I don't remember what we talked about. But I remember sitting on the bus and we started talking about something.

Christopher 2:23

Yeah. And I don't I I'm trying to remember like why I was on the bus. Like I should not have been on the bus at the same time you did. Because you left earlier than we did.

Daniel 2:35

Oh I feel like you were there for a meeting. I don't think you were it? Yeah, I don't think you were you had worked that day. I don't I don't think you were in scrubs. I feel like you were wearing like street gloves. Okay.

Colby 2:44

I was gonna say, what time of day was it?

Daniel 2:46

Yeah, it w it was. It was like early it's evening. Yeah.

Colby 2:50

Yeah.

Daniel 2:50

5 36.

Christopher 2:52

I guess it depends on w what do you consider evening?

Colby 2:55

Yeah, like four. Anything after three to like six thirty. Okay. After six thirty, it's night time. Actually, well, it depends on the time of year. When the when it's dark, it's night.

Christopher 3:06

When it's dark, it's night.

Colby 3:08

That's yeah, for me. So I could be four thirty in December. The evening was short. It was two hours.

Daniel 3:18

Afternoon doesn't exist.

Colby 3:21

Afternoon, who is she? Never met her.

Christopher 3:25

Interesting. But oh yeah. I was wondering if you remembered on the bus.

Daniel 3:30

I d I don't remember our conversation either, but. I remember we talked about disc golf pretty early on, but I don't think it was that conversation. I think it was after that.

Colby 3:40

Broaching healthcare early on, going past it.

Daniel 3:44

Yeah, I'll be real. At least let's talk about something else.

Colby 3:49

Yeah.

Daniel 3:51

We we don't care about people that much.

First Encounters And Gruesome Wound Care

Colby 3:55

Well, okay, so you guys have known each other a lot longer than I've known you, Daniel, but I feel like I've known of you for as long because you and then another one of our friends, Sarah, you the three of you guys were pretty good friends, and I was always hearing about Daniel. And then I feel like there was a period of time where like we would pass each other in the hospital. And I think at least I was thinking, like, I think that's the Daniel that Christopher and Sarah are friends with. And you were probably doing the same thing, like, that could be the Colby. Not sure. And then the first time that I ever did anything with you, and we've talked about this before off mic, but when we were you were doing wound care on one of our LVAD patients, and I was holding the leg, and it was just the most gruesome, like horrific thing of like chunking flesh out with like this crate, the craziest thing I've ever seen, this tool contraption that looks like kind of like a heavy-duty toenail clipper. You were just like chunking flesh, and I was like, holy shit, this is crazy. And like, I will never forget that.

Daniel 4:58

That's that there have been a few nurses and like CNAs who have I've been in a similar, similar situation with. And there was one who I I saw like a few months later after, and they're like, Are you doing any more? Will I remember that last one? That foot was full of maggots. It was crazy. And I was like, Not today, not that bad, but I'll let you know. Because they they don't, you don't forget that stuff.

Colby 5:21

I was just like holding this person's leg, and I was like, Holy shit, this I can't believe I'm not passing out right now. I was like fascinated and disgusted equally at the same time.

Daniel 5:32

It's really helpful having another set of hands because these patients can can really not do a lot for themselves. Yeah. And it's always awkward angles and trying to like do the job and it's really tricky. So I whenever someone's available, I'm like, can you you have can you come holding it?

Colby 5:47

45 minutes now. And it really can take that long.

Christopher 5:52

Does lifting the bed actually help?

Daniel 5:54

Oh yeah.

Christopher 5:55

Yeah.

Daniel 5:55

I it helps your back. I do it, I I do it every time because if I don't, then I'm at a 90 degree angle. Even when I just like trim like a diabetic patient's toenails or something. I went the two days ago and there was a patient and their their big toenail was one and a half inches just just like off of the the nail bed. What? Whoa. And it took I mean, I was in that room for 30 minutes trimming toenails just because it took so much time and if I didn't have the bed all the way up.

Colby 6:22

I have questions about the technique for that. So getting too far off the rails. Like, did you have to like if this is the like if this that's the thickness, did you come from the top as well?

Christopher 6:35

She has three fingers on top of each other. Stack on top of the stack on top of each other.

Colby 6:39

For for our listeners. Um did you have to come from the top and the front?

Daniel 6:44

You kind of have to take like bites off of the side. You're like chunking it. It's like a like a mountain peak. You kind of start from the top and then you go around the edge to work its way down because there's there's no way you could just use like nail clippers and cut a piece because it's so thick. That is wild.

Colby 7:01

Oof, I'm shook. And I just know that there was an odor. Oh like that's a given. That's a given. We're talking limb preservation. Okay, we gotta get rid of the stuff to preserve. All right, let's get us back on track. So, what pulled you toward medicine in the first place? Was there like a defining moment or like a story that brought you in?

Daniel 7:27

I feel like a lot of people have had a family member or somebody that got sick or they were sick and they got pulled in that way. I never had like a specific now is the time I know I want to go into medicine, but I was always interested in medicine. I always thought it was cool. I remember watching, and there was a TV show, it was trauma life in the ER. And you, you know, they go through the ER and you see just people come in and there's blood everywhere. And I was just like, this is so cool. My family was like, this is disgusting. Can you get us off the TV, please? And I always thought medicine was cool and interesting, and I liked a career that I felt like I was making a difference and not just trying to get a paycheck, but actually bringing something to society and helping people. I was interested in med school, but I wasn't all the way sold on it. And so I didn't want to commit to something like that without being a hundred percent. And then I heard about PAs, physician physician assistance, and it seemed like a really good fit. It was a master's program, but you still got to do a lot of medicine and like work as part of a team, and that was right up my alley. And so I started working as a surgical tech in the like an outpatient skin cancer surgery center for a couple years after undergrad. And that kind of solidified that I like medicine. I want to work in medicine and then went to BA school from there.

Colby 8:41

Yeah. And you started in vascular. Did you kind of like know going into like after graduating, going into the real world for career that you were like, was vascular your thing? Was it a situation where you're like you interviewed and that was one of the job offers that you got? Yeah, that's a good question. Yeah. How did you land land there first?

Daniel 9:01

I it wasn't my top choice initially. I'm glad I ended up there, but I really liked orthopedics. I liked the idea of here's a problem, fix it, and it's fixed, and then it's done. And I like clear exactly. Just you've done it, you've fixed a problem, someone is better, and they go home and it's and it's done. And you have helped like changed that person's life in a short period of time rather than titrating blood pressure medications and things like that.

Colby 9:29

Yeah.

Daniel 9:30

But there weren't when I was where I was looking for a job, there wasn't an opening that kind of fit. And I started looking into what was available in one of them was vascular surgery. And the more I looked into it, the more I thought, this is actually really interesting. It's, you know, it's it's vascular, so it's it's it's your it's our your arteries, it's blood flow, which is every part of the body. So you get lots of experience. They're usually pretty sick people with lots of comorbidities. So there are lots of different facets of medicine that you kind of dip your toe into. Um, and it's surgery, which I was always interested in. So you still get that element of it. So not something I was immediately drawn to, but once I learned about it and looked into it and, you know, applied and interviewed and interviewed to it, I was really interested in it. And I still have kind of an aspect of that in my current job, which I still like.

Why Medicine And Choosing The PA Route

Colby 10:15

Yeah, I was gonna say it was kind of almost like a natural transition into what you're doing now with the limb preservation, and that also kind of got you to your ortho like dream, quote unquote. So it's kind of cool. It like gave you a good, a good basis, and it I feel it's not to compare it to like med search nursing, it's obviously two very different things, but like you get a wider, like a wider amount is not the word I'm looking for. I'm just like having trouble finding words right now, but you get a a larger knowledge base, and then you can take that and build off like you have this all this background knowledge extensively because that's your specialty for a while. And it goes hand in hand with limb preservation. I mean, a lot of the reason why limbs need to be preserved is because there's poor vascularization. So yeah.

Daniel 11:00

Exactly. That was part of the reason I I took the job. The the podiatrist that I work with, I also really like her and she has been here for a few years, and that was part of it. But but it was like kind of an easy kind of tangential transition. So it wasn't something where I'm starting over fresh. It was a lot of similar patients, yeah, similar stuff that we're doing, just kind of of a different aspect of it. So it was kind of an easy switch, which I was also interested in.

Christopher 11:24

And it so I I guess this is a question I don't think I've actually asked you. Well in terms of like physician assistants and APPs in general, like when you started, vascular was an immu floor. Like, is there like for nursing, you had to learn like that you become an acute care nurse or an immunurse or an ICU nurse? Is there's like varying degrees of acuity in terms of like when you're learning? Like, does it really matter?

Colby 11:56

Oh yeah, that's a good question. Because even nurse practitioners, you can do family medicine or you can do acute, acute and be in the hospital versus like a clinic or something.

Daniel 12:05

A clinic, yeah. For PAs, there's there's not like a delineation. It's you're you're trained and once you graduate and and pass your boards, you're you're qualified to do kind of anything and everything. So we can work in the operating room as a first assist, which can be, you know, up to quite a bit depending on the the surgeon and their level of comfort. You can work in the ICU, you can work with kids, you can work on the floor, you can work outpatient. There's really anything. And when I first started this job at on like the acute and intermediate, I didn't really know what an intermediate unit was. Right. I had very little experience in a hospital before my first job. And so I was kind of learning and I remember asking, like, what what is what is the difference? What patients are are in the or in the intermediate versus just the acute care? Like what what do I need to know? Yeah. Took some time for me to figure that part out.

Christopher 12:58

Well, interesting enough, it depends on the the health system too. Yeah. Because like our health system has a certain guideline or what what is the take? It's what's the do you remember on our little like just like levels of care.

From Ortho Dreams To Vascular Reality

Colby 13:13

Yeah. Yeah. But yeah, it which is a guideline on how to determine if someone is immunostatus. And as far as our health system goes, it's pretty cushy. And some people who have never worked other other hospitals may have may have an argument for the opposite of that. But there's a lot of hospitals that I've worked at at more multiple hospitals. So there's a few hospitals I worked at where like their guideline is like much more strict. And so you could have like a very heavy acute care assignment where at our facility it would be considered an immu assignment and you wouldn't have had that many patients. But I've also worked at another hospital who's even more cushy. And really. Yeah. Like there's a hospital system I worked for when I was traveling. And there they had a PCCU, which is a progressive coronary care unit, and it was all like post-CAF, post-pacemaker, but it was just like post those procedures. But they were like, this is a very serious MU, and you can't have more than three patients. I'm like, these are like the easiest patients that I get, like in my home hospital. This is a joke, right? And so I would love when I got floated to that floor because I knew I'd be like kicked back. Right. Like, this is nothing. I'd be like, all right, cool.

Daniel 14:33

It's like a nice unit.

Christopher 14:38

Well, I, you know, it is interesting to kind of hear about your like start to medicine. I'm curious, like outside the hospital, what keeps you busy? Any hobbies or any random skills we would like to know about?

Daniel 14:55

I don't know about random skills, but hobbies. As as you know, I like to play pickleball. You're right. Christopher and I play pickleball pretty much together. We have one. Two leagues.

Colby 15:07

Yeah, they have a championship ring.

Christopher 15:09

We don't have one.

Colby 15:10

Oh, I have never seen the other one.

Christopher 15:12

Oh. Okay, I'll show you the second one. Um as I dig into my book bag.

Daniel 15:19

I like pretty basic stuff. I like, I don't know, I sort of consider myself a foodie. I like to try new foods. I'm always, you know, like to eat and go out to restaurants. I like sports. I'm into football. I like games in general, video games, card games, sport games. Anything you can win at. I like to I like to play them.

Christopher 15:41

Yeah. I I realize Daniel is actually as is probably my equal in terms of competitiveness.

Colby 15:48

I was just gonna say that.

Christopher 15:50

Yeah. And it's it shows because he's starting he's starting. He's been beating me at Biggleball recently, and it's been so sad.

Colby 15:59

And that is I think the ground just shook.

Daniel 16:02

It did. To be since they're an earthquake. We're pretty comparable. They're they're they're pretty close games. It goes back and forth. Yeah.

Colby 16:08

I'm sure. And that's also why in doubles you guys smash the smash in every league that you're in. Literally. Lordy. Well, okay, I have to ask, what were your first thoughts when you heard about Nursing Life 101 when you when Christopher was like, listen to our podcast?

Unit Acuity, Roles, And Training Differences

Daniel 16:25

I I think I heard about this podcast years ago. I think Christopher talked about it early on and kind of threw it out there. And it sounded like a great idea, but once it really got going, I started listening to it right away. And I it's I've I've really enjoyed it. I I know it's you know geared towards nursing, and I've never been a nurse, but I think it's pretty relatable to all of healthcare and working in a hospital and working in the healthcare field when you know, there's lots of different aspects there. And I I I feel like it's it's interesting and you guys dig deep, and I feel like you guys are, you know, have good banter back and forth. So it's a I I like it. It's a good podcast. My wife started listening to it as well. She's not in the medical field.

Christopher 17:10

Really? Yeah. Oh, that's cool.

Colby 17:14

That's awesome.

Daniel 17:15

She she hates medical film.

Colby 17:17

That's how much she likes you, Christopher, and me. We've only met once.

Christopher 17:21

I do appreciate that actually. A lot. A lot, a lot. Roman says hello.

Colby 17:29

Shout out to the kids. Um, which is funny because also that's my sister's name, so it's like a double, double shout out.

Christopher 17:35

Yeah, it is pretty cool.

Colby 17:37

Oh goodness.

Christopher 17:38

That's funny. Yeah, I mean, you know and we'll t we'll talk about this like later on in terms of like future stuff, but what what has been what has been your like favorite episode so far? And then like what could we improve on? The critic.

Colby 18:02

That's a good question. I'm excited to hear this though, actually. I like feedback.

Daniel 18:05

I don't know if I could list off a favorite just I feel like I've listened to them all and it's hard for me to specifically say which one was which. I think the like work relationship romance one I liked. I just felt like it was it was kind of funny. Okay. That's just the one that that jumps out. I feel like you guys had had good banter and it was like a fun little back and forth.

Colby 18:34

Yeah, that one we I definitely had the giggles throughout. I can't imagine how much you had to edit out of that one.

Christopher 18:40

Well, and it's funny because like there's so much more that I would like to say in that like realm that I've like, I just probably can't.

Colby 18:48

We could always go back and make another one.

Christopher 18:50

Well, we'll we'll think about it.

Colby 18:52

I don't have a lot to bring to the table for that one.

Christopher 18:54

We've well, I know. And I'm the only one that's probably been borderline. Well, not borderline. I've been in relationships with people.

Daniel 19:03

I do, I do think it was really funny the um the burnout episode. Oh. Because that was 90% golfing in preserver.

Colby 19:10

That was just my episode.

Daniel 19:11

Nothing to add. Not that I think it was better without Christopher, but I just I just thought it was it was funny that it was just not not a lot you could uh you could weigh in on. I couldn't.

Colby 19:23

You're like burnout, never heard of her. Yeah, me and I was like burnout, me and me and burnout are best friends. I can tell you a lot about that.

Christopher 19:33

Yeah. Okay, so what what could we improve on? That's a good question. I mean, I know I asked it now.

Colby 19:39

Not not to put you on the spot or anything.

Daniel 19:42

I can't think of anything that you actually like I would say you need to improve on. I think just continuing to expand what your what your each episode is about. Like I think this is a fun episode. I'm obviously I'm I'm here, so it's biased, but I think, you know, including guests that I think you had mentioned potentially doing another guest in the future. And I think that'll be cool. And just kind of continuing to get into kind of more niche topics of healthcare. I feel like healthcare is so broad and trying to pinpoint on kind of little specific things that you can get into.

Colby 20:16

Yeah, I think that's good advice.

Christopher 20:18

Well, you know, ultimately I just want to say we promise we didn't pay Daniel to say any of this.

Colby 20:26

Not yet.

Hobbies, Pickleball, And Podcast Feedback

Christopher 20:29

Yeah, I'm not opposed to being You're like, wait a minute, I could get paid? I mean, technically I paid for the food. You just didn't know me. You can reject that. Yeah, I could, okay. Oh my god. Just send it back to you. You're like, and that's done.

Colby 20:53

All right, it's time for Spotlight Case where we dive into real life patient story that sticks with us.

Christopher 20:59

These are the cases that test your judgment, your teamwork, and sometimes your emotional limits.

Colby 21:04

So, Daniel, you've seen a lot of medicine in action. Do you have a case that changed your practice or how you see patient care?

Daniel 21:13

I think it's hard to narrow down a specific case, but just as my time, especially for the first few months of working in a hospital and seeing these, you know, more acute patients, just seeing what these people have to go through and what it takes as, you know, the whole hospital system from the surgeons, the doctors, the residents, the fellows, the APPs, the nurse, everyone all together. And it's, you know, it's everyone's job. And I think it's easy to just kind of come in, do what you have to do and clock out. But when you can kind of look at it as a this is the worst experience in this person's life. They're having the worst time and just being able to spend a little extra time with the patient. I feel like they were. a lot of times when I'm around with the surgeons and they come in for a second. How are you doing this morning? They're still asleep. They're not even able to make their eye cracked. They're like, okay, yep, everything looks good to you. And then they you come back in and you're like, so did you catch everything they said? And they're like, no. And so then I'd sit there and you know spend 15, 20, 30 minutes and kind of talk it through with them and explain everything going on, explain the next steps. And just being able to give the time that the patients really need to help understand what's going on and kind of help them feel better in the situation when, you know, they're terrified. They don't know what's happening. It's it's a horrible situation. And I think just being able to slow things down and try to look at it from their perspective. It's stuff that we come in and do all the time. So we we do a lot of amputations and major amputations where we're cutting off someone's leg and it's completely changing their life.

Colby 22:53

Right.

Daniel 22:53

And we do it all the time. And so it can become a little bit kind of like benign to look at from our perspective, but it's it's completely life changing for these people. And so I always try to you know take a second one I before I go in the room and be like, this is going to change their life. Let me make sure I'm I'm approaching it in the right like state of mind to be able to see it from their perspective and try to spend the time and talk them through it and work with them.

Colby 23:20

Yeah. That's so true from like almost anything that we do as healthcare workers, especially in the hospital settings if you're in the hospital you're sick as shit. And that, you know, on all levels it could be something like we see every single day and we're like, okay, whatever. But it like you said it's life-changing for that person. It could be their worst day that they've ever had. And just because it's our normal, it's we have to remember and like keep ourselves in check that it's not their normal by any means.

Christopher 23:48

For sure. And you know you mentioned earlier Colby about you know holding the leg of a person so that like and Daniel you were like yeah it's nice to have somebody to hold a leg for 45 minutes. Is there any is there what's been the longest you've had somebody hold a leg?

Daniel 24:10

Like do you do you know? Like there was there was a patient the one probably the one that I mentioned where this lady came in and and she came in from a facility and she was just getting really poor care and she had just her foot basically full of maggots. It was pretty bad.

Colby 24:24

From a facility not even from home.

Daniel 24:27

It was it was it was unfortunate and it was something where I'm like I I need help. Yeah. And so there was I think it was a I think it was one of the CNAs and she came in and she helped me it was it was over an hour. And as I'm sitting there like doing it the assistant nurse manager on the unit came in and you know saw what was going on and went back and like brought her the little like coffee gift card and like put it in her scrub pocket. You deserved it. And I was like can you give her more than one please what do I need to do to like write write her a positive accommodation. I don't know. I mean you could have gave her a B nomination yeah.

Colby 25:05

It's just like the I don't know okay sidebar like how the daisy is for nurses. The B is for like any ancillary staff or CNAs but even like a facility like maintenance guy could get which I also wrote one for one of them can get a B award. Yeah. It's necessary. The same QR code same QR code so if you walk by any of the daisy stuff and you take the QR code in the future just in case.

Christopher 25:29

Good you know all right back on the It's unfortunate for that person that you didn't know.

Colby 25:33

Yeah whoever you were you were this close to a B nomination. Great job Oh well while we're on the sidetrack is the B nomination just our healthcare facility? I don't think it is it goes with Daisy because Daisy's like could be nationwide. Okay. Okay. Cool.

Christopher 25:54

But to that is there anything that's similar to the Daisy for APPs?

Spotlight Case: Time, Empathy, Perspective

Daniel 26:00

Oh yeah. I think I think that nurse practitioners are still eligible for the daisy. Okay. And PAs are not You can get a B. Really? That that's like why not? Come on now.

Colby 26:13

Who says they can't?

Daniel 26:14

It's not that sucks that they can't get a daisy though. I I was technically nominated in a group once for a daisy which I didn't really think made sense because I'm not a nurse or in the nursing umbrella in any capacity but the group that I was working with was nominated as a group.

Colby 26:32

Oh okay nominated did not receive that's okay I've only been nominated once we talked about it we've talked about this wait Christopher have you ever been nominated?

Christopher 26:43

I don't know that we ever talked about you we only talked about me I've been nominated Once twice? I'm trying to think he's like more than once I want to say three times.

Colby 26:58

Oh of course I've never won I've I've been nominated though how does the nomination versus receiving work is it a group gets nominated only one person of that for that time period or yeah and I think they do it monthly okay and there's a committee of people who like read all the stories and like all of like the names and units that they work on are blacked out and then they put in their votes for who should win.

Daniel 27:22

Do you get anything? Is it just a little pin?

Colby 27:25

Well you get the the daisy pin for being nominated but if you win you get a marble statue that's about maybe seven inches.

Christopher 27:34

It's marble I thought it was well it's like a rock. Well I thought it was glass.

Colby 27:38

Well the B is a glass oh got it but the daisy is like this like it's like this statue of like I feel like it looks like abstract emoji with arms kind of arms out encompassing another emoji avatar movie. Google it I'm probably not describing the right thing.

Christopher 28:02

I was watching you describe it with your body well let me grab let me get you a picture. Please hold okay Daisy Well well we'll wait so MPs but so MPAs don't actually have one?

Colby 28:20

Tell me I'm wrong though. Oh okay if you googled at this point if you weren't driving what I was describing was exactly what you're seeing if it's not the pin and it's the marble rock statue with the arm sound.

Christopher 28:34

I didn't know yeah man that's wild. I would have never guessed that I've never seen that before me neither there oh there's a team pin.

Colby 28:44

Wait so this might have been what you could have gotten for a winner I guess? It's like a group of daisies.

Christopher 28:51

There's a nurse leader one that could be me or you no I'm not getting one anytime soon.

Colby 28:56

And then there's the nominee one and then whatever an honoree pin is maybe that's what the the the the bee was at some point. Honoree an honoree? Eh whatever.

Christopher 29:07

You know we might actually need to look to see if the bee is a national thing.

Colby 29:13

I think it is because this is a different health system that's also talking about the good to know which makes sense it goes you know like did not did not make that good okay but then also this Etsy pin it's wilted daisies. Oh no and that would be okay I'm gonna get those for you both of you I would wear it.

Christopher 29:43

We are tapped out some burnt out daisy What point of your career you know you you were saying seven years has been like a moment where you're like man this has been really challenging or really rough during COVID I feel like there were some tough times.

Daniel 30:07

It was I think I'd been working for about a year so I felt like I would kind of just gotten on my feet. And then as COVID was ramping up in in the US but in our area specifically they combined the unit that I was working on that we were working on to from vascular to include cardiac thoracic surgery and vascular surgery. Right. So they merged all those together. So it was two new service lines, a bunch of new surgeons, all new staff that we were learning in addition to the COVID epidemic and having to deal with all of that.

Christopher 30:43

Well and that's that's when you move to like you moved from our unit to a different unit to have that.

Daniel 30:50

Right when I was getting used to all of the nurses, all of the staff, you know, starting to really get relationships with everyone and then it was here's a brand new group of people I didn't I guess I didn't really think about it.

Colby 31:01

But yeah when they did that like Christopher who worked on that unit like it's funny the staff came to the the medicine side of cards or I guess you guys had a a choice some of Yeah no yeah we had a choice but everybody stayed. Yeah so everybody ended up coming to m my unit which was like acute cards which is like a step down from our CCU.

Recognition Culture: Daisy Vs. “B” Awards

Daniel 31:22

But yeah then you like our vascular went with TCV with the thoracic cardiovascular yeah we we all moved units and the the nurses who the whole the whole nursing unit there were all vascular surgery nurses. Not one of them went went with the patient joined TCV. They all went to cards or a few of them I think went to other random units. But none of them moved with us. Which was wild but but was that the challenging part was it like what made it challenging then I think all kind of all of the aspects of it COVID in itself was hard. I feel like it wasn't as busy because we stopped doing a lot of surgery because um and those were our main patient populations, but they told us that if things got really bad then we would have to just start taking care of COVID patients as the primary team without having you know any real experience doing it. We had to go onto COVID units. We were doing a lot of chest tubes and so you know having to have someone watch you don and doff to to go into COVID units and do that. So all of that going on with the you know kind of the scariness of the US during that time and not really knowing what was happening and you know knowing people that got really sick and all of that and what the future looked like post COVID and then kind of you know more microscopic level changing units, ha having to readjust and do that. When I started the job, they said you won't have to change or we're not going to combine these and I say that sounds great. And then a year later they're like we're combining them.

Colby 32:56

Yeah they're like just kidding here we here we go.

Daniel 32:59

We pulled a vast one on you.

Colby 33:00

Yeah all of that layered on top of each other and you're just barely at like a like out of the year mark of like just feeling comfortable and being like all right I think I know what I'm doing out here now. Like I feel more confident more and then it's like just kidding we're gonna pull the rogue out from underneath you and you're gonna start over. That's a nightmare.

Daniel 33:17

That's a nightmare for sure it was a little rough there for one I guess that's a great segue into the next question that we had was like what did you learn from that experience that you still carry today I think a little cheesy but the teamwork aspect of it like leaning on the other providers the the people that I work with that moved with me and then the other the the new APPs that were already on that unit that I could really rely on and learn from and some of them had quite a bit of experience and it was really they're really good resources. And then trying to kind of quickly find the nurses that were the more senior nurses that, you know, I they'd have I I'd have a question I could just ask them like what's going on with this chest tube can you can you walk me through this and so just really relying on resources but just of of everyone from you know the surgeons, the fellows, the nurses, the residents the there were a few DNA so I still when like if if they came into the room and said you need to see this patient, I was up and out of the door in a second because I'm like this person knows what's up and they have like they can tell when something's going down.

Colby 34:27

So yeah for sure.

Christopher 34:28

Trust your staff yeah I I mean I would say that's a powerful takeaway. Those moments really remind us that medicine is more than tasks or orders.

Colby 34:39

Right. It's about how we show up for patients and for each other.

Christopher 34:42

Yep. And that wraps up this week's spotlight case a reminder that every patient teaches us something even when we don't realize it in the moment. Exactly those lessons shape who we are the challenges the teamwork and sometimes even the failures all right let's talk about something that's both real and sometimes tricky the dynamics between RNs and APPs. Yeah because teamwork between nurses and providers can either make a shift fly by or make it feel like 24-hour marathon so Daniel from your perspective what do you think makes nurse to APP relationships work well?

COVID Merger Stress And What It Taught

Daniel 35:24

I think communication is key but I also think it's the specific communication. There were definitely some nurses that I used to work with that were over communicators. I love how you're looking at me I feel like it's me. It's not okay just page after page with borderline normal vitals that we're not going to do anything about. Right. You know, questions about is it okay to hold mirror axe the patient has had three baldum today. Yep, it's okay. You can say the patient refused it and not give it it's it's fine. I I like I was always a fan of of the communication we we had our workroom on the unit and so the the kind of the culture was nurses would just pop pop in and ask us a question, which I liked. I liked the kind of instant gratification of ask a question, here's an answer but I know some of the ABVs and some of the residents got really frustrated with the constant bombardment of like why are these nurses coming in here all the time asking us questions. Can they just send me a page?

Colby 36:25

I liked the open communication and we were I was pretty close with most of the nurses at the time but sometimes it would be a little much I think that's huge for me communication is everything personally I like to know the why behind why we're doing something and so sometimes like I I definitely am not that person who's like the blood pressure was 128 over 70 should we hold that medication like no the blood pressure's normal and it's gonna it's normal because they got the medication. They need to continue to have it. I agree with you when I see nurses with years of experience nurse with one day of experience when I hear them ask questions like that I want to like bop them on the back of the head and be like use your brain like come on this is like this is like when you're getting report from the ED and I hear a nurse say well what's their skin look like I'm like are you kidding me right now that that ED nurse doesn't even know. They have no freaking clue what the the back side of that patient looks like they hardly even know what the front side looks like. Get the patient upstairs so we can get them safe like they anyways but tangential.

Daniel 37:31

I always thought it was funny that I feel like the APPs that gave the nurses the hardest time were the nurse practitioners. There was one NP that I worked with who had been a nurse for 20 years. She worked in the SICI she worked in and if a nurse asked her like a quote unquote dumb question, she would be like you shouldn't be asking that question. You should be able to figure that out you should talk to your colleagues you should talk to your charge nurse this is not a question that you need to ask a provider and I was like that's a little rough but they were like but yeah that's what I wanted to say.

Colby 38:02

That's exactly what I wanted to say. Even as an as a more qualified not more qualified but like more seasoned nurse on the floor I also share those when I like hear these things I'm like why didn't you just ask me like why didn't you ask anybody else because we all probably would have told you I don't care I did not that's like another example of that is in the cards world when someone's in AFib like it can it can ring for a pause frequently but unless it's greater than three second pause when someone's in AFib the providers don't care at all because it's not like a true pause it's just they're an AFib and the the monitor room will call us incessantly being like the patient had a 2.8 seconds pause the patient had a 2.3 second pause and I will literally tell them like do not call unless it's greater than three seconds. But some nurses will page the doctors incessantly and they don't respond which makes them page them more. It's insane. It's like okay can we just all talk about this for a minute?

Daniel 39:07

Yeah and that's almost why I'd rather just you come in and say it and so I can be like that's fine. Yeah this patient's done that a hundred times in the past 48 hours. We're good. It's okay. We're okay you can ignore it.

Christopher 39:18

Let me know if it's eight seconds well you know that actually brings the question there there was at one point and this is this is not in to do anything with RN to PA or APP interaction there was one point we were playing pickleball and you said you wanted to say something about some episode. He's like Do you remember what this was I feel like it was something cardiac related.

Daniel 39:45

Wasn't it EKG related I'm trying to remember I think it was somebody had was it was it EKG and they had like it was already done I have to go back and listen to the episode I remember the situation but I can't remember the specific details. It was something EKG related Oh something that we are had already talked about you you guys had mentioned that they wanted an EKG for something and it seemed pointless or like it wasn't going to change management.

Christopher 40:15

And then my mind I was like well it could change management for XYZ reasons and Christopher was like you should have just commented on it and told us I didn't I just told him later this people these this these things listeners is the reason why we have an open communication for you to contact us and tell us that we're wrong. We're okay with being told we're wrong.

Colby 40:39

Yeah yeah we would love to hear we're wrong just to allow wonderful communication and learning opportunity No now it's gonna bother me I'm gonna listen to every episode until I figure out which one it was and be like okay Daniel I found it teach me what was wrong like what we were missing.

Christopher 40:57

I want to man I I yeah but I I think it was because we were saying like EKGs were expensive.

Daniel 41:05

Oh yeah maybe maybe uh someone had a run of VTAC and see it on telemetry and then capture it and they were already back in normal sinus and I'm like why are we going to get another EKG if they're already back in normal sinus? Right. Okay. I think that was it. Okay. My my explanation was that or my my reasoning and reason I would want one if it was something new, if they'd done it a bunch of times, that's one thing. But if they have if they had an acute event that initiated the VTAC or whatever it was, you could see those changes on an EKG if you compare it to like an old EKG and now they had flipped T waves or if they had you know some ST elevation or something that's changed post the VTAC incident.

Colby 41:50

It's like all of a sudden now there's like now there's a difference ST changes that would interest I agree you're not gonna catch the V you're not gonna catch the VTAC right after you saw it.

Daniel 41:58

You're like, oh let's do it eight minutes later and see if we we catch it. But there's still competing reasons.

Nurse–APP Dynamics: Signal Over Noise

Colby 42:04

See I'm so glad that you said that because that makes a lot of sense. But that's like in my brain I'm just like we're not gonna catch the the VTech run. Yeah but that now I love to know the why I love to have the communication literally no resident has ever explained that they're just like get another gonna like why and they're like I don't they probably don't even know why to be honest. Some of them I'm sure do some of them might not they're like I think they just tell us to do these things. And then it gets trickled down to the nurse and then here I am I'm like why?

Daniel 42:36

I'm like all right I'll freaking do it I guess I have seen that before where I feel like especially July interns their first time being a doctor and you know they're upper level or the attending tells them to do something and then so they have the nurse do it and then nurses ask and they're like I don't know I'm they told me to do it so I put the order in and now you have to do it.

Colby 42:55

Oh yeah definitely very true. Oh wow okay I also kind of feel stupid now that you're like no maybe there's maybe there's some changes that we are looking for that cause the V tag wrong like duh of course but I think I mean 99 times out of a hundred you're gonna do it and it's gonna be the same EKG that you when you got the day before and the day before you're not gonna see changes. But just in case it's but that one time is enough that warrant the EKG that makes sense. What's really cool is we're getting these new EKG machines that will hopefully be rolled out starting next month in March.

Christopher 43:31

Is it just inpatient or everybody?

Colby 43:33

The whole health system but they're gonna they're rolling it out in phases. Phases. Yeah. So like heart and vascular obviously will be like the first areas to get it. And I don't know if they're gonna do inpatient which would make sense to do like the cath lab, you know, the EP, like they would get them first and then the floors and then outpatient. So but hopefully the next the next month they can start rolling that rolling them out. But I got to play with it last Last year when GE came to kind of show it to us. Did you get to go?

Christopher 44:03

No, you had to ask if I could go and I wasn't able to.

Colby 44:06

Did you get to play with them? No. I didn't even know this happening. They're so they're sick. Like the technology on them. Like you we could probably capture VTech. Like we can hook them up and like it's very cool. It can like run continuously without without printing continuously, and then it it's able to like self-detect when something is awry and then it'll like print its print itself. Yeah. So if someone's like going in and out of it kind of frequently, you can just leave them hooked up to it for a few minutes and it'll capture it. And then you can go back and look at like a full disclosure and like grab it, which is awesome.

Daniel 44:38

I've seen some patients where they just keep printing and it's just a one-inch stack of EKG strips because they just keep printing and printing trying to catch something. Well, yeah, you can do like a a run.

Colby 44:49

You can, yeah.

Christopher 44:50

You can like make it run.

Colby 44:52

But then at like what point is is it like different from just being on telemetry? It's like not really.

Daniel 44:59

Not really.

Colby 44:59

Yeah. So we have that to look forward to. Nicer.

Daniel 45:03

Exciting stuff.

Colby 45:04

Exciting things, yeah.

Daniel 45:05

That is neat.

Colby 45:06

Yeah. And I guess barcodes, I'm pretty sure, if I remember correctly, it's a barcode scanner too. So you just scan the band. And it'll marry it to the order.

Christopher 45:15

That's neat. Yeah. You don't really care about that part though, do you?

Daniel 45:18

Well, with with my position now, I haven't looked at EKGs in a couple of years. But when I was working on the inpatient unit all the time, and then you know, the strip wouldn't save and get uploaded into the electronic medical record. It's like, well, we we wanted the we wanted to see it, and if we can't save it, why did we do it? So hopefully that will make that much better.

Colby 45:45

It should, yeah.

Christopher 45:46

Oh my goodness.

Colby 45:48

What's something you've always wanted to ask a nurse, but maybe never said it out loud?

Christopher 45:53

Oh, this is a good question.

Daniel 45:55

I've I've been pretty close with a lot of nurses I've worked with, and obviously I've known Chris. So if it's something I probably would have asked him at some point, but a couple, I can throw a couple examples out. There is this one. Well, you didn't know about the B. Tell me about B. There was a nurse one time who about two in the morning on a night shift sent a page that said the patient's advanced directive was not up to date. Will you come and talk with them about it? And this is two in the morning. Two in the morning. And I just couldn't understand why. Were they like close to death? No. They were fine. They were gonna discharge home in a day or two. What? And I really could not understand why they were doing it. But as a more general question, I I get night shifts are a little bit slower and you have more time. Yeah. But digging into all of these orders and trying to, you know, clean up the orders and go through everything and then bring them to the provider who's only cup who's covering the all of the patients and doesn't really know all of them in great detail. Right. And then asking, will you go through all of their orders and discontinue everything and make the adjustments? And it was kind of like, why do you why are we doing this now? Why are we doing this at two in the morning? Yeah.

Christopher 47:12

I mean I think I think there's an importance because aren't they charged for like per order?

Colby 47:21

Yeah.

Christopher 47:22

So like are they charged per order?

VT Runs And Why Post-Event EKGs Matter

Colby 47:25

I will I don't it's I would have I don't know for sure, but I know that's part of charge capture, like is the orders that are put in. But I know that there's also you they kind of like do like a lump sum of like it'll say like nursing care and it'll list like a bunch of stuff. So I'm not exactly sure how how it looks on the bill. But I would say it happens at two o'clock in the morning, like you said, because we have a lot of time. And like that's when we're like looking at orders, and like I would say like after eight years of working night shift, I would look at it and this was before we had like a the what's it called? It's like save where you like do it and you just pen them for relationships. Pen them. Yes, exactly. So it was before we had penned pending orders as floor floor nurses. So I would go through and I'd be like, this patient was in the CCU for 24 hours and then came out to the floor. They've been out on the floor for six days now and they still have ICU orders and acute care orders. Like, can we just clean this up? Like, clean it up.

Daniel 48:23

That's fair. That makes sense.

Colby 48:25

Yeah. So like that's but like to ask somebody to come to the bedside at 2 a.m. to talk about an advanced care. Like, this is another thing that I would like want to smack somebody in the back of the head for. Like, use your brain. Come on.

Daniel 48:37

Yeah. What were they thinking? Like, I can't even I don't know.

Colby 48:42

Another thing people do is like ask for like bowel management like medications at two o'clock in the morning when the patient's asleep and it's not like just tell day shift on in your report on the way out and get it in the like they can have it in the morning. We're not gonna wake the patient up at two o'clock in the morning for a suppository of their butt. Yeah. I mean, not in like unless the patient's in pain, awake, saying, I really gotta have a bowel movement, like I'm so uncomfortable. Like, let them sleep. Let them poop in the morning.

Daniel 49:08

Like, why are we peaching about this? Totally agree. Yeah, cosign. Let them sleep. Decrease their chance of delirium. Decrease their chance of prolonged hospital stay.

Christopher 49:20

Let them sleep.

Daniel 49:22

Exactly.

Christopher 49:24

During night shift, because you also did both shifts too. So what like what what do you have any for the APP colleagues that are listening? Do you have any tips, tricks on staying up at night?

Daniel 49:40

It was uh our the the way that that my unit did it, I I think was less than ideal because it was usually one week a month and it would be three 12 hour shifts. And so it would be three night shifts and then back to days. And at one point we were short staff and it ended up being like two weeks per month, but it would be split up, so it would be like every other. Every other or something like that. I would always try to lump them all together and just do six or seven in a row or something and just do them all, but not always worked. And the back and forth was really hard. And that was the I I didn't mind night shift, but I did not like the trying to switch back and forth. And I think I think you guys have said before, it's you should they have like six-week blocks, which I wouldn't have loved to be on nights for six weeks straight, but at least you can kind of make have a more formalized schedule. That's what I did. That's what CRISPR does. Everybody does that.

Colby 50:39

But not every unit does that. So like cards doesn't do that. You have like a if you're if you're hired as a rotator, you have two weeks uh required of working night shift, and you can do it however you want. And some floors do it like that as well. And my previous unit, if you weren't very clear with your boundaries, they could put you on night shift, day shift, night shift in the same week. Like it's not, it's really unhealthy. It's really crappy that they do it like that. But it's like also like if you're not clear with your boundaries, it's gonna happen to you. I was very clear with my boundaries. I did try to rotate for a little while when I came back after I was done traveling and I was doing the inpatient charge role, but as like a hybrid half day, half night, and I was basically just covering like PTOs. And I wanted to die. I think I did it for I did it from May until September, and then I had a mental breakdown. Sure. One morning after a night shift, and I was like, I can't do this anymore. And they were like, okay, well, it's your lucky day because somebody's gonna like trans, they're like transitioning into being an NP in two more weeks and you can have their spot. And I was like, thank God. So I think I did, yeah, I did it for like five months and I it broke me down the being a rotator like that.

Christopher 51:56

I remember when you would just pop over from the unit and hop over to like my unit, and you'd be like, yeah, just trying to stay away.

Daniel 52:09

And that's I I think I was lucky. I know some people say they're, you know, a black cloud or whatever. And I had some colleagues use it every time they were on night shift, somebody would code, somebody would have problems, people would get escalated to the ICU. And I had like months, a year where all of my night shifts were pretty quiet. A couple little things here and there, but very, very little. And so, you know, I things could always happen, and so we were always like ready and little stuff did, but it really was pretty chill most of the time.

Colby 52:40

Very lucky, I'm gonna knock on wood. Yeah.

Daniel 52:42

Yeah, sorry.

Christopher 52:43

Yeah.

Daniel 52:43

The key word.

Christopher 52:44

The key word. Oh I'm gonna jump into the superstitions really quick. Is there indie I have that question and then I have another one? Like I have all these questions popping up in my head now. Ask away. Do you have like a medical superstition that you like you it is it is your superstition? Like you you can't like you can't say the keyword or No. Oh, are you are you a non-believer?

Night Shift Realities And Superstitions

Daniel 53:16

I always thought it was so dumb when nurses would get freaked out when people would say I'd come over to your unit and I'd say, Wow, it's really quiet over here, and then all the nurses would look over at me and get rid of it.

Colby 53:27

Christopher's flipping a table.

Daniel 53:30

There was there was one, I think she was a case manager who said that there was a ghost on one of the units or on one of the rooms on our unit. Yeah, yeah, yeah. There was like a picture that somebody took and you could see in the picture using the bill.

Colby 53:43

Oh yeah. In Fort West. Oh yeah.

Christopher 53:47

Did you say the I guess it doesn't matter what unit it is, yeah? Yeah.

Daniel 53:54

Pictures of floating around.

Christopher 53:56

I've seen it.

Daniel 53:57

Wow. No, I'm not a very superstitious person in general.

Christopher 54:02

So there was somebody else that was not a superstitious person, and they said it's quiet around here. And literally, the bathroom like emergency was pulled at the clinic, and they were they turned red because they were like, I just said it. I was like, Yeah, this is why you don't say it. This is your fault. Now they're just a little stitched. Yeah, they're not super, they're just stitches. That's funny. My other question is you worked closely with attendings. What were what's something nurses did that pissed off an attendant?

Daniel 54:47

Um probably the biggest one, at least in that unit, was the eyes and nose. Oh, see, that it's important, y'all. Yeah. They were, you know, a lot of these patients had had cardiac surgery, open surgery, and their volume status was a little tenuous, and we would they would be getting dosed diuretics, lace expume, something every day. And the, you know, the weights were always questionable because they were bed weights 50% of the time and would be up six kilos from the day before. And you're like, I don't know if that's right. And so it would be a lot of just trying to measure I's and O's. And it was always hard to get. And I remember coming on in the morning to I would just I'd look and they wouldn't be up to date. And I would just send like four or five pages in a row just so that I could try to have that information by the time we rounded with the fellows in the attendings, just because I I knew it wasn't going to be documented and it wasn't gonna be on our on our printout, our little handoff, just because it was it was not there. So I feel like getting patients up, which I know it, you know, it takes a village, it's not just the nurses. So I don't want to blame it on nurses because it's PT and it's the tech and it's the family and it's the patient who's refusing. And you know, even the APPs and residents can go in there and do it and can encourage people. So I understand it's not just the the nurses, but I feel like it's easy to just say, yeah, those nurses really slide. So anything that, you know, they not getting up, not documenting.

Colby 56:17

I feel like that's a very real list, though. And I feel like that's exactly like what you hear from management, like the ask, like make sure everyone's doing as a charge, like make sure everybody's getting their eyes and nose in. Make sure you talk about that at huddle, make sure you talk about at huddle that we need to get people up on standing scales. Night shift cannot be doing bed weights. Make sure like it's like everything you just listed. I'm like, yep, yep, yep, chip, chip. Yes.

Christopher 56:41

Which is wild. But I mean, it apparently I mean it it makes people upset.

Colby 56:45

Yeah.

Christopher 56:45

I mean, but it makes sense. It's medical, it's it's medically relevant for it to happen. Yeah. So like I yeah, I get it.

Colby 56:53

Especially on my old unit being acute cards was heavily heart failure. And those are like the two main things. Like these patients are here to get IV diarrhees. These are the two main things that we use in order to decide dosing and you know, outside of lab work, and we still can't get it right.

Christopher 57:12

Well, I mean, and then for you, and then for transplant, it was we had the kidneys. We needed to make sure, are we done the need to do dialysis or are we not? Like, yes, we have labs to see all these things, but are they v volume overloaded? Like what is it, what is going on? So Yeah.

Daniel 57:29

And it's it's not yeah, it's not just because they want to know. It's because it makes real decisions and you know, it affects the real decisions and the medical management of these patients, which can, you know, do a lot if you over-diurce them and they can have kidney damage and they can have kidney failure, and you they just had this. And so you really have to, you know, toe the line. And when you don't have that information, you can't go back and get it. It's it's got it's literally flushed down the toilet.

I&Os, Weights, And Decisions That Count

Colby 57:59

True. Man. Well, I think a lot of us nurses forget that while we have a lot of pressure, so do our APP like colleagues. They have an insane amount of pressure on them too. So it's a it's refreshing to hear and remember and get reminded that it does go both ways.

Christopher 58:19

Yeah, it really does. So I asked you earlier about, you know, anything that we could do to improve or to uh change in terms of nursing life 101. And you had mentioned like exploring more deeply in terms of the niche aspects of medicine. But then Colby asked you a question.

Colby 58:43

Topics?

Christopher 58:45

Oh, yeah. About topics.

Colby 58:46

So like Did you think about that as you'd like us to cover?

Daniel 58:50

Yeah. Just to kind of lean into the the guest aspect, and it doesn't have to be, but I think maybe picking specific aspects of nursing or healthcare. So I work in the operating room sometimes now. And I feel like OR nursing is quite different from outpatient-inpatient nursing. So and I think neither of you have experience in the operating room. So either, you know, getting into that a little bit, finding an OR nurse to talk to, because it's it's a pretty, you know, there are a lot of nurses down there.

Colby 59:22

Yeah.

Daniel 59:22

And so I think that could be cool, something just like that. I think getting getting a resident or getting a a doctor and would be interesting, just to get them, you know, their perspective.

Colby 59:33

Yeah, that would be.

Daniel 59:34

Christopher's making quite a face right now.

Colby 59:37

His eyes are like fulfilling out of his head.

Daniel 59:40

But just the kind of yeah, little little niche things. But I like what podcasts are.

Christopher 59:47

She'd probably do it. I know. She is like really cool.

Colby 59:52

Does she listen to her podcast?

Daniel 59:53

She probably does it. I I told her she was doing this weekend. Oh, did she? Well, Christopher has a podcast.

Colby 1:00:01

So she might listen to this episode.

Daniel 1:00:02

Oh, yeah. So you need to plug this episode. All right, I'll tell her she's next. Strap it up.

Colby 1:00:10

We've got we've got our eyes on you.

Christopher 1:00:14

Oh man.

Daniel 1:00:16

Wow. Okay.

Colby 1:00:17

I can I mean We love that idea though.

Daniel 1:00:20

Yeah. Yeah. Overall, I I do. I think you guys are are doing doing great. And I I like the podcast. I'm not a nurse. I've never been a nurse, but it still is interesting and it still is relatable. So I think, you know, continuing to expand upon kind of the things that you guys know really well and then diving a little bit further away from stuff. I'm sure you could, you know, get us get a school nurse in here.

Colby 1:00:42

Yeah.

Daniel 1:00:43

Okay, maybe not that well yet. I mean, I could.

Colby 1:00:47

And then we can always have you back.

Daniel 1:00:48

I'm I'm happy to come back.

Colby 1:00:50

It'd be fun.

Daniel 1:00:51

Season four question mark. Season four. Wow.

Christopher 1:00:54

So we we'll wait a whole season. Okay, season three.

Colby 1:00:57

Yeah, you're like season three, yes.

Christopher 1:01:00

I mean, we can't. I wouldn't want to presume. Who knows? Well, yeah, I think that's it. So, unless is there is there anything that you're like wanting to say, or do you want to plug your social media account? No, I don't want to plug my account.

Colby 1:01:17

Like, absolutely not.

Daniel 1:01:21

One of the the big things that I think that I've noticed that nurses struggle with, especially like new, it's mostly new nurses, but in general. It's just, and I think you guys talked about it on the last episode, two episodes ago, is like the critical thinking aspect to it. An order comes in, sure, it's an order you need to, but think about it for a second. It is a team. Everyone's heard the like the Swiss cheese model. If an order comes in that seems crazy, question it. Yeah.

Christopher 1:01:49

Ask it.

Daniel 1:01:50

If a patient is not doing well, but there's no, you know, order that says to do something about it, take the initiative, escalate it, talk to your team. It's, you know, you got a whole hospital full of resources. Reach out to somebody. Yeah. We're talking about patients, we're talking about people's lives. It's important stuff. It's not a clock in, clock out job. Yeah. There's a lot to it. But we're all here. We're all here to help.

Colby 1:02:19

Yeah.

Daniel 1:02:19

That's good.

Colby 1:02:20

No, I love that. That was a great, great way to end it.

Daniel 1:02:22

Yeah.

Colby 1:02:22

A solid piece of advice to our to our up-and-coming nursing nurses out there.

Christopher 1:02:26

For sure. And and for those that might think they know everything.

Colby 1:02:30

I mean, you know, like it's a good reminder.

Christopher 1:02:31

Yeah, it's a it's a good reminder to be like, it's okay to not know.

Colby 1:02:35

Mm-hmm. Yeah.

Christopher 1:02:37

All right. Class dismissed. That's a wrap for today's session of Nursing Life 101.

Colby 1:02:42

Huge thanks to our guest, Daniel, for joining us and keeping it real about teamwork, growth, and respect in healthcare.

Daniel 1:02:48

Thanks so much for having me. Can't wait to come back for season three. Yeah.

Future Topics And Expanding The Lens

Christopher 1:02:52

Well, hey, I'm okay with that. Let me know. You have my number. I do. Quite literally. We hope this episode reminded you and everyone that collaboration is what makes healthcare work.

Colby 1:03:06

You can find us on Twitter slash X at NurseLife101. That's life with a Y, L-Y-F-E, Facebook at Nursing Life101, or Instagram at nursing underscore life underscore 101.

Daniel 1:03:17

Don't forget to subscribe, share, and leave a review. Tag us if you've got a story about teamwork that made a difference.

Colby 1:03:24

Until next time, take care of yourselves, take care of your patients, and keep showing up for your team.

Christopher 1:03:28

Thank you so much. Thanks, guys.