The Bossy Nurse Podcast
The Bossy Nurse Podcast is a show about nurse creators, innovators, risk-takers, and the ideas that shape their success. Hosted by Marsha Battee, Founder of TheBossyNurse.com.
The Bossy Nurse Podcast
8. From Critical Care to TEDx and Lifebeat Solutions: Dr. Julie Siemers Talks Patient Safety and Business
In this episode of The Bossy Nurse Podcast, Marsha speaks with Julie Siemers, DNP, MSN, RN and how she turned decades of missed early-warning signs and communication breakdowns into Lifebeat Solutions, training that equips nurses and healthcare workers with clinical-judgment and patient-advocacy tools to prevent harm.
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What should have happened is, sir, I'm really concerned. I'm uncomfortable with how this foot looks. I need you to come in and assess. And that didn't happen. Unfortunately, the man lost his leg.
Marsha:Welcome to the Bossy Nurse Podcast, a show about nurse creators, innovators, risk takers, and the ideas that shape their success. I'm Marcia Batti, and on the show today, how Dr. Julie Seymours turned decades of missed early warning signs and communication breakdowns into life-beat solutions. Training that equips nurses and healthcare workers with clinical judgment and patient advocacy tools to prevent harm. Hospitals don't just save lives. They can endanger them when early warning signs are missed or voices go unheard. Research shows patients often exhibit clear signs of deterioration 6 to 24 hours before a code event. Yet basics like respiratory rate, an early sensitive indicator, are frequently undocumented or guessed, letting trouble snowball. And because many harm events trace back to communication breakdown, patients and families need language that gets attention before the cliff. Before creating her company Life Beat Solutions, Dr. Seymour spent a decade in flight nursing where autonomy and rapid clinical judgment were non-negotiable. And later seeing preventable codes and missed early warning signs, she pursued graduate work on failure to rescue and began teaching communication tools that patients, families, and clinicians can use to escalate concerns. That instinct for decisive action just didn't start in the ICU. It started at home. Dr. Seamers grew up in a military family where readiness and service were expected, which brings us to where her story begins.
SPEAKER_00:Yeah, my dad was in the Air Force. He retired when I was 14, and we settled in Spokane, Washington. So I was there for, you know, high school and middle school. And um yeah, it was a real change from being, you know, moving every two or three years. But uh yeah, I was the second of the oldest of seven children. And so yeah, it was a great experience learning all about um, you know, what the future could hold, because that's what my parents always tried to probably like all parents, what do you want to do when you grow up? So that was a conversation around our house with all of us kids.
Marsha:So with seven kids in the household, what were the various answers to that question?
SPEAKER_00:Yeah, second to the oldest. Um, my oldest brother ended up in the Navy. And then I don't know if he planned that, but he wanted out of the house so bad. You know, the oldest child. Um, and then I don't know why. Two of my brothers wanted to be doctors, and they are. My parents weren't in the medical field at all. So my mom had always wanted to be a nurse, which is why she um recommended to me, hey, that would be a good profession for you. So that's how I ended up in there.
Marsha:With your mom wanting to be a nurse, do you feel there may have been a reason why she didn't have the opportunity to pursue? And she was really excited about are you the only daughter?
SPEAKER_00:I have one, I have five brothers and then one more sister, and she ended up in IT and now is in healthcare. But it was probably because moving around with my dad in the Air Force that didn't afford my mom to be able to go to school and having a family to take care of and raise. I mean, back then you couldn't do online anything. So going to sit in a classroom was next to impossible.
Marsha:Yeah. So you applied probably, I'm assuming, to a number of nursing schools. And I know you tell this story about your mom in a letter.
SPEAKER_00:Yeah. No, I only applied actually to the local community college. And this was, gosh, back in 1978, they had a lottery system. And I was chosen. So I was kind of freaked out because I was only 17. Um, and I started out in the ADN program, but I had no prerequisites out of the way. So I was taking all of my nursing classes with all of my prerequisites. I only lasted about two semesters. I thought I can't keep this up for two years. I was dying. And so they let me go to the LPN program for the next two semesters and then, you know, got to be able to graduate with that certificate or that license and did that work for the first 10 years and slowly got the rest of my prerequisites done so I could finally go back and get my associate's degree.
Marsha:Oh, wonderful. So when you did get your associate's degree, did you know around that time when you were finishing up where you wanted to enter into the nursing workforce? Or was it just a given that everybody goes into med surge?
SPEAKER_00:Well, I started out in med surge. Um, and then it was actually oncology first, and then I went into the cardiac step down. So with all that training on watching monitors and getting really good at heart rhythms, I just went straight into the ICU as soon as I got my RM.
Marsha:I know that's sometime a challenge nowadays, um, getting right into an ICU or a critical care field, what you're passionate in, you don't have to be pigeonholed into one specific specialty as you come out of school. I always say any specialty will give you a foundation in your nursing care, any specialty. And I wrote a blog post about that years ago, and I'll probably link it in the show notes. But any specialty will give you a foundation for your nursing care. So, so going into critical care at such a younger age, how was that for you starting out?
SPEAKER_00:I felt ready and prepared. I mean, we had a great ICU program to get us ready. Um, you know, teaching us the didactic portion of vasoactive drips and postoperative open heart surgeries and, you know, all the deeper um concepts that med surge and cardiac nursing had prepared me for. So yeah, it was a great journey. I loved it. And I transferred um hospitals because I moved to Las Vegas in 1996, started out in the surgical ICU, but there was a critical care transport team opening in a hospital next door at the trauma center. And I was like, oh, that sounds really fun. So I did that for a couple of years and then transitioned with that skill set over to flight nursing. So I did that for about 10 years.
Marsha:So with flight nursing, how was that experience?
SPEAKER_00:You know, I loved it because I I guess I've decided over all these years that I'm a lifelong learner, which is perfect for this profession. But I worked with paramedics, you know, as my flight partners, and they taught me so much about pre-hospital. You know, we learned how to give classes, how to set up landing zones for the fire departments, especially in rural areas, you know, that would have us fly in and pick up a patient. Um and the trauma center training was very different than when you're first on scene. And you never know what you're gonna get. So I loved it because sometimes the radio, you know, would crackle with the paramedic on the ground telling us, oh, your patient's gonna need intubating. They would over-exaggerate or they would under-exaggerate. Sometimes they were right on, but we what I loved was I knew I had to be prepared for any scenario. So to me, that was really challenging.
Marsha:Yeah, it sounds like a pretty fast-paced environment as well. I remember shadowing when I was a forensic nurse. And I remember we had to go to a scene on a metro platform of a patient who I can't remember now if it was a stabbing or a gunshot wound. And so the paramedics on the scene, it's amazing. And I was emergency room nurse at the time, training in forensic nursing. It's amazing what the paramedics on the scene do so much more than we would ever think about ever doing as an emergency room as a nurse. Just how fast paced it is and how much you learn from paramedics, especially in the emergency settings. So, with all the knowledge and specialty experience that you have, which one would you say was the most rewarding or the most, the most enjoyable to wake up and go to work every day if you had one, if you had one to tell?
SPEAKER_00:It was definitely flight nursing because the one really big differentiator was we were autonomous. I mean, we had protocols and we had a little book we carried in our flight suit pocket, you know, to refer back to. But we also had a medical director who was amazing. And he basically said at our monthly chart reviews if you can justify what you did for a patient that's outside of protocols that was actually helping them, because we're never gonna teach you everything or have protocols for everything, then I support you and I've got your back. And, you know, I think nearing the end of my ICU transition before I went into pre-hospital was so frustrating because I had I worked with residents and they were always flexing. All of us nurses know what that means when you're like, hey, you know, BP's down, CVP's down, I think we need a fluid bolus, and they would come back with, well, we'll see how they're doing in an hour. And you're like, dude, we're in this together. Come on, right? And so as a flight nurse, I didn't have to defer to anyone. Yeah.
Marsha:Which sounds like challenging and exhilarating all at one time, especially when you never know. I mean, you you do know because you get the call, but you just never know, like you said earlier, what is actually going to be there once you arrive. And I imagine you've seen some maybe traumatic experiences throughout.
SPEAKER_00:Yeah, for sure. And to a lot of people, that can be terrifying, not knowing what you're walking into. But I think it was also really motivating to keep up on your skills. Well, we had to. We had the requirement every month of um a central line insertion, five intubations, a chest tube. Um, and we had to do those every month to keep up our skill set. Oh, and so there was a part of me that was just like, oh, come on, I know how to do this, but it's muscle memory. So when you've done that many intubations, if you get a difficult one or it's two o'clock in the morning and the guy's ejected from his vehicle out in on the desert, you know, ground, and you've got to get that airway before you get him into the helicopter, you're grateful for all those practice runs, you know.
Marsha:Yeah. Is that pretty typical in flight nursing?
SPEAKER_00:Yeah. When I um was first on the flight team, there was a prerequisite of five years critical care experience, either ED or ICU. And then they changed it to three years, which I thought was really ridiculous because you have got to be so solid in your thinking and be able to, your clinical judgment, your um critical thinking, you've got to be able to think fast because the patient's life depends on it. You know, even you know, you're going to pick up a patient that was electrocuted, safety is absolutely first. And that was a tough lesson for me to learn. Like you have to look at the scene and make sure it's safe before you even approach the patient. Or, you know, the takeoff and landing is the most critical phase of flight. And so even if we were doing CPR or the patient needed an airway, all eyes out the window because we've got to look for obstacles like wires or anything like that. And so patient care didn't come first like it does in the ER or the ICU. It's safety first. And so there were so many things like that. But I would say that yes, your patient's life depends on your ability to quickly critically think and be adaptable. You've got to pivot. Let's just say, and we would practice these in our flight meetings, our chart reviews, you know, let's just say, hey, the nurse before you forgot to replace the hydrolysine. Now you've got a hypertensive patient. What are you going to do? And at first you're like, well, I don't know. I don't have any other drugs. And then it was like, okay, can we use LASIKs to decrease, you know, the uh fluid volume? Or we have morphine, even though they're not in pain. I mean, that probably would be, but you know, we can decrease the preload and decrease the blood pressure. And it's thinking like that that you've got to be ready for. So I think three years is not quite enough. I would say five years when you're feeling comfortable with your clinical decision making.
Marsha:And also all emergency room trainings are not the same. I'm an emergency room nurse and I've been at three trauma ones. And the training and the care that we provided, all three trauma ones, even though they were trauma ones, was significantly different, but it also depends on where you're getting that training as well. Yeah, and where you're walking in the hospital. So flight nursing. So what happens after flight nursing? I know at one point you discovered that there are some critical aspects of care that were missing and within our nursing field and our nursing care and saw some errors that made you think, hey, maybe go to nursing, maybe go to grad school for education.
SPEAKER_00:Yeah, I transitioned after the 10 years on the helicopter into nursing education. I only had my bachelor's at the time. And so I could teach in the simulation lab and at the hospitals doing clinicals with the students. And I loved those. But I really wanted to teach in the classroom too. And so I needed my master's for that. So then I finished that. And then what drove me to completing my DNP was I had several students that would share things that the dean had decided, or the director. And to me, it wasn't care. And I'm like, we're in a caring profession. For example, one student's grandmother in the Philippines died, and he wanted, he was super smart, wanted to take his final exam two weeks early. And the dean would not let him. And so he failed the course, had to come back and repeat. So I said under my breath, well, I'm gonna be the boss someday so I can make do the right thing. Yeah.
Marsha:Yeah, that's so disheartening. I know rules are rules, but sometimes there's exceptions that we should we should want to make and be helpful. Um so going into going to get your graduate degree, how was that process for you?
SPEAKER_00:I was actually working for Tarot University, which is health sciences in uh Nevada, Las Vegas. Um, and they had an MSN and a DNP program. So that worked out great. Um, I could do that, you know, while I was working and teaching. Actually, it really worked well because that's when I decided my master's thesis and then my DMP project was going to be on failure to rescue. So I was so surprised that so many educators or even nurses working don't understand that concept, even though it's been in the literature for decades. And it is failing to recognize a patient becoming unstable or deteriorating, because the research tells us that those physiological signs happen six to 24 hours prior to an unplanned cardiac arrest. I'm like, okay, well, if we know that, then why aren't we teaching students and nurses how to recognize those early signs? For example, the research again tells us, and it makes sense physiologically, that the respiratory rate is the single most sensitive and earliest indicator of patient deterioration. And yet 80% of nurses don't even truly count it. They make up a number of people.
Marsha:I was gonna say that. Yeah, it's usually what, 16? Yeah, yeah, 16.
SPEAKER_00:And so they're missing those early signs. And so we can't get in front of it if we're not recognizing the signs or mental status changes. Those respiratory rate and mental status changes are the least documented, but the most serious of patient signs of deterioration. So that really fueled my fire. Yeah, yeah.
Marsha:So if there's one nursing note I have to say in this particular episode, and that's one, count your respirations. Dr. Seymour says so. Uh number two, altered mental status. That's probably the one thing I would recognize first, knowing that I'm not doing vitals in the moment, is a confused patient or them answering a question that doesn't quite seem right. So altered mental status and respirations, count your respirations. So before you did your thesis on failure to rescue, were there any specific instances or episodes that you specifically saw in the workplace or in the hospital setting that made you really want to go into this area of patient safety on your thesis? Is there anything that really stood out for you?
SPEAKER_00:When I was um as a flight nurse, we had three bases. Two were remote and one was hospital-based. And so we had the helicopter up top on the helipad. But if we weren't on a flight, we were in the hospital responding to codes, um, you know, starting difficult IVs, that type of thing. And I guess it always just blew my mind the codes we responded to. I'm like, this guy's had an elevated once you start digging into what's going on. This guy's had an elevated potassium for hours. How come this wasn't addressed? You know, and so it was those missing pieces, again, of we could have caught this earlier before the cardiac arrest. But again, I know nurses are busy. I totally get it. And they're very task-oriented. I totally get it. But if we don't think and we don't put the clues together when we assess a patient and really understand, here's how I tell it to my students. We have this continuum. Here's your healthy patient, which we don't have healthy patients, and this end of the spectrum, they're dead. Our job as a nurse is to play Sherlock Holmes or private investigator and find out where on the continuum is that patient, hour by hour, and sometimes even, you know, minute by minute. Yeah, are they becoming more unstable as we we see? Um, I'll give you a really good example as we were talking about earlier with neurological changes. I was with the students in the hospital. We had a 74-year-old who had come from a nursing home who had anterior cervical neck fusion. So we got him post op and he was confused. The nurse, the primary nurse, assumed that was his baseline because he was 74 and because he came from a nursing home. Well, it wasn't. We found out later. But she kept, he tried to climb out of bed. You know, he was combative to some degree and She kept calling the doctor and getting medications to sedate him. Well, long story short, he decompensated within the next couple hours and had to go to the ICU and get intubated. Well, what they found was that he had a hematoma internally from the surgical site that was blocking his airway. And he couldn't get oxygen to his brain. So he was toxic. Yeah. And it's like nobody even considered that he this may this confusion may be not normal for him or something physiologically is going on.
Marsha:Yeah. Something I think important to note too altered mental status. That's not a normal finding. Right. So if they come into our care with an altered mental status, and there's nothing alluding to it in the assessment or the exam or the patient coming first coming into the hospital. That's not a normal finding just because they're of an older age. Thank you for sharing that example. I think it's a really important example to show how, again, assessment is really key within nursing. And so I think those points really will hit home with a lot of nurses listening today. And even those who aren't nurses, because we'll have probably family members of the nurses listening to this episode. On the patient side, there are things that you call out for family members and how to keep your family members safe. And I know and I love this that you have cuss words. And can you talk a little bit about your cuss words and your cuss words framework?
SPEAKER_00:Yeah, and where that um came in as I was researching when I found that the Joint Commission tells us 70% of patient harm events are related to communication breakdown. And that's why, too, that I focused my TEDx talk on communication from both the family side and the healthcare team. Families, patients and families need to learn to speak up, and healthcare workers need to listen. So I know that a lot of families are frustrated because the healthcare team dismissed them, don't take them seriously. And so that's where the cuss words came up with I modified it just a little bit. It's in the literature somewhere. But when the families and even nurses can use this when speaking to the physicians, you know, or providers, it's concerned, uncomfortable, scared, and a safety issue. So for example, one of the stories I wrote about in my book was a man who had decreased pulses to his foot after knee surgery, and it was getting cooler and increased pain. And the nurse called the resident at two o'clock in the morning, and he said, Don't worry, it's been like that before since before surgery, which was not true. And so, again, escalating what should have happened is, sir, I'm really concerned. I'm uncomfortable with how this foot looks. I need you to come in and assess. Um, and that didn't happen. Unfortunately, the man lost his leg. So it really is using those key words to get the attention that, hey, something is wrong here. Um, even for patients and families that don't have medical knowledge, your gut intuition is a real thing. So don't let that response that minimizes you or dismisses you don't stay there, escalate it.
Marsha:You mentioned your TEDx talk, and I'm really glad that you did that. It's a short master class and teaches you a lot, especially on the patient side, about how to bring up your concerns in a way that's respectful and still making sure that your needs are your needs and your family members or patients' needs are being addressed. And you've also written your book, Surviving Your Hospital Stay. It's a nurse educator's guide for just keeping patients safe in the hospital. Was this part of your thesis or after your thesis?
SPEAKER_00:Or it was after because I kept thinking, what can I do besides educating nurses to really help this patient safety situation? And I thought, you know, patients and families are so vulnerable. They don't know what to ask, they don't know what to expect, they don't know what's normal. And yeah, that's why I wrote the book to help them navigate healthcare because it's like a foreign country. We speak a different language, doctor comes in and says, okay, well, your wife has congestive heart failure, and we're going to do an echocardiogram, and I'm going to put her on diuretics and walks out of the room. You know, and the family and the patient is like, What they just say? What does that even mean?
Marsha:Right. Yeah. Yeah. And it's a way for us to really advocate for ourselves. And I told my mom all the time, and I think you mentioned this, I can't remember where. Maybe it was in your TED talk or maybe another podcast episode I heard you on, where you talk about like documentation. Like, if you can't remember the questions, make sure you have something like a notebook or something when you're going into your exam, your appointment or exam with your provider. Just having some sort of note-taking system where you keep it all in one place. And if you're having these questions, make sure you write them down before you go, because then you can say, Oh, by the way, before you leave, I have a couple of questions. And so if you're coming in already prepared to ask those questions, it may help you leave without having the regret of not addressing something further.
SPEAKER_00:That notebook is so essential in the hospital, too, because if patient errors are resulting from communication breakdown, not all of the information gets translated between shift change or between doctor to doctor. And if you have your notes, and just say the cardiologist comes in the room and says something different or something new than what the primary care or the nephrologist said, then you have it written down and you can say, Can I please clarify? Because yesterday we were told, you know, whatever. And like you said, it's so hard to keep track of all the details. And writing it down really does help keep you organized. Even if it's mom is more confused than yesterday because she didn't recognize me or she doesn't know what day it is. And when you see the trends, that's really valuable information as well.
Marsha:Yes, very valuable. And from the nurse's perspective, part of my role is looking through charts and trying to find these indicators of communications between providers and patients. And it's so wholly lacking in the organization, whether it's in a notes tab or an encounters tab or a telephone encounter or a referral tab. It's very important documentation, not only for healthcare providers, it's also important for patients as well. So, yes, if you're in the hospital, of course, because you can always refer back to, well, doctor so-and-so told me yesterday that this was this, and now you're saying something different. Can you help me understand that? I'm uncomfortable. I'm scared about what this means. I'm concerned that we're getting two different messages. Using those cuss words is very key. Yeah. Yeah. So switching a little bit to the gears of nursing, to how you brought all this experience, your patient safety experience and looking at hidden risk within hospitals and preventing patient harm. I understand that you went into business and founded a Life Beat Solutions. There may be nurses who are listening to this episode who are in this community because they're interested in starting business and seeing what your transition was from going directly from patient care and teaching nursing students right into business. How was that transition and how did you do that?
SPEAKER_00:You know, it was just that my passion for patient safety kept growing. And then I thought once I finished the book, I'm like, okay, what's next? What else can I do? And the idea came from reading research on how ill-prepared nurses going into the profession are. There's three articles that I'd like to reference and I can send them to you. Um, back in 2006, it started with an assessment of new grads that already got their license. They passed NCLEX, and there was a five-hour exam assessing the critical thinking and clinical judgment. So both application at the bedside in a simulation type environment, but also written. Well, of those 5,000 from 26 different states and 141 different schools, they found that only 35% were safe and practice ready. And I thought that was pretty abysmal. Well, they repeated the same type of study with the same, you know, quality markers, et cetera, a decade later in 2016, and it had fallen to only 23% of nurses were considered safe and practice ready. And then five years later, probably because of the pandemic in 2021, they repeated it again. 10%. Nine. Yeah. 10%. 9%. And so I thought, well, these nurses are passing NCLEX and they still aren't safe and don't know what they're doing. So I took all of the teaching that I'd been doing around the topic of failure to rescue because I found there were pillars, such as vital signs. Again, we know, but it bears repeating. It's not just a task. It gives you the ability to see where on that continuum is your patient, you know, looking at trends and baseline and lab values, critical lab values, and fluids, fluid volume and nutrition. And so those key pillars is what I put into now 35 courses for nurses of really building that strong foundation. Patient communication is in there. Um things that these NCSBM, the National Council of State Boards of Nursing, identified a decade ago. And what they did was they took all of the 50 states, the medical errors that nurses made that either egregiously harmed patients or killed them, and they put them into eight categories. So documentation errors, surveillance errors, and that I put in the course as well. Each one of those is a course. So that grew. And it was from that passion of I've got to do more to help.
Marsha:Yeah. So when you were creating the course, were you at first marketing it to nurses? Or how did you get started? Did you say, oh, okay, I'm going to sit and record videos or I'm going to just write out a course, make it PDFs? How did you get started in that part of it?
SPEAKER_00:I started with PDFs on the failure to rescue courses. So there's 10 and then made videos because I didn't want just PowerPoints and marketing to hospitals, but I'm realizing that there are nurses who really want that information and students that want that information. They're engaging, they're about an hour each. And so I finished that project. It took me 18 months. I will say I had no idea it would take that long. I had no idea I would do that many courses, but I kept thinking of more. I had no idea how it would be so costly. But if I didn't have the passion for it, I would have quit a long time ago.
Marsha:So when you were creating this course over the course of 18 months, were you testing it out with audiences first? Or were you just in the mode of I'm going to create it and then I'm going to put it out into the world and then realize, oh my goodness, the cost of putting it out into the world or the cost of creating it? Or where did the cost of creating it come from? Was it the cost expense was creating it or actually putting it out into the world?
SPEAKER_00:I guess there were some questions there. Yeah. I hired a video editor because I did the scripts, I did the voiceover, um, and some I did on camera in the course. Um so yeah, the video editor took probably about two to three weeks to do each course, you know, and that pay. And then I have another video or another virtual assistant that helps me with my social media. For example, getting podcasts. I think this is number 51 for me. Oh, wow. Yeah. So getting that, you know, out to my socials page and tagging my hosts, et cetera. And so it really is. I also joined, here's some of the other business expenses. I joined some masterminds. Um, I paid for speaking coaches to get on the TEDx stage. And the whole idea with that was to get the message out there as far and wide as I can. Um, and it's had about 200,000 views. So I'm pretty pleased with that. But it was really, I can't keep this song inside me. I've got to get it out as far as I as far and wide as I can. And so I just committed to doing whatever it takes. And I think two, I realized I didn't have the timeline to learn slowly how to run a business, and which is why I paid for coaches. Um, but I'm happy to share with your audience, you know, if they've got any questions, they can reach out, they can find me on my website, but I'd be happy to answer questions because I had nowhere idea where to learn this stuff or you know, how to integrate AI, obviously, is now huge too, as you know. So it's been a journey.
Marsha:Yeah. And I'll put all of that information about Dr. Seymour's contacts and how to get in contact with her and the show notes for this particular episode. And I do want to point out one thing that you said about coaches and hiring coaches. I over the years have hired many coaches, not in terms of just business, but other coaches as well, to help me through whether it's life challenges or just to improve myself, professional development. So I've done that as well. And it's a fast track to get you where you want to go. Because, like you said, when you don't really know how to get started, you can get the help of a coach who's going to guide you in next steps or provide recommendations for next steps and help you out with that. So, with creating your course and getting all of that packaged together, did you first feel like, hey, I want to first start with nurses and given this information? Or did you want to start with hospitals, health plans, those kind of systems first? Or what was your thought process when you first got it done and you got that finished product? What was your thought process?
SPEAKER_00:Yeah, it was hospitals and CNOs because I honestly don't think they understand how ill-prepared the new nurses coming in. You know, we've also got a problem that nurses aren't staying in the profession like they used to. When I went into ICU, I had mentors with 15, 20 years experience. And now those are really hard to find. Yeah. So nurses aren't learning good habits from nurses with longevity. We don't have the role models that we used to. And so you may, I mean, I hear this from my students all the time. They'll say, Well, I know you say I really need to do an assessment on every patient, but I don't see my nurse doing it. And they don't do one unless it's, you know, that something's wrong. And I'm said, but let me help you understand. If you don't have a baseline, how are you gonna know the patient is changing and that you need to escalate and get help if you're not aware, you know? And so they're like, oh yeah, that makes sense. So they are learning shortcuts, which are not safe. In fact, I posted on social media one of the um one of my posts was about medication safety, you know, trying to let patients and family knows that the nurse should be doing at least five or six medication safety administration, the five, six rights. And it was interesting. One nurse replied and said, Yeah, my hospital is so busy that the CNO decided we only have to do three patient rights. And I said, Oh, well, which ones did they throw away? Because they're all important. And if you skip the one that could harm a patient, is it worth the shortcut? Oh, I was just appalled.
Marsha:Yeah, that's that's a little shocking to hear. I've never heard something like that. And hopefully that practice has been corrected. And hopefully, if it hasn't been corrected after hearing this episode, that will get corrected. Uh, so I'm curious about when you were working with the help plans and going into those systems, did you find any resistance to the services that you were trying to provide? And how did you reach out to them? Did you know right away to reach out to the chief nursing officer, or did you start with the manager level and a stakeholder that could probably get to that CNO first? Or how did you start off with that?
SPEAKER_00:You know, I think I try to do a lot on LinkedIn to reach the healthcare leaders. But, you know, in all honesty, they are so busy nowadays and they've all got really big projects going on. And it just seems like they're in their own way. For example, I met one chief quality officer at a conference, a patient safety conference. We talked in March, and she said, Oh my gosh, we really need your courses. I didn't hear from her for a couple of months. Um, and then I connected with her um educators for critical care and gave them access to see the courses. And they're like, I know, we haven't gotten to it yet. We're so busy. And this has been like three or four months ago. And so they they told me that they have these issues. And yet, I mean, I don't know what big projects they're working on, but the capacity for hospitals to implement even something like this, and especially now with funding cuts and they're operating on razor-thin margins, um, it doesn't seem to be a priority, and that's challenging. But I know my mission is to save a million lives. And if I can start with, which I know I have already, one or two or 10 or 20, you know, that still what I'm doing is worthwhile.
Marsha:Yeah. And the sales life cycle, especially with huge hospital systems, enterprise organizations, the sales life cycle, if you're starting off in business. And something I've learned along the way when reaching out to huge organizations, is that sometimes it may take months to actually get a response. And that doesn't mean you just send one email or you call once and you leave it at that. But you want to be persistent. And so I'm assuming that's what you usually do is be persistent in your outreach. Yeah. Yeah. Yeah. So moving along with your in health systems, helping them educate their nurses, helping them educate other healthcare providers, not only nurses, because I know your work is for all the medical professionals that you reach out to. What made you decide to start on the speaking circuit? And Get that type of career going and you had your TED talk as well.
SPEAKER_00:Just to get the message out there. I've I thought that I could reach a larger audience. Um and it has been helpful, especially when people are like, wow, I had no idea. And that really was what the impetus was in this whole beginning of the journey was learning that medical mistakes were the third leading cause of death. I had been in healthcare for 30 years and had no idea. And when I did the research and found this has been a problem, at least documented in JAMA in 1955. And so I thought, well, how come this doesn't seem like the top priority of our healthcare system is to keep patients safe? So that's why I continue doing what I'm doing.
unknown:Yeah.
Marsha:Well, we greatly appreciate the work that you do helping to empower nurses, other healthcare professionals with the judgment tools, the practical skills, communication skills to really advocate for our patients, our family members, ourselves. I think it's very important that the work that you do, and I'm sure those who are listening can really appreciate that as well, especially the nurses who are listening to the show. Before we end this call, I would love to ask you is there some type of moment that you always come back to that helps you move forward in your nursing practice?
SPEAKER_00:Gosh, I have so many. One that comes to mind is when I was a flight nurse at the hospital and running to the code. And we always tried to get there first before the resident or doctor, so we could do the intubation. But anyway, I didn't make the first in the room for that. But the resident at the head of the bed, we're starting CPR, et cetera. And he's like, okay, where's the nurse? And nobody spoke up. And we're trying to run the code, and we really don't know what's going on with this patient. People are trying to flip through the chart and figure out why was this patient admitted? Are they renal failure? What's the issue? Well, we called the code after about 45 minutes and found that the nurse had been hiding in the linen closet because she was new. She'd only been on the job for six months. She had not done the assessment of this patient, was still trying to organize her patient load and figure things out. And she knew when she heard the code overhead that she couldn't answer any of the questions and didn't want to look stupid, so just didn't show up. She did get terminated for that. But, you know, I guess that reinforces why it's so important to do your assessment and to really understand what's going on with your patients early when you first get there and prioritize that in your, you know, your care that you're giving.
Marsha:Yeah. And that's a lesson learned, I'm sure, for that particular nurse. Um, I would imagine if you could do things over again, you know, that nurse may have thought what could she have done differently. And we're so grateful that you're here to help us with those patient safety episodes and events.
SPEAKER_00:Yeah. And it really is, I think, another reason that I feel so strongly about educating patients and their families because they go in really naive, um, thinking the healthcare system is going to heal them. And it should. But when we look at the statistics of one in four patients suffers some kind of harm in the hospital, I mean, that's just devastating. And, you know, I'm not trying to make nurses out of the family members, but if they don't say, hey, what medication are you giving my dad? You know, then if we're not asking questions, we're just passive recipients. Can I add one more thing? Sure. I am working on, it should be done within two to three weeks, a patient app. So not everybody reads a book. And what I've got is six modules or courses that teach patients and families what to look for, what to watch out for, advocacy scripts. I've got so many free guides in there. So I'm really excited because they can have that on their phone in their pocket and just look up what's normal lab values and what does it mean if my white count's elevated. You know, instead of going to Google getting random, you know, answers, they can go to this one source.
Marsha:That was Dr. Julie Seymours, nurse, educator, patient safety consultant, and founder of Life Beats Solutions. You'll find the link to her patient safety app in the show notes over on her podcast page at thebossynurse.com, episode 8. And then one last thing that guides her work and all that she does.
SPEAKER_00:Listening to my intuition, listening to my inner guidance, whatever you want to call that, is my priority because I really want to leave a legacy and a life and live a life on purpose. And it really has evolved. You know, back when I was working on the med storage unit or even on the helicopter, or when I first began teaching nurses, I had no idea how my purpose would grow. And I just am so thrilled that I had the education and I have the experience to really help people because that's what healthcare is supposed to be about, right? It's compassionate care where we actually can impact each other with a smile, a touch of the hand. That connection is more powerful than morphine, is what I tell my nursing students.
Marsha:Thanks so much for listening to the show this week. Please make sure to rate and review this episode in your favorite podcast app. Then don't forget to click the follow button so you won't miss an episode. This episode was produced and edited by yours truly with administrative and research support from Liz Alexandry and Renan Silva. I'm Marsha Batti, and you've been listening to the Bossy Nurses Podcast.
