Annc: This Studio Sacramento episode is supported by UC Davis Health where doctors, nurses, and researchers share a passion for advancing health.

Learn more about their latest medical innovations at health.ucdavis.edu.

♪♪ Scott: Nurses are the frontline of medical care in both the hospital and the community.

These caregivers are often the lifeline to their patients, playing a critical role for us in getting well and giving our families the comfort and confidence that their loved ones are receiving the care they deserve.

Three nurses, Bertha Ramirez-Preciado, Leigh Clary, and Greg Woods, join us today to tell us their stories.

Bertha, why did you get into nursing?

Bertha: Um, I had a very, uh, personal situation where, um, my mother became ill, and we were in a different state.

And, um, until I can get family support to come and help me, um, it didn't look like my mom would be getting better.

Um, I would not leave her side and the only time I was asked to leave was during report and those nurses just inspired me.

I was going to school to be an early childhood educator, and once they took amazing care of my mother, and then were actually taking care of myself, um, even giving me trays because I would not go to eat, I would not sleep, I was just in the-— between the waiting room and my mother's, um... um, side.

And so those nurses were the ones that made me look into nursing.

And the 20 plus years that I have in nursing is-— I wish I remembered their names-— um, it's to, um, honor them and honor my mom's memory.

She... she passed away, but the nurses made a big impact in my life.

Scott: Wow.

Greg, you crossed industries, uh, to come into nursing, that's not where you started.

What inspired you to get into nursing?

Gregory: Uh, well, as you mentioned, um, I worked in the pharmaceutical industry for 15 years and nursing is my second career, but after winning many awards, president's awards in pharmaceuticals, it always felt like there was something missing, you know?

Yeah, I dealt with doctors and nurses and pharmacists each day on a regular basis, uh, but I just felt in my heart there was something missing.

So, I'm not sure whether it was a midlife crisis, or I was just, um, bored, or I wasn't achieving the goals I wanted to, but I looked at going back to school and nursing just kind of matched... matched my personality and matched what I wanted to-— what was missing in my life, and that was directly caring for patients.

And, um, it just seemed to be a match made in heaven cause I've been a nurse eight years now and, um, I've just really loved every day going to work.

Yeah, there's-— sure there's... there'’s hard days, just like any job, but caring for patients and seeing them... seeing them get better, collaborating with other nurses, and doctors, healthcare providers, and technology constantly changing.

It's just, um, those are probably all the motivating factors that number one led me to nursing and then probably gave me job satisfaction in nursing.

Scott: Leigh, you work in the ER, which, uh, many consider to be the E-ticket ride of the health care space because there's always something going on.

What made you choose going into the ER and pursuing your career in nursing there?

Leigh: Well, I spent a lot of years doing other types of nursing before I became an ER nurse.

Um, mostly what they call med-surg nursing, which is when you're a nurse up on the floors of the hospital, um, taking care of admitted patients, um, and I really enjoyed that.

But I came to UC Davis as a travel nurse and, uh, the manager on the floor while I was, uh, being a med-surg travel nurse showed me that there were some opportunities in the ER and I had never really seen myself as an ER nurse, but when he presented me with that, I thought this... this actually sounds interesting, and he thinks I can do this.

Or if he thinks I can do it, I should try.

Um, so I applied, and I got the job and it's just, it's been a blessing ever since.

I really loved med-surg nursing, but ER is where my heart really is.

It's just such a fast paced, dynamic environment.

You get to see such a variety of people every day and it's just nonstop problem-solving, nonstop reprioritizing.

Um, always interesting.

Always satisfying.

Scott: Bertha, I want to come back to your story about your mom.

And I'm just curious to dig a little bit deeper on that.

What is it that you observed about those nurses that cared for your mom and... and really provided support to you that affected you so much, uh, that you made such a commitment, a life's commitment, in terms-— from a professional perspective?

Bertha: Um, it was, I guess I can say it's the compassion, you know, that they demonstrated, you know, knowing that, um, I think in their hearts, they knew that things, you know-— I was hopeful.

I was hoping I could take my mom back home, but I guess them knowing that I was out there by myself and... and that things were looking good for her, you know, they... they really stepped it up and... and went... went that extra mile.

And I know that in nursing, um, a lot... a lot of us do that, you know, it's kind of, we get this sense that that person needs a little bit more TLC, you know, tender, loving care.

And... and they actually demonstrated that to me.

And so, um, I always wanted to be in a career where I could always give back.

And this was just, I mean, it... it was just the perfect career to be able to do that.

Especially, um, experiencing what those nurses did for me.

And that's what I try to do in... in my... in my care with my families and my patients.

Scott: I want to ask a... a... a quick question to follow up on that, and I'd love to hear everybody weigh in on this.

And that is, how is the role of a nurse, from your perspective, different from that of the doctor?

I know that you... you both work hand in hand and side by side, but... but how is it different from your perspective?

Bertha: Well, I believe, um, advocating is a big thing, you know.

And sometimes, um, because we are able to have a little bit more, uh, one-on-one with the patients or the families, we... we get a sense of what else do they need or what we're not reaching.

And so, it helps us dig in a little bit more deeper into that.

And then that's how we can advocate and say, you know, and recommend to the doctors or anyone, "“How about if we try it this way?

"” or, you know, "“What, if we did this?

"” you know, or "“She's having fears about this,"” you know.

It... it helps us, um, modify our care so it's personal.

It's more personalized.

And... and... and I think that's the beauty about nursing is that you are able to do that where you can still give efficient, safe care to the patients.

Scott: Greg, what do you think on that one?

Gregory: I think Bertha kind of hit the nail on the head in that advocating is a really big difference between the nursing model and the... and the medicine model.

Um, and I'd say that the nurse is probably what is the number one advocate for the patient.

And if you just think about it, um, UC Davis is a teaching institution and we have teams of doctors that come and see our patients and, um, just like many other hospitals do.

Um, however, the nurse is with the patient 24 hours a day.

And the doctor is there when they'’re around five, 10, maybe 20 minutes max, but the nurse is with that patient 24 hours a day.

And so, we really know that patient inside and out and what they need.

And we're in a unique position to advocate for the patient for not only their inpatient needs, but you know, the needs they have when they go home, uh, the needs they have to get better, um, themselves and for family healing when they go home.

So, we're in a really, in a unique position to advocate for patients when they're sick and when they're trying to heal at home.

Scott: Leigh, you work in the ER and, um, everything there is about an emergency and stabilizing patients, uh, getting patients, uh, to the care that they need at that particular moment.

Is there a lot of stress related to that?

Given the fact that, uh, as Greg says that you all are the first line of advocacy sometimes for the patient.

Leigh: Absolutely.

Um, it can be very stressful, particularly when you're working as the triage nurse, or we have a role called the flow nurse that specifically decides which patient gets the next bed and in which part of the ER do they get that bed.

And so, during times when, um, we have a wait time, meaning there are patients in the waiting room, it can be really stressful.

We get really nervous.

What if... what if we're missing something?

What if this patient does need to go back and see the doctor immediately?

And so, we all, we really worked together.

We... we bounce ideas off each other.

We say, "“Hey, what'd you think about this patient?

"” We... we are very lucky to be the nurses in the hospital who have doctors, you know, right there with us, so we can always talk to our doctors and... and get their perspective as well.

Um, but yeah, I would say that's probably the most stressful part of... of ER nursing is worrying about those patients who are waiting to get into a room.

Scott: Given the range of people that you see, how has being an ER nurse, or just a nurse in general changed who you are and how you see the world?

Leigh: Well, um...

It's... it's changed it probably more profoundly than people who aren't nurses realize, and especially who aren't ER nurses.

Um, I think that we all agree that we over time develop a little bit of a, um, a wall, a barrier between ourselves and a lot of the trauma that we see in our patients, because it can become overwhelming, um, to see... to see so much of that.

Um, so... you-— and it ends up carrying onto your life outside sometimes.

So, you have to really be cognizant of it and remind yourself to stay human.

And, um, remember that emotions are okay.

But if we allowed ourselves to just feel everything that we experienced in the ER, uh, we'd probably have a really hard time doing our job.

Scott: Bertha, I want to ask you, you were inspired by the experience of your mother and the nurses that cared for her.

How has nursing for you as an experience that you've had different than what you expected from that initial inspiration?

Bertha: Um, I'd have to say that, you know, it... it... it... it's not any different of what I experienced and, um, and the, you know, it... it just helped me to-— I always go back and remember that feeling and, um, in my mind, I'm always thinking, you know, I didn't get the opportunity to care for my mother, but I'm going to take care of this patient like I was taking care of my mother.

So that's the kind of care I always try to, um, make sure that they receive, you know.

And, um, and yeah, just kind of piggyback on what Leigh said, sometimes, you know, it's... it's a little too much to... to take and you have to be able to have enough, um...

I guess the wall is appropriate, but it's... it's-— you can't intake everything that, you know, you... you see day in and day out, because then it will, you know, help you not to perform the job that you need to do that they need to receive.

And so, um, you know, it... it-— like what you were saying before, how do I see the outside world?

Well, I know that every person has a story and... and... and it gives us that opportunity to dig in to more deeper with that patient to know what is their story.

And... and then you kind of tune up your care to... to be able to be, you know, help... help, um, you know, if there's, I don't know, a religious or a cultural or, you know, um, some kind of restriction that, or something that you need to be more respectful, you know, it... it helps to get to know your patients in that way, by knowing their story and how to fine tune your care.

So, they are-— they'’ll feel comfortable.

Yeah.

And... and that's what you want to build, is that trust with your patient, so they know that you are providing them the best care that you can give.

Gregory: And Scott-— Scott: Greg, when-— Oh, go ahead, Greg.

Gregory: Um, I think, um, Leigh and Bertha hit a great point in that sometimes nurses have to put up a wall, uh, between ourselves and patients.

And then, uh, Bertha said that, um, we try and deliver the care, um, just like we were caring for our parents.

Um, however, you know, in the hospital, as nurses, as healthcare providers, we pretty much see patients at their worst.

They're sick.

They're tired of being sick.

Leigh is at the front door, at the front lines and when those patients come in, they're truly at their worst.

So, we see them at their worst.

So, many times we have to build that wall between the us and the patient to really deliver the care that we know we want to deliver.

And sometimes, many times, that's very, very difficult.

Um, many times sends nurses home crying or we're even crying at work.

Um, but, um, if you don't have that wall as a nurse, you probably won't last long.

Scott: Is it hard to take that wall down when you come home?

Leigh: I think so.

Yeah, I think so.

Bertha: Yeah, I think-—go ahead, Leigh.

Leigh: And I've had people tell me that too.

So, it must be true.

Scott: Hmm.

How so?

Leigh: How so?

Um... You know, I've been a nurse for 25 years so I have to think back really far in the past to remember times when I would be really kind of sentimental or emotional... emotional about things.

Um, I rarely cry anymore.

And I used to cry, just kind of like a normal person.

Um, a couple of years ago, I was in a class that was, uh, being led by one of my colleagues.

And, um, he's a wonderful nurse.

He's kind of seen as a little bit more of one of the, you know, tougher, gruffer nurses in our department.

And he was-—as... as part of the class-— he was recalling a story about a really traumatic, um, event, a couple of pediatric patients that came in.

And as he was telling us the story, he actually started to cry.

And it just, it... it made me realize that all of us are still a human deep down inside.

Sometimes we just, we have to dig for it.

And it was, it was just so moving to see that.

Scott: Bertha you work with pediatric patients.

Uh, how does, what Leigh described, uh, resonate with you?

Bertha: Um, you know, the-— working with kids makes it a little bit tougher sometimes.

And, um, and one of the... the-— I'm in the outpatient setting now with pediatrics.

So, one of the... the good things that I get to see is, um, the follow-up care that I get with them.

And also, um, kids are resilient.

And so, you know, if... if they're learning to live life with, um, a chronic health condition and they can still smile, you know, it's like, why would I, you know, take that away from them.

This is what they learn to live with.

And so, you know, you... you... you build on that and you make them stronger and you-— what I try to teach the patients that I work with because it's a chronic condition that they are going to have to deal with the rest of their life is, I'm trying to build them up to be advocates for others, you know, and to-— I mean, I've had, uh, the opp-— I've...

I've asked some of them at, uh, you know, some of them are very young if they wouldn't mind talking to, you know, a newly diagnosed patient to, you know, let them know what... what... what to expect, and they're willing.

And that's just, to me, that's just amazing to know.

So, um, you know, Leigh'’s job is a lot different.

She, like Greg said, you know, she does see the worst, you know, coming into the hospital.

And, um, and working, you know, now with pediatrics and the, um, ambulatory side, you know, on the... on the outpatient side, uh, you don't see that as often.

It's more the social economics part of it, you know, and making sure that they're receiving everything that they need to be able to continue their care and... and live full lives, become adults.

Scott: Greg, I...

I want, in talking about all of the stories that come through the doors of the institution that, uh, had been mentioned a few minutes ago, I want to talk about the pandemic and how it affected the institution and the people you observed and dealt with.

What would be one word to describe, uh, the year of the pandemic, in just one word?

Gregory: In one word, I would say fear.

Scott: How so?

Gregory: Um, fear in that, you know, this is something we had never seen before.

Um, maybe we'd seen versions of it, but it had not affected us in this modern day like it has been.

And so, I say fear because, um, I start my day at 5:30 AM so I cross over a little bit with night shift and a little bit with day shift.

But when I come in during the day and it was a start of the pandemic, the first thing people do is come to me and say, "“Hey, what do I do?

How do I protect myself from this virus?

How do I protect my patients?

"” And I could just see fear in their eyes.

You know, as nurses, um, we sign up to take care of, um, any type of patient in any situation, whether you're in the ED or whether you're in pediatrics or oncology, but, um, a lot of people were afraid.

They weren't afraid to take care of the patients, they were afraid to take it home to their families.

Yeah.

And so, um, if I were describing it with one word, it'd probably be fear.

And then the second word would probably be change... change... change, which is happening daily.

What type of face masks do we do?

What type of protection do we do?

How do we take, uh, precautions with patients?

All that, all those things were, we were taking for granted in prior years with things like TB and HIV and, um, influenza.

Um, but now here's something we had never faced before.

So, it was fear of the unknown and then things were changing daily.

So, um... um, uh, we just really didn't know what to do and wanted to protect our families.

Scott: Leigh, you want to comment on that?

Leigh: I agree completely with Greg.

That was the first, well, the word that came into my mind was scary, um, and then also change.

Both of those two things just really dominated, um, our... our time during the pandemic.

Everything is much more even keel now, but we were very, very frightened at first.

We-— I mean, because so much was unknown, we didn't... we didn't know that much about the virus.

We didn't know exactly how to protect ourselves.

We didn't know exactly how to take care of the patients.

And we had, um, some physicians and nurses that actually went to New York to help when they were at their worst.

And they would report back to us and the stories they were... were... were sharing, we were just terrified that this was going to happen here, and it never did, thankfully.

It never did get quite as bad here as it did in New York.

But just that fear of... of being overwhelmed with patients and having to make decisions about which patient you're going to help now and imagining having to not provide the best care for patients because you were out of resources.

Um, that, I think, was the scariest part for all of us.

Scott: Did you... did you ever come upon a time where it is that you all had to make any of those tough decisions about how to allocate resources?

Just based on the scarcity of things like ventilators and other aspects of medical equipment that were in short supply in the beginning?

Leigh: No, I think we... we got very lucky and, um, I think our institution did the best job that they could possibly have done in procuring everything that we needed.

We never... we never ran out of PPE for ourselves.

We did not run out of ventilators for the patients.

Um, we did not run out of places to put very sick patients in our... in our emergency department.

So, um, it ended up, so far, hopefully we don't end up with another surge.

I think we're... we're pretty much clear now.

But it ended up being okay because we... we... we did a whole lot to prepare all the change that Greg talked about.

Tons of change, tons of new processes.

We even opened up new areas of our ER, in places that used to be storage areas.

Um, so a tremendous amount of preparation, um, was made and it helped out.

We survived.

Scott: You know, I want to take a step back for a second because all of you have such fascinating perspectives and bring very different points of view into this conversation.

I was told years ago by a physician talking about a group of physicians that he was working with, that physicians specialize and, in some ways, their... their specialties reflect their personalities.

And a radiologist, this physician said, studied stuff a lot, sometimes too much.

And that an ER physician, no, uh, no disrespect, uh, Leigh um, made decisions quickly and kind of like came to judgments very, very rapidly.

And that internal medicine physicians, um, wanted to chart and investigate everything.

You three, uh, all nurses and all obviously very committed, um, I'm just curious, do-—uh, does the specialty that each one of you has taken on in any way is it reflective of your personality or that does the job help shape personality in any way?

And Bertha I'll ask you first.

Bertha: Um, well, like I had mentioned before, I was looking into a career in early childhood education.

So, I knew that I did want to work with children.

Um, and I think it was more, um, because they're, you know, they're... you... you can kind of mold them and... and... and... and help them, you know, see the future, you know, or... or inspire them.

You know, sometimes we get kids who, I guess I wanted to be a good role model.

You get some kids that really don't have that in their home.

So, you try to, um, see if you can inspire them to... to... look, and you know, these are our future gen-— I mean, this is our... our generation, you know, they'’ll be the next ones up to be the next president, the next, you know, um, doctor, nurse, you know, so you want to make sure that you're... you're giving them a positive, um, how would I say, just being, you know, positive with the care that you are, just because they're young, you know, it's not that you're, um, you can't talk to them about certain things.

You know, you... you have to be able to give them, um, knowledge and, and-— Scott: And, well... well said, Bertha.

Uh, in our final moments, Greg, just a quick response, any relationship between your specialty and your personality?

Gregory: Oh, I think there's definitely a relationship between your personality and specialty.

Uh, if you talk to most nurses or if you talk to 10 nurses, um, most will say, um, that their specialty that they're in, um, is a reflection of their mo-— their ethics or their values.

And most nurses will tell you that there's three... there's three nurses that, um, that only a certain nurse can be, right.

Scott: Ok. Gregory: ED nurse, and, uh, um, a pediatric nurse, not all nurses can... can go into those two specialties.

Scott: All right.

In our last moments, Leigh, yes or no, your being an ER nurse reflective of your personality?

Leigh: I think so.

Yeah.

It's... it's fast.

It's dynamic.

It's interesting.

Um, yeah, I think so, for sure.

Scott: All right.

And we'll leave it there.

Um, best wishes to all of you and please, uh, keep up, uh, your service to all of us.

We appreciate it.

Leigh: Thank you.

Bertha: Thank you.

Gregory: Thank you.

Thank you for having us.

Scott: All right.

And that's our show.

Thanks to our guests, and thanks to you for watching Studio Sacramento.

I'm Scott Syphax.

See you next time right here on KVIE.

♪♪ ♪♪ Scott Syphax: All episodes of Studio Sacramento, along with other KVIE programs, are available to watch online at kvie.org/video.

Annc: This Studio Sacramento episode is supported by UC Davis Health where doctors, nurses, and researchers share a passion for advancing health.

Learn more about their latest medical innovations at health.ucdavis.edu.