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Emergency Nursing

"The Desire to Serve, The Ability to Perform, The Courage to Act"

Nicholas Palczer host of the new podcast: Bottom Line Nursing! He has his Bachelors in Nursing, Associates in Nursing, &  Associates in Fire Science

He is currently an Active Duty Air Force Nurse, which he has been for 9 years and was an Enlisted Firefighter/EMT before he got commissioned!  He has been stationed at overseas and stateside assignments.

He is a Paramedic candidate and a BLS/ALS Instructor. 

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S10E2 Emergency Nursing


Lita T  00:07

Hello, and welcome to another episode of podcast dx. The show that brings you interviews with people just like you whose lives were forever changed by a medical diagnosis.  I'm Lita Jean Marie is not with us today.


Ron  00:20

And I am Ron and I am with us.


Lita T  00:23

Yes, you are. Collectively we're the hosts of podcast dx. On today's show, we're going to be speaking with Nicholas Palczer, host of the new podcast, "Bottom Line Nursing". Welcome to the show, Nick.


Nick  00:38

Thank you Lita. Thanks, Ron. I appreciate you guys letting me come by today. It's a pleasure and an honor.


Lita T  00:43



Ron  00:43

Great. It's good to have you. Let us just say that Nick was born and raised in Florida. He has his bachelor's degree in nursing, and associates in nursing and also an associate in fire science. Nick is currently an active duty Air Force nurse which he has been for the last nine years and was an enlisted firefighter EMT before he got commissioned. He has been stationed in overseas as well as stateside assignments. Nick is a paramedic candidate in a BLS / ALS. instructor. That's a very impressive resume Nick. And before we start, let me just say thank you so much for your service to our country.


Nick  01:24

Oh, thank you, Lita, thank you and your daughter for both your services as well. It's definitely a pleasure to serve as I would say, I just appreciate you guys let me come on. And our resume is really not that impressive. But thank you.


Lita T  01:36

It is for us.


Ron  01:37

Yes, it is.


Lita T  01:38

And we stand behind nurses 1,000%. On Facebook, actually, this week, I put a meme up of, you know,


Ron  01:48

I saw that


Lita T  01:49

... all the Yeah, all the IV machines and everything set up and everything it says if you don't think if you don't think a nurses worth something, a doctor, no doctor in the world can set up all this equipment here. And that's very true. You guys rock it.


Nick  02:05

Lita. I actually think I heard that meme.


Lita T  02:09

Thank you. Thank you. Well, Nick, I'd really like to know what inspired you to become a nurse.


Nick  02:17

So that is a great question. And what I actually really like telling, I actually started out not wanting to be a nurse a long, long time ago, I originally was gonna plan on being a pilot in the Marine Corps, every little kids dream in life,


Lita T  02:32



Nick  02:32

And then through an organization that you guys may or may not have ever heard of called Civil Air Patrol.


Lita T  02:38

Uhuh, uhuh


Nick  02:38

I was in that program through my youth and I praise that organization love it definitely guided me through my childhood very greatly. I met a man in that program who's still to this day, a great mentor of mine. He's a registered nurse by trade as well. who showed me nursing and slowly but surely I started wanting to get into medicine. And then I started taking more classes at school, you know, health science related classes, anatomy and physiology. And then he said, Well, I guess I'm gonna go be a nurse. I think this is how this should happen. And then I got my EMT license fast forwarding a couple of years without boring you guys too much.


Lita T  03:19

No, no, no, never boring. It's your show.


Nick  03:25

You know, fast forward a little bit and got my EMT license and then said, You know what, I'm gonna leave military school because I went to Virginia Military Institute for a little while. Got my EMT license, said, You know what, we're going to go into the military because I'm going to go be a military nurse.


Lita T  03:42



Nick  03:44

Then I enlisted. Again, like, like Ron said, I became a firefighter first. So I did that gig for the first while of my enlistment, which is a great job. Being a being a fire EMT is one of the greatest gifts that I've ever had in my life, and I still miss it every day. You get to be a giant kid every day. It's great. (laughter)


Ron  04:03

You don't have to do the "adulting," right? (laughter)


Nick  04:06

(laughter) No, I didn't have to adult It was great. I got to ride the big red truck, like every little kids dream, every day of my life. It was great. So you know, through that, I then said I'm still going to pursue nursing, started pursuing nursing prerequisites all through my enlistment, did what's called the nursing in the listing, commissioning program. And then I finally became a nurse. And here I am.


Lita T  04:31



Ron  04:32

That's great.


Lita T  04:33

That's a great story.


Ron  04:34

Sure is. I'm curious though, why did you start "Bottom Line Nursing"? Why do you start that podcast and actually what's it all about?


Nick  04:44

So this is kind of funny, actually, you're gonna laugh. First off, it's a very brand new podcast. It's got about five episodes.


Lita T  04:52



Nick  04:53

I started it predominantly because I felt like we were missing something in nursing. I feel Like we need to do better in professional development amongst ourselves as a profession, which we already do good. I think we can do better.


Lita T  05:08

And then there's the Air Force talking... (laughter)


Nick  05:10

(laughter) That's not wrong.


Lita T  05:13

Yeah, you're right.


Nick  05:15

 But I actually got the privilege to meet a colleague in the military. She's also a physician who has her own podcast,


Lita T  05:23



Nick  05:24

 And at one point she, we were working on I think we were talking to college students about medicine in the military. And she was like, hey, I'd love to have you on the show, and talk leadership and medical. And I'm like, Sure. So I was on her show at one point. And then she's like, why don't you start your own? And I'm like, I never thought about that.


Lita T  05:43



Nick  05:44

 So six months later, a few Jag, a few legal phone calls and Public Affairs phone calls later to the military. I said, Well, this is what we're gonna do, we're gonna do a nursing show. And I just want to be able to give more professional development, more knowledge, just more open talk discussion about nursing amongst our profession. And especially coming from the military side of it, I think we can do better with talking about military nursing and military medicine, too. So I use it kind of as a platform for all nurses across the board. And for those who don't know the phrase "Bottom Line Up Front", which is a military phrase, of course "BLUF". That's where the bottom line nursing came from.


Lita T  06:32

Okay, got it. Got it. I wasn't sure if it was like a, an IV  line or,


Nick  06:38



Lita T  06:38



Nick  06:40

Yeah, so then I decided I said, Okay, we're gonna do professional development, we're going to talk specialties. We're gonna have interviews with guests, we're gonna talk pretty much anything nursing you can think of


Lita T  06:53



Nick  06:54

 Most recently, I did an episode with a colleague who's a flight nurse, except we were talking about the nonprofit youth organization that she founded and started, but a lot of her interest in that started in her nursing career.


Lita T  07:11

Okay, great. Great.


Ron  07:12



Lita T  07:13

That's great. Ah, well, Nick, nursing is, like you said, it's a very broad field. What are some of the nursing specialties that we might come across as a patient?


Nick  07:24

Oh, there are so many Lita.


Lita T  07:25

I know. Actually. I have met a flight nurse. I have met a a surgical nurse, actually a surgical nurses, a very good friend of mine. But those are the only two nurses that I've actually met. So then what other what else is out there?


Nick  07:46

So there literally are hundreds and hundreds of different nursing specialties. So you touched on a couple of the surgical nurse or the operating room nurses we call them sometimes too.  There's post op care nurses and pre op care nurses, we call them "Pack-U" that also deal with surgery. There's I work on a medical surgical unit. So that's a specialty all by itself, that you can specialize further and from what I currently do, you can work cardiac, so all heart related things you can work Intensive Care Unit, so your ICU, which that alone branches into cardiac ICU, neuro ICU, and just goes down a rabbit hole. There is nurse, nurse anesthesia. So you can become an anesthesiologist as a nurse or a Certified Registered Nurse Anesthetist. And I probably said that wrong but that's okay.


Ron  08:36

It sounded good.


Nick  08:39

So that the nurse was never a anesthesiologist. So you can do a clinical nurse specialist which I work for two of them right now on my unit, really great guys, which is another advanced practice nurse. But they focus predominantly on clinical teaching and working on skills and running a unit clinically, then those geriatrics you can get into that kind of population, you can work on mental health nursing, which that goes into you can become a nurse practitioner, or you can become say a family nurse practitioner, which is something you, I or everybody here listening would probably go see potentially at saying Urgent Care down the street because you got a really, really bad flu.


Lita T  09:20

Oh yeah okay


Nick  09:20

But yeah,


Lita T  09:22

my eyes are opening now so so really anything, anything in the medical field, just like doctors specialize in different areas, nurses will also.  Right?  Would that be fair?


Nick  09:33

We could Yeah, reasonably. So I mean, it it also goes as far as to the point where you can get on to the leadership side of the managerial side, and kind of step back from the clinical side to be a nurse manager per say, the unit. So I mean, it could we could literally sit and talk for hours on how many specialties we can get into. Of course shameless plug. My personal favorite that I'm trying to go back into is emergency nursing.


Lita T  09:59



Ron  10:00

 It's not shamless!


Nick  10:00



Lita T  10:01

 No, not at all? No, we certainly need them all.


Ron  10:05

Yeah, my next question is going to sound kinda, I guess trivial after what you just said. But what are some of the different qualifications and levels of education and different licensing requirements needed to become a nurse? And imagine depending on what area you go into to be more specialized as well, right?


Nick  10:26

Absolutely. So not not trivial at all. very valid question because a lot of people don't realize what I think goes on with becoming a nurse just at the basic level. So you start out with your basic registered nurse, so that has that itself has two educational levels. You can be a registered nurse at the associate's level. So I initially got my associates degree as a nurse and got my registered nurse. So associate degree is your base level for a registered nurse backtrack slightly prior to that you could do as your licensed practical nurse or your licensed vocational nurse, which is about half as long as a program for your registered nurse, but it's not a degree program.


Ron  11:09

What I'm sorry to interrupt, what is, ummm I know what a licensed practical nurse, what about LVN you mentioned?


Nick  11:17

Yep, so some states call it LVN or vocational nurse versus practical nurse.


Ron  11:22

Okay, same thing.


Nick  11:23

It's just semantics.


Ron  11:24



Nick  11:25



Ron  11:27

Gotcha, thanks.


Nick  11:28

No, no, of course. So going past, you know that phase and then becoming a registered nurse, then you move up into the Baccalaureate level. So then I went on and got my my Bachelor Degree in Nursing, you can go forward even further, again, to the master's degree, of course, which that branches into about 20 billion different areas that you can specialize in. That would be the level where you'd start seeing your nurse practitioners at the baseline. Which then that gets into the advanced practice nurse, your your nurse practitioner, your clinical nurse specialists, your registered nurse anesthetist, things like that. So that's kind of like your baseline education. And of course, you know, long behold, if you want to be called a doctor, you can go get a doctorate in nurse practitioner, and become a doctor.


Lita T  12:15



Ron  12:17

doctor, nurse.


Nick  12:18

So you absolutely Yeah, I know, a few DNP or DNP, doctor, nurse practitioner, I know a few of them actually, that are practicing.


Ron  12:26

Really limitless. I mean, there's so much education and so much you can do with it. You're not limited.


Nick  12:33

It really is. And you know, to get to that point, we all take what's called the NCLEX, the National, National Council of Licensing Examination for the RN or the PN.  Terrible tests, just throwing that out there. (laughter)


Lita T  12:49

I'm sure.


Nick  12:51

So that's the licensing, credentialing, kind of how we get to become a nurse.


Lita T  12:55

And then I have a follow up question. If I can interject.


Nick  12:59



Lita T  12:59



Nick  12:59

of course,


Lita T  13:01

 I am aware that different hospitals specialize in different things around the country. Not every hospital will, will really handle transplants the same way as another hospital or heart disease as an I mean, they really kind of some hospitals will put a big focus on a certain thing. Or you have Mayo Clinic will cover anything or Cleveland Clinic, anything in the world, right? What about schools? For the nursing? Like, if you wanted to be a specialized nurse? Are you really limited as far as where you go to school to get those extra certifications in order to fit into those pieces that you want to go?


Nick  13:52

That's a good one. And I actually I've never looked at it from that perspective. So thank you for that. Now you're making me think (laughter)


Lita T  14:00



Ron  14:00

that could be part of your next podcast!


Lita T  14:01

 Yeah, yeah.


Nick  14:03

It very well actually could be because that's a great thought. As I sit in research master's programs for myself, I'm thinking about this now. So my thoughts about it Lita, would be it really depends on what you're looking to do. And here's why. A lot of programs for like, say your master's degree will use that as just since I'm searching for my master's right now. We'll have a Master's nurse education and your focus on like education. So there's your specialty. Some programs will have your Masters of Science, nursing FNP DNP to get your nurse practitioner, but then others will have that specialty as an acute care nurse practitioner. So you're focused on your urgent care, your emergency room, things like that, but not every school that I've seen in my research currently to find my programs have all those


Lita T  14:57



Nick  14:57

you'll see kind of like a baseline that I see Education, some have an most have NPS. And then probably I'd say, some have a CNS program.


Lita T  15:09



Nick  15:10

So you'll you'll always see a master's program at most, but you may not see some of those specialties and like,


Lita T  15:16

right, I'm just, I'm just wondering if they are if the schools are are localized nearer to hospitals that that would need that?


Nick  15:28

That would be a great question. Like, I would be very curious to find that,


Lita T  15:32

right. Like, I'm one of our very first podcasts. And the reason we created this podcast to begin with, was my cousin had to get a liver transplant. And we, Jean and I were actually in North Carolina near Duke, going to a rehabilitation program at Duke for Jean after she started walking again. And while we were there, we learned that Duke does more transplants than anywhere in the country. At that time, this was four years ago. And I'm curious if Duke if that if the schools, what's the school at Duke isn't isn't also ...


Ron  15:35

University Medical,


Lita T  15:47

... okay, if their school probably would have a bigger influence on transplant nursing, because they do massive amounts of transplants at Duke. That's what I thought


Nick  16:28

That would be a great question.


Lita T  16:30

That's what kind of triggered my so there's something you're gonna have to work on


Nick  16:34

 I now have a research question because I'm gonna go find that out.


Lita T  16:38

All right,


Nick  16:39

because I've never actually Lita, I tell you the truth, looked at it from that perspective. And I've been near quite a few specialty hospitals in my career so far. So that's actually a really good one. Another one comes to my mind would be an one you're probably familiar with is Walter Reed.


Lita T  16:58

 Right? Right, right.


Nick  17:00

As far as trauma surgery, it's


Lita T  17:01



Nick  17:02

traumatic injury.


Lita T  17:03

Sure. Or what's the one in San Antonio?


Nick  17:09

San Antonio medical and then there's


Lita T  17:12

just an army base down there that does a lot of critical care.  I'm off the topic.


Nick  17:18

I was talking about BAMC (Brooke Army Medical Center).


Ron  17:21

So yeah, get it back. Um, you've had a pretty varied background, a lot of a lot of experience. What has been your biggest challenge so far in your career, Nick?


Nick  17:33

Oh, man. (laughter)


Ron  17:35

Keep hitting you with these don't I?


Nick  17:39

haven't given with volume we all these. So the biggest challenge thus far, and there has been many, and there still continues to be challenges every day. I would have to say the biggest thus far. was probably Wow, it's toss up. On one hand, I would love to say it was going to nursing school while on active duty.


Lita T  18:07

Oh, yeah, that would be hard.


Nick  18:08

Which wasn't sure. Yeah, for sure.


Lita T  18:10

What was your task is? That's when you were an EMT?


Nick  18:14

Yep. Yep. I was still enlisted as a firefighter.


Lita T  18:17

Yeah, so, that would be hard.


Nick  18:19

So that was a chore.


Ron  18:20



Nick  18:21

 And the other toss up, would probably have to be, I would say being a supervisor actually. Because I know I just probably shocked everybody cuz it's not medical.


Lita T  18:33

But that's okay. So you've been in the military, or,


Nick  18:37

Yep, yep


Lita T  18:37



Nick  18:38

In the military.


Lita T  18:38



Nick  18:40

And I say that thinking about a couple specific situations


Lita T  18:43



Nick  18:43

that I've come across as a supervisor,


Ron  18:45

cuz you knew I was gonna ask, right?


Nick  18:47

Oh, yeah, I know I'm sure this is going down. So try to preemptively do that. But I would say probably the, you know, some of the biggest challenges I faced was being you know, a young noncommissioned officer, as a you know, an effective staff sergeant in the Air Force, and having to be a supervisor, you know, some of these really young 18, 17, 18, 19 depending on the year airman coming in our troops is like, you know, I call them my troops, 


Lita T  19:18



Nick  19:18

.. and almost in adapting them to the military life in this that in the other, but where it got really challenging for me was then you have to adapt to knowing how to deal with their lives. In it kind of tied to nursing for me a little bit because I was going through school and I had had my LPN at the time. You know, I had a young troop come to me with thoughts of self harm. And you know, that definitely was a challenge to kind of navigate that in my own headspace. But also, what am I supposed to do here? How am I supposed to take care of him so I honestly thought part of that being a supervisor and the things that come up with that kind of life, tide well as a nurse for me, but also it was definitely some of the biggest challenges in my career versus the trivial. Oh, you know, me going to nursing school. Oh, you know, my career goals and aspirations and this, that and the other I, it's nonsense I cared more about the challenges that came up in my career with dealing with the people that I was in that I was charged with.


Lita T  20:23

I can understand that


Ron  20:24

understood. Absolutely. So here's a little easier question.


Nick  20:30



Ron  20:30

 With everything.


Nick  20:31

No easy questions (laughter)


Ron  20:32

 I promise I promise, with everything that you have going on. What helps you find a nice work life balance.


Nick  20:43

I get asked this a lot. And my wife tells me a lot, is there's only 24 hours in the day. I get told that a lot. For me, I spend a lot of time doing physical training, going to the gym, going for runs going on hikes going running. You name it, I probably do it. I like going skydiving to relax to it's always fun.


Ron  21:09

 Look at Lita Ha ha ha!


Lita T  21:10

(laughter) skydiving to relax? (laughter)


Nick  21:16

Yeah. the look on Lita's face. (laughter)


Lita T  21:19

Listen, folks, you will never find me. You will never find me in a parachute unless the plane is going down.


Nick  21:26

Oh, come on Lita. You know, you want to go back to Brag?


Lita T  21:28

Oh, never. Never.


Nick  21:31

But so. But finding that balance is definitely a challenge for me. Because I do think there's more than 24 hours in the day.


Lita T  21:40

Well, we, yeah. Ron and I are both recreational therapists. So we try to incorporate that question so that we can show people that there are things that you can do to help balance your life and typically


Ron  21:58



Lita T  21:59

 right? Typically people will come up with something. Now if I were you and I was in Florida, I'd be fishing every single minute


Nick  22:06



Lita T  22:07

 of the day.


Ron  22:08

If I were you and I were in Florida I'd be scuba diving every single day.


Nick  22:14

So if I still lived in Florida, I and I love both of those hobbies actually excited. You both


Lita T  22:19



Ron  22:19



Nick  22:20

 If I was still living in Florida, absolutely. I would go diving, surfing.


Lita T  22:25

Yeah, I could never I could never be a diver because I love to fish. I'd be down there. Like, wait, I don't have my pole.


Ron  22:33

No, you'd be down there looking at him and saying I'm gonna have you for dinner tonight.


Lita T  22:36

Yeah, that's good.


Nick  22:38

That's what you take spear fishing up.


Ron  22:40

There you go.


Lita T  22:41

All right. All right. Win win? Nick, what role have your family and friends played in your career?


Nick  22:51

The biggest. Absolutely the biggest I would not be where I sit today. The Nick you see in front of you, was not the Nick 10 years ago, I promise. I joke with, I joke with people at work all the time. They're like, Oh, you're so successful. You've done this. You're not? And I'm like, no, no. Friends and family got me here, trust me. So they absolutely have played the biggest role in my career, though. All all joking aside.


Lita T  23:17

 Good, good


Ron  23:18

I mean, we that's a common response from a lot of our guests. And you got to have those backing in support.


Lita T  23:25

It's very good to have it, but there are some who don't. And that's, that's a rough thing to hear.


Ron  23:31

Right. So we're glad that you're


Lita T  23:32

yeah, very happy


Ron  23:33

here. And we're, you know, 100% behind you.


Lita T  23:35



Nick  23:36

Oh, absolutely. And such as a quick example of how much of a role is my wife is also a nurse as well. We're both. We both do nursing together. She was one semester behind me in nursing school.


Lita T  23:50



Nick  23:50

 so if you can picture that the husband wife tag team going through nursing school and just pushing each other at school all day.


Lita T  23:58

Is she also military?


Nick  23:59

 that she was she's not anymore now she's actually just she does civilian nursing now. She loves probably a little bit more honestly,


Ron  24:07

wait a minute, she was a semester behind. You should be able to get all the answers from you. (laughter)


Lita T  24:12



Nick  24:13

Yeah, common misperception. Everybody thought that.


Ron  24:17

I'm just kidding.


Nick  24:18

 But really not.


Lita T  24:21

No, that's good to have that kind of support,


Ron  24:22

Right, How did your military service help prepare you for your career in healthcare?


Nick  24:30

So I think a lot of it honestly, ties pretty well together, especially now that I'm a nursing officer, I have to balance the two hats, which a lot of people think we're one or the other, but we're really not. So I think the time and the service definitely gets you set up for healthcare with prioritization for one, which is something that we use in nursing a lot. It definitely helps with the teamwork side of it. Because obviously there's a lot of people realize, nurse, we all say  Nursing is a team sport, because it really is a team sport, promise. But the service is no different. And I'm sure Lita can attest to this, if you don't have your teammates left and right to you, you know, downrange or be you know, in garrison, if you don't have your team with you, something ain't gonna go right, there's just no doubt about it, and you're not going to get what needs to get accomplished. So in healthcare, it's no different. My medical technicians that are awesome, you know, they're EMTs, or LPNs, I work with both right now, if I don't have them, as my teammates, caring for our patient, it's going to be a really bad day, because I'm only one person. And the nurse for me, you know, on my side, I have certain responsibilities and tasks and things that have to get accomplished as the nurse that my technician can't do. So if I don't have a good teammate, technician with me that day, you know, to take care of our patient. One, I'm either going to be running around like a chicken with my head cut off really desperately or two something's going to get missed, and then I'm going to get, you know, give bad care. And that's obviously something I don't want to do ever for my patients. So teamwork. Absolutely. The military couldn't prepare you more for it, honestly.


Lita T  26:12

Good point. Great point. Excuse me, my niece, Vanessa, recently graduated from her nursing program this year. What tips and advice do you have for her and all the other new graduating nurses this year?


Nick  26:27

Learn as much as you can.


Lita T  26:30

Now that they're graduated, learn from...


Nick  26:33

what? So now that they're graduated, the learning is actually going to start is what I tell new nurses,


Lita T  26:39



Nick  26:40

And the reason being is because in school, we absolutely you want all the baseline knowledge, you want all the baseline skills, X, Y, and Z, you cover all the basics. And then we come into the real world,


Ron  26:51



Nick  26:52

 And we're out of that school world, which don't get me wrong school world is great, because it's controlled, it's clean. You have all that you have all the things to balance out things, and there's no liability attached to it. Now you're in the real world. And you're going to learn how to really take all that baseline and utilize it yourself in the real world. And that's the biggest thing I give to new grads, especially and congratulations to your niece.


Lita T  27:19



Nick  27:19

Lita, that's so awesome to hear, especially given the current state of affairs that nursing school was a challenge.


Lita T  27:24

Yeah, this is our first nurse in the family. I was very excited.


Nick  27:30

That is so awesome.


Lita T  27:31

 I wanted to...


Nick  27:31

 tell her Yeah,


Lita T  27:32

I wanted to be a nurse when I first joined the military, but my recruiter said, No, you don't have enough college. You could be a mechanic's, right? I started out as a tank mechanic, but


Nick  27:43

nothing wrong with that. I would definitely tell her now that she's out of school, it's learn as much as you can just be a sponge, and take, take that time when she's precepting. And she, when she hears this, she'll know what I'm meaning in orientation, and just learn as much as she can, and just start putting into practice what she knows. But also thinking outside of the box of that textbook, you know, that school test world where everything's perfect,


Ron  28:14



Nick  28:14

 Because then test in case you don't know, in test world, everything is perfect in nursing school. You've got everything in the world, but in the real world. That's always not the case. And a lot of new nurses get hesitant with the, well, this is not what my book said, well, that's okay. But we're in the real world now. And we're gonna learn how to adapt.


Lita T  28:31

Right, right. And, and the Military probably helped


Ron  28:33

 there's a baseline to baseline college. I mean, it gives you a beginning, but again, every situation every everything is, you know, like Nick said, it's real world. It's not what's in the textbook.


Lita T  28:48

Right? Right.


Ron  28:49

 But you do need the textbook stuff to have that.


Nick  28:51

Oh, absolutely.


Lita T  28:52



Ron  28:53

 that's what I was looking for was foundation.


Lita T  28:54

Right? Right.


Ron  28:55

Yeah. So what advice would you have for people starting in a nursing program or those who are wanting or thinking about going into healthcare?


Nick  29:06

prioritization is key.


Ron  29:08



Nick  29:08

And I say that in the respect of nursing school is very challenging. It is also very, very busy. Through my associate program, I was in classroom or clinical, four to five days a week, minimum. And that's two hour lectures, on the low end, three on a bad day, and eight hour clinical days, twice a week.


Lita T  29:33



Nick  29:33

So four to five days a week, I was actively engaged on campus or at a clinical site.


Lita T  29:41

So make sure that make sure that you are organized.


Nick  29:45

Yep, organized life balance, prioritization and


Ron  29:49

be prepared


Nick  29:49

has to get accomplished mental preparation for sure.


Lita T  29:52

Right, right


Nick  29:54

Yeah. You really, it's you have to be ready for it.


Lita T  29:57

 Good tips for success. Okay. good tips. Nick, what can we expect to hear on the "Bottom Line"? "Bottom Line Nursing Podcast" this year, what's next on your agenda?


Nick  30:11

So I've got a couple of things that I'm, I'm starting to work with some different people right now, the biggest thing that's gonna come I think soon as we're gonna do, we're gonna start transitioning to a lot of the specialties that I wanted to touch on, like we kind of talked about earlier. I'm gonna have a lot of specialty practitioners of different varying specialties come on to talk about the specialties. Because a lot of people don't realize how many there is kind of what we were talking about earlier. And how to get to those specialties. And that's where I think that knowledge gap is that I was referencing earlier, is some people are just not sure the roadmap to get to these certain things. So we're going to ask the people who got there and say, How the heck do you do it?


Ron  30:53



Lita T  30:54



Nick  30:54

 And I want people to learn that


Lita T  30:56



Nick  30:57

One of the big things that I'm going to do and I'll let the cat out of the bag for you guys ahead of time for my viewers, cuz I haven't told him yet. is I'm going to do an entire probably subspecialty series on how to become an Air Force nurse.


Lita T  31:11

Okay, good. Excellent.


Nick  31:13

Because a lot of people don't know that either.


Lita T  31:14

Sure, sure. Absolutely. Absolutely. That's great


Nick  31:18

for you Lita and my army friends.


Lita T  31:20

Yeah, yeah


Nick  31:20

I you know, I've got a tie that in with, you know, kind of how to become a military nurse.


Lita T  31:24

Right. Great. Excellent,


Ron  31:26



Lita T  31:27

I love that. And what do you do? Oh, no, you already said no, no, I early onset Alzheimer's. What do you keep in your personal first aid kit?


Nick  31:41

Oh, man. (laughter)  So I'm gonna preface this ahead of time to cover my butt, by what I keep in mind is not what everybody needs.


Lita T  31:52



Ron  31:53

I'm sure it's not some small little


Lita T  31:55

is yours. Like, you know, the size of a duffel bag? a backpack? Yeah,


Nick  32:01

so ironically, mine is actually probably a small duffel bag. It's I would say,


Lita T  32:06

yeah. I would picture that


Nick  32:08

 It's, I call it my jump. We call it a jump trauma bag in the fire service. So mine entails a lot of advanced airway stuff. So I keep airway adjuncts and things like that to open people's Airways, whether it be through the nose or through the mouth. I also keep some surgical tools such as a scalpel, and a few tubes in place in case someone would need a surgical airway. It keeps them suture sets. But at the barebone basics, I start with the basics. I keep some things to breathe for people. So I keep a valve mask in place for CPR. Fun fact keeping your car folks


Ron  32:45



Nick  32:46

just throwing out there. I also keep some basic breathing supplies so I keep some the airway adjuncts and stuff like we said, I keep a small bag, bag mask in there for helping people ventilate their breath if I need to. And then the biggest one is I keep a lot of bleeding control stuff.


Lita T  33:04



Nick  33:04

 I keep gauze at different sizes. gauzes I keep trauma dressing some abdominal dressings. I also keep it's the go to thing that you'll ever hear, I keep a tourniquet in my truck.


Lita T  33:15



Nick  33:17

 I have two tourniquets in my truck at all times one attached to my bag and one just sitting in my truck for a random day because bleeding is what kills everybody folks. (laughter)  case you don't know. So really the biggest things for like people that I tell at home, like their approach is just start with the basics. Start with some stuff for bleeding. You know, some and even if it's just band aids, no band aids, some gauze, just a couple dressings, some tape for mom, for mom and dads with little kids who cuts neosporin always works great. You know, but I always recommend people to keep a tourniquet and a bag mask for breathing and things of that nature. But yeah, my personal want to get the little Oh, well advanced.


Lita T  33:26

Right  I thought it would be fun. You know, I've tried


Nick  34:02

Oh, no, I love it.


Lita T  34:03

I'm trying to picture this in my mind, did I I can kind of picture it. Well, as a mechanic, you know, you open the toolbox, so you got to get it. And I'm picturing yours just as filled. So that's great. Thank you very much.


Ron  34:14

And I know he's gonna beat me up with this next question.


Nick  34:18

Go for it


Lita T  34:18



Ron  34:19

 If your first aid kit is the size of a duffel bag, what do you bring with you when you go on a medical appointment as a patient?


Nick  34:31

Not my medical bag. (laughter)


Lita T  34:34



Nick  34:35

So it's kind of it's kind of nice for me. Obviously being in the service I go to, you know, the Military Medical Centers for my most of my appointments. I actually currently only have to bring my ID card which is kind of nice, and nice. (laughter)


Lita T  34:52



Nick  34:52

So joke's on you. (laughter)


Lita T  34:54

Good. What is the biggest misconception people have about nurses


Nick  35:01

Oh, there's so many. I think I would I say extremely jokingly. But there's a lot of misconceptions about male nurses


Lita T  35:12

still, still?


Nick  35:13

 yes. I guess


Lita T  35:15

Well, I  didn't know that.


Nick  35:17

Yeah, if it's the question, if it's one of the things I'm thinking of Lita, then yes,


Lita T  35:21

Oh wow!


Nick  35:22

 that is still out there, I've been asked that I've been asked that a couple times, actually,


Lita T  35:25

I met, I met my first male nurse when my daughter was born. So 40, I don't know, a long time ago. And I would have thought by now that that would have been nothing, I, it still is?


Nick  35:45

it's better, it's better, I will say it's better that we I work with a lot of male nurses. And I would possibly chalk that up to a bias about the fact that I work in the military setting. So we have just dominantly male, naturally more males.


Lita T  36:00



Nick  36:01

But we'll just we'll say I've been asked some interesting questions about from patients about being a male nurse. But in general, misconceptions about nurses. I think a lot of it honestly boils down to a lack of knowledge, or the misconception of what we really do, or what nurses can and cannot do, which I think is a big misconception, too, because there's a lot of nurses who you get the Oh, you're just the nurse, you're not the doctor? Well, I will arguably, probably do a lot of things the doctor can't (laughter)


Lita T  36:35

Right, or won't. (laughter)


Nick  36:37

Oh, won't, yeah for that matter. But the nurses, will,


Ron  36:39

you probably saved a little money from medical school.


Nick  36:42

I mean, really, that's the best thing in the world. It's like, I don't have to pay the medical bills, I get to do a lot of cool stuff.


Ron  36:48



Nick  36:48

So I think there's still misconceptions, I think, across the board. I think Unfortunately, the current state of affairs over the last year probably helped dispel a lot of that, that the just nurse thing kind of is hopefully I think, pass knock on wood.


Lita T  37:03

I'm trying to picture in my mind. I watched Grey's Anatomy.   I know, I know, Okay, I'm addicted. But I'm trying to picture yet there. There are male nurses, but are there other programs? Are there other TV shows, movies, etc. That will raise male nursing to a level that will help advance the career?


Nick  37:07

Oh, God! (laughter)


Ron  37:07



Nick  37:29

I would be really curious and I'll preface that by I watch Grey's too, shamelessly Don't worry.


Lita T  37:35

 Okay, good.


Nick  37:36

 (laughter) I absolutely do I got a little upset a while back about it.


Lita T  37:41

Oh, wait, wait wait!  Don't, don't say anything because I did not watch the last season yet.


Nick  37:45

Neither did I


Lita T  37:46

 okay, yeah, I started over again,


Ron  37:49

This isn't on the script


Lita T  37:50

 that I'm running. I'm going through reruns and I'm up to season 10 right now and I'm not going to watch the last season until I go through it this last time. But


Nick  38:01



Lita T  38:02

 there is there is a couple of shows that are taped here in Chicago.


Nick  38:07

Chicago Fire Chicago Med


Lita T  38:09

Right, and I'm just curious if I should maybe write a letter to them and and say you know, if you're not already doing it, could you help male nursing by giving them I guess I should watch the show first before I tell them what to do.


Ron  38:24

I mean it's  it's the stereotype but I mean in my job been there 20 plus years we run three shifts the nurses and 20 plus years we've had one male nurse


Lita T  38:25

 (laughter) but but we're not near we're not near a military base. Chicago doesn't have well, Great Lakes but that's it.


Nick  38:44

Ironically, you're not too far from where I'm stationed. So that's kind of fun.


Lita T  38:48

Where are you?


Nick  38:49

I'm stationed in Dayton, Ohio.


Lita T  38:50

Oh, okay. Okay. I think if you're closer to a military base, you will see more male nurses?


Nick  38:57

I would say 100% as far as the shows are concerned, I think they could do a better job of bringing up males Grey's has a few I actually now that I think about it I haven't seen one male nurse on Chicago Med


Lita T  39:10



Nick  39:11

Now that I think about it so please write that one...


Lita T  39:13

 I think I will. I think I will I haven't watched the show. Even though it's taped right here in our city.


Nick  39:18



Lita T  39:18

 I just, I don't know. I get too scrambled with with shows. I


Nick  39:22

know. I mean, I think and it's it's sad and I and if you guys feel the urge that needs to be pulled out later, by all means take it out. But the biggest I think male misconception is how many times do I have to get asked how my husband's doing before they realize I'm married to my wife.


Lita T  39:40

Oh, wow. Wow, that's another misconception.


Nick  39:45

I get Yeah, I've gotten that one a few times. But again, I say jokingly because I think it's hilarious, but it is kind of it is a big misconception about most male nurses.


Lita T  39:54

That's a shame. Oh, yeah, that's a shame.


Ron  39:55

Yes, it is.


Lita T  39:58

Alright, who's got the next one? Jean, get up out of bed


Ron  40:02

Jean, so I guess I'll...(laughter)


Nick  40:03

I feel bad because I took everybody down a really dark rabbit hole.


Lita T  40:06

No, no, no, no.


Ron  40:08

I mean we do like to have fun on the show I mean obviously serious topics. But if we can make it a little light hearted you know, we try to enjoy ourselves a little bit and hopefully have our guests enjoyed themselves and you seem like you're having a pretty good time.


Lita T  40:22

Yeah. Okay,


Nick  40:23

well, all the episodes I've listened to listens to you guys seemed like you've had a great time


Lita T  40:27

Yeah we do, we do


Ron  40:29

to be with these two. Is it worth the price of admission?


Lita T  40:32



Ron  40:32

I say they should take it on the road.


Lita T  40:33



Ron  40:34

Good show


Lita T  40:35

Ron. Ron really gives us a dig quite a bit. All right. Jean was gonna ask you. Let's say I'm in a hospital. And this is gonna sound weird, but when should I push the call button? I always feel guilty asking for anything like help to the bathroom? help with my food? help getting dressed, more ice more water? When do you push the call button?


Nick  41:05

The correct answer is anytime you need your nurse.(laughter)  No.


Lita T  41:08



Nick  41:08

Um, however, I actually think this kind of a cool question and give Jean Jean My thanks for putting this one on here because I really do. And I hope she feels better I do Lita. This is actually kind of cool for me, because I'm thinking about, like, we call it call Bell fatigue in the nursing profession. Because it's a real thing. I promise. I'm 100 percent,


Lita T  41:31

I'm sure


Nick  41:31

that I have gone to sleep with call bells ringing in my head before. (laughter) But it is a real thing. Because I actually have had patients who have told me they felt guilty about calling. But then when I go see him and you know, ask him, you know, this, that or the other, how's your pain? How's your how's your breathing, you know, important things, no big deal. And then something's wrong. But they said they felt guilty about calling me and then it unfortunately turned into like a care issue that I had to deal with and make sure that they were okay. So I always tell people, like, you absolutely Call me if you need me. I'm not, I will never get mad at you for calling me when you need me. But I would just graciously asked people when they're in the hospital and that kind of setting, please remember?


Lita T  42:22

Don't abuse the system


Nick  42:23

don't, I don't abuse it. And I tell my patients, you're my only patient as far as you're concerned. Because I get the I'm sorry, I called you again, blah, blah, blah, I know you're busy, which I appreciate the fact that they're thinking about that. But you know, I'm My job is to be a nurse, you know, it's not like, I'm going to go anywhere, I'm not going to leave, you know, I don't don't feel guilty about it. You're my only patient when in reality, I have five others,


Lita T  42:47



Nick  42:47

So I would ask that, you know, people just try to try to keep in mind if they're in the hospital, when they're in the hospital, or with your with your when you're with family in the hospital, that nurses and staff, really you're running all the time, there isn't a shift where I'm not bouncing from one room to the next to the next the next 90% of my shift. So while we absolutely want you to call us try to just have some extra patience when you can if it's not something that's a life threatening issue. Say, you know, you need more ice or water? Well, unless that is absolutely going to kill you that second, which nine times out of 10 it's not try to be patient if you call and it takes a few extra minutes, you know, maybe two or three because I've had people, you know, snap at me over two minutes to get to their room.


Lita T  43:37



Nick  43:38

Which Believe me, we try to get really fast to rooms we really do. But I would just say it's not weird at all. Don't feel guilty, because that's what we're here for. And sometimes it can actually turn into an issue medically for somebody if you don't call me sooner than later that it's something you may not be thinking about. But I am


Lita T  43:56

Right, right. It brings me back to an event that happened to me. Probably 40 years ago, I was in the hospital. And I push the call button because I felt like I could not breathe. I felt I mean, I, I, was like consciously thinking but obviously you're breathing because you're alive. And I'm trying to concentrate on my breathing. I'm trying to figure out what is wrong with me. I could tell that something was wrong, but I couldn't tell what it was. So I pushed the call button and nobody came. And I'm looking at the clock. We didn't have cell phones back then. I'm looking at the clock. I'm thinking oh my God is taken for and maybe I was panicking. So I called my doctor from the phone in the hospital. I called my doctor at home. And I said, I can't breathe. He said you're in the hospital. I know I can't breathe, he said "Lita, you're breathing" I said, I feel like and what it turned out to be was my blood pressure had dropped so low, that everything was kind of slowed down from a medicine that they given me, maybe it was morphine or something. But I felt really like I was dying. And I didn't know what to do, because the nurse wasn't coming in, I almost felt like a lead weight. Like I couldn't move, I couldn't do anything. So the doctor called the hospital in the hospital, and the nurse came in. So I'm sure that the nurse got reamed. But since that event, I have always been cautious, and only call the nurse when I want what I really, really need something. Don't call them when because I'm thinking, well, I might have been calling she that he or she, this was way back. The nurse may be with somebody else that's even more critical than me. So what do you do? I mean, it's kind of like a it's Don't you think there should be like a two level call system like a CNA call button and a nurse call button or a volunteer call button just for ice or water? And another call, you know what I mean?


Ron  46:11

But a lot of time, right? I mean, I don't mean to interrupt, but a lot of times when people are in the hospital, they want to be taken care of. So it's it's an emergency. So even if they have the different levels, I think in just my opinion, I think people are gonna say, this is for me, and it's emergency. So I'm going to the highest level.


Lita T  46:30



Nick  46:31

They're both 100% valid points. And Lita, let me just say, as a nurse, I'm sorry that you had to experience that, because I don't agree with how that happened. Personally, obviously, I wasn't there. So I can't speak to the nurse that was working that evening.


Lita T  46:47



Nick  46:49

But,. What I will say is, things have gotten a little better, I think, over the years in time and technology. So our call Bell System is actually like a microphone system on a phone.


Lita T  47:00



Nick  47:01

so when they call me, I can actually, you know, speak to them and say, yes, you know, whoever What do you need?


Lita T  47:06

 Right? Right. That's true.


Nick  47:08

 If, if the words coming out of your mouth to me on the phone, or I'm having trouble breathing, trust me, I'm going to come to your room really fast.


Lita T  47:15



Nick  47:16

There's somebody's going to walk into that door in about two seconds flat,


Lita T  47:20



Nick  47:22

 So I think that's helped a lot. Because you know, the older call Bell systems you couldn't talk. It was just push button.


Lita T  47:30

Yeah, right.


Nick  47:32

 Now it's both. So when our call bells goes off, I get to pick up a phone, I can see which room it is already. So if it's one of the rooms that I'm you know, taking care of that evening, I already know who it is. And then they can actually verbally Tell me, or attempt to tell me depends on the day. Sure. What is going on?


Lita T  47:49



Nick  47:49

 which helps us assess. I won't say it helps us assess how quickly I need to get there. But it assesses the urgency of Oh, it's just water, we'll be there in a second. Not a big deal. No one's gonna die over it. Or it's, you know, way to yourself that situation which you probably got some pain medication that probably dropped your blood pressures,


Lita T  48:08



Nick  48:08



Lita T  48:08

Yeah. And I have low blood pressure anyway, so that it probably just put me over the edge. All right. Let's see. Yeah, thank you. Sorry, I didn't mean to go down or another rabbit hole.


Nick  48:16

No, but it's definitely I think it's a valid thing. Because you're right Lita. There are times where, and again, I won't speak for every nurse in the country, but like every profession, we do have bad apples.


Lita T  48:28



Nick  48:29

 I won't sugarcoat that there there were absolutely we have bad apples, who sometimes the compassion and empathy that should be there may not be to the level it is. And I won't say that I am the perfect compassionate empathetic nurse. Because believe me, there was a lot of times at the nurse's station where there are things that come out of my mouth about some patients that aren't exactly compassionate or empathetic.


Ron  48:52

But you're human


Lita T  48:53

You're human. Yeah,


Ron  48:55

On a daily basis


Lita T  48:56

 and and the only way you're going to be able to survive mentally is to be able to distance yourself from that every so often. So we understand that don't worry about that. Don't take that personal.


Ron  49:06

No, it's


Nick  49:07

I try not to but I just you know, it's one of the things that I as a nurse, I think giving the best care we can and again, that's kind of why back to the starting the podcast for me, you know, "Bottom Line". It's just wanting to get out more about our profession in the big picture for everybody. Not just nurses, but everybody in general, which is why I was so excited when you guys said hey, can you come on? I was like, Sure, absolutely.


Ron  49:33

Very cool.


Lita T  49:33

Great, great . Yeah.


Ron  49:35

It's been great having you on it. The the information that you've given it's, it's been amazing and very pleasant to talk with and have the conversation with. We thank you and also for your service to the country, like I said at the beginning. Is there anything that you would like to leave us with at this time?


Nick  49:58

I really first just want to say Thank you guys for doing what you do with with podcast dx because I've actually learned so much about different disease processes listening to you guys so it's actually helped better me as a nurse to.


Lita T  50:11

Love it!


Ron  50:11

 I appreciate that!


Nick  50:11

 not because there's some some of the random ones on there and I'm like, what is that?


Ron  50:16



Lita T  50:16

 We say that we have too when we're doing the research (laughter) we're like, I've never heard of that.


Nick  50:22

you know, first really just thank you guys for doing that because it's it's definitely I will say been educational for me even just the short snippets about hey, this that or the other Oh, that's what that is. That's what that patient goes through. This is what I should look for. It helps me as a nurse get better at what we do and teach other nurses too. But you know, really just thank you guys. It's been a pleasure. Whoever's listening. If you ever you know want to learn more about nursing one, check out the podcast, two. You guys can feel free to put them in touch with me wherever y'all want. I have no qualms about nursing, nursing school, military time, firefighting time, EMT, time paramedic time, I love trying to bring more people into our profession, because it's an awesome profession. It's probably the best joy of my life to do. So I can't say that enough. And just thank you guys so much. It's been so much fun.


Lita T  51:14

Great, Well, we're gonna put links for your show on our webpage. For each guest, we build a page, and we'll put links, you know, for that guest. So we'll definitely have links for your bottom line nursing podcast on there. And if our listeners have any questions or comments related to today's show, they can contact us at podcast through our website, podcast, dx com on Facebook, Twitter, Pinterest, or Instagram.


Ron  51:43

And also we are currently looking for guests to interview in September of this year. So if you'd like to be a guest on a future episode, please follow the link on our website and schedule an interview with us.


Lita T  51:55

And if you have a moment to spare, please give us a review and wherever you get your podcast as always, please keep in mind that this podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always keep the advice of your physician or other qualified health care provider, top of the line and any questions that you may have regarding a medical condition or treatment before undertaking a new health care regime. Never disregard professional medical advice or delay in seeking it because of something you've heard on this podcast


Ron  52:29

till next week.

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