Patrick McMurray (00:03): I say that nursing is an act of justice, or at least that it should be an act of justice, because we live in a world where so many people aren’t treated fairly and there’s a lopsidedness and disproportionate treatment of people. And as a nurse, when I’m working with a patient or when I’m working with someone in the community, I have the opportunity, for that short amount of time that I’m with them, to negate or correct the wrongs. And not permanently because I don’t believe in nursing saviorism because I can’t do it alone, but for a moment I can make that person feel valued. It’s my job to make them feel valued, make them feel heard. And I think if more nurses get into the idea that, for this moment, I’m trying to correct the injustices to the best of my ability, I think we would start seeing more progression in equity.
Nacole Riccaboni (00:50): It can be overwhelming to hear that nurses need to support health equity on top of everything else. Most of us aren’t as far along in our career as Stacy from episode two. She brought 20 years of experience to her role as Boston Hope CNO. And not all of us can set up a clinic like Nikki from episode three. She built a whole practice dedicated to helping women of color. If you haven’t heard these episodes yet, definitely, definitely go back and listen. They’re amazing. What these nurses have accomplished is commendable, no doubt. But when I talked to my friend, Patrick McMurray, I realized that there is a huge range of ways to make an impact, and they’re all super important.
On every shift, we can help our patients feel heard. On every shift, we can take steps towards correcting injustices. As you listen to my amazing conversation with this young thought leader, teacher, and practicing nurse, I hope you see that whoever you are and wherever you work at, you have opportunities in both big and small ways to influence equity.
My name is Nacole Riccaboni. I’m a critical care nurse working in Florida and your host for SHIFT Talk Season Two.SHIFT Talk is a podcast that brings nurses together to talk about the challenges we’re facing on and off the clock. This season, we’re interviewing nurses who are working to ensure that all patients can have access to the resources and care that they need to be healthy, and that’s called health equity by the way. We’re going beyond the clinical and looking at the social factors that impact health from a person’s zip code, to their health, to even their job, and even structural racism. No healthcare provider knows more about nurses lives than nurses, right? We can really make an impact here, folks.
This podcast is brought to you by SHIFT, an entertaining nursing community for today and tomorrow’s change makers. SHIFT is sponsored by the Robert Wood Johnson Foundation. Follow us on Instagram @shiftnursing, and for more amazing stories and real talk about nursing, head over to shiftnursing.com. One final note, this episode was recorded in July. So please keep that in mind as you listen to this great conversation. Now, let’s dig in.
Welcome, Pat. Can you give the audience a little introduction into who you are and your background?
Patrick (03:12): Thank you. My name is Patrick McMurray. I am a registered nurse based in North Carolina. I have been a nurse for eight years. I am actually a second generation nurse. My mom is also a registered nurse. My career has mainly been in the inpatient setting. I started off in the cardiovascular ICU, but I recently transitioned to work in outpatient and a pre-anesthesia testing clinic. I also am a part-time nurse educator, and I write, and I have a lot of passion for a lot of different things like nursing education and citizen science.
Nacole (03:44): Many, many hats. Now you said that your mother was a nurse. Was she the one that inspired you to be a nurse?
Patrick (03:49): I hate to say that she was but she was. Because I hate to say that I just went and did what my mom did, but she was very like, “You don’t have to be a nurse and you should probably consider other things.” But she didn’t discourage me from nursing. She was certainly the first nurse in my life and she showed me the potential of what nursing could be. So, I will say that she inspired me heavily. I did not decide to go into nursing just because of her though. I’ll say that very proudly.
Nacole (04:14): Well, it’s just great. When you see someone doing something they love, it attracts you to that profession.
Patrick (04:19): It does.
Nacole (04:19): So she definitely was a good example for that. Now, you entered nursing through an associate’s degree, and I did as well. And I checked on your Instagram and stuff and it says that you’ve written and you’ve spoken about the importance of keeping multiple pathways open. Why do you feel like keeping multiple pathways open is so important and crucial?
Patrick (04:38): Nursing fulfills a very…We show up for communities and for people in very specific ways. And so, because of the way that we show up for people, we really can’t afford, at this moment in time, to be picking and choosing how we get nurses. Now, it doesn’t mean that we don’t have, and I hate to use this term, but we don’t have standards. But it’s to say that we want to keep the doors wide open to nursing, because historically we know that nursing has been predominantly white, predominantly female. And that doesn’t match what the population is, and so we need to keep these multiple pathways open because not everyone has the same starting point. Not everybody has the same resources starting out. There are people who depend on associate degree programs or LPN programs to be able to get their foot in the door in nursing.
And there’s actually research that shows, particularly for black nurses, once they get in the door, they’re more likely to go on and get their BSN and go on to continue their education and beyond, even the BSN. But a lot of us depend on the ADN entry and LPN entry. And even if we don’t enter nursing via community college, using the community colleges to be able to transition to get into a bachelor’s program at a university.
Nacole (05:42): Well, I personally did the ASN to BSN to MSN to my doctorate, and I didn’t have the BSN option. I could not afford it, like you said. I had to, not even wanted to, I had to start work as fast as possible for my finances and my families, and if that pathway wasn’t there, I would not be where I am right now.
Patrick (06:03): Agree. And I was fortunate, I went into this with a little bit of privilege because I had the opportunity to go to university. I applied, I got in. But I decided…Because I knew I needed to work because I was like, “Look.” I remember they were telling me how long it was going to take and I was like, “I need to make money. I need to be independent.” Look, I got stuff I got to do. So I was like, “I’m going to do this ADN route.” It worked for my mom. I actually attended the same community college my mom did many years before me. So, it’s a legacy in our family. And then, it’s also the same school that I first started teaching part-time as a nurse educator. So, I just come full circle and I love it.
Nacole (06:36): What school was that if you don’t mind me asking?
Patrick (06:37): I’m super proud. Robeson Community College from North Carolina.
Nacole (06:43): I went to Valencia Community College. I follow them on Instagram. I love their program. Something about community college just always sticks with me. It’s your community. You get to meet people that live near you. The community college has a more intimacy that I did love and enjoy.
Patrick (06:59): And then, there’s literature that supports that. We know that nurses who go to community colleges are more likely to work in the communities that they come from or the community that the community college is located in. And once they go and get a BSN, they’re still more likely to work in places that are underserved. So ADN nurses and LPN nurses educated in community college are more likely to work in an underserved area. So, we know that there’s already these things that a lot of people don’t bring out because so many people bag on ADNs and LPNs. If we didn’t have ADN programs and LPN programs, the reality is that well over half of the United States nursing workforce would be non-existent. We’ve just gotten to the point where we have about 60% BSN or higher prepared workforce in nursing. So, almost 50% of all BSN graduates for the last three or four years are RNs that have associate’s degree or have a diploma are the ones getting their BSN. In addition to people who are going straight through our pre-licensure program for their initial education.
Nacole (07:56): Nice. Now I know on your social media platform, you talk about diverse workforces. How does a more diverse nursing workforce benefit patients in particular?
Patrick (08:06): I think about my own lens of experience. I think that coronavirus has been a big example of why we need diversity. We hear things like vaccine hesitancy and it happened in a lot of black and brown communities, because there’s legitimate reasons why people have distrusted healthcare. And people love to be like, “Well, but the science says this, why can’t you see people are just trying to help you?” But it’s not that easy. There’s been a lot of harm done. Nursing has played roles in it. Medicine has played roles in it. Leadership and policy have all played roles in it. And so, that distrust is real. With me, with the pandemic, and with the vaccine, many people in my family, the ones who aren’t in the medical field, were like, “I’m not going to take the vaccine.” I didn’t overcome that hesitancy, and I don’t even like the word hesitancy. I don’t know what a better word is. But I didn’t overcome that thoughtfulness about why and that desire to wait by bombarding them with why are you being so stupid? I overcame it by being patient with them and being able to relate to them on a personal level.
And so, what you’re going to see is that when you have more people that look like you or who have lived life experiences similar to yours, they’re going to be able to relate to you on a different level. Your ability to communicate health information with them is going to change. I can have a black patient that grew up in the same hood I grew up in and I know how to talk to them, because if I say that you just had a myocardial infarction, I’m only going to reach them so far. I don’t want to paint this picture by any means that people that come from diverse backgrounds are unintelligent, but sometimes you just understand things better in the vernacular common to your community or to your ethnic group.
Nacole (09:36): I am working where I grew up at. And like you said, you know the community. I grew up there. I was talking to a patient about diabetes and he didn’t understand how the A1C was related to his diabetes. And he’s like, “No one ever explained that to me.” And I was like, “Well, you’ve had diabetes for 10 years, no one explained it to you?” And he’s like, “It’s confusing.” So, I basically explained how red blood cells work. I drew some pictures and I explained, “They live this long and this is why you have to get the A1C check.” And he was like, “Oh okay. They just kept telling me that I had diabetes, but I didn’t know how they were checking that.”
Patrick (10:07): Science communication is a big thing. SciCom is a thing. People who communicate science. I think that needs to be infused into the nursing curriculum, because it’s more likely that you’re going to have a nurse in the family than you’re going to have a physician in the family just because there are almost 5 million nurses in the United States. So, it’s understandable that somebody will have contact with a nurse, whether it be in their family or in their community, more than they would pretty much than any other licensed healthcare worker. Other than maybe pharmacists because pharmacists are everywhere in the life of pharmacies.
I think that we have to really appreciate that, and nurses need to be able to communicate science well. And you know this Nacole, because sometimes you’ll be like, all right, this and this and this and this, and then the doctors or the physicians will come in on rounds at 6:00 in the morning and waking the patient up when they’ve been sleeping all night and say, “This is what’s happening and this is what the plan is.” And they’re like, “Okay, yeah.” And then they leave out and they’re like, “I didn’t understand a single word he said.”
Nacole (10:56): I know. It happens all the time. Can you have the nurse come back here? I don’t know what he said. I don’t know what he said.
Patrick (11:02): People trust nurses. They feel more comfortable being vulnerable with us. And so, nurses need to be really good at being able to communicate health science. And it’s something we learned in nursing school, but I think we need to learn a new level of how to reach people whether that’s making GIFs, and it helps people… Is it GIFs or JIFs? The little moving picture.
Nacole (11:19): I think either or. You know I’m old. I don’t know.
Patrick (11:22): Okay. My friends all said, “It’s not GIFs, it’s JIFs.” I’m like, “Okay. I don’t know.” But anyway, learning how to make a GIF or JIF that helps a patient learn something or learn how to make an infographic. I’m a big infographic person. You put a picture, and some charts, and some arrows, I’m going to get it.
Nacole (11:35): Now, do you think that patients are scared to ask provider questions when the provider doesn’t look like them?
Patrick (11:40): Oh yeah. I mean, in the past, when I had a provider that didn’t look like me, I’m just like, “Okay. I don’t want to look stupid.” But if someone looks like me, I’m going to be like, “Okay. Yeah. You know where I’m coming from. So, I don’t know what that was. I need you to say it again.”
Nacole (11:53): Break it down for me.
Patrick (11:55): Yeah. You keep saying these words and they don’t make sense.
Nacole Riccaboni (11:58): Sometimes providers feel like they’re being as blunt as possible and they’re using layman’s terms. And I always ask them, “Well, what did the patient say when you stop talking?” If they can verbalize understanding or even re-demonstrate, then they got it. But then just saying okay does not mean that everything was understood.
Patrick (12:14): Right. And I think that’s a big principle we learned in nursing school. When you do teaching, we ask the patient to regurgitate it back to me. And I tell them specifically, “You don’t have to repeat what I said, but tell me how you understood what I said.”
Nacole (12:25): Yeah. That is from nursing school, you’re right. I don’t think most providers get that, you’re right.
Patrick (12:29): I really don’t. They have a lot to learn from us. I think there are a lot of great physicians out there, but I think that so often nursing is competing with medicine.
Nacole (12:36): For sure. Now let’s shift gears for a little bit. What parts of your education and experience made you start seeing healthcare through the equity lens?
Patrick (12:44): It started with my ADN because that was the core of what I know. I was fortunate enough to be in a program where the majority of people are black and indigenous people of color or BIPOC, and our program director was a black lady. I got to grow up as a nurse with that idea of equity. And then, when my mom was a nurse, I got to see that manifest with her. So, I probably even had that start beforehand, but because I went to nursing school at the same place my mom did and I had her guidance, I saw that beginning of the need for equity in my associate degree program. And so many times the narrative tells us that with the BSN, you become more well-rounded, you understand people, but I challenge that. Not to say that the BSN doesn’t, but the BSN is the end all be all and it’s not the only way for people to learn how to think and see outside of themselves.
I think we can’t discount the position and the ability of lived experience or life experience to be able to give us knowledge and to give us well-roundedness as well than my ADN program. For my peds rotation, we worked at a center for autism in our county. And we got to understand the challenges these kids face, and we got to interact with them and play with them and realize how this world is not setup to benefit them. And so, how do we factor that into how I nurse them? Are we going to be quick to label this as a behavioral thing when it’s not? And so, it really helped me because I had this good education as an ADN. A good well-rounded education, which a lot of people don’t realize about ADN programs, because I think people are stuck in the idea of ADNs when they were first created in the late 1950s. They’ve grown and matured and evolved just like any other nursing program has.
Nacole (14:21): Well, as a person that started out with an ADN, we had a couple of LPNs on our floor and those females were amazing. Now, they were “new nurses” like I was a new nurse, but their experience and their background from the LPN aspect, they were light years ahead of us, and they taught us so much stuff.
Patrick (14:39): Yeah. And I think that so much of the conversation focuses on what the limitations and the difference is. When really, in a lot of ways, they’re not so significant that they should divide us. People make all these assumptions BSNs are this and ADNs are that, but we really can’t apply that to every situation, and we realized that they all have value. We had Dawn Wooten who was an LPN and she was the one who blew the whistle about what was going on in Georgia to immigrant women and them getting hysterectomies and being assaulted there. And so, how dare I say that she wasn’t a leader just because she was an LPN and she didn’t have a bachelor’s degree or a graduate degree.
She was a leader more than many people that have degrees and credentials that go above beyond the LPN. So, I think we need to divest from this idea that the BSN, by itself and alone, makes you, one, a leader, makes you, two, well-rounded. We should be able to have conversations about ADN and BSN, and MSN versus DNP, DNP versus PhD. We shouldn’t have to have all these versus conversations. We should be able to have conversations about progressing academically as a profession without denigrating other pathways into nursing, because not everybody has the same starting point, period.
Nacole (15:51): I completely agree. Now, circling back regarding that equity lens, do you think that nursing schools are preparing nurses to think that way?
Patrick (15:58): I think nursing schools are developing their ability to prepare nurses to think that way. Even from my education, even in a program that had a high population of people who came from the BIPOC community. I see where our education is still very Eurocentric in nature. We only see pictures of white skin. Typically, the patients that we use and see in books and in our test subjects are white. I think we’re still learning. We look at everything through a lens of what the Western world has set as what is normal and what is not, and I’ve come to find out that that’s called “othering,” and we “other” people outside of a white lens. So, I think we’re still developing our abilities. I think schools now are in a much better position because the social determinants of health and things like that are becoming such an important part of nursing education. So, I think that they are developing the ability. We have work to do.
Nacole (16:48): Now, as your role as a professor, are these issues that you talk about in your courses or with your students?
Patrick (16:53): It is. And it’s something that even me as someone that is a black man in nursing, I had to find out how do I… I teach pharmacology primarily and I teach clinical for LPN students. So I was like, “How am I going to introduce the social determinants of health in pharmacology?” But actually there’s a lot you can do. I think so often in nursing we think that pharmacology, it’s a very science heavy course. And it is science and math heavy course, and it really is. But we don’t realize that also in pharmacology, we need to talk about the issues of access that people have to medications, issue with access to insulin, issues with access to reproductive care and the way that pharmacology plays a part of that.
If you get creative, regardless of what class you teach, you can infuse these ideas about equity and social determinants of health and relate it back, because I have a patient that speaks Spanish, for example, and all of the labels are written in English. How do I navigate that for them? What if they have a question and if they don’t have answers to their questions, are they more likely to stay with the drug? Or am I not understanding what it takes for them when they have to choose between putting food on the table and buying this drug? If I don’t understand this social situation and the social economics behind things, pharmacology can only play a certain part. So, I think that we need to stop separating the socioeconomic and the equity from the biological and the chemistry. Science without understanding the social phenomenon that surrounds science, it only gives us half the answers.
Nacole (18:24): So you just integrate the content into the course. It’s not like a one hit thing where you do with a PowerPoint and move on. It’s constantly integrated into your courses.
Patrick (18:31): Yeah. I try to introduce the thoughts. And I don’t think you have to hammer it in. You have to feel where to do it, and I think we have to also be honest about, okay, do I have the lens and the range to discuss this topic? Because if you don’t, I ain’t got no business speaking about something I don’t know about. But I can help find resources and talk to other people to point my students to resources that may give them a perspective. Because I don’t want to take on the work of speaking for communities and populations that I don’t have the right to speak for. So, I do try to integrate it throughout. And because ADN programs are really big on what we call on concept based curriculum, so instead of isolating…You’ve been through the experience like… When I was in nursing school, our first semester, we only have one class, but that one class was 10 credit hours. Literally, it’s 10 credit hours.
And so, it infused fundamentals of nursing, nursing assessment, and pharmacology all into one course. We infuse the concepts of pharmacology throughout the rest of the curriculum. And your med-surg two class, so you’re going over pulmonology or when you’re going over cardiovascular, we’re doing another review of cardiovascular medications and everything, so that way it sticks with people better. Instead of just isolating everything to one part of the curriculum, you infuse it throughout because that way you’re getting this constant exposure that helps you to be able to relate to information more and it helps it to be able to stick in your head more.
Nacole (19:44): Now for our audience out there that doesn’t know, can you explain what concept based education or learning is?
Patrick (19:50): Yeah. Rather than isolating content, it says that we’re going to take this concept and I’m going to teach you how to do a head-to-toe assessment on an adult and a child at the beginning of your curriculum. And then, we’re going to grow that knowledge as you go throughout, so then as I’m going through my peds rotations, we’re going to talk about focused peds assessments. And we may come back and review quickly the general assessment, but then we’re going to layer that knowledge.
I like to think of concept based curriculums as layering knowledge. We give you a foundation of something. And then as you go throughout the program, we show you how to take that concept and apply it to different situations. Rather than having to teach you the content over and over again from a slightly different angle, I’m going to show you how to do a physical assessment for a pregnant woman. I’m going to show you how to do a physical assessment for a newborn. I’m going to show you how to do a physical assessment for a teenager. Then I’m going to show you how to do it an assessment for somebody with psychiatric mental health. It’s taking a concept and not living in one spot, but helping you to learn broad concepts and be able to apply it to different situations.
Nacole (20:50): Well said. I completely agree. It’s starting generalized, and then focusing in as needed. Now in your previous interview with SHIFT, you talked about how the future of care is in the community. Can you explain to us how community-based care helps address these inequalities?
Patrick (21:06): Well, a lot of the things that we see, we see because there are inequalities in people’s access to health care and the quality of care that they get. I’m from a very rural place. And I remember in the CVICU, we got a patient admitted, and this patient was admitted for having cardiac issues. And me doing my physical assessment, I was like, “I need to take off your socks so I can look at your feet.” And he was like, “Why do you have to do that?” And I was like, “Well, that’s just what I do because a lot of people don’t take off socks, but I believe in getting a thorough assessment on everybody.” I mean, I put on gloves. Let me make it clear, I put on gloves. You can come across some stuff.
I saw this man had a huge diabetic ulcer in between his toes that had gone unrecognized. And I said, “How did this get like this?” And he was like, “I can’t afford my insulin. Sometimes I can get my insulin, sometimes I can’t. And sometimes I’ve been reusing old insulin.” And I’m like, “Oh my gosh.” It’s sad. And so I’m like, “There are programs out there where we can help you get insulin. We can give you on a sliding scale. If you couldn’t afford it here, there’s a resource available for that.” But people don’t know. And because we live in this system where healthcare providers are overburdened, we’re doing more with less, not everyone is going to always have the time. If you’re a busy ER nurse and you’re treating a person who treats the ER as their primary care provider, because indeed it is because they can’t afford to go to a clinic that says I won’t see you until you pay this money.
I can go to the ER. And even if I don’t have money, I’m going to be at least treated and seen, and that manifests in a lot of different ways. And so I think that what we see is that when you implement nurses in the community, it decreases the need for hospitalization and it decreases the burden on tertiary care. Tertiary care is when you get acute care, basically hospitals, y’all. That’s what tertiary care means. So it reduces the burden, but we have to make that care in the community accessible.
Everybody doesn’t have insurance. Everybody can’t afford to pay a $50 copay or a $30 copay. So, we have to get nurses out there. And not only advanced practice nurses, because I think a lot of people think, well, I need to go and become an FNP and open up my own clinic or work in a primary care office. I think there are more creative ways for us to do that. There’s public health nursing, and the issue with that is that we haven’t invested in public health nursing a lot. So, public health nurses often make a lot less than a nurse working in the hospital. So, a lot of nurses are like, “I have a family to feed and I don’t come from generational wealth. I would love to be a public health nurse, but I can’t afford to live off of that salary.”
Nacole (23:27): Yeah. I’ve heard that too. I remember I did my rotations at the health department locally here, and there was a nurse practitioner and she’s, “I’m leaving in two weeks.” And I was like, “Oh really?” She’s like, “I would love to stay here. I would really love to, but financially I just can’t do it.”
Patrick (23:41): But girl, we got bills.
Nacole (23:42): I know. You couldn’t blame her. But she was like, “I love this place. It’s a free clinic. I get to help my community. But I also have bills that are due and student loans, and this is just not working for me.” And I was like, “Well, who’s going to replace you?” And she’s like, “No one. That no one’s going to replace me. It’s just going to be one doctor by himself.” I was like, “Oh my gosh.” She was like, “Yeah, that’s how it goes.” I was like, “Oh, wow.”
Patrick (24:04): Yeah. So, we have to invest in these communities and community care. There’s this company called Navi Nurses. I don’t know if you’ve seen them on Instagram. And I say that nursing is an act of justice, or at least that it should be an act of justice because we live in a world where so many people aren’t treated fairly and there’s a lopsidedness and disproportionate treatment of people. And as a nurse, when I’m working with a patient or when I’m working with someone in the community, I have the opportunity, for that short amount of time that I’m with them, to negate or correct the wrongs. And not permanently because I don’t believe in nursing saviorism because I can’t do it alone, but for a moment I can make that person feel valued. It’s my job to make them feel valued, make them feel heard.
Even when a patient, you don’t get along with them or they frustrate you, it’s my job to make them feel valued and heard. I’ve been hurting all day. I’m going to do my part to make sure that you’re not in pain. I don’t understand what’s going on. Well, I’m going to make sure I do the part and make sure I understand things in a way that you understand it. If I have to go on the internet and find a YouTube video to play in your room, on the computer, in your room, I’m going to do that. I have an opportunity for a moment. And I think if more nurses get into the idea that, for this moment, I’m trying to correct the injustices to the best of my ability, I think we would start seeing more progression in equity. At least from a nursing standpoint.
Nacole (25:26): I completely agree. The hospital is filled with vulnerable people that just want to be heard. As a person that’s recently been a patient myself, when people just come in and listen to me, it means the world to me, and I have a medical background. I couldn’t imagine someone that doesn’t have their own voice in life in general or they have a lot of health disparities. Just as a nurse, you’re not going to do it on your own, but all you have to do is just listen and be there. I mean, you’re a part of a team. I’m not saying nurses solve every single healthcare problem there is out there, but sometimes just listening to that person is enough for them.
Patrick (25:57): Yup. I agree.
Nacole (25:58): Now, do you feel that nurses are uniquely positioned to lead community health?
Patrick (26:02): I think we are. One of the things I respect and why I love nursing is because we hold the biological and the basic or physical sciences as equal to the social science and the socioeconomic considerations. Every step of the way, nurses are considering those two. And a lot of other professions are like, okay, we consider that up until a point, but right now we need to focus on this. And it is true we have prioritize things at certain moments, but I think nurses inherently think on a community level and we inherently think on this social level. And I think that’s why we’re the most trusted profession. I think that’s why people feel comfortable around us because we realize that there’s more to a story.
Nacole (26:42): For sure. To me, nursing is all social. I mean you’re communicating with people whether it’s part of your team or your community. It’s constant communication, constant education. And like you said, people get into nursing and they’re like, “I don’t know it’s going to be with all these emotions and all this talking.” I said, “That is what nursing is. I don’t know what you thought.”
Patrick (26:58): Right. I don’t understand. Why is everybody confused?
Nacole (27:02): Why is everyone…Why do I have to keep educating people? That’s the job, dude.
Patrick (27:05): That’s what nursing is.
Nacole (27:06): That’s it, guy. That’s the whole thing, you’re educating. You’re not just passing meds, you’re impacting a community with education and knowledge. That’s the whole thing. Now, let’s talk about your role as a thought leader in nursing. When did you decide to start speaking publicly about diversity in nursing and equity issues?
Patrick (27:23): I’ve told you this before, you were a really big inspiration because…
Nacole (27:28): Oh stop.
Patrick (27:28): Nacole stop playing games. You know. We’re cousins in my head that might be. We’re cousins in my head.
Nacole (27:35): We are. That’s just who we are. Yeah, I agree with that.
Patrick (27:35): We’re cousins in my head. I saw you and you were the first…You and the Nurse Mo were the first black nurses that I saw. I was like, “We got some black nurses out here.” What I loved about you in particular, is because you will be on your stories, then you would go from talking about some kind of pathophysiological issue to ranting about something on Netflix and I loved that balance, and you are genuine in the way you communicate. I was like, “Okay, that’s how I am.” I’m like, “So I can just be myself and be out here.” You more than anybody told me just be your authentic self. And no matter how weird you are, no matter how people may think you’re a nerd, be your authentic self and that it was okay. So I was going to be my authentic self, and so I can talk about equity and say stuff like y’all be a raggedy and that’s my catchphrase.
Nacole (28:20): I love your IG. I love it. I love your Twitter too because you always drop knowledge about education that I never even thought about when you bring it up, and it just touches me in a special way.
Patrick (28:29): Yeah. That really inspired me to be like, I can come in this space because I think so often. We have this idea that we have to talk about equity in this very scholastic and this “professional” way, and I’ve been interrogating the word professionalism. I think we can all agree that professionalism is important, but sometimes professionalism is used as a code word for proximity to whiteness. How close you’re aligned to what the white majority says is normal and it’s not. So, I’ve been more intentional about how I use professionalism.
Nacole (29:00): Some Instagram nurse saw me at work and she was like, “You’re so different at work.” I said, “Listen, this is a social media thing where I can be myself, but I’m at work taking care of people’s families. I don’t get to talk to them any kind of way.” So, don’t get confused where you think I talk to everyone the way I talk to my children at my house.
Patrick (29:18): Right. I totally agree.
Nacole (29:20): Now, in terms of your professional work, how does a nurse as an advocate role play out in the day-to-day things that nurses do?
Patrick (29:27): I think that nurses can advocate in very small ways, but also in very big ways. I think a lot of advocacy is about, first, just having the audacity to speak up. And it starts with yourself because if you can’t advocate for yourself, it’s going to be a lot harder advocating for other people. But I think that advocacy is not separate from nursing. I think that it’s a core tenant of what nursing is. We learn about patient advocacy a lot, and it means that I may have to advocate for people who are doing things or making decisions that I personally wouldn’t make. So, a large part of advocacy is having that humility to be like, I don’t know. And so, I’m going to find out for you, or even though I don’t agree, and this is a wish and it’s going to help with your overall wellness, which is not just physical, but also mental and emotional. I’m going to do this.
And I don’t have to feel bad if people make me feel silly or stupid. I don’t wallow in it because I know I’m doing it because it’s going to bring enrichment and it’s going to bring justice to my patient, so I’ve let go of that. And I’m not saying that it’s always easy, but when you get in the habit of doing it, it becomes second nature. And you still may feel uncomfortable while you’re doing it, and people will try to gaslight you and be like, “You’re doing too much or you’re making a bigger deal out of this than it is.” But if it’s a big deal for the patient, then I’m going to make a big deal out of it. I’m going to talk to somebody. I’m going to do what I have to do.
Nacole (30:47): I’ve been there too because you know I work night shift, and getting people to come in on night shift. They’re like, “You’re doing too much. This is too much.” I say, “This is what he wants. He wants his last rights, call a priest to come in.” “It’s 2:00 in the morning.” “That ain’t got nothing to do with I just said.” This guy is passing. He’s passing away. We could at least do this. I’m not worried about waking somebody up. This is what he wants, I’m advocating for him. Now, I’ve seen the pandemic show me some great examples of community-based nursing and care. I know that you were doing these things called keep warm kits. Can you describe that project?
Patrick (31:20): That was an effort between me and some of my friends on Twitter and this group I’ve developed called Disrupt & Reimagine Nursing. But this is before we even had a name. There was homelessness in my community. And so I was like, “I want to do something.” Because it was winter time and it was COVID. I saw people walking around and I’m like, “How do you get a mask when you don’t have the money to buy one?” Or you have a paper mask and you’ve been wearing the same one for weeks. I just put out a question on Twitter about like, “Hey, I want to get some bags together.” In two days, people had sent me money on my cash sharing apps and sending $2,000, and I was able to buy these bags.
In the summer, that’s for keeping them hydrated, keeping them cool hats and stuff. And then, we did it in the winter and we called them the keep warm kits. And I was able to pass them out to my community, and we did two sets of bags because one sets of bags were given out by an organization, by a local hospital system. And then, the other bags I’ve been able to give out personally. I will literally drive around between 6:00 and 7:00 o’clock at night and find people and give them to them, and it’s been nice to be able to come together with nurses who are so adamant about I want to show up in this way. Even though it was only helping the people who are experiencing homelessness in my community, they were so gung-ho to support it. I think it shows that nurses want to do these things. We want to be involved on this level with the community.
Nacole (32:37): That’s a great project, and you said that all the nurses came together, as nurses always do with stuff because we’re all one big team working together and we help each other out.
Patrick (32:45): Yeah. It was great.
Nacole (32:46): What advice would you give nurses who are trying to address health disparities?
Patrick (32:50): I think that nurses share work with the community. We teach family members how to do dressings, how to administer medications at home. If you’re not sure where to start, just look around. I think a lot of it is paying attention. As nurses we learned to assess, and one of the big things I teach my students in clinicals is that we don’t just assess people, we assess their environment. I’m a former ICU nurse, so I love the physiology, I love the clinical and high level assessment. But we also have to zoom out a little bit and start looking at the larger things. Getting in touch with organizations. If you don’t know, don’t try to act like you know everything. Ask people who are living through something, what can I do to support you? What are the things that you need me to do? Instead of making decisions about this is what they need. I tell somebody, how can we show up for you? How can we support you? They tell me the ways and we show up in that way.
Nacole (33:37): Pat, thank you so much for this amazing interview. I follow you on social media. I learn something with each and every tweet, post, and update that you give us, and this interview is no different.
Patrick (33:48): Well, thank you so much for having me. I’m just glad that someone actually wants to hear me talk and doesn’t just think I’m ranting like I sometimes do.
Nacole (33:55): I always learn from you. You’re a published author. You have all this knowledge. I learned so much.
Patrick (34:00): Oh gosh, I’ve been very fortunate and I’d have a lot of support and I’m thankful for it, and I’m thankful for you allowing me to have the chance to talk and hear my voice out, so I appreciate it.
Nacole (34:10): No worries. It’s been a pleasure. Thank you again.
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