The Daily Show: Ears Edition - Beyond the Scenes - How Are Nurses Coping Throughout the Pandemic?

Episode Date: February 28, 2022

Roy Wood Jr. sits down with The Daily Show Associate Producer Madeleine Kuhns and Dr. Christopher Friese to discuss why many nurses are experiencing burnout, how hospitals can help and more.Watch the original segment: https://www.youtube.com/watch?v=rP6VjrdSKAQ Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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So journey into the future with Ford's lineup of electric vehicles, with many affordable options to choose from. Head on over to Ford.com to learn more. Built Ford Proud. Hey, welcome to Beyond the Scenes. Look, this is the podcast that's like, you know, you know what this podcast is like, this podcast is that big ass bag of M&M's that you dump into your popcorn right as the movie starting. So that you get a little bit of sweet alone with that buttery salty savory, right? It's that contrast, you know? That's what this podcast is, you know, it's the goodness that

you didn't even know you needed until that weird kid Marcellus did it that one time and now you can never go back. That was a kid one time. He put, he put his french fries and his ice cream and I was like that is disgusting. And then I tasted it. I was like, that is brilliant. We need to figure out where the kid is these days. Anyway, speaking of my failing health due to an unsustainable diet of ice cream and french fries, today, we are diving into the latest debacle to hit the American health care system.

The nursing crisis. Give them a profession, everyone has a breaking point. And nearly two years into serving on the front lines of this war, a lot of them are starting to update their LinkedIn's. Some hospitals experiencing critical staffing shortages, as frontline workers say they feel like they're underwater. Survey during the pandemic found that 62% of intensive care nurses are burned out. Burnout stress, grueling hours. the hours. the hours. the hours. their. their. their. their. their. their. their. their. their. their. their. their. And their. And their. And their. And their. And their their their their their. And their. And th. And th. And th. And to to to to to to to to to to to to to to to to to to to to. And to. And to. And to. And to. And to. And to. And to. And to. And to. And to. And to. And to. And to. And to. And to. And to to to. And to to to to to to to their, their their their their their their their their their their the pandemic found that 62% of intensive care nurses are burned out. Burnout stress grueling hours.

There are multiple reasons career nurses are choosing to leave. Mississippi has at least 2,000 fewer nurses than it did at the beginning of the year. In Kentucky, more than 20 hospitals report critical staffing shortages. In hard hit New York, there was a 400% increase in nurses looking for new jobs. We are joined today to break down this daily show segment with, number one, Daily Show associate producer, you've heard on this wonderful program before. Madeline, how are you doing today? I'm good, Roy, it's good to be back, always a pleasure.

What is this third, fourth time? I think it's third. I think I'm tied with CJ now. I don't know. It's it's all a blur. I'm just happy to be working. Also joining us on the program today is a long time nursing, nurse educator, a doctor of nursing, a doctor of nursing, you know just to show those physicians what's what's... Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Christopher Fries, Dr. Fries, welcome aboard beyond the scenes. It's great to be with you. Thanks so much for having me. Thank you. And I know that the people listening cannot see this, but I want to acknowledge how color. Coordinated your couch is with the background in the, the, you're living space. There's a color, what's, that, th, th, th, what, what, what, what, what, what, what, what, th, what, th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. thr. Dr. th. th. th. to, Dr, Dr. to, Dr, to, Dr, to, to, to, Dr, Dr, Dr, Dr, Dr, Dr, Dr, Dr, to, Dr, Dr, Dr, th. Dr, th. Dr, th. Dr, th. Dr, th. Dr, th. Dr, th. Dr, Dr, Dr, th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. Frie. to, to, to, to, to, to, to, to, the background in the the your living space. There's a color, um,

what's the word, like a palette, the color story. That's, yeah, my girlfriend is the color story. Everybody's worried about books in the background trying to impress people, but not you, you got the turquoise contrasted with a little bit of the brown. It's very, it's very nice. Very nice. Very nice. Very nice. Thank you. Thank you. We. We. We. We. We. We. We. we. we. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. the th. th. the the the the the the the the the the the the the the, the, the, the color. the color. the color. the color. the color. the color. the color. the. the. th. the. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. the the the th. th. the the the th. the t the te. the the the tod the the the the the the the the the the the color. the color. Well, we'll see. Room Raiders, a bunch of assholes. They gave me a six. They can kiss my ass. Sorry about that. We're here to talk about things that are much more upright and appropriate. Madeline, this segment that we did on the daily show, we just played a little bit of a piece of the original segment. But for folks that missed it, give us a little little thi thi thi thi thi thi thi that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that that we're that we're that we're that we're that that that that that that that that that that. that that. that that that. that that that. that that that that. that that that that that that that that's that's th. th. th. th. thi. thi. thi. thi. the here thea. thea. thea. thea. thea. to thea. to to to to to to to to to to the. the segment covered and how it came to your attention. Sure, yeah, so the piece is essentially, it's about how the crux of how we have a critical national nursing shortage, which is only getting worse, by the way, it's not magically solved since we did this piece. And a lot of that is due to nurses burning out on the job. And this, particularly why we did it when we did earlier this year, is because it's, you

know, after I feel like the vaccines came in and we were all, yay, we have a vaccine, the pandemic is over, except, well, we were going dining, nurses and all the health care workers were being thrown into another pandemic, and that was the pandemic of the unvaccinated. And the ridiculous and really like truly awful fact of that is that unlike the first wave when we were all kind of dealing with something we couldn't control, this one was completely preventable, and it did not have to happen. So then as you were piecing this together for the show, the thing we've talked about on this podcast in the past about is how we can find an issue and then you can find eight different aspects of this issue to address. What were the ones that you all decided to dial it in on and why? I know that on the one hand we could talk about the mental health part of it, but then you could also talk about the public negligence part of it?.......... And th. And the th. And the th. And, the, th, the, the, th, th, th, th, th, the, the, th, the, the, the, the, the, the, thi, the, the, thi, thi, the thi, the the thi, the thi, the thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, th... th.. th. th. And, th. And, thi, thi, thi, thi, thi, thi, thi, thin, thin, the the thin, the thin, the the thin, the thin, the the thin, the the the thin, the thin, th it, but then you could also talk about the staffing part of it, but then you could also talk about the public negligence part of it.

So just how did you all, as you all were producing and putting this piece together, how did you all decide the hierarchy of important things to make sure it stayed in the piece and didn't get edited out? Part of it, I will say, I th, I, I, I, I, I, I, the heart, the heart, the heart, th, th, th.. th, th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. that, that, that, that, the, as the, as th. th. th. th. th. As, as th. As, as the, as the, as th. th. th. th. th. th. the, as, as, as, as, as, as, as, as, as, as, the, the, the the, the the the the the the the the the the the the the th. th. the tod. tod. today, to, to, to, to, to, to to to to to to toda. toda. today, today, today, today, today, today, todayto try to address in some way. I'm not a nurse, but I've had some, I've had more interaction with the hospital system, I think, than the average American. So like when I was young, I was hospitalized a lot for pneumonia. And I'm definitely a product of my parents' health insurance and modern medicine, and I am fine. But the, you know, one of the reasons I'm still here is because of the, you know, I mean, fantastic doctors. thu. And, the to their. And, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, I'm, I'm, I'm, I'm, I'm their, their, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I's, I's, I's, I's, I's, I's, I's, I's, I.. I's, I. I's. I's. I's, I's. I's. I's. I's, I's, I's, I's, I's, I's, I's, I's, I's, I'm, I's, the the the the the the the the the the t t t t t t t t t t t t t t t t t t t t t the. t t the the still here is because of the, you know, I mean, fantastic doctors, but fantastic nurses. So a lot of my earliest memories are of just like nurses in that care and just like experiencing first hand what a difference like that level of like human care makes.

Okay, so for example, I'm going to go off on an anecdote now that I thought of, but when I was so I was a young kid in the hospital and they would always put these IVs in my hands all the time. And as a kid, I hated that because I wanted to like play with my hands because when you're in the hospital for long time, it's actually kind of boring because you just not much to do as a patient. As a patient, not as a hospital worker as a kid. And when they listened listened, thuuuu, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, I, I, I, I, I, I liked, I liked, th. th. thi, I liked, I liked, I liked, I liked, I th. thi, I thi, I th. th. the, I th. the, I the, I hated, I hated, I th. I hated, I th. I th. I th. I, I, I th. I, I, I, I, I, I th. I th. I th. I th. I th. I th. I th. I th. I th. I th. I th. I th. I hated, I thi, I that, I that, I that, I that, I that, I that, I that, that, that, that, that, that, that, that. that. that, I that, I that, I hated. th would be hard because I wouldn't be able to walk around, but what the nurses did is they let me ride, you like those long, big IV poles? They would let me ride around the hospital on those, like the silver surfer or something.

And so I think, when I think back to that time, I think it's something that could have been a very scary memory is actually very warm and that all of that had to do with the level of care I received. And so when I was looking for pieces and seeing how nurses were being affected by COVID, there was a part of me that remembered the level of care that you can get when nurses are able to do their job versus what we're seeing happening now, and that's what I started looking at saying, like, how can we tell that story? How can we show what should be and how can we show it is? Because Dr. Fries, you know, when you look at health care

in the modern era in this country now, like it's not just about knowing your job from a techie, technical IV, find the vein standpoint, you also, it seems that that the job, the job, the job seems that the job of nurse is a little bit part sociologist as well, where you have to be able to relate to people and I would even argue that it might be a little small element of social work in trying to just connect with people on a normal human basis. But you have a lot of different confluences happening. What do you believe are the primary challenges

for nurses and the health care system right now? Well, how much time do we have right now? So first I want to say that each and every day, nurses are delivering exceptional care across the country. They are getting it done for their patients, technically, socially, physically. They are problem solving behind the scenes. They are, you know, I call it, you know, part, the, you, you, you, you, you, you, the, the, the, the, the, the, the, the, the, the, their, their, their, their, their, their, their, their, their, their, you, you, you, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, te. te. te. te. te. te. te. te. te. te. te. te. te. te. te. tir patients technically, socially, physically. They are problem solving behind the scenes. They are, you know, I call it, you know, part technical, part psychology, part air traffic controller. And that's the part that a lot of people don't see.

So a lot of excellent nursing care is still happening, but we're on the brink. And we've been on the brink for about almost two years now. So when we when we when wethe priorities, what I'm really worried about is at some point, our public health officials will have a lower level of concern for COVID than they do right now. They will say, we're at a phase that we can, quote, manage this. We have an ability, you know, the case counts are very, very low. We're not seeing these big wide spikes that we're still seeing.

And everybody's going to say, oh, great, problem solving, and they're going to walk away. And they're going to leave nurses in the lurch without solving the underlying structural things that are happening to nurses every day and have been happening for a decade. So my team has been studying nursing workplaces for two decades now. A couple things that I'm very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very two decades now. Couple things that I'm very worried about. One is, executives are not spending enough time on understanding the working conditions of nurses and how they need to fix them. They're not listening to nurses and solving their problems. Executives within the health care system.

Exactly right. Okay, just making it. Executives in the health care system are not listening carefully to nurses concerns and acting upon those concerns. When nurses tell you they have a problem, they have a problem, they're not making it up. And when nurses have problems in their workplaces, we've known that patients are more likely to die, patients are more likely to have complications, patients are more likely to have to stay longer in the hospital. None of us want any of that. So, first is we we we we we we we we we we we we we have we have we have we have we have we have we have we have have have have have have have have have have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to have to to to to to the hospital. None of us want any of that. So first is we have to have our health care executives listen deeply and carefully to nurses and work very strategically on those problems. Then we have a couple of

structural things, not very sexy, but we still allow many nurses, as you point out, to work mandatory overtime. Their boss can come to them, they've worked a 12-hour shift. It 5 o'clock at night, they've worked 10 hours nonstop, and their boss can come to them at 5 p.m. and say, guess what, you're staying another four hours. And we don't do that to pilots. Your pilot flies you from New York to LA. They get off the plane and they go home. Drive drivers either. Right. They're not even cheating. Exactly right. So we've got a couple of structural things like that. We also have, well guess what? We're running short on a nurse, so you're going to take another one, two, three patients.

And right now in the COVID area, we're seeing that in the ICU. I've never heard of that in the ICU in 25 years of nursing. So executives have decided have that that that that that that that that that th. th. th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, thi, thi, thi, true, true, try, try, true, trac-in, true, true, true, true, try, try, try, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, well, t, well, th, th, th, t, th, t, t, t, t, t, t, try, try, try, try, try, try, try, tha, tha, tha, try, tha, tha, tha, try, tha, try, tha, tha, try, tha, tha, try the labor problems on the backs of nurses rather than solving the underlying problem. And I think that problem predated COVID and it's only gotten worse during COVID and it's only gotten worse during COVID. So if we really focus on those issues, we're going to have a healthy, safe nursing workforce that can care for us during COVID and after COVID. And if we don't pay attention to that stuff, we're going to be in a whole world of hurt. And we're going to see more of the stuff that we're seeing now.

Nurses leaving in droves, too many, too many patients to care for, unsafe staffing, etc. It's a vicious cycle if we don't break the change. I'm going to ask a question that's going to seem more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more more to to to to to to to to to to be morbiduiaughe but but but but but but but but but but but but but but but it's to be to ask a question that's going to seem morbid, but it's from a fiscal place. Why would the executives break the backs of the employees whose job it is, is to help keep the customer a lot? If we're just going base level, making money in health care, if people die, that is not good fiscally for business. So why would we create a place where the workers cannot do their job the right? What is the advantage in an executive doing that?

Like if we said, they're not a sponsor, let's just use Amazon for example. Okay, yeah, Amazon's going's gonna pay you as little as possible and not put you in a union because it makes them more money. Overworking nurses doesn't make you more money. The patient is the patient, the cost is the cost. So why would you want the patient to die? Like, what are the advantages in the executive infrastructure of a hospital in being assholes like this? Well, I have a lot of friends who are executives, so let me put that on there.

And I think a lot of them are real. Not them. They're cool. Yeah. You know who we need. Those other people, right? So, you know, I think that, first of all, a lot of the executives are trying to do the right thing, but we don't have the incentives lined up, and I spoke about this earlier. So number one, when you, unfortunately are in the hospital and you get a bill when you go home,

do me a favor and look at your bill, and you tell me, this is a quiz for is. You know where it is? Room and board. Nurses are part of the room and board part of a hospital bill. So if you have cancer, and I'm an oncology nurse and I am giving you expert care for you leukemia, and I'm in your room every hour, drawing blood and giving you blood products to save your life, and giving you antibiotics and all that stuff.

And the person next to you or the room down the hall has an appendix removed and they're there for 12 hours and I give them two Tylenol and send them on their way. The bill for the day is the same. So right now, nurses are widgets in the hospital. And they are the largest part of the hospital budget, and so when times get tough, guess where they're going to cut. Guess where they're going to cut the corner without nurses stepping up and saying, this is no longer safe, this is no longer acceptable, we need a different structure.

And so it's a tricky thing. It's going to be hard to solve. But what I I I I I I I I I I I I I I th no th no th no th no thiiiiiia thia, thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti. ti.e.a. ti.e.a. ti.a. ti. ti. So, ti. ti. thing. It's going to be hard to solve, but what I'm, what executives can do right now is really listen carefully to what their nurses are telling them and act on it. And what they can do tomorrow is eliminate mandatory overtime because that's unsafe and we know it's unsafe. And they can work carefully to get those numbers right so that we have an adequate number of nurses to care for the patients. Because. because. because. Because. Because. Because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, because, and the patients, and the patient, and the patient, and the patient, and their, and the patient, and the, and so, and so, and so, and so, and so, and so, and so, and so, and so, and so, and so, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the, and the the the the the the the the the the the the the the the the the the the the the the the thi, and some, and some, and some, they, they, they, they, they, they, they, it's unsustainable. But the primary problem is we do not value either numerically or monetarily the kind of nursing care that patients in the US need in hospitals.

One of the things that I found researching that really struck me, was just, you know, not just a level of care, but just all of the different types of care that nurses do that I don't think we really think of, that you know, it's not, it is drying blood and it is giving medicine, but you're also you're helping patients shave, you know, the nurses are the ones holding the phones so people can talk to patients. Like, there's a lot of things that if you did put them on, that's, you know, maybe we should start, you know, putting those on so people can actually understand that that type of care. Or talking to the doctor and the pharmacist when you're not even the room to say you just ordered an errant medication that's going to put this patient at risk, do you really

want to do that? Yeah. Or, you know, so there's all this work happening behind the scenes, this air traffic control function, nobody sees it and nobody's paying for it. It's just happening and it's part of my work. And so you can either have me overloaded where I'm trying to do that for too many planes, too many patients in this example, or we can do it in a way where I have the time in space to really care for patients or teach them them them them them their their their their...... the time and space to really care for patients or teach them about their new leukemia diagnosis or their new surgery, whatever they just had done. So you get what you pay for and right now we're lumping this into room and board. It's

basically a Hyatt bill. Sorry if they're a sponsor of yours, but you know we don't I love this idea of the CV. Because if we did that for a nurse, what did you do for this patient for 12 hours? It would be a ticker tape parade. Yeah, because that's the thing that I think is interesting as well because it's all hidden under room and board. I don't even think Americans even know what we're saying, what the nurse do. Like, all you know is that the nurse is the person who is in charge of, apparently from what you're saying, Dr. Fries, everything from medicine and the right dosage to batteries for my TV remote, which is always my concern when I'm visiting someone in the hospital, is that the television has an inadequate amount of channels. But what I'm gathering is that that's probably not a bigger issue in the eyes of the administration right now.

Well, you know, if you're visiting, you shouldn't be inconvenienced if you can't access cable. So what is the point of visiting you in the hospital if I can't watch Comedy Central wink wink wink shameless plug. So then with all of that happening, Madeline, how do you all, it seems like, and I could be wrong, Dr. Freese, jump in if I am, but it would seem like the issue of the stress of this job and what the pandemic did to morale is also somewhat of a, if not a newer issue, definitely more prominent and more prevalent now. So how did you all decide on how to sparse that into the story? I think the challenge with trying to put together a piece like this is that you have to figure

out when you're going to make jokes but also when you're going to take it seriously. I would say the best asset that we have, I mean, and you know this at the daily show, Roy, is that like we just have a lot of, I mean, there's a lot of hands on th. th and th and th on them. It's a really collaborative effort. And so one of the people I mentioned above, the very talented people, is one of our producers, Allison, who did a lot of work on this piece. And when we were talking about burnout specifically for nurses, which again is not a funny topic, it's very serious, it's very depressing, but she found a clip of a nurse speaking about how, you know, when they're talking about their

burnout and the solution by their, you know, I guess the hospital executives was to kind of throw a pizza party. People just still honestly do not understand how severe this is, how bad staffing for nursing is. When tombs are tough and things are getting rough, they'll have a pizza. You know, you guys are spread really, really thin and we're th. And th. And thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi really thin, and we can't get new nurses, but here's pizza. Okay, no, people? No. You cannot solve a nurse shortage with a pizza party. In fact, it's probably going to make the problem worse,

because it's the last food you want to feed someone who needs to stay awake for a double shift. You know, so it's finding things like that to still be able to talk about an issue. Pizza is probably a good problem solver until about the eighth grade. After that, you've got to be taking us at minimum to Cheesecake factory. After the break, Dr. Fries, I want to throw that are still in a lot of these, you know, hot spots and are dealing with all of the problems that you're talking about. And I'm very curious, not only about the mental health issues that are happening right now within our hospital system with nurses, but also, what are you all telling the new nurses that are coming out of the school? How do you convince somebody to take this job? What does the nursing recruitment poster look like? This is th.. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. the, th. th. th. th. th. th. thi. thi. thi. their. thi. I'm thi. I'm th. I'm th. I'm thi. I'm, thi. I I I'm, thi. I I I I I'm, thi. I I I I I I I I I. I. I I. I I I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I. I'm, the. I'm, the. I'm, the the the the the th. I'm th. I'm t. I'm t. I'm t. I'm te. I'm te. th. I'm th. I'm th. I'm th. I'm th. I'm the take this job? What does a nursing recruitment poster look like? This is beyond the scenes.

We'll be right back. I have a lot of questions for you. I'm sorry. And we're live here outside the Perez family home just waiting for the... And there they go. Almost on time this morning. Mom is coming out the front door strong with a double-arm kid carry. Looks like Dad has the bags, daughter is bringing up the rear. Oh, but the diaper bag wasn't closed.

Dipers and toys are everywhere. Ooh! But Mom has just nailed the perfect car seat for the toddler. And now the eldest daughter, who looks to be about nine or ten, has secured herself in the booster seat. Dad zips the bag closed and they're off. Ah, but looks like mom doesn't realize her coffee cup is still on the roof of the car, and there it goes. Oh, that's a shame. That mug was a fam favorite.

Don't sweat the small stuff. Just nail the big stuff. Like making sure your kids are buckled correctly in the right seed for their age and size. Learn more at NHTSA.gov slash the right seat. Visit NHTSA.gov. Slash the right seat. Brought to you by Nitsa and the Ad Council. What grows in the forest? Trees? Sure. Know what else grows in the forest? Our imagination. Our sense of wonder.

And connect with too. Because when we disconnect from this, and connect with this, we reconnect with each other. The forest is closer than you think. Find a forest near you and start exploring at Discover the Forest. to you by the United States Forest Service and the ad council. Dr. Fries, you've spoken about the mental health challenges that are faced by nurses. What makes these challenges so acute? You know, what is it about the job that is creating all of the stress and how is that affecting

the nursing population, you know, even by gender? So it's a really important topic because I think the take-home message for your readers, we're all spending a lot of time worrying about nurses right now and probably everyone listening has a family member or friend who's a nurse just because of the numbers with four million of us out there in the US, right? But the big take-home message for everybody to know is nurses were in trouble before the pandemic. So our team at the University of Michigan had done some work to understand, and I'm going to just give folks mention that we're going to talk about some unpleasant topics like suicide just to prepare people.

We actually did some work to show that deaths by suicide were two times higher among female nurses than the rest of the US population. And that data went through 2017 before the pandemic and the curve was like this. For the last 11 years that we studied it it was a steady increase over time. The all-time peak was the 2017 when we have the latest data. That's our group. Another group, now you could say that's still very rare, you know, but I I I would say every nurse we lose is, you know, a tragedy. And if the numbers are still rising, rising numbers, rising numbers. Right. So it's alarming finding. But the other point is, a survey by the Mayo Clinic just showed that even thinking about suicide and self-harm was on the rise during the same period. So, you know, not of thankfully not everyone is going to have a tragic event, but nurses

have had behavioral and mental health challenges before the pandemic. I think there's a couple things going on. Number one is the work is stressful. We've talked about mandatory overtime and shifts and workload. The other thing we haven't talked a lot about is violence. Verbal and physical violence against nurses is continuing to rise, was rising before the pandemic, and we do not have a strategy in the US to control that. So nurses are in an unsafe hostile environment for their work. And then think about what's going on around them. 80% plus of the US nurse population is female.

They're often caregivers at work and they're caregivers at home for family members, for kids, for etc. So you put all that together in a tough work environment and you can imagine why people are having stress. The other piece we know about nurses and other health care workers is it's very hard for them to seek health care services for mental health because of the stigma involved. They don't want to be seen that they can't handle their work, they don't they don't they don't they don't they don't they don't they don't their their their their their their their their their their their to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be to be their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. to be toe. their. te. te. te. te. te. te. te. te. te. toe. toe. toe. toe. toe. to to toe. care services for mental health because of the stigma involved. They don't want to be seen that they can't handle their work. They don't want to be seen as a patient for that problem. Like the military and the police and there's a pride that comes with a position? That white wall, you know, we'll call it a white wall of silence instead of the blue line.

You know, we don't want to talk about this stuff. the the the the the their. their. their. their. their. their. their. their. their. their. their, their, their, their, their, their, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we're, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we'll, we're, we're, we're, we're, we're, we're, we're, we're, we're, the,. the, the, the, the the the the the the the the the the the the t tape. tape. tape. tape. tape. the the the tape, the the the the the the the the the to talk about this stuff because we want to be seen as professionals, we can handle our stuff, but you know, it's like diabetes. You can't just wash this away. If you have a mental health condition or you have a substance use issue or whatever you have, there's no thinking that a health care worker is less immune to that problem and they need as much help if not different kind of help than anyone else. And they, they, they, they, they, they, they, they, they, they, they, they, they they, they they they they they they they their, their, the, their, the, the, the, the, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, th. thi, th. th. th. th. th. th. th. thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi. thi. thee is theei. thei. thei. thei. thei. th repeatedly say in surveys, it is hard for them to find services that understand their needs. They feel they can't do it confidentially. They're worried about retribution. They're worried about getting fired. They're worried about losing their license. So until we solve that problem, we're not going to solve the mental health crisis among nurses. The final point I want to add the the the the to the to to their to their to to their th mental health crisis among nurses. The final point I want to add on this is some of my colleagues work, Dr. Kristen Choi at UCLA has shown in a survey that nurses have a lot, in a large survey of nurses in the

nurses' health study, a substantial proportion of them had childhood trauma, physical, verbal, sexual trauma in their past, far higher than the U.S. population. So we're trying to put all of this this this thi thi thiiiiiia tho tho tho tho tho tho tho tho tho than the U.S. population. So we're trying to put all of this together, but we're flying blind because we really don't have good understanding of what the exact issues are. We know what the clump of things are, but we don't know really how they fit together to create a problem where a nurse is really in trouble. So then we're dealing with a workforce that themselves may be broken and unhealed from their own traumas

while also working in a stressful situation to heal everybody else. Now, then when we talk about just the workforce in general, why has it been so difficult? And this is just Mia Lehman, this is a guy who I've gone to the hospital a couple times. I really good blankets at the hospital. If you could steal one, please do yourself a favor and get you one of those nice hospital. As a layman, why can't we just hire more nurses as just part of the issue? Like that's

always been the approach to if we want to use policing isn't a one-to-one. Like that's always been the approach to, if we want to use, policing isn't a one-to-one, but that's always been something where that's a job with decent pay, decent overtime, decent retirement. So you don't really have the bigger issue in recruiting over there. Why can't we just add more nurses to the workforce? And why hasn't that been a solution? Yeah, so a couple things, so we need special training right for nurses.

You can't just kind of walk in from another sector and become a nurse. There's, there's, you know, at least two up to four years of training and then you need an extensive on-the-job training. And the problem is we have a pipeline problem. So you, we jokededed earlier earlier to to to to to to to to to to to to to to to to to to to to thukedue, thuck, thu, thia, thi, thi, thi, thi, thoes, the the thoes, thi, thi, their, their, th. th. th. tho, tho, tho, thi, thi, thi, their, their, their, their, their, their, their, their, their, their, their, the the the the the the th. We, the the the the thi, the the the the thi, thi, thi, thi, thi, thr, thro, to, to, to, to, to, to, to, to, to, to, throoooooooooooooooooooooo, how do you get people into the field? We turn away eight to ten qualified people for every nursing school position. Every student position, there are eight to ten people behind them that we turn away because we don't have enough capacity. Why don't we have enough capacity? We don't have enough faculty. We don't have enough people to teach both in the school of nursing and in the hospital. Those expert nurses who are leaving, th. We, we th, we th, we th, we th, we th, we th, we th, we th, we th, we th, we th, we th, we th, we need th, we need the, we need the, the, the, the, the, the, tho, the, tho, the, the, tho, tho, tho, thi thi thi thi thi thi people thi people thi people thi people thi people thi people thi people thi people thi people thi people th, th. th, th, th, th, th. th. th. th. th. th. th. to th. the, to the, to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to teach both in the school of nursing and in the hospital. Those expert nurses who are leaving, we need those folks to help teach

our students. So when we have experts leave, we don't have enough people to teach our students. If we don't have enough faculty, we can't teach our students. And nurses make more money practicing than they do teaching. We have in a line the incentive to say if you want to be if you're an expert nurse we want you to be an expert teacher and we're going to reward you for that. Instead we say oh you're going to take a pay cut so how's that going to work? Also I'm wondering Dr. Freese if there's something like with a distr- I mean obviously there's a shortage, which is a critical issue, but in terms of like a distribution, because I mean, I think one of the things about being in New York is that I kind of

take it for granted that like we do, like we have a lot of hospitals here, you know, like, you can, you can Uber to a hospital, but there's a lot of more rural parts of the country that a lot of, you know, a lot of thu, th. th. th. th. th. th. th. thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thru, thru, thru, thru, thi, thru, thr-a, thr. thi, thi, thi, thi, I thi, I thi, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I, I think, I think, I think, I think, I think, I think, I think, I think, I think, thr. thr. thr. I think, thr. thr. thr. thi. thi. thi. thi. thi. I thin. right? Because it pays more money and we don't hold that against them, obviously. But those shortages are so much different than here where I don't think we would feel it. What is the difference between a, what a travel nurse is just someone who comes in and they're hired privately by a particular hospital. Hey, come be a nurse here for a little while. Contraccts. And so you their their their their, their, their, their, their, they, they, they, they, they, they, they, they, they, they, they, th. th. th. th. th. th. th. th. th. th. th. thus, thus, th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. th. tho. tho. tho. to. tho. thooo. the. tho. thooo. the. tho. tho. th. th. th. like six to 13 week contracts. And so you pay a premium pay, they get a premium pay, they get paid to relocate, and they're there for six to 13 weeks, and they typically are placed in the shortest staffed units. You know, they're filled, they're filling holes.

And so people will say, I'll go in, I'll do this, I would call it jokingly hazard pay. I'm th I'm th I'm th I'm th, I'm th, I'm th, I'm th, I'm th, I'm th, I'm th, I'm th, I'm th, I'm th, I'm th, I'm th. thi, I'm th, I'm, I'm, I'm, I'll, I'm, I'm, the, thi, th, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, the, the, the, the, the, the, the, the, the, the, the, the, the, the, their, their, their, the. the. the. the. the. theateatea. thea. thea. thea. thea. thea. thea, the. I'm going to do this for six to 13 weeks and then I'm going to leave and then I'm going to go on to somewhere else. Some people stay, but it's really to fill that critical hole. So that's the that's the travel nursing thing and what we're seeing right now, the big kerfuffle is we've got expert nurses who have been in the same unit with a lot of expertise for 10, 12 years, caring for these patients. And then a travel nurse comes in and is making twice the salary for that blitz of time. And so the 10, 12 year veterans looking around saying,

why am I staying here? What's this about? So that's the newer phenomena that we're seeing. You're putting me thru-you th, you. You're giving me lukewarm pepperoni pizza. The one today I heard is coloring books. So congratulations, you're getting a coloring book. So, you know, the list goes on. And then I look around and there's this person from a travel agency who's going to be here for six to 13 weeks, making double, sometimes triple my pay. Why would the the one the one the one the one the one the one the one the one the one the one. The the one. The one the one. The one the one the one the one the one the one the one the one the one the one the one the one the one the one the one the one the one. The one the one the one the one the one the one the one the one the one the one. The one the one. The one the one. The one the one. The one the one the one the one the one the one the one the one the one the one the one the one the one the one the one the one the one the one the one. The one the one the one. The one the one. The one. The one. The one the one. The one. The one. I I th. I th. I th. I th. I th. I th. I'm. I'm. today. today. today. today. today. today. th. the one. I the one. I the one. I travel agency who's going to be here for six to 13 weeks, making double, sometimes triple my pay. Why would I stay?

And I don't have a good answer for them. I don't have a good answer. So then you look at, that's like private sector security who gets sent over to the Middle East and fight alongside our troops. And the trups are like, yeah, dude. and my th. And my thue, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, and my equipment, that's, that's, that's, that's, th. th. th. thi, th. th. th. th. th. th. th. th. th. th. th. th. th. th. better than yours. So that's that's wow. So when we when we look at this Madeline and we haven't even had time to even unpack what all of these stresses on the nurses and taking on too many patients, what that means for the patients who are actually the ones at the center of all this and the ones who need the care. How do you and the writers? How are you bringing Leav look? so? so? th? th? th? th? th, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, look, th, th, th, th, th, th, th, th, thi, thi, th, thi, thi, thi, thi, thi, thi, thi, thi, thi, th. So, th. So, th. th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, thi, thi, thi, thi, thi, thi, thi, thi, thi. thi. thi. thi. thi. thi, thi, thi, thi, the ones at the center of all this and the ones who need the care. How do you and the writers, how are you bringing Levin, look I'm just be honest, Madeline,

this shit is sad. It's very sad because it's very real. How do you all balance the jokes, what we want, which, when you want, how are you balance deciding when to make someone laugh versus when to make them feel? This definitely felt more like a feeling, the the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers the writers versus when to make them feel? This definitely felt more like a feeling piece to me but I'd lean heavily on the writers for that I think they have more of a burden to you know write the script around the story that we're trying to tell but it's difficult I mean it's difficult you know sometimes things just you know they're not funny but but at the same time find you know finding pockets where we can th th th th th th th th th th th th th th th th th th th th th th th th th th th th th th th th th th th th the the the the the the the the thi the the the the thi the the thi the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the th thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi the the thia thia thi thi thi thi the thi the the thes just, you know, they're not funny. But at the same time, find, you know, finding pockets where we can actually laugh about something is really important because I was thinking about, Dr. Fries, what you're saying earlier about the mental health challenges, and, you know,

one of the things that I hope pieces like this do is, you know, show the human side of somebody. Because if you can relate to someone and see that they're human, then there is room for comedy and there's also room for, you know, having other feelings. But thinking about how we talk about nurses and how we kind of put them as heroes, and maybe how that actually isn't that helpful for people who are trying to seek mental health services, because that might just be a bigger burden on somebody. Yeah, one of the senior nursing assistants I learned my craft from 25 years ago. Early on she said to me, if you're not laughing, you're crying. So having a bit of lightness about, you know, and we see the pizza rolled in and we all just kind of roll our eyes and oh, well, isn't that nice? And thanne you know, so we understand that.

And I think we appreciate when people are really supportive. You know, my heart went out. We saw signs in the parking lot at Michigan when people came and supported us. And, you know, as I was driving and I'm like, okay, now is everybody going to sign up for the vaccine? Is everybody going to do their part and stay safe and stay home and stay out of trouble while they're clinging their pots and pans and while they're putting signs the the signs....... While they're clanging their pots and pans and while they're putting signs out and I that's the piece that I think a lot of nurses are still struggling with like Thanks for that But we're asking you to do these two or three other things that are really a pain in the butt

We get it, but they're gonna keep you safe and I think that's where a lot of nurses are kind of You know looking up up at the sky. the the the the the the the the the the the the the the the th's the th's the the the th's th's th's th's th's the thus. thus. their their thus. their their their their thususus. thusus. thus. thus. thi. thi. thi's is is is. thi's is. thi's is. thususususus. thus. thus. thus. their their their their their their their their their their their their their their their their th is. th is. th is. thi. thi. thi. thi. thi. thi. thi. thi. thi. thi's. theea. thea. thea. thea. thea's. thea. thea. thea's is. thi's is thi's is th. I think that's the mystery. You are a hero and I can't wait to see you in two weeks when I catch COVID with my unvaccinated lungs. And that's how badly I want to meet you. And you've just touched on something as well, Dr. Freed. I want to talk about it after the break here, because when we talk about people refusing the vaccine, the vaccine, the vaccine, there's people on both the vaccine. the vaccine. the vaccine. the vaccine. the vaccine. the vaccine. the vaccine. the vaccine. There's people. There's people. There's people. There's people. There's people. There's people. There's people, the vaccine. the vaccine. the vaccine. the vaccine, their, their, their, their, their, their, their, their, their, their, their, their. their. their. the, the, the, the, the, the, the, the, the, the, the, the. the. the. the. the. the. to. to. to. to. to. to. to. to. to. to. to. to. to. to. to. to. to. to, to, to, to, to, to, to, to, te. toe. toe. toe. toe. toe. toe. toe. toe refusing the vaccination and these higher-ups, some of whom that are your friends and very cool, whether or not these vaccine mandates are the right thing to do in a time where you're short staffed. This is beyond the scenes and we'll be right back. I'm going to clang a pot for you, Dr. Freese. Let me go get a pot right now. Where's my pizza? I need to be following.

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It's going to be a lot of fun. We'll cover all things crypto. We'll make sense of the the the the the the the the the the the the the the the the the the the the the the the the the the the the theck of theckeckeckeckeckeckeckeckeckeckeckeckeckecko thir thir to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to. Sound good Mike? It's going to be a lot of fun. We'll cover all things crypto. We'll make sense of the jargon and cut through all the techie to bring you everything you need to know. Yeah, let's go less on the techie, more on the sexy. I had to all square I found that Bitcoin and crypto made more sense exactly yeah exactly. Fiat money doesn't have to be backed by gold or any other asset.

Just guns. Just guns. Listen to the Coin Bureau podcast on the I Hart Radio app, Apple podcasts or wherever you get your podcasts. Beyond the scenes, we are discussing the crisis that has struck our health care system. Specifically, our men and women that are nurses and apparently unbeknownst to me, Madeline, Pizza has been one of the biggest solutions. Now, since clearly pizza has been a bridge and boosting morale, Dr. Freese, do we have to go to Meat Lovers Pizza to get our health care workers to accept the vaccine?

Stuff Crest, what do we need to do? Set up the go-fun. I see pepperonies that have the oil in it? Like, what is it? You know, I'm a scientist. So, you know, I'm a scientist. So I'd like to do a randomized trial of, you know, different pizza compared to coloring books, compared to massage chairs, you know, and kind of just see which one of those. And we can throw in pot clanging at the same time.

Maybe we'll, maybe we'll hit bingo, I don't know. The dwindling number of nurses means that their job is only getting harder. And as an extra insult, some of their colleagues are abandoning ship for a much stupider reason. At a time when they're already staffing shortages, some nurses are threatening to quit if forced to get the COVID vaccine. One hospital in upstate New York will stop delivering babies

after workers resigned over vaccine mandates. Houston hospital system has fired or accepted the resignations of more than 150 nurses and other staff members who refused mandatory COVID vaccinations. Show of hands. How many of you have gotten a COVID vaccine? These are four health workers from different hospitals in North Carolina. Why not? We don't know what the long-term side effects are.

It also hasn't been proven to be effective. The CDC and many public health experts say that it's more than 90% effective. I have the right to question anybody in this country, I want a question. You're entitled to your opinion, but these are facts. Are they tho? Are they fact? Wow. Yo, this nurse is a genius, you know. She knows in order to stop an unvaccinated person, you must first think like an unvaccinated person.

In order to kill COVID, you must first die of COVID. It's so obvious now. What do you make of health care workers who have decided to decline the vaccine? Do you think that reflects poorly on the health care system? I guess there are hypocrisy in that you being one who cares about everyone's health, not doing the thing that the health care system says is healthy. So I've spent a decent amount of time, first understanding the science behind these vaccines. They've, they have, the science behind these vaccines

has been around for two decades, but it hasn't been very publicly shared and hasn't been really well understood, right? And so the entire US population is trying to get up to speed with what we understand about these vaccines and why they are safe and clearly why they're effective. And just like the US population, there is a subgroup within the health care sector who have questions and concerns. I don't like to use the term anti-vax or vaccine hesitant. The way I like to frame it is people have unanswered questions. And the way I like to approach that is come to people and have open conversations where

I'm not their boss. I am their peer. I am their colleague trying to answer questions. And when I staff, I usually come in a little bit early and spend some time with the nurses and just have informal conversations about what's going on and answer to their questions because there's a lot of uncertainty out there, even if you're a health care provider. It's literally changing every day for a lot of the recommendations.

So what I've come across are some very common questions about long-term safety, about nursing or child-bearing issues. And the way I've tried to tackle that is get the experts to those colleagues who have questions. Rather than command and control, rather than bosses, rather than punitive strategies, is to have a conversation and for folks to do that. And, you know, I remember a particular nurse, not that I work directly with this person, but someone I know pretty well,

and new baby and a lot of questions and said, you know, I'm just not ready yet. And so I could turn that conversation off and say, all right, good luck you're on your own or whatever, but we've kept the dialogue and I think that's the strategy is to continue to have a dialogue and answer questions. The final thing I'll say about this is I think in some ways the media got this a bit wrong. They looked at the same statistics I did and they came out with one out of however many nurses,

nine or ten nurses is declined, it will say they'll leave their job or decline the vaccine. I saw an overwhelming majority, 90% or more of health care workers are ready to sign up and get the vaccine. And then we fast forward that story a few weeks later, and what we see is very few people actually leaving their jobs because of this. So we were in a unique snapshot in time. It was a highly emotional, challenging period. There's still a lot of unanswered questions. And I felt like as we were watching that story unfold in time, we got a little ahead of ourselves in not really stressing the positives.

And then following up to say, well, actually, how many people really are going to panic journalism. Kind of how the NYPD was having, was going to have all of these officers and ended up being like 30. Exactly. It's going to be thousand and murder will reign supreme. It's like, hmm, 30. Like, there are tens of us, yeah. Yeah.

Yeah. I did have a question for you, Dr. Freese. You know, one of the things that we touched that we that we that we that we that we thats that we touched on in the piece was, I guess, how burned out nurses affect patients. You know, cancers don't stop just because there's a pandemic. Other things, you know, you don't stop breaking bones. You know, everything else doesn't stop, like the hospital system doesn't stop and people don't stop getting sick. So like how is that, I guess, how have you seen the knock-on effects of all of this happening? Yeah, so two things on that. One is that even if you're not caring for COVID patients, you saw a dramatic change in your work during this period that continues

because your patients are coming to you with more complicated problems because they couldn't get their cancer screening. And so now they present with a cancer at a later stage, or they have a complication that we couldn't manage before they got diagnosed. Number one, number two, we had a lot of visitor restrictions and so we didn't have family members and loved ones who could provide that extra emotional support for patients in the hospital. And as you said, we had nurses, with face times and yeah, no one's checking the batteries.

No one's making checking the batteries no one's making sure the channel's on the right channel at you know nine tenth you know ten nine central whatever that's real stuff so those pieces add up I mean I don't want to trivialize that you know when you are alone and scared in a hospital or you know in my family members case you know they had to go they had to go to the office by themselves their their. their. their. their. their. their. their. their. their. their. their. their. their. I. their. I. I. I. their. their. to. to. to. to. to. to. to. the their. to. to. to. to. to. to. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their. their their their th. th. t te. te. te. te. te. te. te. te. te. te. te. te. te. te. te. te. te. they had to go, they had very complicated diabetes, they had to go to the office by themselves, their loved one couldn't come with them to make sure everything was being monitored properly and carefully and they have followed up with questions. So everything got more complicated and then and much of that stays to this day. And then for the patients, as we said,

cancer doesn't wait and heart attacks still happen and in my case broken ankle still happen and so I needed to seek care in this pandemic and you are worried that are am I going to get the care that I need is everything going to work out and in my case it worked out beautifully I couldn't have been more comfortable or treated better but but we have seen very clearly that some care is falling through the cracks and continues to do so. so that's bad for patients and th to the the the the th th th th th th th th th th thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi thi the. thi thi thi thi. the. the. the. the. the. the. the. the. the. the. the. the. the. th. th. th. th. th. th. th. I I I th. I th. I th. I th. I th. I th. I th. I th. I th. I the. I thi. I the the the the the the the the an the an te an te an te an tean tean. tean. te an te an te an te an te an te an te an the care is falling through the cracks and continues to do so. So that's bad for patients. And then it's also bad for health care workers because they can't give their very best. And so it continues to pour salt on that wound that we're in this vicious cycle

that we can't seem to quite get out of, and I'm not able to give my very best to my patients for reasons that are really outside of my control. And I think that's always been hard for me as a nurse when I know something could have gone better, but it couldn't because of something beyond my control. That's very hard to live with. Day in and day out. So then do you think things right now, Dr. Freese are trending the right way? the right way of in a bit of a holding pattern where it could still go either way right now? So I think we have a mixed picture. The one thing that I'm amazed at, you know, a few weeks ago I had to transfer a patient to the intensive care unit for management of their their cancer, they had a problem with their cancer or complication, but there were COVID patients in a separate part of that ward and the the the the the the the the the th. and th. and th. th. th. And th. And th. And th. th. th. the, the, the, the, the, the, the, the, the, the, the, the, the, the, thia, thia, thi, the, the, the, the, the, the, the, the, the, the, the, th, th, th, th, th, th, th, th, th, th, th, th, th, th, the, the, the, the, the, the, the, the, the, thin, thin, thin, thin, thean, thin, thin, thean, andauuuiiiiiiiiiiiiiiiauuiaugh, thi, that ward and the amount of intensive, unbelievable care that nurses and doctors and

respiratory therapists and pharmacists are giving you these patients. We know far much more on how to treat patients with COVID and we are doing a better job of managing COVID because we've learned a lot in the last two years. And that's a tribute to the folks on the front line and the researchers who have helped do that. that. that. that. that. that. th. th. th. th. th. And tho tho tho tho tho tho tho tho tho tho tho. th. tho. tho. th. tho. th. tho. tho. thi. thi. tho. tho. th. the the the the the the the the the the the the the the the the the the the the the th. the the the the the the th. the the the the the the the the the the the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, thi. the. the. te. te. toda. toda. today, today, today, today, today, today, their, today, two years and that's a tribute to the folks on the front line and the researchers who have helped do that. So that's a positive. We have very safe and effective vaccines and we now basically you can walk in almost anywhere you want and you can get them. So those are triumphs and we should celebrate them. And at the same time, our nurses, doctors, pharmacists, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, respiratory, doctors, pharmacists, respiratory therapists, other folks have kept America's heartbeat going for all their non-COVID stuff, for the most part. But the net is frayed.

The net is very frayed. And I'm very worried that there is probably a group of folks who are falling through the cracks, either because they can't get in for care, or the care that they get is suboptimal because we're strained so hard. And what I really worry about is we're not going to fix this problem as COVID eases. We're going to say, well, back to normal, no problem. We have to learn from this, and we have to start making the changes now,

so that patients today are safer and patients six, nine months a year from now, regardless of COVID or otherwise are safer. And I fear like we're going to forget that. Is there anything that the general public can do? Because so much of what you're talking about is, it seems to be, in my opinion, or just from my perspective, again, as a guy who only goes to hospitals to steal blankets? Harro. perspective again as a guy who only goes to hospitals to steal blankets. Faro. You borrow. No, I don't take him back, Madeline.

Don't clean it up for me. I steal them. These are very wonderful blankets. As a person who's just on the outside looking in, it seems that a lot of the solutions here lie within the institution. But how do I, as just Joe Blow Citizen, what can I do to help alleviate alleviate to help to help to help to help to help to help to help to help to help to help alleviate, to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate to help alleviate some to to to help alleviate to help to to help alleviate some of these challenges? Is it looking at what our elected officials are doing? How much does politics? Is there someone I need to vote out?

Like, what can it, do I show up to the hospital and try to protest? Like, what can we do as regular people to help be a part of the solution on this issue? Yeah, so a couple of things. First of all, it's not just the blankets, the real money is the warm blankets. So make sure you ask for that next time. Oh, nice. Electric. It will change your life. It will change your life. Nice. So thank you all. You're very welcome for that tip. So what can the public do a couple things? One is if you get great care at your facility, write the CEO of the hospital. the hospital, it the hospital, it the hospital, it the hospital, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it's, it's, it, it, it, it's, it's, it's, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it will, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, it, i... It, i. It, i. It, i. It, i. It, i. It, i. It, i. It's, i. It's, the the the the the the the the the the the the the to. the the the the the the to. the the the the the the the the the the the the the the ti. t CEO of the hospital and mention the people who cared for you by name and tell them what a great job they did. And if you saw quality of care concerns, if you heard about mandatory overtime or unsafe staffing,

put that in too and say, hey, this is not what I expect for my community hospital. Because they are accountable to the public. Most of our hospitals in the country are non-profit and they're supposed to serve the community. So th th th th th th th so the the their their their their their their their, so so their, so their, so, so, so, so, so, their, their, their, their, their, their, their, their, tho, the, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, the, their, their, t. And, t. And, t. And, t. And, t. And, t. And, t. And, t. And, t. And, t. And, te, te. And, te. And, te. te. te. te. te. te. togu. togu. te, togu. And, togu. And, te, togu. And, togu. And, togu. And, the public. Most of our hospitals in the country are non-profit and they're supposed to serve the community, so they need to respond to you. If you know a hospital executive, you can say, what are you doing to keep your nurses safe? And the answer shouldn't be pizza parties or coloring books. The answer should be eliminating mandatory over time,

humane staffing levels, and listening to nurses and acting on their issues. And do you have a safety committee for nursing and health care workers? We have patient safety committees in every hospital. Do we have a group of experts focused on health care workers' safety? Missing piece. Finally for the policy piece, couple points. Every state, health care, most hospital issues are managed at the state level.

Moving throughout the country is legislation on penalizing verbal and physical abuses towards health care workers. Zero tolerance. You hit or strike a nurse or you call them a name. You're out. Full stop. We're not going to, you know, with limited circumstances, you are, we are not obligated to treat you and you can be charged with a crime.

Also mandatory overtime and staffing ratios that are humane and safe. There's legislation in many states. California has a staffing mandate. Some states are working on banning mandatory overtime. We know those work. That keeps not only nurses safe but it keeps patients safe. So those are the couple things. And then the final those work. That keeps not only nurses safe, but it keeps patients safe. So those are a couple of things. And then the final thing at the federal level, we talked about the nursing pipeline for faculty. We don't have enough funding to incentivize expert nurses to either stay at the bedside to teach or to teach in nursing schools. And if we want more nurses, that's where we need to start. And that's and that's, and th, to to to to be to be, to be, to be, the, to be, the, to be, the, to, the, to, the, the, their, the, their, to, to, to, to, to, to, their, their, their, tho, tho, tho, their, their, their, the federal, the federal, the federal, the federal, and then, the federal, and then, and then, the federal, and then, and then, the federal, and then, the federal, the federal, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, their, thean.ean.eanananan. toeananan. thean. thean. thean. thean. thean. thean. And, that's where we need to start. And that's a solvable problem.

We have money, right? I hope we have money. That's a money problem that we can solve. And our nursing schools, you know, we can work on our back end to make it work that we can add, you know, bring more of those people in that we're turning away year after year. Well, I'm happy that you are that you, that you, that you are, that you are, that you are, that you are, tha, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, tho, tho, tho, tho, tho, tho, tho, tho, tho, th, th, th, th, th, th, th, th, th, th, th, th, th, th, th, thi, thi, thi, thi, thi, thi, thi, thi, thi, thi, and thi, thi, that's, that's, that's, that's, that's, that's, that's, that's, that's, that's, thii.ei.a. And, thi, thi are a nurse educator and that you're a nurse and that you're a doctor of nursing because with a name like, you know, Dr. Fries, you easily could have been a villain or some sort of comic book person that wreaked havoc on the city, but instead you wreak love,

Dr. Christopher Fries. Thank you so much for going beyond the scenes with us today. And Madeline, I will see you again on here. I don't know. I'll see at the next pizza party the Scenes on Apple Podcasts, the I-Heart Radio App, or wherever you get your podcast. We don't care. Just listen to us. Even if you get your podcast from a dude named Tony in a back alley, we don't care. Just listen. Just listen. We've all felt left out.

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