Big Journeys Begin With Small Steps

Rachel
NICU stands for Neonatal Intensive Care Unit. So basically what I do is any I mean any type of a baby can end up in the NICU, not necessarily a premature infant. That's one common misconception is it's just automatically premature babies. The smallest baby I've actually taken care of as a 22 week infant which is significantly premature and she is alive and well today. She was my primary baby in the NICU. I took care of her for seven months, and now she's my goddaughter. love her to death. And so it she was 350 grams too, so she was even less than a pound so we can go as small as that to I've taken care of 12 pound babies, you know, so it's just very big spectrum.

Brooke Smith
Hi, everyone, welcome to MDF instruments crafting on this podcast. Today I have the pleasure of introducing you to Rachel, introduce yourself. Tell us you're from and where are you currently live?

Rachel
Sure you're full. I am a NICU nurse but a NICU nurse a little over six years. I absolutely love my job and I'm in California, but I'm in Ontario, California. So a little bit southern.

Brooke Smith
So can you tell us a little bit about a NICU nurse? And does that stand for something? Is that an acronym?

Rachel
It is so it stands for neonatal intensive care unit. So basically what I do is any I mean, any type of a baby can end up in the NICU, not necessarily a premature infant. That's one common misconception is it's just automatically premature babies but we get babies that are supposed to come out at 40 weeks, which is term a term babies at 40 weeks for multiple different reasons. We just get any type of babies that one are premature to have made them a congenital abnormality or defect, a heart condition respiratory distress at birth. Literally any reason so I can see your eyes. This last baby I've actually taken care of as a 22 weekend vent which is significantly premature and she is alive and well. Today she was my primary baby in the NICU. I took care of her for seven months. And now she's my goddaughter love her to death. And so it's she was 350 grams too. So she was even less than a pound. So we can go as small as that to I take care of cool pound babies, you know, so it's just very big spectrum. Wow,

Brooke Smith
we are gonna have to touch base on that story where you're the guy that sounds inspiring and awesome. I can tell that you're really passionate about what you do. I can tell you have a really great heart and we have really like talked too much about that. So can you tell me a little bit? I know that a NICU nurse is a specialty? Did you always know that this was the specialty you wanted to go into? Or did you start out just nurse nursing in general and then you went into NICU or tell us a little bit about your journey into this specialty?

Rachel
You know what's actually very funny is I did not want to be a NICU nurse at all when I was in school. It terrified me you think of really itty bitty tiny babies and it's just it's terrifying. And I actually I personally was a NICU baby I was six months sick or six weeks premature. So my mom always kind of thought when I went into nursing as you know, as a profession that I was going to end up being a NICU nurse I was like, No way not, I can't do it that's just terrifies me. And when I was I really wanted to do labor and delivery I wanted to deliver the babies bring some happy moments into people's lives. Like that's totally my you know what I wanted to do. And when I was applying to new grad positions after I finished nursing school and passing my boards, there wasn't anything available and labor and delivery. And so I was like, okay, you know, what are other options I can do? Because I didn't I didn't want to necessarily do adults and all the different type of you know, things going on with adults. I wanted to kind of stay in the maternal health kind of feel. And I had a friend that worked at the hospital that actually was hired at who works in NICU and she was like, you'd be the most amazing NICU nurse you need to apply and I was like, Oh my God, that just terrifies me. I don't know if I could do it. And she's like, worst comes to worst you apply. You don't like it switch specialties I'm like, okay, okay, I'll you know, I'll try it. So I we try our I tried, applied got hired. And so for those that don't know, because NICU is such a specialty, we don't learn about NICU nurses or Neonatal Intensive Care Unit in nursing school. So we had to do a three month like, almost like a crash course in it. And we were taught at UC Irvine actually Medical Center. So their whole program kind of taught a bunch of different local hospitals in the area about Nikki nursing because none of us had any idea. And honestly one of the educators there she was just the NICU girl knew everything about anything and just was so passionate. I was like, Man, she just she made me love it. She made me love it even just in the beginning of the classes and then I just I fell in love with it and I literally will never do anything and

Brooke Smith
I think that's a testament that sometimes you know, Life finds a way to put us into positions and in places that maybe we didn't think that we would want to be in and it ends up being the perfect place and we're so blessed are like oh my gosh, this is this is everything. How do they not No, this is what I wanted. And it just kind of clicks right in. And it sounds like you found your passion that way. Yeah, so what what drew you to nursing in the first place?

Rachel
You know, okay, so it was funny because in high school, I always, it this is gonna sound kind of odd. But I always wanted to break a bone. I purposely would try to like fall down the stairs to like, break a bone. I know, there were a cast. It was ridiculous. My family thought I was crazy. But so I thought I was going to be in I thought it was gonna be like sports medicine, like kind of go that route. And so there was a class in high school that I took it was sports medicine, and I really liked it because I played sports throughout high school. But it just, it didn't give me the like, the like, I don't know what a nurse you're nurturer, you just you help people a little bit more. And I want more of that. So I kind of it kind of just dawned on me one day, and I you know, thought about the thought about it. And then actually, when I was a junior in high school, my mom had open heart surgery. So she collapsed in the middle of night, stop breathing. And so she had open heart, she ended up getting open heart surgery was in the ICU for a little over a month, just like recovering and whatnot. And honestly, her nurses were amazing. And that was ICU. That was Intensive Care Unit, adults, not neonatal intensive care. But they were just amazing. And they kept you know, me and my two sisters, like very well informed, like we all felt very comfortable that I knew she was in great hands. So I think seeing that I was like, okay, nursing all the way, boom, I'm going to do it. That's what kind of deterred me.

Brooke Smith
You know, it's funny, because talking to a lot of people on these podcasts, a lot of people in healthcare and they have a similar story, their dad or their grandpa or someone in their family got sick, someone that they cared about, and they saw a doctor or nurse, someone take care of them in such a way that it comforted them. And they wanted to bring that feeling to other people and say, You know what I want to help to I want to bring this feeling of comfort and the time that I'm the most panicked and frightened, because that's my loved one, that comfort that you're bringing me to make to make me feel like it's going to be okay, I want to do that too. I like to hear for people who are listening or watching who may want to get into this, what is the education process, like

Rachel
my personal journey, I went to a junior, I had this goal that I wasn't going to be in any debt and which is it's hard now, especially for students, which I think it's so horrible that nurses are I mean, just nursing students in general, because they're, they're so impacted at programs, they're, they're forced to go to like really expensive programs, just to kind of get, you know, get them through a program to get them to become a nurse. And it's very important that you know, and that but my main goal was I just didn't want to be in ton of debt. So I went to a junior college first and my prerequisites. So I spent about two years there, I met with a counselor initially and they kind of put me on a path to finish all my prereqs for for nursing schools, because I was going to transfer out to either a university or a Cal State. And so they kind of made me take all the specific classes that generally they all kind of wanted. And then granted if I wanted to go to a specific school and they were required on their specific class, then they you know, I would just take that class additionally. So that's how I kind of did it. And then after my two years, I transferred to Mount St. Mary's University, which is in LA for people that don't know, and I went to the Doheny campus. So my program was the associate's degree in nursing program and I did that for one of two reasons. One I wanted because I know a lot of people are like, want to go back to school and get their bachelor's which I think is amazing, which I ended up going back and getting my bachelor's. But there's you don't necessarily have to go right out of school to get your Bachelor's there's multiple different ways to do it. And the set which is the second reason hospitals pay you to go back to school so they want to encourage you to go back to school so there's always an incentive to do it. So I so I did my my core nursing classes for the two years in the nursing program. And we learned every type of specialty all the different didactic, you know from ICU to just med surg to mental health to pediatrics, ob they talk about everything and in those two years, so when you're done with that specifically, then you graduate up hurrah, this is awesome. Now you take your NCLEX which is your board your nursing boards, so you train for that you once you pass that then you're officially a registered nurse and then you can start applying to new grad programs, which I highly recommend anybody that is listening is to look for new grad programs those are the programs that are going to set you up for success not for failure, they put you on like they give you didactic courses to kind along with other people that are like minded you know students that are in the exact same boat as us You guys are all on the same path together which is awesome. And then you want me mean you might be in a group with a bunch of different specialties doesn't matter because you're all still like the same same brain space that you've just graduated school, you're all very new and you want to be put like in a path where you're going to be successful because you don't want to just be thrown out onto the onto the floor, not knowing anything and then you know it comes back on your license because honestly it's hard to get your license but it's it's super easy to lose it so that's like what I tell all my my nursing students I'm like you know, just be really careful because your license Yeah, it seems like it was hard to get it. But it's even it's super easy to lose it. So yeah. But then when I got hired at my, my hospital, they pay me to go back to school. So then I got my bachelor's through them.

Brooke Smith
I love it. And so now you've been a NICU nurse for six years, you said, right,

Rachel
over six years? Yeah, oh my gosh, it's crazy how time just kind of knew it. But what's great about any such thing you pick every single day, or every year, you still feel like you're learning something. So it's just an ever like, you can learn anything, being a nurse every single day, you you don't know everything.

Brooke Smith
Yeah, I totally understand that. Because I feel like you're just gonna, you know, what you were talking about earlier, where you had a baby, that wasn't even a pound. And then you have like a 12 pound baby, but maybe there's similarities and but there's differences in all the cases are not going to be the same. And you're gonna learn how to treat them differently. I would love to hear a little bit about this baby that you helped, that was less than a pound, and how you protected it and nurtured it. And a little bit about how you became the godmother to that baby, and as a boy, or girl I want to hear.

Rachel
So her name is Avery, and she is just the sweetest, most amazing, I just want to call her amazing, amazing miracle because she has a miracle at birth. So she was born at 22.6 weeks, which for those that don't know, when we admit babies into the NICU, we they have a certain criteria, which is like viability, for you know, for success of the baby, obviously. So they try not to go below 23 weeks, give or take, but it's mainly based on their age and their their weight, which is 500 grams, so anything under 500 grams, they try to see or stay away from it just because for viability reasons, they want to have the best outcome possible for the baby for the family, you know, so it was a very big risk that they took, she was 350 grams significantly lower than, like NRP guidelines to resuscitate to be able to, you know, bring her up to the unit. But I remember the doctor on that day, and she said the reason I brought her up because I heard her cry. So normally babies at that age, wouldn't cry, but she she cried. So she's like, taking it right upstairs. So we took her upstairs. And I remember seeing her because I took her I took care of her on the second day of life. And usually, when we first admit babies that small, they have like a honeymoon period where they're, they do really good for a couple days. And then they kind of you know, some of them take a turn for the worse, and they kind of you know, decline after that. But like for her, she did not decline, she just kept getting better. I mean, you know, for being a really, really tiny sick infant. But it's just, it's incredible to see like, where she like started and how she is now and I you know, I bonded immediately I bonded with the dad, because the mom, you know, she had, she had blood pressure issues. So she was still in the hospital. So she wasn't able to come to the bedside right away, but the dad was and so like, immediately I was bonding with the dad. And I remember it's funny, because we always talked about this, he he tells me he's like, you know, I love the interaction that we had, you were just so comforting and warm. And like you just kept telling us like, everything's gonna be okay that you just, you know, you're you're just really trying to be there for me and, you know, for my family and without even meeting the mom yet. And so he was like, I had to introduce you to my wife who you know, is downstairs getting, you know, in recovery or whatnot. And so when she got brought up, she's like, you know, I this is the famous Rachel, this is the one that we've heard about, like we like we've been talking about, and I just And she's like, I'm so happy to meet you. I'm like, I'm so happy to meet you guys. Like you guys have a little like a little fighter on your hands. I remember Avery she's so she was so feisty, super feisty. But I say by seeing the best way possible, because the feisty ones do the best. And she just she wanted to live, she fought to live. She had every hour against her. I remember the doctor saying she had a 5% chance of just living. And she surpassed that and now is hitting every milestone, it's just absolutely crazy. But going back to her kind of growing up a little bit. So I, the parents had both asked me to be your primary nurse. So if people don't know, you know, primary nursing is amazing. I don't I think that's only kind of geared towards in the NICU, I think maybe even pick up pediatric intensive care. But for babies that are in the unit. For long term purposes, it's great to have a primary nurse just because it's continuity of care. You have the same type of nurse at the bedside, every single shift that they're there. And they know that baby they know that baby from back to front, if there's any little thing that's going wrong, they can usually detect it first, which is it's so amazing. And it's it really is amazing for like those types of small babies that just any little thing can can make or break like like, you know how, like their outcome. And so they asked me to be the primary nurse and I was like, of course like I would love to. And it's crazy because I wasn't even supposed to take care of her that day but she was the smallest baby I've ever seen like literally ever seen. I looked I looked past her incubator and I'm like, wow, like she's so tiny. Like we have nano preemie diapers. I wish I had a picture of one nano preemie diapers. We had to cut them in fourths to fit that fit her because they did not fit her. It was just it was encrypted. And I had told the nurse that was Taking care of her. I was like, please let me take care of her, like switch assignments with me. I just I don't know, I'm just getting a good vibe from her. I just, I just want to take care of her. And she's like, Yeah, but she's in the honeymoon stage, like, are you okay? Like, and I'm like, no, like, like, I got this, like, it'll be, it'll be okay. And I'm so glad I did. Because I loved I loved Avery loved her parents, it was wonderful. And so several months, so she actually had a primary respiratory therapist as well, too. So the two of us, we just were like, super close, you know, choreographed. Like, all of like, everything that she was doing. It was it was an awesome experience to have with another individual. And just like with the family, it was it was wonderful. So after a couple months, the parents they texted us individually, because we we gave her numbers to the families because we were just, you know, and she was like, Well, how's my baby doing like out like all night, so she'd have to bug you know, the unit went on, I would just give her updates. And it just having that type of relationship with a parent is like, absolutely incredible. My favorite thing is to bond with those parents because their babies are in such you know, critical care, and they just want someone to just make sure that their babies are going to be okay. So I remember them saying, Hey, can you come to the unit like a little bit early? I want to give you something I'm like, sure, like no problem. So the both of us came, and they gave us these little bags. And inside the bags, there were it was a picture of me. So I did photoshoots with a mom with with me the mom Avery we like only decked out her bed with we just have so much fun with it. Because ultimately, we tried to make it as like normal as possible because she you know, was going to be in the unit for so long. We wanted to make it as normal as possible. And so she had a picture of me and Avery. It was for her Easter photoshoot that we did together. And on the on the the picture frame it said will you be my godmother. And then on the back then there was a paper that said like what a godmother is and how special it is to, you know, be a godmother in this family because we take it you know, super seriously and whatnot. And so I started to cry because I'm like, Oh my gosh, like this is so sweet. I love this. And yeah, so I became her godmother. And then you know, the respiratory therapist, he became her godfather. So I think that's bonded us even more because we just we just have such a special bond with that family. And I go see a and so you know, fast forward a few got discharged. Avery, luckily, they live maybe 20 minutes away from me. So I visitor I probably care, maybe every like month and a half ish during COVID was a little harder, just because I didn't obviously I'm working in the hospital, I didn't want to pass anything to her. And so when she was first discharged, she was on oxygen still and she had a G Tube. But I think her mom was so determined to you know, just make make her have the most like normal experiences possible. So her oxygen actually was discontinued, maybe six months after after discharge, and her G Tube maybe like a couple months after. So she really had nothing like a newborn so early and literally got to go home with like, nothing wrong with her. It was it was incredible. And she's told us you know, she's two and a half, two and a half has had every single milestone, she runs, she walks she talks, she screams, she you know, everything she feeds herself. It's incredible. Because, you know, sadly, a lot of the babies that end up in our unit, they have developmental delays, speech delays, you know, all these different things, which, you know, I mean, coming from so small, you would kind of expect that she literally has nothing and she didn't have a brain bleed, nothing. So she's she's just miracle. She's perfect. She's my just Avery. I love Avery.

Brooke Smith
Wow, that is such an awesome story is so inspiring. I can't even imagine just seeing that whole process from being probably like, I don't even I can't even imagine how small and then to see her now two and a half running around screaming being in normal tunnel. That's that's got to put a huge smile on your face and make you feel so good for what you do in your job and how you're there for other people and help these tiny little human beings, which is amazing. I mean, that's such a such a great story. And it sounds like you put a lot of heart and love into into your job and ensure that there aren't always happy endings with these things. Is there something that you do like to help going through this process of, of being there and it's a such a stressful situation, I'm sure they'll be hard on the parents to not be away from their child for seven months. And then you know that you you grow that bond because you're there all the time in that seven month period. And then you get to give the child back and it's great that you still get to see her. But what about the times when things don't go so well? What do you do for yourself? For your mental health, just your physical health, like self care wise, because I know nurses you guys give so much to other people a lot that sometimes you don't get back to yourself and I think it's so important to talk about mental health and just if you have any advice or anything that you do, that kind of helps bring you back to that, you know, back to zero so you can continue doing what you do.

Rachel
I, it's crazy, bring up mental health because like, people do not talk about it enough. And I think there's like this crazy stigma about, like, if you go to therapy, you're crazy, which I think is, I think that's crazy. That statement is crazy. Because, you know, everybody goes through different things in their life, whether it be job related, or you know, personal related, like everybody goes through something. And it's always just wonderful to talk to somebody, some unbiased person. So I was gonna say, the first thing I do is I go to therapy. And I am proud to say that I love my therapist, she's, she's gotten me through so many different things. Like, not even just work related stuff, like personal stuff, family stuff, you know, she's just wonderful. And anybody and anytime I have something going on, I, you know, I text a really quick and I get a session in and it's like, to me that is, it's just amazing. So I stress to all my friends, my family, I'm like, you just need to go to therapy, it will just make you feel significantly better. But I do work out. So I tried really hard to I do boot camp a lot. So I like doing boot camp, which I think is I mean, that's great for my physical health, too. So it's mental health and physical health. And but you know, honestly, like, especially at the in the unit, when like, something doesn't go, right. We I've like, when I saw babies that had passed away, I had the most amazing co workers where we like we did like debriefs after something bad had happened. So we all kind of talked about our feelings, how we were how, how everybody was doing throughout the entire, you know, situation. And, but it's, it's hard because you take that stuff home with you. So I think like, just honestly, the best thing is just like talking to getting talking to somebody, whether it be someone like a trusted friend, or you know, a significant other family member, but I really strongly suggest that therapist because they're unbiased, you know, they're not going to sit there and judge you, they're just going to give you just like open honest feedback, and just gorgeously you talk. And I think that's awesome. So yeah, mental health does not get talked about enough. So we need to advocate for that.

Brooke Smith
I agree, I couldn't have said it better. I think it's so important. It is a stigma, there is a stigma to it. And that's why we're having so many problems with especially in healthcare alone. mental breakdowns and suicide, because you guys are on the forefront of, you're there for the happy moments, and you're there for the not so happy moments. And most of the time, you know, in healthcare, generally, it's more of the not so happy moments where you're fighting for your life or in like these babies are fighting for their lives being so small and an early. But I think it's it's therapy is incredible. And if you can't afford a therapist, because you're a student, and you don't have health insurance, or it's too expensive, I think what you just suggested about having a community of people, other nurses or people who can understand what you're going through, just have a little dialogue and say, How are you feeling, you know, in talking through everything that happens, because if we keep everything inside, then it's really not good, it's only going to hurt you and it's only going to, it's just it's going to be bad, it's going to be really bad. So the best thing you can do is try to feel your feelings, and then talk about them with someone you trust and someone that will support you.

Rachel
Definitely also too. So before I even started seeing my specific therapist, our hospital offered something called an EAP it was part of an EAP program, which is an employee assistance program. I know a lot of hospitals, companies, they offer stuff like that where they actually provide mental health services at zero cost to you so the hospital covers it. And so like for me specifically I had five free sessions so I got to test out my therapist see if we had a good bio and then that's how I chose her so there's there's tons of different resources like free resources, you know, for people that maybe they can't afford it or whatnot, there's tons of stuff out but you just got to just find it look for it.

Brooke Smith
Yeah, I found like women's support groups in the past which is also a great thing you know, you can find those and you can just have a community of people that you can talk to if it's your mom, if it's your dog, it doesn't really out and not keeping it in you can we keep it in it tends to poison Hey, I am a big advocate for mental health especially in health care. The things that you guys go through it's it's it's it's a pretty I think it's a pretty thankless job like I don't think people realize how many sacrifices both mentally physically that you guys make. You know, you're working on Christmas, a lot of time we're working on holidays, you're I kind of want to get into talking a little bit about what your hours are like at the hospital if your day or night. Because I know, for some people, night shifts can get really rough and you're up all night and then you're back. Again, can you talk a little bit about what your schedule is and has been in the past and how were you like it? Yes.

Rachel
So as a new grad, I'm sorry to say for all the new grads listening, you'll probably start on nightshift. Unfortunately, unless you find some amazing position that alters how you on day shift, which, you know, I think in a way night shift kind of shaped me to be a nurse because the nurse that I am because you don't have all the additional stressors, that Daesh day shift, just kind of offer you don't have the all the extra, you know, physical therapists, occupational therapists, management, like you have more time at night to kind of not saying Nights is easier because it's significantly it's not easy at all, but you just have less people so you get to like, kind of dive into the specialty and you can learn a little bit more and kind of take it in and not feel so stressed out. So I don't think necessarily going on my chip at first is a bad thing. Staying on nightshift. Uh, no. I know, I did nightshift for I want to say four of my of my six years. And it was it was rough. It was hard. And then at one point I flip flop so I did. I worked full time, nightshift and I worked per diem. So I basically worked like kind of as needed at Kaiser. And I did a day shift. So I flip flopping it it was just like it was it was really hard to kind of go from because when people people don't understand, like when you work nightshift, you either work like seven to seven, or you know, at my hospital was 6:45pm to 7:30am. So you have to sleep, obviously, before you go into work, and so your whole day is just gone. Like because even if you go into work, and you come off of work that morning, like you sleep a little bit and then let's say you don't have to go back to work that night, you're gonna be groggy like a zombie all day, nightshift is, is really hard. So I commend those nurses that stay on night shift the rest of their career. It's It's crazy, but I can't do that I worked a shift now. So I work 7am to 7pm. It's significant. It works better with my schedule. You know, I come home, I eat I sometimes work out and then I go to sleep. And I'm perfectly content and happy doing that. But we work 12 hour shifts, usually three days a week, I usually pick up extra either at my hospital or surrounding hospitals, I do registry with a couple different hospitals. And I'm actually I'm going to start doing travel nursing. So

Brooke Smith
to ask you about that. Because yeah, oh my gosh, we have. I was curious. I didn't know if because I'm still learning about travel nursing. And I was like, Well Can a NICU nurse travel? Because, like, they need that. So why wouldn't you? That's I love that. Okay, so but you were on the ship for four years of your six years.

Rachel
It was miserable. It was horrible. In the beginning, I lived at home so I you know, my family didn't get it, you know, because they have a normal life a normal schedule. So they kind of do things normally and I had to have blackout curtains because I couldn't stay asleep. And it was miserable. It's crazy now because my sister is actually in nursing school. She's about to graduate in a month. And she's working overnight shifts, right. I'm so excited for her. But she's working overtime shift shifts now she's like, wow, now I get it now and I feel so bad that you know, you're loud and like, it's okay. You know, we don't think about that. You know, so people listening. If you know some of that person, I should give them some grace. Let them sleep. If they're tired, just let them sleep some more. It's hard.

Brooke Smith
Yeah. So can I ask you okay, you said you work 12 hour, days, three days a week, but you pick up extra shifts? Can I ask why you do that? Is it? Is it you want to save up more money? Or is it just like three days doesn't feel like enough because 12 hour shifts are those are long shifts. It's not an easy.

Rachel
You know, I kind of go through spurts of like, I like to invest a lot of money. So my extra shifts go to investment purposes. Like I have, like I have different businesses and I have different things that I'm involved in. So to me, like extra shifts means extra money, I can put an investment. So that's the reason why I do it. I don't always do it. Like around Christmas time. I usually just work my three days I spend more time with family. In summer, I slow down too, because again, I want to spend time with family but like I'm like weird off seasons. I'm like, why not pick up a couple extra days. And I usually pick up like two or three a month. It's not anything crazy. It's something because because again, like, you know, yeah, we only work three days a week, but we do work a fort like a it's like it's a 36 hour, which is like a 40 hour week, you know, because we you know, half the time we don't we say 12 hours, but we stay we stay longer. So we work a 40 hour week in three days. So it's a lot so it does take a toll on you. But I like I go through spurts where I'm like, Okay, I'm gonna pick up a couple now. You know, I'm gonna kind of not work a couple you know, so it just goes back and forth.

Brooke Smith
Yeah, so that was gonna be my next question is is there shifts we're in a row. So it's every every day is three days. 12 hour shifts three days in a row.

Rachel
Not necessarily three days in a row. It depends on the hospital. So he says

Brooke Smith
it three three shifts a week then. Yes.

Rachel
So usually hospitals that you pick. So the hospitals I've actually worked at, let you pick your schedule, which is nice. So you pick and choose when he I like doing my underwrote because you get them done and you get more days off. And it's nice when doesn't always work out like that. And that's okay. And you usually have to work like X amount of weekends a month, X amount of, you know, Mondays and Fridays. So there's like different things each hospital kind of requires. So you just you within those means you usually get to pick like your own schedule, which is awesome. I do have to say, when I worked at Kaiser, they have a block schedule, so you don't get to pick your schedule. So that's something to consider if you want to work on Kaiser. Yeah.

Brooke Smith
Any advice for nursing students. So if you could tell your younger self, something, anything? What would it be?

Rachel
Don't be so hard on yourself, be patient with yourself, I am a perfectionist, I remember when I first started as a new grad, I get so upset if I if something didn't click right away or something. If I had to ask, you know my preceptor a second time, like can you really explain that to me, just to give myself grace, because honestly, like, I, you know, you take the time to learn why you're doing something, not just to do something. And I think that's like, during nursing school, they didn't really teach us that they just kind of just was like, okay, you know, use it, you have to know this, this this, but like, when we are getting prepared to take like, you know, our exams and then like our, our boards, like they, you have to know why you're doing something because ultimately you're going to be taking that to the bedside, and you need to know why you're doing something. So just to give yourself more grace, it's going to take, it's going to take longer than other people and don't compare yourself I man when I was in nursing school, I, I mean, I wasn't not smart. But there were a lot of kids that were a lot smarter than I was and we get A's and on my on their tests. And it actually that it affected my mental health. So I ended up seeing a doctor and they wrote something where I took my test separately, because for me, like it gave me anxiety when I would like be sitting there taking my tests, and I saw everybody get up and get up and finish their tests. And I'm still sitting here and I'm like, Oh my god. So I actually got to take my test separately, I had a little bit longer time. And I did significantly better that way. So that was it was awesome for me. But yeah, just to give myself more, you know, just just to like, enjoy it. Because like everybody's in school, so focus on school, but they're not like they're not enjoying it. So just to do that. And also when you become a nurse, trust your gut. Because ultimately, like I know, like someone will say, Oh, well, that doesn't make any sense. Like if it's another nurse or a doctor, but like you're there at the bedside, the entire shift, like you see if something's going wrong. So just trust your gut, and and you know, and report it to somebody. So that's definitely what I would say.

Brooke Smith
Yeah, that's really great advice. I think there's a quote, Comparison is the thief of joy. And I can really relate to the comparison thing, because I think we all do that, you know, especially with social media, it's really hard to not see what other people are doing and be like, Oh, wow, they're really ahead, or they're doing this better than me or like I'm behind or whatever the societal pressures are. But one one piece of advice that goes along with that for me is someone said eyes on your own paper. You know, when you're a kid, they the teacher was teaches you like, they're on paper. And so sometimes when I find myself doing that, I go broke eyes, on your own paper, like, what's in front of you is is what matters. And it doesn't matter what everyone else is doing. So eyes on your own pain. Because it will mess with your mental health majorly. If you are comparing yourself to other people because you don't know their journey, you don't know their struggles. You don't know what they're going through. You're just comparing, like their test score on that one test or how quickly they answered something. But that doesn't necessarily mean they even did it. Right. So you know, it's always bigger mines and we're all on our own journey anyway. Right?

Rachel
Exactly. No, that's, it's just so important to know that

Brooke Smith
yes, I think it's such good advice about like tips, tricks, hacks, anything I know you give plenty of great advice on your social media, but do you have any tips tricks hacks for nursing students or just in NICU nurses in general or staying up during lectures? Do you have anything for us?

Rachel
Let me see. Okay, so night shift, I would say get blackout curtains that's like a number one. I use melatonin to help me sleep because you're basically flip flopped, you know, you you can't sleep at the time you're not really used to sleeping so I use melatonin I used blackout curtains I use lavender essential oils like rubbing my temples something to kind of calm myself down to try to just sleep also using white noise so I've kind of still use that practice now. So now I have to sleep with a fan going which is my white noise. So like you find those little things that kind of help you sleep and whatnot. So that'll be for night shift for let's see, ooh become a new a new nurse do not say quiet today's a quiet day Today's a slow day Don't say any of that. Because as soon as you do you're gonna get a trauma a something an admission no just don't say the key word that don't say anything just just literally when you're about to clock up like oh my god, you guys now it was a wonderful day. You know also which is really interesting is bullying. So new nurses in it It's, again, going back to comparing yourself, you know, don't let people bully you. I've had people bully me at different hospitals, because I came from a different hospital and did things differently. And you know, and you kind of just have to learn how to like, stand up for yourself. And even if you don't know, something, just admit that you don't know it. And, you know, don't try to just do it. So if you don't know something, ask, you know, find someone that you could trust, that's not going to like, look at you in a funny way and be like, hey, you know, I don't know how to do this. Can you just show me how to do it? So now I can know how to do it next time. So just always ask for help. Because regardless, you know, whatever anybody thinks you're all there for one common goal. One common reason is for those patients and for like, for us, it's for the babies, you know, so I think that's just really important.

Brooke Smith
Absolutely. I really think about the bullying thing. But I have heard of this happening, where people are bullying each other. What do you think? Why do you think that happens? Do you think it's like a power trip? Where they're like, finally boss someone around? Yeah,

Rachel
I think it's I think it could be a power trip. I think I,

Brooke Smith
I honestly, or that just the person? I don't know. But because it feels like if you have had that done to you, why would you and you know how terrible it feels? Why would you be continuing that pattern and doing it to someone else? Like, you know, I would be like you're holding on to come up with the B word, I'm gonna be like, you need to. Because you see that word. And people, people sometimes don't even realize that they're being condescending, or they are calling you or they're being rude or whatever. Sometimes they don't even realize it, because they're caught up in their own moment. And sometimes calling it out and saying, Hey, you're bullying me actually

Rachel
will help. Oh, no, it's like, it's like the elephant in the room. Like, as soon as you see that, as soon, as soon as you say that b word. It's like, Oh, my God, maybe. But then also too, because like, I know, some of my friends that had been bullied at different hospitals, they stand up to the bullies, and then they don't get bullied anymore. But like, for me, because I think they just a bit for me, I'm a chicken. And so I just I take it all in, but it definitely affects my mental health. So that's what therapy comes in.

Brooke Smith
But the thing is that in healthcare, especially, I mean, your that that profession draws empathetic people, it draws people with really good hearts, and have a high level of empathy and want to help other people. So you're going to naturally be more a more sensitive, and be not as likely to be able to say, Hey, you're being rude to me, because it's just, there's a kindness in health care that I think like just naturally draws very kind people. So you get the people who aren't so much or who are bullying you, it's not as likely for you to be as aggressive to stand up for yourself. But it is so important. I think it kind of comes with age too. As you get a little older, you realize, okay, I need to advocate for myself and have to speak up, it's not okay for you to do that to me. But I encourage people all the time, if someone's disrespect, being disrespectful to you, bullying, you be being rude to you, stick up for yourself, you can do it in a polite way. You don't have to stoop down to their level. But definitely, you know, own your worth and and let people know if they're crossing a boundary with you because it's never okay. And it will affect your mental health. And people sometimes don't even know that they're doing it until they get called out on it. And that's why people get away with it is because they can because nobody says anything. And like, honestly, some

Rachel
people like you said, like, they don't know that they're doing it. And then when like you just say, hey, like you're like kind of hurt my feelings, or I don't like I don't like the way you kind of said that. They're like, Oh, my gosh, I didn't mean it that way. Let me rephrase it. You know, maybe someone had a bad day, I was here to give people the benefit of the doubt. Maybe they had a bad day or heard something, some bad news or whatever. So you just you know, but then again, like you said, it comes with age, I think like, you know, be more to the field. Maybe later on. I'll be like, oh, like nobody's messing with me. But I don't know.

Brooke Smith
Yeah, no, I get the bullyiing thing. I'm not a fan of bullies. So tell me a little bit about your career trajectory? What does your career look like five years, 10 years from now? Is it going to be very similar to what you're doing? Or is there like a step a step in a different direction that comes with more experience.

Rachel
So for me personally, I know as a nourish what's amazing going into nursing, you literally could do anything with it. That's what's so great about this profession, you can advance your career and go in, get your master's degree and go into management. You could get your doctorate you could do write paper, like there's so many things you literally could do with it. Me personally. I'm thinking for like five years down the line. I I like I just told you, I'm going to travel nurse so I'm super excited about that. And I think for me, I'm do I want to do that? Well, I want to do that for a couple different reasons. One of the reasons I want to I want to get exposure to different hospitals kind of see how they run how the different Nikki's run I want to see how the people are the cultures. I want to see I want to just experience different hospitals and kind of how they run. But like for me, I don't plan on going back to school. So I have my bachelor's degree. I don't want to go back and get my masters. I don't want to get back go back and get my doctorate. Um Just because for me personally, I like I don't want to become a nurse practitioner I love what I do I love being at the bedside I find it very fulfilling maybe I'll feel differently later on law what bro? Like want to do you know management or something and then I can go back with right now, you know for at least the first five years like I love being bedside. And I don't know I do definitely want to get my RNC so an RNC is is is a certification that you get in like your specialty, you just have to have two years of experience in it. And basically you just have to, you have to take a test, it's like another, like another set of boards. And then once you pass, then you do like when you renew your license, you have to do a continuing education. So you may have to just do a little bit more for having that certification. So that's something that's in my horizon for this year actually to do. So travel nursing, and then that but for 10 years, who I'm like, see, well, hopefully 10 years, I'll be a mama. So maybe I'll step back a little bit. I'm 31. So I it's kind of crazy, because I am a NICU nurse, I have no kids and I have the worst baby fever ever. I go to work and I just want to like love on everybody. And I'm like, please just like give me love because I want babies in my own. I can't wait. I'm so open the neck. Well, hopefully next five years, I have kids, but next 10 years, I'll have kids. So at that time, you know, maybe I'll take a step back and you know, not work full time or work. The extra steps just work part time because I want to be a moment too

Brooke Smith
you're gonna be an awesome.

Rachel
We can have kids later. So it kind of It hurts me at work when some of the nurses are like, Oh, you're 31 and you don't actually it's funny. I did. I did a post on this. I earn like a funny post on this. Like where they just make not like make fun. But they're like, oh, like you're not married or you don't have any kids like, like, what are you waiting for kind of thing. And I'm like, Well, honestly, like, for me, I just I was career focused. And now I'm getting to the point where I'm like, now I want to and I have a boyfriend so hopefully, hopefully if he listens, he can get the ring on the finger. I'm just kidding. I mean, we've talked about marriage and kids and we talked about all the time but um, it'll be sometime in the future. But every regardless what age and I'm learning now it happens whenever it's supposed to happen. Everything. Yeah,

Brooke Smith
I completely agree with that. Like when it's meant to be it'll be but that goes back to the mental health thing and the societal pressure of especially that women have have. What's wrong with you? Why aren't you married? You're in your 30s Why don't you have kids? What's wrong with you? You're selfish, like, whatever that is. And it's not always, you know, we we can do things a lot older now. And I'm a big believer in you're only as old as you feel. And I hope that that will happen too. But you can some your life just doesn't always go the way that you think it's gonna go and it doesn't always happen on your timeline. And you just have to be okay with that because there's just things you can't control. You know, so as a NICU nurse, is there a specific stethoscope that needs that you have and what are those needs and also like any other medical equipment that you find that is very helpful for your for your job.

Rachel
So I'm a little biased I love the MDF stethoscope and I am obsessed with the ProCardial Titanium one because and because this is the reason why it has different attachments. So for as a NICU nurse or even even a pediatric nurse we deal with little itty bitty we don't deal with big people. So we need little itty bitty bells. So what I love about that specific stethoscope is you literally can take the bells off and put on a tiny small one for a little infant or a pediatric one which I think that's super important especially you know being a NICU nurse you have to have a smaller bell or smaller stethoscope and for equipment you know let's see usually like what I carry around with me I always carry on scissors for something because I mean we need it to do you know to put orogastric tubes into their nose and their mouth and tape it to the side or for IV purposes. I use let me see

Brooke Smith
yeah so like if you have a medical bag if you were to pack a medical bag for your job what will go inside it?

Rachel
Oh actually didn't medical bag so in my medical bag I have gum because an immense because you know especially having to work well even when we didn't have to wear masks all the time in the hospital. You know you eat and you get stinky breath because we're just you know you're up in people's face. You're talking to people you're talking to babies, they you know they could tell they don't want bad rep nurses either. But even like after lunch and you have a mask on you could teach your own food is nasty. So don't bring your toothbrush somebody bring gum or bereavements. I have scissors in mind. I have multiple pens, I have highlighters. I'm very organized when I do my report sheet I color coded with highlighters pens, I want to know exactly what's going on I'm I think that's my anxiety, my mental health kind of poking through. I like to be in control of my paper my day and granted as A nurse, you can plan it, it's not going to go the way you plan. But if you have a general idea and you kind of do, you know what you can usually your day goes a little bit better. So I have a bunch of pens highlighters, I have sharpies in there because for NICU we fortify breast milk. And so are we thought and then we fortify it. So we do have to put like when we fortify it to make it you know, different calories or whatnot. We use Sharpie so we Sharpie at the top and say like how many calories you've ordered by two. I also have like alcohol swabs in there too, like sweat sanding off my phone standing up my stethoscope usually and my stethoscope is obviously in there. And then usually I'll put like put a calculator in there too, because we don't necessarily have like we're not allowed to really have our phones out. So I have a calculator to like when we have new IV rates we have to calculate or you know, orders from the doctors that are feeding related that they need to we need to calculate something so I have a calculator in mind. Let's see I think that's about it that's in my bag, maybe an extra hair tie. I don't have anything like crazy because honestly, what's great about my department is we have we have a bed car or we have like a like a storing cabinet with like everything in it so we don't need too many other you know, too many other things. But most of our stuff is in up there. So we just we were a little bag with her and we make sure you get a bag you could wipe off with the sandy wipes it doesn't harbor like bacteria and whatnot. So that's what I bring.

Brooke Smith
Awesome. I love it.

Rachel
I love it. Oh, I also bring I bring ginger chews reason for that I get migraines, so I bring ginger two's just in case I forgot about that. I have a bag of ginger shoes.

Brooke Smith
Now that that helped migraines I get migraines are really bad to ginger Chews.

Rachel
And mango, you have to get the mango and you can't get the nasty regular ones. Get the mango ones.

Brooke Smith
Okay, that's good advice. I like it. Okay, Rachel, will you give us your social media handles, so for anyone listening, who wants to give you a follow and check you out? She offers all kinds of really great tips and tricks on her Instagram. She also has advice. She also has really funny videos that she puts on. I'm a big fan of her social media. So can you give it to us, Rachel?

Rachel
Yes. Okay, so it's the at symbol Rachel, the RN, underscore so it looks like @rachelthern_ That's my last name. No, it's Rachel, the RN underscore so yes, give me a follow in your

Brooke Smith
Well, Rachel, thank you so much for being MDF Instrumens Crafting Wellness Podcast today. It was such a pleasure having you and talking with you. And I'm going to have to check back with you to see how the travel nursing getting us going and how your medical back changes. Yes.

Rachel
Thank you guys so much for having me honest, this was so much fun. So thank you guys so much.