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Scott Benner 0:00
Hello friends, welcome to episode 1146 of the Juicebox Podcast

we're calling today's guest Mimi, she's 27 years old was diagnosed with type one diabetes in 2001. And she's been a nurse for about a year before that Mimi was an ER tech for eight years, and this is what she experienced at her job. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juicebox Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's juice box at checkout to save 40% at cozy earth.com. I'm talking about T one D exchange again and I hope you head over to complete the survey T one D exchange.org/juicebox. Looking for US residents who have type one diabetes or are the caregiver of someone with type one. They're especially looking for you if you are a male, a male of color, or the caregiver of someone who is T one D exchange.org/juicebox podcast. US med is sponsoring this episode of The Juicebox Podcast and we've been getting our diabetes supplies from us med for years. You can as well us med.com/juice box or call 888721514 Use the link or the number get your free benefits check it get started today with us med this show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn Find out more at G voc glucagon.com forward slash juicebox Hello and welcome to the cold wind series from the Juicebox Podcast. These episodes will feature physicians, nurses and other professionals who agreed to come on the show anonymously to share what they see in the healthcare profession. I've altered the voices of each guest so that they can remain anonymous and feel comfortable telling us what really goes on at their job. Just listen to how well the voice alternative works.

Beth 2:35
My name is Beth and my oldest child has type one diabetes diagnosed in October 2020. My name is Beth and my oldest child has type one diabetes diagnosed in October 2020.

Scott Benner 2:47
If you work in health care and have a chilling story to tell about your experiences in the healthcare field, contact me today. I'll get you right on the show. Your story does not need to be specific to diabetes. Mi Mi tell me what you do for a living.

'Mimi' 3:05
I am an ER nurse.

Scott Benner 3:07
And do you have type one diabetes?

'Mimi' 3:10
I do. I was diagnosed February 28 2001.

Scott Benner 3:15
Oh, that's a while ago. Okay. Yeah. You knew the exact date February 28. Oh,

'Mimi' 3:21
we celebrate it?

Scott Benner 3:22
Do you do the thing where you have like a diversionary party?

'Mimi' 3:26
Ah, no. So much a party it kind of it's just like eating absolutely anything I want all day. That's how it started. And then as I got older, I'm like, Wow, it's really not fun feeling like crap all day. So now it's really just like, I'm gonna have a little treat here and a little treat there and call it a day. Celebrate yourself.

Scott Benner 3:47
So you've had type one for over 20 years. Yeah, for most of my life. I was gonna say how old are you now?

'Mimi' 3:54
27.

Scott Benner 3:55
Okay, how long have you been a nurse?

'Mimi' 3:59
I've actually only been a nurse for a year, almost exactly a year. But before I was a nurse, I was an ER tech. And I did that for just under eight years. What does an ER tech do? So it depends on your hospital and state. But where I was working, I basically did what nurses do, except I wasn't doing assessments and giving medications. So I was starting IVs I could put in catheters EKGs casting and splinting CPR when necessary, but lots of like task oriented stuff.

Scott Benner 4:35
Okay. How long does it take to become an ER tech?

'Mimi' 4:37
So similarly, it's dependent on your hospital and your state, but I just had my CNA, my nursing assistant license, and then everything else that I was able to do, I was taught on the job.

Scott Benner 4:49
Okay, so you went right into like a, what happens after high school you get like an associate's degree.

'Mimi' 4:55
So for CNA, it's just a certificate. So some programs are like weeks summer 12. I think mine was an eight week program. I actually started working at like an assisted living facility as a resident aide. And they were like, Oh, if you go get your CNA, we'll pay you more. And I was like, okay, like, why not? It's not expensive to get. And then once I got my CNA, my best friend's mom, who was a charge nurse at our local er was like, Oh, now that you have your CNA, you can come work for us. And like, we'll teach you all these things. And it'll be really great if you want to go to nursing school in the future. So that's what I did. I it was like, probably six months after I graduated high school, because I wasn't really sure what I wanted to do. I knew I wanted to do something with medicine, but like, I had no idea because there's so many different ways you can go, right?

Scott Benner 5:43
I guess the assisted living place was thrilled, they suggested that CNA and then they lost. So

'Mimi' 5:51
get your certificate, and we'll pay you more. And then I was like, Oh, I'm actually going to leave now. But thanks for the suggestion.

Scott Benner 5:58
They should have said, but you have to stay after you do it. Right. So okay, so you did the ER tech thing for what like, geez. For?

'Mimi' 6:09
Yeah, it was almost eight years, because I kind of went back and forth between wanting to go to like PA school or even med school. But then I was working more as a tech and seeing how those roles, like interact with patients and stuff. And I was like, I don't know, there's really not that much patient interaction. But I really liked the like, hands on tasky skill stuff. So I was like, I can still do that as a nurse and like help providers with those, like skills and tasks and procedures as a nurse and still get more patient contact. So I ended up going to nursing school. Let's see, I actually started before COVID. And then the place that I was working at the time, the ER had mandatory overtime. And I was like, I can't do school and work with mandatory overtime. So something's gotta give. And I took a break in school, actually, because obviously, my job was my health insurance. And I can't go without health insurance. So I took like a year and a half break in school and just did like online, general education classes to stay with it. And then went back. Let's see two years ago now, three years ago,

Scott Benner 7:23
what pushed you down and what pushed you to go back and finish?

'Mimi' 7:27
I loved being a tech. Honestly, if it paid a livable wage, I would probably do that forever. But it didn't. I was on the East Coast and the cost of living was really high. So I was like, I have to finish something to make more money. And I'm really happy with my decision actually to take a break because nursing school is very cutthroat, especially working full time and being in school full time. So full time for like nursing in hospitals, 36 hours, so I was working 36 hours a week had 24 hours of clinical a week, plus probably close to 1012 hours of lecture a week.

Scott Benner 8:04
36 type or 30. And that does like 70 hours worth of work for the degree. Yeah, and

'Mimi' 8:11
that's not including, like sleeping, and eating and going to the gym and like

Scott Benner 8:16
being a human being. And you were working you would have to work to Yeah,

'Mimi' 8:20
so it was a lot it was very time consuming. And most nursing schools, you have to have an average of 80% to be passing. So it's not like C's get degrees like you'll be fine. Do the bare minimum and you can be a nurse. So it was very time intensive. And like if you showed up late to lecture, you don't get to enter the room. And if you don't get to enter the room, you only get to miss three lectures that semester like it's very cutthroat. So taking a break was probably the best thing I could have possibly done for myself and I have absolutely no regrets even though at the time I was like wow, could have been a nurse two years ago but when

Scott Benner 9:00
you say cutthroat you mean unforgiving? Where do you mean there are actually people out there trying to knock you down? US med is sponsoring this episode of The Juicebox Podcast and we've been getting our diabetes supplies from us med for yours, you can as well. Us med.com/juice box or call 888-721-1514 Use the link or the number get your free benefits check it get started today with us med if you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action Luckily G vo Capo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you storage EVO Capo pen and how to use it. They need to know how to use G vo Capo pen before an emergency situation happens. Learn more about YG vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit GE voc glucagon.com/risk For safety information.

'Mimi' 10:42
I think it kind of depends on the program. But it does feel like they're kind of out to get you sometimes. Our clinical Instructure instructors are part time staff so they don't teach like any lecture or anything. They're strictly clinical. So you go to the hospital and you practice your skills and patient interactions with a bedside nurse. And some of those instructors. I think nursing is a very young profession, which a lot of people know a lot of people say they don't like but then a lot of people also contribute to. So it was kind of like they don't want to see you fail. But if you start to go down that route, they're not going to help you kind of thing. Okay, they want you to like figure it out on your own. And that's not the easiest thing to do when someone's life is in your hands. It's really tough. I just I always say cutthroat, but like, there's some professors that Like genuinely want the best for you and will do everything in their power to help you pass. And then there's some that are like, Well, if you can't figure it out, you're not meant to be a nurse.

Scott Benner 11:48
Have you had experience, I guess, with people who take joy in the failure? Or do you think they think they're washing you out and saving the profession from someone who's not prepared and couldn't do it?

'Mimi' 12:01
I would like to think it's the latter. Like they want strong nurses out of school. But a lot of nursing, you don't learn in school, you learn it on the job. So if you can't make it to the job, you're never going to become a strong nurse. The same people are the ones complaining about like being overworked and understaffed because we can't get good nurses and like, you're not giving nurses the opportunity to become nurses.

Scott Benner 12:27
Is it a hazing?

'Mimi' 12:29
I think it really depends on honestly, your geographical location. Because like I said, I checked on the East Coast for a long time. And it's a very densely populated area that I was in. And nursing is much different there than where I am now, which is like, kind of Midwest Pacific Northwest. And nursing here is I tell people all the time, it's so much better, that patients are genuinely nicer. I feel like we have more time to spend with our patients. They're almost healthier here. Because people live such an outdoors, like active lifestyle, it's just almost easier to care for them because they want the best for themselves. So my experience out here has been so much more positive than any experience I ever had during nursing school on the East Coast or even as a tech on the East Coast. Okay.

Scott Benner 13:20
I wonder if your nursing school experience would have been different? Had you done it somewhere else?

'Mimi' 13:25
Maybe right, I would like to think so. We see a lot of nursing students in my current er, and they all seem like very excited to become a nurse. Wow, my classmates were like, dreading it.

Scott Benner 13:41
So yeah, the process is so bizarre. No, it's not the process of going through nursing school makes you just think, Oh, this is going to be if this is what this was, then the job is going to be 1000 times worse.

'Mimi' 13:53
Yeah. And honestly, during nursing school, I thought I was going to be a bad nurse. Because we did all of our clinical like on inpatient units or not in the ER, and the ER was the only thing I really knew. So I was like, I feel like I'm supposed to be doing more things. But I don't know what those things are here. And the documentation was very different. And I was like, if this like my instructor had to keep, like prompting me to do things and I'm like, I feel like I should be better at this. Like I have a lot of clinical experience and very comfortable with patients. So like, why am I struggling so hard with this? And then as soon as I got back into the ER, I was like, oh, okay, I am a good nurse, I'm going to be fine. I don't know why I felt that way in a different setting, but it's not me.

Scott Benner 14:42
During nursing school, how are things broken down? I think people listening, you know, they go to a hospital and they expect the first person that they intersect and every person thereafter to have a complete understanding of what's going on and their needs, which it seems unreasonable to me but at the same time You know, what else am I supposed to think? Because a patient walking in like I come in and I have a disorder, I have a disease. I have type one. And I'm here for that. I feel like you're supposed to know but you don't really know. Right? You do. What is it that a nurse is prepared for in nursing school is my question. In

'Mimi' 15:16
nursing school, we are prepared for taking tests. As bad as it sounds. A lot of nursing schools are just focused on pass or success rate for the boards, which is called NCLEX. I don't remember what that stands for. But it's like your national registry. You take the exam, you pass and then you're officially a registered nurse. So like, just because you're done nursing school doesn't mean you're a nurse yet.

Scott Benner 15:41
So nursing school taught you how to take nursing school tests.

Unknown Speaker 15:44
Yes, okay

'Mimi' 15:46
with understanding of basic disease processes and the human body. So your first semester of nursing school was basically like an introduction to med surg. And med surg is just like general medicine. A lot of the chronic things that people deal with mostly like heart failure, COPD, and basic like taking vital signs and how to do a bed change and stuff like that. Second semester, this is different for every program, it's generally broken down. Similarly, second semester was med surg two and maternal and fetal medicine. So like OB, third semester was med surg three, and mental health. And then fourth semester for us was like critical care, and er, which it wasn't really a ton of Emergency Medicine stuff. But it was just like, really critical thinking and like, disease processes that would lead you in the ICU kind of thing.

Scott Benner 16:50
So you get a background of a general overview of what everyone most likely comes in with. And then it's learned on the job after that. Oh,

'Mimi' 17:00
yeah, I learned way more as a tech being very vocal with my nurses and providers in my er, than I did in nursing school. Nursing School did teach me how to test questions and break them down to where if I don't know the answer, I can figure out the answer from the question and like process of elimination. But yeah, I didn't really learn a ton of information in nursing school other than like, OB and fetal medicine, because like, I did not know anything about that, because that's not anything we deal with in the ER at all. Yeah, usually. But I struggled with that semester, the entire semester, I was not passing until the final exam, I took the final and got like a 90%. And that brought me 1% of passing. It's

Scott Benner 17:50
funny, you're describing nursing school, like an LSAT prep course.

'Mimi' 17:54
That's exactly how it felt. Okay,

Scott Benner 17:56
have you taken one of those LSAT preps?

'Mimi' 17:58
Oh, a long time ago, but

Scott Benner 18:01
I have same idea like this is how you break down a question. This is how you figure something out when you don't know the answer to it. Like, here's how you pass the test. Yeah,

'Mimi' 18:09
that's exactly right. And like I said, it's because they want us to have that higher testing percentage in order to pass boards. Because if you so if I graduated, and like, I think it's less than 70% of my graduating class doesn't pass boards, we lose our accreditation. So they want everyone to pass boards, whether they're a competent nurse or not. They want them to be able to answer the questions correctly to pass.

Scott Benner 18:37
So I'm getting so it's possible, I'm getting a nurse that was just kind of pushed through. Yes, unfortunately, that the institution could continue on. Yeah. Every time we set a rule, it seems that just people find a different way to break it. Like you know what I mean? Like you get understand in the beginning, where somebody's like, Look, you have to pass at least 70% of the people to keep your accreditation as a, you know, a place that's good at teaching people how to be a nurse, but instead, to quickly turn it into a business thing, where they're like, well, we just got to get them through so that we don't lose the accreditation, because that's where we make our money selling nursing to people. Yeah,

'Mimi' 19:13
yeah. And I actually went to an Associate's program. So I have my associates, associate's degree in nursing versus a bachelor's in nursing. And at least where I came from on the East Coast, our school did have a much better reputation of our graduates versus some of the bachelors programs, because we had more required clinical hours. So while they are really like pushing us to just test well, we also were required to do a lot more hands on experience time, which I think is a huge benefit. Even though we have more than most schools. I still think more is better, especially with my background, like during nursing school. Yeah, I had 24 hours of clinical week, but I was also working in addition Not 36. So that's like another 36 hours of exposure to patient care for me. So I think that prepared me more than anything for my current job. Yeah, I

Scott Benner 20:11
once had a nickname NICU nurse tell me that they, they laugh at the kids that come out of like a four year bachelor's program from a private college, you ended up spending 60 $80,000 on their undergrad to be nurses. And they're like, you could, you could have done that in community college for four grand. And yeah,

'Mimi' 20:30
that's exactly what I tell people to like, where I am now, there's not really many community colleges. So it's not really a an option here. But because I was working full time, I didn't pay anything for my degree. My hospital paid for it.

Scott Benner 20:46
Oh, because you can Oh, that's right, because you kind of went back to school while you were a met. So once you were attacked, you told them look, I want to go back and get my RN, and they're like, well pay for it. Yeah. So

'Mimi' 20:57
depending on your hospital, despite what program you're doing, I think they reimburse up to $2,500 a year for undergraduate, and 3500 a year for post grad. But then there's some hospitals that also have like a Nursing Scholarship Program, where they'll pay for it. And you owe the hospital like two years of employment after versa. They say, some people take their chances and leave. And they're like, well, if they want me to pay it back, they can find me.

Scott Benner 21:29
Find me? Well, they did take a risk, because you really screwed over that. The elderly care place. Yeah, exactly. Like I can blow right out of here.

'Mimi' 21:41
I actually did leave before my time was like, due for my tuition reimbursement. It was like, I think one year after the last payout. And I hadn't even graduated before I put in my notice, because I knew I was moving. But the hospital that I was working at, I just was not interested in staying. And like I said, the culture of like East Coast medicine or religious a densely populated area was not a great culture to work in. And I wanted it to be at a trauma receiving hospital versus a hospital that receives a very sick or high acuity from a patient and then ships them somewhere else. Yeah, I had worked in that environment for long enough. And I was like, I kind of want to be on the receiving end and like, see more acutely ill or injured people. I know, it sounds kind of twisted. But I really liked like critical thinking and like more sick patients.

Scott Benner 22:36
Gotcha. My wife once described her job as like King of the Mountain. She's like, everybody below you is trying to knock you off the mountain. Like just, it's nonstop. She's like, it never ever stops. And you know, you're in meetings, and you have to say things in certain ways so that people can take advantage of your words, if you miss speak, and they're always everybody's throwing everybody ever under every bus they can find and all just, you know, ladder climbing, trying to trying to get up there. I mean, you moved halfway across the country, I don't want to tell people where you are. But you move pretty far getting away from getting away from all that. Yeah,

'Mimi' 23:13
I moved, I think it's actually like 2073 miles or something away from where I was.

Scott Benner 23:21
So if I asked you to, you know, blow the whistle on nursing, what are the things that popped to your mind right away that you'd want to share with people that are happening that they wouldn't imagine? I

'Mimi' 23:32
don't really see much at my current job. But as most of my background was that my most recent previous job, a lot of nurses hate being nurses, they do the bare minimum, and they protect their licenses the best they can. And they don't really advocate for their patient. They don't use that critical thinking, like prevent future problems, which it comes from both the nurse and the patient, because a lot of patients don't even want to help themselves. So what are we going to say that's going to help them. So there's just so much burnout, that it's tough to provide really good care, because they don't want it like patients want a quick fix. They want a pill to make their blood pressure better, instead of changing their diet or their lifestyle. And you give them that pill and then they go on their way and you'll see them in six months for some other medical emergency. Burnout is just so severe in nursing right now that it's really hard to want to provide good care. And especially in like an ER you're surrounded by your co workers, and if they don't want the best for the patient and like you kind of just like almost stoop to their level and it's really hard to change the energy in that situation.

Scott Benner 24:50
So going, going back to the first step of that. You said that a lot of nurses you know, don't want to be nurses. So using your story, to try to surmise Are we just becoming an RN for the, because it pays more? Do you think they want to help people when they get there? And they fall into the machine and the apathy? And they're like, Oh, what am I trying for?

'Mimi' 25:11
Yeah, I think it's a little bit of a ladder. But I think a lot of nurses also don't have the like, real life nursing experience that I bring with all of my tech experience. So like, they don't really know what they're getting themselves into. Granted, you have your clinical nursing school, but that is, so it's like not self directed at all. So like, every minute of every day is structured, you walk into clinical, and you have a piece of paper saying, at 7am, you go in and introduce yourself to your patient. At 8am, you go do an assessment, at 9am, you pass morning meds at 10am. You make sure no one needs to go to the bathroom. Like, it's just so programmed into your head that everything is like a timed process. Yeah, that if anything skews from that you like panic, like there's no autonomy in clinical and also when you're forced to use autonomy as a nurse after school. I think people really struggle with that. So they get out into the field, and they're like, Oh, this is not what I've done. And I'm uncomfortable. And now I'm just gonna, like fall into a pattern of what everyone else is doing. Because it works for them. So it'll work for me, you'd

Scott Benner 26:23
like answered an ad that was like, you want to work outside? Do you like having the wind in your hair? Do you like driving, you'd be like, Oh my God, it's amazing that you realize that you're like, gonna ride the back of a garbage truck. And they left out the part where there'll be maggots and hot bags of garbage all day. And like, so yeah. It's not quite what they think until they get there. And they experience it. And they're like, Oh, I didn't want this. But now it's too late.

'Mimi' 26:46
Yeah, and it's really, it's really tough to because people think emergency medicine, they're thinking like trauma and like broken bones and all kinds of stuff. And, as I'm sure everyone knows, there's like a huge mental health crisis across the country, probably the world, but we see a lot of mental health patients. And that's, it is an emergency, it's an emergency for them. And it's a crisis. But like, it's not the like thrilling emergency that everyone thinks they're going to get when they work in the ER, we see a lot of homeless patients. We see a lot of patients who don't have insurance. So the ER is the only place that will treat them prior to payment. Like it's a healthcare crisis, not just a mental health crisis. Let me rephrase that.

Scott Benner 27:32
One of the people who's been on the show already and recorded for this said that she's like a, I forget how she said it. Like I I'm sorry to say this, she said, but there are a lot of nurses who are trauma hoarse. She told me yeah,

'Mimi' 27:43
we can trauma junkies and like, I won't deny that I am not a trauma junkie, I love trauma, but it's also something that will burn you out really fast, too. So you see the worst of the worst. And if you see that, three shifts in a row, you get off and you're just like, wow, that was really emotionally taxing. Like as good as you can be at dissociating, it's still taxing probably

Scott Benner 28:08
like an adrenal overload, right? Like all that. Oh, for sure. The dopamine kick you get from it, and the adrenaline and everything. And then is it? Is it like doing drugs?

'Mimi' 28:16
I don't know, because I haven't done drugs. Very good. Mimi, there you go. But it is very exhilarating. There's a roller it's a good job. Yeah. Okay. There are certain parts of the job that I'm like, Wow, this must be like what cocaine feels like. Like one time, I put an IV in a six day old premature infant who, like the IV team couldn't even get access in I put in like a very small IV in her ankle. And I was just like, wow, they stuck this kid like eight times. I got it on the first try. I am on this high, and I'm gonna ride it the rest of my shift like, I'm unstoppable. But like, then you crash from that, like, I got home and I couldn't sleep. And then I was so tired. Once I like, came down off at high I was like overtired couldn't fall asleep. And then I like barely slept before going back for my next shift. And I was like, ah, was it worth

Scott Benner 29:12
it? Yeah. And then the next day a lady poops on you. Yeah,

'Mimi' 29:16
exactly. Or you have like a patient with bedbugs. or somebody's like, trying to punch you like, it's, it's chaos all the time.

Scott Benner 29:25
They're talking to you and spider man at the same time. And you're like, Oh, this is yeah, great. I gotcha.

'Mimi' 29:31
Trying to like, get the bugs out from under their skin. And you're like, please don't do that in front of me. And

Scott Benner 29:36
then when you get to like a regular old, everyday normal person who's just in there and sick their thing is, like banal and at least it's not insane. And then they don't get the level of care that you'd love to give to them because you have all these other influences bothering you. These variables. You're a real person to you have all these variables pushing on you. And then when you probably get a moment where it's not, oh my God, look at this amazing thing I did or Jesus, please stop pooping on the wall. It's just like, that's boring. It's regular, and you just get it done. And then you go back to this 10 o'clock do you have to pay blah, blah, you go to the schedule, you get them out of there. And that person later probably thinks I did not get very good care.

'Mimi' 30:15
Yeah, and it's really tough. Again, with the healthcare crisis, we're getting all these patients in the ER that need to be admitted to the hospital. And then there's no either open beds, or there's open beds, and no nurses to care for those open beds. So those patients just sit in the ER for sometimes days on end, we call them borders. At my hospital, it's pretty standard that you have four beds in your assignment. And if I have two borders, and then two er beds, that I could be turning every couple of hours with very sick, critical patients. My borders are gonna have to wait, whether it's scheduled meds are getting them to the bathroom. Luckily, we have great Tech's very work that'll help do most of those things. If they can, like, oh, we need to put them on a hospital bed to make them more comfortable or take them to the bathroom or something like that. But like if I get a patient in one of my er beds, it's having a heart attack that requires all of my attention until they leave my room. Right. So then yeah, my boarders will not get the attention that they need for possibly up to like four hours, I say. So it's definitely a disservice to them.

Scott Benner 31:24
I want to go back to the other thing that you said when you were kind of laying out the job, which is people are there because they're sick, and they recognize that they need help, but they're not necessarily the best shepherds of their own health to begin with. Yeah. And so is it like being a lifeguard for a person who's trying to drown?

'Mimi' 31:45
Yes, a lot of times, like I said, people are generally in better health here than they were back on the East Coast. Like people who have COPD or heart failure, they've had these things for a better portion of their late life, let's just say they're like 80 years old, they've probably had COPD, since they were 5560. They've also smoked a pack of cigarettes a day, every day for their entire life really, and they have no desire to quit. So while I am at the room next door dealing with a patient having a heart attack, they're on oxygen, they're vitally stable. They're pounding their call that and because they need their nicotine patch. And then I can't get them their nicotine patch in time. So they're like, I'm leaving against medical advice, because I need a cigarette. So then I have to page the doctor that's taking care of them, because while they're in ER patient, the ER doctors right there, but when the reporter, the admitting physician is usually not in the ER, they're somewhere else. So I need to page them and either get them on the phone or have them come talk to the patient. Because nothing I say is going to change their mind and make them want to stay. They have to hear from a doctor and that's most patients. So like, you're just a nurse, what do

Scott Benner 33:01
you know? Yeah, the addiction is driving them to at that moment. Yeah. And

'Mimi' 33:05
it's the same with like alcoholics to Alcoholics can withdraw and very quickly be an ICU level patient. Despite what we can give them. It's not going to help their withdraws. It's not going to help their their tremors and all of the symptoms are experiencing. So they just want to leave and drink to feel better.

Scott Benner 33:23
I was like 16 years old, my father took me to lunch. And we were heading into this diner. And this a long time ago, so used to walk into a diner and in the vestibule there were two things like Miss Pac Man and cigarette machines. And I would imagine most people don't even know what a cigarette machine looks like, to be perfectly honest, right? But there used to be these things. You put quarters and you pull the lever back and a pack of smokes, which smoke drop out of it. So my dad would go into the diner. He would put quarters in take a cigarettes go in and sit and you could smoke in restaurants. So he'd sit there and smoke while he was waiting for his food. And we walk in and the machine does not have his brand. And it's out of his brand and his backup brand. For old school smokers. My dad smoked Chesterfield kings, which were filterless cigarettes. And then in a pinch, he'd smoke a Pall Mall if he had to. I said, Oh, that there's no cigarettes. And he's like, yeah, he goes, it'll be fine. So we go in, and we sit down. And I don't think we ordered before he broke a sweat. And then his he got red in the face. And you could see the anxiety hit him. You don't I mean, and then the West, and then immediately the withdrawal. And to the point where I was like, I can go across the street to the gas station and get cigarettes for you. And he goes, No, no, don't worry about that. And then two minutes later, he's pulling money out of his pocket. Go get those cigarettes for me. Yeah. Yeah.

'Mimi' 34:50
And that's how it is for drinkers too. Except I feel like the symptoms of withdrawal are like they're much worse. It's almost like having like the flu. Like you'll get a fever. Yeah, you'll be having like the cold sweats, vomiting, hallucinations, like, they are very time intensive patients. And in the hospital, everyone is so worried about falls. Because if a patient is there for something, and they fall, whether they're whether they sustain an injury or not, it's a big deal. And especially when they're hallucinating, they're vomiting. They have to go to the bathroom frequently. They're always trying to get out of bed. Yeah, they're a huge fall risk. So you either need a tech or a senator to sit with them, or you need to be within earshot. They're very time

Scott Benner 35:36
intensive, called on fall. Yeah.

'Mimi' 35:39
Don't fall. Stay with me called

Scott Benner 35:41
Don't sue us. Exactly. Call

'Mimi' 35:45
don't fall and give yourself a brain bleed.

Scott Benner 35:49
So here's what I'm getting. By the way, I don't have we even touched on the things you were going to talk about. No, not at all. Go to that stuff, then I'll go back to my thing. What

'Mimi' 35:58
did you want to talk about? So I tell type one patients all the time that I understand their frustrations and how the hospital does a huge disservice to well control diabetics. I hear that I know it. I, personally, relating to the previous ER nurse that was on the podcast. Similarly, I don't want to be admitted to the hospital. I know it's going to do bad things for my control. But I do trust about 90% of my co workers to take great care of me, including our physicians.

Scott Benner 36:31
You heard the the nurse who said I wouldn't go to my own er, if I had a problem for my diabetes. Correct? Yeah.

'Mimi' 36:38
I would absolutely go to my own er, I don't, it might have something to do with personalities. Obviously, I don't know the other nurse that was on here. But I am very open about my diabetes. I tell everyone I work with please ask me questions. If it's going to help you understand something better or help a patient. I often get text messages and phone calls. While I'm off saying like, hey, my patient has an insulin pump or like a CGM. How do I take it off, which if a patient isn't able to tell a nurse how to take their pump off, that pump absolutely needs to come off, because obviously, they're not going to be able to do what they need to do to manage it. And on the same hand, there's also an admitting physician at my hospital, we'll call her, Dr. Jones. She is a huge advocate for type loans as well. And she has an excellent order set for pharmacy for patients to keep their insulin pumps. So anytime I have a type one patient, and she is not the admitting physician, I message the admitting physician and say please consult with Dr. Jones for this patient's insulin pump orders. And I would say probably 60% of the time it happens. But that's again, only when patients are like alert and oriented enough to tell me like their settings and stuff like that. There have been plenty of instances where a patient tells me that they want to keep their insulin pump, but they have to get in contact with your endocrinologist to find out their settings. And I was like, I've had Omnipod T slim, and Medtronic in my 20 Some years of diabetes. If you don't know how to find the settings in your pump, that's alarming to me. Yeah. And I don't feel comfortable letting you keep your pump if you don't know how to find your settings, right.

Scott Benner 38:25
I wish you wouldn't have said Dr. Jones, by the way, because it made me think of Indiana Jones. And then it made me then it made me think that I wonder if people know that Indiana was the dog in the family. Nevermind. And that's what happened to me while I was listening to you just now. So you're telling me you're telling me that if someone comes in with a complete inability to even understand their device, how are you supposed to believe they know what they're doing? Exactly. Okay. And so they're set up. And they've probably got a rhythm going. And they, you know, they push this button, they say this much for this meal, but they really don't know what's happening is the thing that's been set up for them. And it's running, but they they couldn't be the stewards of it. So this is an interesting problem, because all these problems are multifaceted. I'm going to I'm going to tell you that, you know, the first half hour of this conversation, what I heard was that nurses, people, doctors, and the system are all entities that have multiple bool variables impacting them, yes. And depending on your perspective, like you can go you could go into an ER and be me with my kid. And I'll be able to say that nurse doesn't know anything about diabetes. And I'll be right because I know a lot about it. And then there could be another person that goes into the can't find the settings on their pump who would think that you know a ton about diabetes because you know more than they do. So it's it's varying levels of understanding. Coupled with your perspective, your death desire. And then all these things have to come together over and over again, between you and the nurse, who is also sitting on four other beds and has the pressure of moving people out, holding people who can't leave, but can't go upstairs. And if there is an emergency, abandoning all those other people to get to that emergency, and then on top of that, what you have is that adrenaline, this isn't even the job you wanted. The doctors and asshole, like all the other things that could possibly come with this are impacting you while you're trying to help those four people and three of them probably don't even want to help themselves.

'Mimi' 40:38
Yes, exactly. Okay, there's so many moving parts to being a nurse, being a doctor being a patient, like, it is impossible, like there's no one size fits all, as we all know, like, diabetes is so complex and different from person to person. And like I tell all my co workers, my diabetes is different based on the week of the month, whether I'm on my period, or I'm ovulating or I'm working night shift, or I'm working day shift, everything is different. So if I'm here for like, appendicitis, or I broke my arm, it's gonna be different. Like, I'm not even going to be able to control it. Well, yeah. So why should I expect them to? It's interesting,

Scott Benner 41:19
but you can see the other side of it too, right? Like if I was just an everyday, everyday person, and I have type two diabetes, I'm not doing a great job with it. My a one sees the nines, and I'm having some obvious health issues, metabolic issues and some other things that led me to the emergency room. When I get there. I'm probably hoping you're going to tell me how to keep this from happening again. And you're probably thinking, even if I knew what to tell this person, they wouldn't do it anyway. Or

'Mimi' 41:48
even if we know what to tell this person, we told them and they're still not going to do it anyway. Or

Scott Benner 41:53
even understand at times. Yeah, yeah. The problem is people Yes. But on all sides of the problem, we are having a problem of humanity is what we're having. Yes, we're very stubborn beings. In the past, if you had a mental health concern, you didn't really go to a regular hospital. There were other facilities, we don't really do that anymore. So everybody goes to a centralized place. So there used to be, there'd be a trauma center for trauma, there'd be you know, a regular, like local hospital for, you know, regular old problems, there'd be a mental health facility for mental health problems. These people would mostly be filtered in through EMS, or police so they could take them to the right places. And now everything happens in one spot, and everybody is expected to be able to deal with all of it.

'Mimi' 42:45
So yes and no, okay, there are ambulatory places like you can just walk into a mental health facility. Depending on the type of crisis you're having, they're going to send you to the ER anyway to make sure it's not a medical emergency first. So, like if someone is extremely intoxicated on drugs or alcohol, they can't be in those mental health facilities. Because if they were to withdraw, it would be a medical emergency, and they would be at an inappropriate place. We just had, a lot of people get really bogged down by the mental health patients coming into the ER. But sometimes we find that it's not a mental health crisis, you can have hallucinations because you have a brain tumor, not because you're bipolar or schizophrenic.

Scott Benner 43:33
I say. So you like the idea that they come to a centralized place where everybody where people have like a medical background? Yes,

'Mimi' 43:40
I like it to the extent of medically clearing and then getting them out. As soon as they're medically clear, which doesn't happen. Patients can be medically cleared and then still sit in the ER for 48 to 72 hours before an inpatient bed opens up in a mental health facility.

Scott Benner 43:59
So do we have a lack of facilities or too many people who need them? Both? I never have one of these conversations and feel good when they're over by the way.

'Mimi' 44:08
I know. Yeah. I've

Scott Benner 44:09
never like oh, good answer. I've actually never had anybody give me an answer. I recorded with a seat a CDE the other day, who has type one? And at the end, I said, What do you think the answers are? And they're like, I don't think there's an answer to this problem. I'm like, Oh, great.

'Mimi' 44:25
Yeah, it's really tough too. Because even if there were enough facilities, there wouldn't be enough nurses. So and the nurse shortage is not a shortage of people who want to be nurses. It's a shortage of people who want to be paid appropriately for what we're dealing with.

Scott Benner 44:44
So it's an underpaid. You find it to be an underpaid profession. What's a nurse make?

'Mimi' 44:50
Because I'm anonymous. I started out as it's considered a new grad because I'm fresh out of school despite my years Have Tech experience. I'm still a new grad. Right? I started out at 34. Oh, for an hour, I got a significant lump sum to move as far as I did, and a sign on bonus and housing savings.

Scott Benner 45:15
Oh, okay, slow, slow down for a second. When you were a tech, what did you make an hour?

'Mimi' 45:19
Oh, gosh, around $20 an hour. So

Scott Benner 45:23
about the same age. That's insane. Okay. And then minimum

'Mimi' 45:27
wage where I was living, I did get benefits, but I still had to pay a significant amount out of pocket for, you know, all of the

Scott Benner 45:35
things Yeah. Then you became a nurse, they moved you all the way up to 34. Oh, that Oh, force insulting, by the way, 3404 to be a nurse. And then that was east coast, then you kind of went middle of the country. So the middle of the country would be 3404. That was the day that I received at my old job where I was the tech was, I

'Mimi' 45:55
think $29 Oh,

Scott Benner 45:57
they bumped you up to 29. You said no, I'll go I'm going to take the extra five an hour and go to the move across the country. They also give you a bonus and a moving stipend. Would you tell me what it was?

'Mimi' 46:06
Yeah, so my sign on bonus was $10,000, which is taxed. My relocation bonus was 8000, which is also taxed, right. And then I got a housing stipend of $1,000 a month for nine months, which is also taxed, but still.

Scott Benner 46:21
So they basically gave you 28 $27,000 tax. I'm just gonna knock 30% off of it just for the fun of it here. So okay. And that was to move uproot your entire life versus staying for $29 an hour.

'Mimi' 46:37
With no sign on bonus, no incentive to stay nothing,

Scott Benner 46:42
nothing to get you moving. Do you actually still have some of that money in the bank?

'Mimi' 46:45
Yes. And no, I acquired a pretty significant amount of credit card debt during nursing school because of medical supplies. Because I had to pay rent, which where I was living, I was paying like $2,200 a month for a 600 square foot studio. I actually sold my car and it was like commuting by bike. So I didn't have a car payment. And I was still struggling to make ends meet.

Scott Benner 47:10
So you were working hard and making concessions. And you still had to use credit cards to get through school. Yeah. And then the bonus, you got to move the credit card debt wiped that out, basically.

'Mimi' 47:21
Yeah, that and like, it's expensive to move. The place that I lived in when I first got here, which I actually just move out of, I had to pay first last and a deposit upfront to move it. And then I actually only moved here with what fit and who suitcases and my dog. So the moving like of things was very inexpensive. It was just my flight. Yeah. But yeah, it was like $8,000 upfront to move into where I was living. And that doesn't count furnishing anything. Yeah. So

Scott Benner 47:51
what kind of dog fits into the luggage? He's

'Mimi' 47:55
a miniature Doxon. So he rides in a plane with me, like under the seat in front of me. Okay, that's like, how

Scott Benner 48:00
are we flying with a dog? Okay, that makes sense. Wow. And then you get there. 3404 an hour.

'Mimi' 48:08
Yeah, so that was my, that's my base pay. I've since gotten a raise. Because I've been here, I think it was either a market adjustment or like the annual raise, but the hospital gets, which was a whopping 71 cents. And then there's also shift differentials. So I was hired as night shift. But for my first three months, I was on day shift for orientation. I would work between 24 and 36 hours a week. And then I also had classes. So as a new nurse, you have to do like residency classes, we call them. And it's basically just like learning how to use equipment and like, basically procedures and protocols for different processes. I guess you could say like, there's a whole seminar on, like, blood gases and like our DKA protocol, which is actually I love but a lot of people find very confusing. So there's a whole class for it. And then we have classes for neonatal emergencies trauma, if someone's in cardiac arrest that like process. So there's a ton of classes you have to take right up front when you start as a new grad. So I was doing like 40 hours a week between classes and working at the bedside. And then once I finished all those classes, I was just at 36 hours a week and could pick up as much extra as I wanted. But once I came off orientation on next shift, so it's an additional, I think 460 an hour on night shift. If it's a night shift weekend, I believe it's 760 additional an hour. And then there's we also have like evening shift, so 11am to 11pm 3pm to 3am. That gets a different differential and stuff. So the only time I'm actually making 34 Now 75 is if I work a 7am to 7pm shift which She's not hired for so that's not why are you not making $70,000

Scott Benner 50:03
a year? Even? No. 60

'Mimi' 50:07
I think it's, uh, ah, it might have been 70. Okay, because I looked at my year to date, and that's including all my stipends and stuff, and I was like, around 97.

Scott Benner 50:18
And so and then you're gonna lose about 15% in tax, I'm actually googling this. So in 70,000, you'll lose about 15% in taxes. What's that, like? 10 grand? Yeah. And so, you're gonna, you're gonna walk away with 60 divided by 12. Hold on a second. 5000 a month? How much is your rent?

'Mimi' 50:39
So before when I was getting my stipend, it was 2240 because I decided I wanted a house with a yard for my dog, silly. We're in a cooped up, cooped up apartment before. We're back into an apartment now, but it's a much nicer one way more than 600 square feet.

Scott Benner 50:55
So now I'm paying about 1400 Okay, so you're losing 1400 Off the top for rent. I gotta imagine do you eat food? Right?

'Mimi' 51:04
I do. Yeah. So

Scott Benner 51:05
what do you $400 a month for food?

'Mimi' 51:08
That's what I budget. Yeah.

Scott Benner 51:10
Uh huh. That's what you budget. I heard what you said there. Do you have a car? I do have a car.

'Mimi' 51:14
Is there a payment? Oh, there is a steep payment? Yes. How much? 656 50?

Scott Benner 51:20
Got insurance. What's that? Like? $100 a month for car insurance. 131 30. Gas.

'Mimi' 51:30
I actually don't use a ton of gas.

Scott Benner 51:32
Let's say 100 a month? Yeah. Okay. Electric. Couple 100.

'Mimi' 51:40
Yeah, let's see my utilities. I bought 175 Because most of its incorporated in my 1400 for rent. Okay,

Scott Benner 51:50
so when you are all said and done. You've made what, like two grand left at the end of the month? About? Yeah. Okay. And so you have to work a year of your life to save $25,000. And that's if I get to save it. Yeah, but I'm gonna say you're not really gonna have $25,000 a month at the end of the year. Yeah, right. Okay. Yeah, yeah, we should ask people to be nurses is.

'Mimi' 52:17
Exactly. And like, there is a great appeal. I won't even live with this schedule. So keep in mind, that's an income working only three days a week. So I guess my 97 is actually mildly skewed. Because I work a lot of extra to get to that. Not every single week. But like, around Christmas, I worked 120 hours in 10 days, because I couldn't go home to see my family. My boyfriend went home to see his family and like, my friends hear from work. So I was like, I don't want to sit at home on my couch by myself on Christmas. So I'm just going to pick up extra go to work. Yeah, so yeah, I worked a lot of extra once I came off orientation. Summers are like trauma season. And since I was fresh off orientation, I was like, super eager to learn all of the processes, all of the equipment we use, which I now feel feel very comfortable and competent. And like, I am the most fit person to be in those scenarios, which is a great feeling after only being a nurse for a year. Not to like boast member riches here. But like, I feel very comfortable in my ability and my skill. Yeah, what you're doing. Yeah, so a lot of extra got me to 9070. Yeah,

Scott Benner 53:30
a lot of extra to get to that number. So I have to tell you, what strikes me over and over again, while we were just doing that little exercise is that if you're helping four people in a shift, I'm guessing that the hospitals being is billing those four people. And it's incredibly possible that your effort makes more money for the hospital in one day than they pay you in a year. Yeah, without a doubt. I mean, like he would probably work for a percentage. Yeah. So

'Mimi' 53:59
I don't want to call it to work around. But the way that people are making more is by leaving, like nursing as a hospital employee and going to an agency. So you can do like local travel or travel nursing and you'll make just about double you.

Scott Benner 54:17
That's insane to me, like why does the hospital just pay their good employees and keep them?

'Mimi' 54:22
No one knows. It's a it's a losing battle. We've been asking this question for years, because even before COVID Travel nurses made significantly more than staff nurses do. And you don't even have to travel. One of the travel nurses that I work with currently. He's been at my hospital for over a year, and travelers contracts are typically like 13 weeks. So he has to take like a week off in between and then he just signed another contract with the same hospital.

Scott Benner 54:50
It's not crazy to say either that if you went to your boss and said, Hey, look, I'm a good employee, pay me more money. Give me double. They'd say no, but you said if you said okay, well I'm gonna leave and Go to a become a travel nurse that they'd hire you back as a travel nurse. Oh, and they do it all the time. I'm glad everything makes sense. Nothing makes everyone jump out the window. We're in trouble. That's all. So, yeah. Okay. Yeah, it's not it's not it's a lot. It's a, you know, this is exactly the same when I talk. There's a therapist that comes on Erica, we talked about people's problems. And I this is exactly how I feel at the end of the hour with her to like, oh, just, yeah, it's such a multifaceted issue. Really layers, so many problems with all of it, like healthcare, hospitals, nursing,

'Mimi' 55:42
there's at least 100 Problems per each of those. Yeah,

Scott Benner 55:46
that we could sit here and drill down and talk about a lesson. If you're going to become a nurse, maybe you should want to do it. Maybe we can drill down at the doctor sign goat, maybe you can leave your ego aside and actually, you know, stop acting like you're God's gift of the situation. You could look at the institution and say, Hey, why don't you take a little less money and pay all these people so they could actually give people good service? And maybe you make people healthier? The patient's you could say, hey, what if you had a basic understanding of common ideas about health and took care of yourself a little bit? Oh,

'Mimi' 56:18
my gosh, yeah, the lack of knowledge that I didn't understand, that most people had about their body is absolutely insane to me, like, obviously, I've been diabetic for just over 20 years, I had no idea that most people didn't know how to read a nutrition label. One of my friends is a teacher for a like, they call it a nursing program, but it's for high schoolers. So it's a like, tech center type situation where they go there for their senior year of high school and get, you can get a CNA or nursing assistant, you can do cosmetology, you can do diesel mechanic. There's all different types of like, skills you can go into. So she teaches the I'm doing air quotes nursing program there, and one of her students as a type one. So of course, she like called me and was like, Hey, do you drink, like Powerade and Gatorade and stuff regularly? And I was like, no, like, I think this year was the first time in my entire life, I'd had Gatorade that wasn't like the zero or like G two or whatever it's called. Right? And she's like, Yeah, my type one has been drinking it like almost every day. And I asked her if she was like doing insulin for it. And she said, No. So she took the power a bottle and looked at the nutrition label. And she's like, said 36 grams. And I was like, Yeah, and that's only per serving. And there's two servings in that bar, sometimes two and a half servings in the bottle. Yeah. And she was absolutely blown away by that. I'm like, Yeah, that's like, you have to look at the servings. She was like, Well, I never really thought about that. Like, ah, the luxuries of not being a diabetic.

Scott Benner 57:57
You know, I saw somebody eating like nachos. Right? Em from from a, from a from a restaurant. They give you a bowl of queso. It's like a softball size of, of liquid cheese. And I thought that's more liquid cheese and you're supposed to eat and five years. And yeah, no, no. And they're just in there like dip in and eaten and dip and eat. And I'm like, Oh my God, you're gonna die. Like you're asking.

'Mimi' 58:24
Literally, I went to Trader Joe's has probably been a while now. And I got they have a frozen like barbecue teriyaki chicken. And it has a lot of protein and not a lot of fat. And so I was checking out and they're like, Oh, why do you get this over? Like the orange chicken? Like, oh, it's like 20 grams less fat per serving. And they're like, Oh, interesting. I've never even looked at the label. And I was like, Oh my God, because the

Scott Benner 58:49
orange glaze is sugar. And then the your body metabolizes the sugar and makes it and stores it is fat. And yeah, these are not big ideas. So not

'Mimi' 58:58
at all. And it's so like, I just like, I don't know why anything surprises me anymore. Like, especially working in the ER, maybe it's because in the ER, I expect people to not know things. But like out in the real world. I think like, Oh, these people have made it this far. Like, they know basic things. But they don't. Yeah, and It shocks me every time.

Scott Benner 59:21
Yeah, don't stop being shocked. It's about opportunity to learn things. Yes. And it's the stuff that no one talks like people don't talk about this stuff. They just they don't like the makeup baby, you feed it something you can afford. You know, you make a little more money or you don't you you know that's the way your food goes. You're not a nutritionist you've never nobody's ever talked to you about this before. And all of a sudden, healthy just means you know, we this is what we eat here hopefully means like, alive and not having to see a doctor frequently right? It's the same exact problem. As when I say to somebody hey, like how's everyone seeing they go? Oh, it's good. Like I learned in the Beginning of making the podcast not to stop at that, I'd say what is it? What's the number? Because the astonishing a number of people who told me that their agency was good, but then told me it was eight and a half. And I was like, well, good compared to what they'd say won't good compared to where it started where it started. I was like, on 11. Now it's at eight and a half, I'm doing good. And I'm like, No, you're doing better. Words are important. And you know, like, like, You're doing better, you're not doing good. Good is, you know, in the fives. Yeah, pretty goods in the sixes, I need help is in the sevens, eight and a half. It's not, I'm doing pretty good. You know, you know, eight and a half is I'm going to be in this emergency room one day, with, you know, some sort of, and they don't know that they don't know that if you live if a type two, for example, lives with an eight and a half a one see their whole life, that by the time they're in their 50s, they are 100% going to be in a emergency room talking to you. Without

'Mimi' 1:00:53
a doubt, and it's not even likely going to be a diabetes. Crisis. Right? It'll be going to be a secondary problem.

Scott Benner 1:01:02
Renal? Cardiac. Yeah, right. Yeah. Yeah. And

'Mimi' 1:01:07
a little blister on their foot that's now turning black and they can't feel it. Yeah,

Scott Benner 1:01:11
right. Right. Look at all the stuff that comes along with that, that nobody. You can say nobody teaches you. But you know, when the stuff I know about diabetes, I had to teach myself. And is it they didn't teach you or you weren't willing to learn? And I do want to say, and sometimes people don't have the capacity. I don't mean that in a harsh way. Like, there's some people who just their minds don't work that way. You don't I mean, they're not going to be inquisitive about things they maybe don't have, you know, that kind of desire. It's not I don't think of that as purposeful, by the way, like, that's where I want somebody to step in and do something, right. And it's funny, because in my heart, I want the person that the hospitals step up and go, hey, here are the things you probably don't know about your life and health, except what you're telling me is that even if you did that, you think what you'd get mostly is go to hell give me a pill, I gotta get out of here.

'Mimi' 1:02:00
Exactly. That is exactly right. Like, I am always stunned by people who come to us for help, and then refuse what we're offering, because they read somewhere on the internet that this is a better option. And that's what they want. And we always kind of joke as nurses like, this isn't the drive thru, you don't get to come here and tell us what you want when you're asking for our help. Because if you knew what you needed, and we're capable of getting it, you wouldn't be coming to us for the hair. Like, yeah, this

Scott Benner 1:02:31
is a never ending.

'Mimi' 1:02:33
Yeah, we get traumas that come in all the time. And granted, they might not be the most severe trauma they've ever sustained. But they were transferred to us either from an outside hospital or from seen based on the mechanism of injury. And they decided that they needed a higher level of care of trauma care, which is us. And it's typically with spinal injuries. So this one very specific one I'm thinking of this man was on a trampoline. His two small children were there. I think they were like, five and eight, maybe. And he dove into a shallow pool off of the trampoline, and had temporary paralysis and his kids had to pull him out of the water. Oh, he came to us with a neck brace on me calm see collars, a cervical collar. And he kept nodding yes and no. And it was making me so angry. Because I'm like, if you have a spinal, specifically a cervical spinal fracture, and you keep nodding yes and no, you could be paralyzed forever. And I probably overslept a little bit here, we were over in CAT scan. I told him many times to stop nodding yes and no. I grabbed his cheeks and got really close to his face. And I was like, you have small children at home. I don't want to see you paralyzed because you weren't listening to me. Stop nodding yes and no. And like a tear, just like rolled down his face. And he stopped. And I was like, I'm sorry. I had to say it that way. But we see this all the time. Yeah, you're here for a reason.

Scott Benner 1:04:09
Yeah, it's so funny. It's funny, because I see like both sides have, like you said, like, you know, you're here and you're not going to do the thing. And but that person could easily make the the the argument and a real, very real argument. No one's ever told me that before. I know, you think it's something I should know. But I don't know that thing. And no one's ever said it. So that's where we're at. We're, it's an impasse like, medical people should be telling every person that they intersect the thing that they need to hear. And either that person takes that information and does something with it, or they don't, but you don't have the time for that. So you're going off of what you mostly see. And that's how the people who could be helped get missed. Exactly.

'Mimi' 1:04:51
Yeah. Like he was transferred from another hospital that was letting him like, walk around and like go to the bathroom. And I was like you absolutely will not be getting upright until we have your CT results. They transferred you here because we know more than they know. And we're going to treat you the way that we're supposed to treat you and that I'm sorry is not going to make you very happy. But you have to listen to us. And he was like, Okay, you're right. And I was like, Oh, am I really? So

Scott Benner 1:05:20
maybe what should I ever told me that before I fill up my car with those little packing peanuts, right? That way, if I have an accident, nothing happens to me. And then I never leave the ground floor of my house and get a house with those steps in it. And then I try to stay out of that. And I don't need 17 servings of Gatorade and I tried to stay out of hospital. This is what I'm trying to do this size of melted melted cheese. Ask yourself why does the cheese not coagulate? Yeah. Why? It's liquid? How is it doing that?

'Mimi' 1:05:54
Right? It was solid at one point. Not going back to solid. Like what's happening? Ask yourself what's in it? Yeah, why is it staying liquid like this? Okay, all right. I'm

Scott Benner 1:06:06
done. Good. Thank you. Did I miss them? Did I miss any out of my mind? But this? Why did I think this was a good idea? Why did I think having people on to tell me what was wrong was going to be a great idea. For me. It's bad for my soul. It's

'Mimi' 1:06:19
bad for everyone's thought and our mental health because I can say all of these things until I'm blue in the face and nothing will change. Nothing

Scott Benner 1:06:26
will change. Yeah, yeah. Okay. Well, then this is for the people who are going to take some sort of control of themselves and their lives and and try to avoid this stuff. Yeah, now, I hope so. Having said this, and I do like to reiterate this every time I can think of if I'm having an actual emergency. I should still go to the hospital, though. Oh,

'Mimi' 1:06:49
absolutely. Yeah. And I don't want to like drag anybody but in our Facebook group. For the podcast. There's people all the time, like questioning certain things like if they should go to the hospital. And more often than not, I'm like, Oh, my gosh, is this even a question? Like, I cannot believe that people would think not to. But I've also worked in other ers where I can absolutely see how going to the ER would be doing a disservice to them. But especially adults in the UK, we are not resilient, like children are like when I was diagnosed, my blood pH was 6.9, which is not survivable, like that is not compatible with life. So if my PH were 6.9, now, I would likely be dead. As a kid, you're much more resilient, you bounce back, your body can compensate a little bit better. But as an adult, if I even like if I'm sick, and even if I don't have ketones, my blood sugar is fine. If I follow up, I get very nervous. Like, okay, if my blood sugar goes low, and I can't keep anything down emergency, if my blood sugar is high, I'm giving myself insulin, it's not coming down. I'm throwing up emergency like, I see that all the time. So I understand I have a different understanding of it. But it is frightening. And like, we are very fragile people like not diabetics, but just humans, like humans are fragile. You don't have those compensatory mechanisms that children have. So if something goes sideways, it can go sideways and stay sideways forever. Like some things you just like, can't come back from. Like, I'm always scared, like, oh, one more like running with DKA kidney failure, or retinopathy. Like there's so many irreversible things that can happen. heart attacks and strokes, especially because we're diabetics. Like, we're very fragile.

Scott Benner 1:08:51
For my money, I like being prepared ahead of time, I have a small group of good doctors that are local to me that we have, you know, become patients of so that when we have certain problems, we're not searching. First of all, we know where to go to get somebody to help those same doctors can be helpful for you, when you're going to emergency situations as well. You'd be surprised that calling your GP who is actually a good person saying hey, here's what's wrong with me, I'm going into the hospital, could you call over there and let them know I'm coming, that actually helps getting to a hospital system where your doctor is affiliated with that helps. There's little things that you can do to be ready. You could also you know, do a little bit of research so that you know how things are handled at certain emergency room situations like what what are they going to do for me if I come in there and DK? How are they going to handle this? What do they know about this? I don't know. I just I like to be as prepared as possible without being a prepper I don't have a truck with a 700 gallon gas tank on it that only pulls fresh water in case zombies come or anything like that. But I do know where I would go if there was a problem, right? And you know, even at that you don't realize you could be Three miles from four hospitals and only one of them's a decent hospital. And you wouldn't know that. You know?

'Mimi' 1:10:06
Yeah, I am always done. There's a few very, very, very small hospitals that are not associated with any large or larger hospitals nearby currently, and the transfer patients to us all the time. And I'm like, It's a miracle, this patient made it to us alive. Like, I didn't even know that this place existed. Until right now they're telling me that this hospital down the street was taking care of this patient, and they're like, knocking on death's door. I'm like, how are they allowed to be a hospital? Like, how have they kept their doors open for this long. And God forbid a patient who doesn't know anything about the area has a medical emergency and goes there, like, it is terrifying to me. Granted, we do have a large house, we have two very large main hospital systems here, that span I believe each of the two systems has at least four emergency rooms and two major hospitals. There's plenty of resources around and if you were visiting the area and you good old er near me, it's not going to take you to that little rinky dink one that scares me, it's going to take you either to my hospital or our neighboring Hospital, which will can provide excellent care. It's astounding.

Scott Benner 1:11:25
I would like to remind people at the end here that you are a human being with all the fragility and that comes with that and so is the person you're going and asking them to help you those people are our people, you're a person, you have limitations, they have limitations, the best thing you can do is know as much about your situation as possible. Advocate for yourself till the very end. Never give in. Don't be mean always push. And at the same time. Remember, you're just asking another person. It's not like Mimi's not a magic fairy. She's a girl wanted to make a little more money. So she became an RN. And then she moved across the country to make $6 more an hour. And she just wants to go home with her dog and not sit on her sofa and be bored. Yeah, and have some grass to run in just like you. Exactly. She's not a wizard, you're not going to a wizard and telling them that you you know, Please grant my wish for me. I'd like to feel better now. So anyway, whatever. I'm sure people are gonna hate me by the time this is over. But I appreciate you doing this very much. Thank you very much.

'Mimi' 1:12:29
Yeah, and honestly, note there like the rinky dink Costco I'm talking about that is not an attack towards their staff at all. It's just like a lack of resources, lack of exposure to a lot of stuff. Like they can be very competent nurses and doctors, but they don't have the exposure to what other nurses and doctors have or the resources to adequately treat these patients. So like, they're not bad providers. They're just in a bad situation. And

Scott Benner 1:12:56
but and once you get there, you're in that situation right along with them. Yeah, yeah. Okay. I appreciate this. Did you enjoy being called Mimi?

'Mimi' 1:13:03
Yeah, I do enjoy being called Me. Me. Alright. Well, if I remember grandma go by

Scott Benner 1:13:08
Mimi. Well, you know, first we gotta get you out of that apartment with just you and that dog. Alright, that's not gonna happen. Yeah.

'Mimi' 1:13:15
Alright, thank you so much. Yeah, absolutely. It was good talking to you. You too.

Scott Benner 1:13:26
Arden has been getting her diabetes supplies from us med for three years. You can as well, US med.com/juice box or call 888-721-1514 My thanks to us med for sponsoring this episode. And for being longtime sponsors of the Juicebox Podcast. There are links in the show notes and links at juicebox podcast.com. To us Med and all the sponsors. A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com Ford slash juicebox. you spell that GVOKEGL. You see ag o n.com. Forward slash juicebox. A diabetes diagnosis comes with a lot of new terminology. And that's why I've created the defining diabetes series. These are short episodes where Jenny Smith and I go over all of the terms that you're going to hear living with diabetes, and some of them that you might not hear every day, from the very simple Bolus up to feed on the floor. Don't know the difference between hypo and hyper will explain it to you. These are short episodes. They are not boring. They're fun, and they're informative. It's not just us reading to you out of the dictionary. We take the time to chat about all of these different words. Maybe you don't know what a coup small respiration is. You will when you're done. Ever heard of a Glice See make index and load haven't doesn't matter. You'll know after you listen to the defining diabetes series. Now, how do you find it, you go to juicebox podcast.com up top to the menu and click on defining diabetes, you'll be able to listen right there in your browser. Or you'll see the full list of the episodes and be able to go into an audio app like Apple podcasts or Spotify and listen to them at your pace. Download them into your phone, and listen when you can. The defining diabetes series is made up of 51 short episodes that will fast forward your knowledge of diabetes terminology. Thank you so much for listening. I'll be back soon with another episode of cold wind. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome. Type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com