Episode 5: Empowering Nurses for Change

Cara Lunsford (00:01.757)
All right. Hello, Dory.

Dorrie K Fontaine (00:05.582)
Hello.

Cara Lunsford (00:06.481)
I'm so happy to have you. Okay, so I got your information in the most interesting way. Yeah, so I have a friend. This is a weird, it's kind of a weird thing. I have a friend, his name is Paul Jaglowski. He's a founder of Feed Trail, which is a real time insights platform for patient and employee engagement.

He works within a lot of hospitals and it's a tech company. And I happened to be in Virginia for a conference and he said, you have to meet up with my cousin. My cousin has this pizzeria and he'll host all of you guys. He'll host, just go to this pizza place. So I go to the pizza place and I meet up with his cousin and his cousin.

was actually, so it was his brother's pizza place, but this cousin was there kind of holding down the fort. And so he started telling me, he said, have you heard about, you know, Bill Conway? Have you heard about the car look? Have you heard about the money that's being given back to nurses and this investment in nurses? And I said,

No, I have not heard about this. So he starts telling me all about it. And then he connected me with somebody else. And, and we were on this text exchange. then it was Zach, Zach. Yes. And so then he said, I know who you need to talk to. You have to talk to Dory.

Dorrie K Fontaine (01:40.142)
12.

Dorrie K Fontaine (01:49.233)
Yeah, that was great.

Cara Lunsford (01:51.774)
And I was like, wow, we took all these twists and turns and weaves and everything and here you are. Here you are, just here you are.

Dorrie K Fontaine (02:00.258)
I know, here I am. Great, yeah, Zach works for Mr. Bill Conway, I'll call him Bill, and he is helping Mr. Conway give away a billion dollars to nurses.

it's really quite a wonderful job to be a consultant with them, myself and another dean. And Elizabeth Minnick is our executive director, so we're kind of a small group, but with a very big mission.

Cara Lunsford (02:24.752)
Yeah.

Cara Lunsford (02:34.491)
That is a huge mission and something like so near and dear to my heart personally. so we'll get into all of this. I'm sure that the listeners are like, wait, what? A billion dollars? Tell me more about that. How do I get some of that? But I would love to start with just learning a little bit more about you.

Dorrie K Fontaine (02:36.263)
I know.

Dorrie K Fontaine (02:47.128)
Yeah.

Dorrie K Fontaine (02:50.419)
Yeah, exactly. I know. Yeah.

Cara Lunsford (03:00.935)
So, you know, maybe just give me a little bit of history of, of your, a little bit of your career and how you get to got to where you are today.

Dorrie K Fontaine (03:08.782)
Yeah, sure.

Sure. Well, I've been a nurse for, you know, five decades now. I'm from Long Island and I went to school outside Philadelphia, Philanova, and I'm on their board now too. And I went into critical care. I think you're an ICU nurse too, right? From the past?

Cara Lunsford (03:30.201)
I did pediatric, so I did pediatric oncology mostly focused on PEDS onc and although that feels like intensive care sometimes. But don't put me with a vent. I'm no good with the vents.

Dorrie K Fontaine (03:37.996)
Okay.

Dorrie K Fontaine (03:42.572)
Yeah, I know. It does. Yeah. So I'm...

Dorrie K Fontaine (03:50.804)
yeah, no, I love patients that need a lot of attention and families. They're all attached to families. so I did intensive care, critical care, was a clinical specialist in that and worked eventually at Shock Trauma in Baltimore, know, with the sickest. But I was also on the academic side. Sorry about that. I was also on the academic side.

and started teaching in like 1978 and just fell in love with it because you could take care of the patient while you are helping educate say eight brand new student nurses and I just loved it. So then I worked my way up in leadership in academic settings all across the country and probably my most meaningful experience was being involved with the American

Association of Critical Care Nurses where I ended up being president about 15 years ago, right when they were coming out with how we really should have a healthy work environment. So nurses will stay at the bedside, patients and families will get quality care. And so I've dedicated the last two decades to that. And I've brought healthy work environment principles, which really is about respect.

how we communicate, how we care for one another, how we develop authentic leaders. I've brought those principles from the bedside now into schools of nursing, which have not always been known as places where people can thrive. So I have done that at several places, most recently being dean at the University of Virginia, which was a wonderful experience.

and I could put into practice just declaring, hey, we're going to be a healthy work environment. And they hired me, and that's what we did. I kept talking about it, and the staff and faculty were very intrigued. And right away, a generous donor sent me and 15 other docs and nurses to a place called Yupaya.

Dorrie K Fontaine (06:14.734)
7200 feet up in Santa Fe, a Zen Buddhist retreat for an eight-day silent retreat, believe it or not, on, it was called, Being with Dying. But it was really about living and how to live. And I was introduced to mindfulness, meditation, what does it really mean to be in the world, be present, and so I came back like, wow.

Cara Lunsford (06:23.719)
That sounds amazing.

Dorrie K Fontaine (06:43.464)
and brought all those concepts into University of Virginia and a couple of the docs and nurses, just started this Compassionate Care Initiative and it's still going on, which is about how do we alleviate suffering to produce compassionate caregivers and systems. And right now there's a big push about the system. So that's kind of...

Cara Lunsford (07:07.527)
Yeah.

Dorrie K Fontaine (07:09.482)
me in a bit of a nutshell. And now I write books on self-care with my colleagues and they're actually big sellers.

Cara Lunsford (07:18.927)
I'm so calm just listening to you. I feel like you just have this beautifully calm energy about you and I can see why you've been so successful at what you've been doing. And I could not agree with you more about how important it is to help teach people.

Dorrie K Fontaine (07:26.247)
well, thank you.

Cara Lunsford (07:48.261)
like compassion and empathy and that there's an ability to hone this kind of as a skill. Interestingly enough, I'm working with a founder right now of a company called Impathable. You would love this story. You would love this. I'll definitely have to connect you with Micah, who's the founder of Impathable because what

Dorrie K Fontaine (08:10.358)
Yeah, please.

Mm-hmm.

Cara Lunsford (08:15.441)
they do is they've created technology that it's called walks and paths. And it allows people to learn kind of to walk in another person's shoes. And that's a challenging thing to do. You know, it's challenging to say, well, I know what you're going through or I learned early on in my career that, you know,

when I'm talking to grieving families and parents who have lost their children, that there's things you don't say. You don't say, well, they're in a better place, or I understand how you must be feeling. There's just things you don't say. But that's something that's very hard for new nurses to learn if they don't have an opportunity to practice it.

Dorrie K Fontaine (09:12.782)
Right. I agree. And I've seen, yeah, excuse me.

Cara Lunsford (09:13.469)
You know? Yeah. And I, yeah.

No, that's kind of my thought is that like there's these new ways of hopefully with technology and with AI and with stuff that the students will be able to learn certain communication tools and kind of develop that emotional intelligence.

Dorrie K Fontaine (09:23.543)
Yeah.

Dorrie K Fontaine (09:31.128)
Mm-hmm.

Cara Lunsford (09:49.017)
and that compassion, I'm hoping that that's what technology brings us, or at least leads us towards.

Dorrie K Fontaine (09:54.414)
Well, I'd love to hear more about it. I'm probably not as technologically savvy as I could be. However, I think the assumption is that nurses are just naturally empathetic and compassionate and actually.

Not everyone is, and these are skills that we can teach. And a lot of it is based in mindfulness, which the first thing is paying attention and learning about how to focus, be present, and then being curious and noticing.

Cara Lunsford (10:21.49)
Yep.

Cara Lunsford (10:26.013)
Hmm?

Dorrie K Fontaine (10:29.964)
And then finally, really speaking up and having courage, which, you know, there's many, many steps in there. But that's what we started to teach at the University of Virginia. We took every student out on a retreat. We had a beautiful farm, know, Virginia's in the countryside here, a beautiful farm that was also donated to University of Virginia. We take the students out and it was part of the curriculum and it wasn't a day off.

was a day to really reflect and consider this career that you've chosen. Well, it really was wildly successful. Everybody wanted to go out on these retreats. We taught mindful eating, relaxation. There was some yoga. We put out the mats and the blankets. And 30 students would.

Cara Lunsford (11:14.663)
Yeah.

Dorrie K Fontaine (11:25.186)
be laying there and all of a sudden you'd start to hear all this snoring, which is fabulous because nurses are chronically sleep deprived and having people pay attention to themselves so they could be better caregivers for others has been our mantra. Let's take really good care of the students and the faculty and role model that.

so that when they get out in the clinical setting, they'll know that they really matter, they're special, and they know how to take deep breaths before they go in a patient's room to do that big dressing change, or anything before they talk to a family about some news that isn't going well. So I think the signature of one of our University of Virginia graduates was that they had a deep...

know, grown up understanding of what it means, the serious job they have, and that they better take care of themselves because the work environment is tough. And I think it's been, very kind, very kind.

Cara Lunsford (12:30.023)
Dory, where have you been all my life? Where have you been all my life? I'm just, no, I mean it so authentically and because I feel like I've been kind of looking for this. I'm like, how?

This is something and probably why I've gravitated towards empathable why I've gravitated I in early in my career. I started the supportive care committee at the hospital when we had to join a committee when you become a Clint to and then they say, okay, well, you have to find a committee and and I've told this story before. So the listeners are like, yeah, we know you started supportive care committee. But

Cara Lunsford (13:22.485)
that was something that was really near and dear to my heart because I found that my colleagues were all numb. They were becoming very numb. And they didn't, they didn't know how to connect. They, it was like, if I, if I start feeling things, well, that's like Pandora's box. Like, what else am I going to feel?

What trauma, what sadness, what grief, what, if I, if I start to allow myself to feel things, what is that going to unleash for me? The very first episode that we did for this podcast was called caring while grieving. And, it was, I interviewed a friend of mine actually, who was a charge nurse at children's hospital.

And at one point her husband had been diagnosed with pancreatic cancer. And so while she was in the process of caring for others and caring for our families who were grieving and were potentially going to lose their children, she was in the process of grieving herself and in the process of having to care for her family and for her children. And so we explored that because

I think that nurses are doing that all the time. I think they are always caring while in a state of their own grief or their own trauma. And how do you strike that balance? You know?

Dorrie K Fontaine (15:06.904)
Yeah, I think you're bringing up an amazing point. You nurses have lives. I have written about how I think rather than talk about work-life balance, I focused a little bit more on how to integrate your lives so both sides can enhance each other. The surgeon general is talking about work-life harmony, which sounds...

kind of happy, but you that balance of you really separate. And some nurses really insist they're able to do that. They leave work at work and when they're home, they're home. But too many wake up in the middle of the night worrying about that patient and family or they go to work worrying about their sister who has cancer in a thousand miles away.

And so I think the trick is having a good understanding of each other as persons and actually getting to know each other. It's that human connection. None of this is rocket science, but making sure that you do connect at work. And that's why I always talk about the nurse manager as the real key. They set the tone, he or she.

Cara Lunsford (16:13.991)
Yeah. No.

Cara Lunsford (16:28.306)
Yes.

Dorrie K Fontaine (16:29.454)
that it's really important that we know each other and that we celebrate each other. And that's what I tried to do. And the faculty was to really get to know each other. By the time I left, I had had 100 birthday dinners at my house over 10 years, every single month. And I learned it from a dean in San Francisco.

every single month I'd have like all the Libras, you know, in October, the Libras would come to my house. Yes, good, me too. October 5th, how about, coming up, well, do something fun. And what I found was that, you know,

Cara Lunsford (16:59.015)
That's my birthday. What's your birthday? mine's the 22nd. Yeah. Happy birthday.

Dorrie K Fontaine (17:14.546)
birthday you don't have to do anything. I mean you don't have to write a grant, you don't have to win an award, you know it's your birthday. So I would invite staff, faculty, and you know the biggest hot shot researcher would be sitting next to receptionist and people do not know each other even in a small school. We had about 140.

Well, and I tell them to bring their husbands or significant others and they were just blown away. Now I lived in a big house the university gave me, so I was supposed to entertain. But it just, some people came for the whole 10 years, you know, and they got to know each other in new ways. It was all about connection.

And then the next day at work, I could see somebody and they had just been at my house and I could say, you know, what do you think about being on that committee? And I wasn't being manipulative. I was just like, well, now I really know you and this would be good for you. Anyway, it was a great strategy. think it's hard to keep it up, but it brought me and the school a lot more benefits than just, gee, we have to have the dinner tonight. Plus my husband loved it.

Cara Lunsford (18:12.445)
Yeah.

Dorrie K Fontaine (18:28.108)
He is very social. So, good strategy.

Cara Lunsford (18:30.461)
Me too. My wife would tell you that I'm very social and very, it's ironic that I am the VP of community because that's probably what would have gone on my headstone anyway, that Kara was VP of community. I can't tell you the number of people that come and go out of my house. I have a man who has been living with us for the last two and a half years. He was homeless.

Dorrie K Fontaine (18:44.64)
Yeah, that's good.

Cara Lunsford (18:59.357)
I met him at a Starbucks and he was 71. He was completely debilitated. And it's amazing because I always joke and say that he has like nine lives because we've recovered him out of a variety of things and now he's thriving and he'll live with us for the rest of his life. And he's really become an integrated part of our family. I consider him

Dorrie K Fontaine (18:59.672)
my God.

Dorrie K Fontaine (19:12.632)
Wow.

Dorrie K Fontaine (19:26.67)
you

Cara Lunsford (19:28.497)
like a father. And, and we have people coming and going all the time, who we've been hosting swim lessons in our backyard for nine years. So every summer, there's just like, it's like Grand Central Station here, there's just a million children who have been coming here every year for years. Siblings of theirs that now start to come because they're learning how to swim.

And we also have a million pets.

Dorrie K Fontaine (20:02.36)
Well, you certainly, with that gentleman story, you kind of sound like Mother Teresa. That kind of was what she did. She found people and just helped them get well, helped them heal.

Cara Lunsford (20:13.573)
Maybe maybe that was my past life. Maybe I had a past.

Dorrie K Fontaine (20:17.311)
Right. I like it. Well, one of the mantras that somebody reminded me recently that I used to have was like, people should come to work happy and they should go home happier. And I was shocked. was like, did I really say that? But I actually believe it because there's so many things, you know, whether you're a student feeling like, you know, you'll never get through this and you don't matter or faculty like, I don't know how I.

Cara Lunsford (20:19.793)
But yeah.

Dorrie K Fontaine (20:44.622)
teach all this, all these papers. You know, people have to feel like they matter and that's another big concept that's being talked about. We're doing research on that. What does it mean to really matter? And if nurses feel like they matter at work in the unit, which means they feel valued, not just by the patients, but by their coworkers, their nurse managers, then the retention is much better and they're not gonna leave. They're not gonna quit.

Cara Lunsford (21:12.252)
Right?

Dorrie K Fontaine (21:13.304)
Because you know that two-year mark, it's just a big exodus of nurses.

Cara Lunsford (21:18.073)
It really is. And one of the things I discovered, I was recently at a graduation and I was speaking at the graduation and there were these student nurses who said, I only had four days of clinical last semester. And I was taken aback and I said, well,

how is that the case? Like how can that be? And they said, well, there's just, you know, we're a private, it's a private university. This is very common within a lot of private universities. Many of us live far from the home base of that university. We're kind of responsible for finding clinical sites and things like that. And...

and none of the hospitals around me are allowing students to come in and precept and do their clinical hours. for me, I went to county. I went to LA County USC. They started as a diploma program back in like the late 1800s. And literally, mean, they had a class of 18.

Dorrie K Fontaine (22:31.331)
Yeah.

Right. Yeah.

Cara Lunsford (22:38.653)
98 or something like that. was like four very stoic looking women. And, and then, you know, but we did so much clinical. mean, it was every week, twice a week. And we were there for like eight hours. And, and, and really in county, they just gave you like six charts and they walked away and they were like, good luck.

Read the charts and good luck to you.

Dorrie K Fontaine (23:12.366)
times have changed. They're doing a lot of simulation now. I hope that those individuals that you saw had at least that, but you're really supposed to only do about 25 % of your clinical hours in simulation. And simulation is great, but this issue of not enough clinical sites is also why

the bed for falls foundation funding funding schools to really provide quality education and give students the financial assistance to finish the program because nursing is

Cara Lunsford (23:48.145)
Yeah. So tell me a little bit more about the Bedford Falls. So I don't really know much about it at all. So I know that there's a lot of money that's being put into and invested into nurses, but I don't know much about it.

Dorrie K Fontaine (23:55.745)
Yeah.

Dorrie K Fontaine (23:59.938)
Yeah, right. Well, Mr. Bill Conway and his wife Joanne, who passed away in January, very sadly, they started this foundation at least 15 years ago. And they used to provide funding to

Cara Lunsford (24:11.133)
I'm sorry.

Dorrie K Fontaine (24:21.196)
Washington DC metro area for like so others might eat and some other local charities and then one day they sort of said well, you know, maybe we should be thinking of something more sustainable they were on vacation and They had a waitress who they were very

enamored of and they kind of asked her what her plans were and she said, well, I was going to nursing school, but I had to drop out. couldn't afford it. So I think light bulbs were going off, you know. What if, you know, we could fund?

fund nurses to combat the nursing shortage. And at one point he asked a question in the Washington Post, just like, well, if we have millions of dollars, where is the best place to put it? He was a little shocked. I think he got 1,300 responses. And he asked Zach at the time, volunteered to help him think about where is the best place to put his money.

You know, there were buckets of, you know, like a tow truck driver would say, well, I just need money for one more tow truck and I could do so much more. And then finally there was nurses and teachers, you know, and if you funded them, you are seeding the next generation, you know, not only take care of a nurse, but they're going to take care of hundreds and thousands. So he decided, you know, about 15 years ago to

Cara Lunsford (25:48.847)
yeah.

Dorrie K Fontaine (25:59.67)
look into funding nursing schools that would then give financial aid to nurses. And he's produced, created 10,000 new nurses. And he wants to do another 10,000. And they're called...

Cara Lunsford (26:16.699)
Let's do it.

Dorrie K Fontaine (26:18.891)
Conway Clinical Scholars and talk about being proud and doing a great job. And of course, in each school, they all write letters to Bill about what they're up to. And he is like so amazed. He loves to meet the students and he tells them, you know.

I've had a wonderful life. So you might think, where did that Bedford Falls Foundation come from? Well, you've seen the movie. It's a wonderful life. Well, that was Bedford Falls, the town. And most people don't really get that. Isn't that great? There was only one faculty at a school that said to me, is that like the movie? And I said, yep, you're right. So he always starts with, I've had a good life and I want to give back.

Cara Lunsford (26:54.107)
I forgot that. You're right. I forgot that that's what that is. Yes.

Dorrie K Fontaine (27:12.438)
And Joanne herself had received a scholarship of $500 and that enabled her to go to college. So talk about paying it forward, giving back. mean, he says this is, you know, just totally joyful. And so my colleague, Pat McMullen, who is retired Dean from Catholic University and I, and Zach,

Elizabeth is running the foundation and Kelly, new colleague. We're all really helping to support Bill in this effort and it's incredible.

Cara Lunsford (27:53.506)
Hey, I'll do it for free. I'll join. Tell me where to show up.

Dorrie K Fontaine (28:00.904)
Well, it's just amazing. When I was a dean, you know, I had to raise money. That's what these do. You raise money for faculty and students. But giving away money is a lot better.

Cara Lunsford (28:14.695)
yes, of course. It's it. Do you have you ever heard of that? Maybe not. I have a 13 year old son. So this is why I know of this of this YouTuber. But his he's Mr. Beast. goes by Mr. Beast and he has something to like 100 million followers. It's like an insane amount of people. But the way one of the ways that he actually grew these subscribers was that he

Dorrie K Fontaine (28:15.944)
Yeah, it's really great.

Dorrie K Fontaine (28:25.194)
nice.

Dorrie K Fontaine (28:36.686)
Wow, that's great.

Cara Lunsford (28:45.255)
had this concept, he's like, well, these companies wanted to pay to be like to advertise on his channel. And he kind of said, well, instead of that, like, I'll advertise for you, but you give me the money, and I'm going to give it away to someone. And so he started just finding people and he would build houses and he planted a million trees and he

Dorrie K Fontaine (28:54.488)
Yeah.

Cara Lunsford (29:13.978)
did all this like really amazing, beautiful work. And I think it's really amazing what Bill is doing and his late wife.

Dorrie K Fontaine (29:25.982)
Very heartwarming and he honors Joanne in all of this work too. I'm sure she was the one who said, is what we have to do.

Cara Lunsford (29:39.611)
I think that's just beautiful. Yeah, any way that nurse.com can help, just, you pick up the phone and you call me and we'll make it happen.

Dorrie K Fontaine (29:46.434)
Okay, well certainly Zach was thrilled when I said, yeah, let me talk, know, let me say yes to an interview.

Cara Lunsford (29:56.677)
It's very exciting. Well, because you're right that when I think about the problems that that nurses are facing, some of it, you know, you can you can look at it from the nursing school perspective, you know, there's a lack of educators, there's a lack of clinical sites. nurses, nursing school students are

not really being well equipped and maybe not, and then they get into the profession. And of course, I mean, no one is going to want to feel like they are not equipped or capable to provide safe patient care. There's nothing sustainable about that. There's no way that you can every day go to work and feel like is today the day when I'm going to make

Dorrie K Fontaine (30:29.356)
Mm-hmm.

Yeah.

Dorrie K Fontaine (30:42.446)
Mm-hmm.

Cara Lunsford (30:55.685)
an error, I'm going to maybe risk somebody's life or have a death or even just feeling like you're not a good coworker because nurses rely on each other. And that burden, that strain on you, it is not something that is long lasting. People just cannot tolerate that for any length of time.

Dorrie K Fontaine (31:24.298)
Well, you're 100 % right. And I think in the last few years, the onus has been on academia schools. you've got to prepare them better. They have to be practice ready, whatever. And I just read a paper out of Emory that was published in April, I think, in Nursing Outlook about

Now wait a minute, let's stop blaming the new nurse. It's the systems, it's the hospital systems that are not practice ready. And yes, there's nurse residency programs and we're actually at the University of Virginia very involved in helping the nurse residency program. And in fact, they're using our little self-care for nurses, small doses of wellness book because

the hospital, you know, they're theirs to lose. So why aren't these environments stepping up? Not just with equitable pay, which is, you know, nothing says you matter like equitable pay, but in environments where nurses are listened to, where there really is adequate staff. And, you know, when things come up, whether it's bullying or...

violence that you know they just hop right on it because all the nurse is going to do if they're not feeling that they're being treated well and worried about this my god i'm going to kill somebody is they're just going to walk across the street to the next hospital and they'll be with open arms embraced so

Cara Lunsford (33:01.255)
Mm-hmm.

Dorrie K Fontaine (33:06.67)
It's really, it's a two-edged sword and Bill is also, the foundation is very interested in retention as well and providing faculty. Because can you imagine they've produced 10,000 nurses? Well, what if only 7,000 stay in the profession? I mean, nobody would think that's a good return on investment. So yeah, but we're doing both.

Cara Lunsford (33:16.742)
Yes.

Cara Lunsford (33:28.795)
Yeah.

That's a tragedy. That's just a, yeah, that's a straight up tragedy to be able to invest in people, but then to put them in an environment where it's impossible for them to, not just like impossible to thrive, but impossible to survive. And we should be pushing towards

Dorrie K Fontaine (33:55.853)
that.

Cara Lunsford (34:01.155)
not just surviving, we should be pushing towards thriving. If you want your patients to be thriving, well then your staff has to be thriving. That's way it works.

Dorrie K Fontaine (34:05.996)
Yes, yes.

Dorrie K Fontaine (34:12.942)
Totally, totally. There's a great book by Monica Worley and Jane Dutton, Awakening Compassion at Work. And that's exactly what they talk about. We spend, they say, over 100,000 hours at work in our lifetime. So why wouldn't we want that to be as joyful as possible?

And there's too many stories, tragically, of nurses kind of giving up and saying, you know, this is just not going to work. And instead of a hospital kind of thing, OK, we have to really look at this.

Cara Lunsford (34:49.564)
Yeah.

Dorrie K Fontaine (34:55.886)
They act like nurses are expendable. All right, well somebody else will come in. So I've been around the block, as they say. I really think that focusing on the environment, let's stop blaming nurses. And they know, it fixes.

Cara Lunsford (35:11.149)
No, it's not their fault. It's like having to keep a candle lit in a hurricane. I've talked a little bit about this, like around moral injury is that when the environment around you, you cannot blame the candle, right? You can't blame the flame. You have to say, well, this environment is not suitable. It's not conducive to having a candle stay lit.

Dorrie K Fontaine (35:21.26)
Yeah. Right.

Dorrie K Fontaine (35:28.952)
Yeah, exactly. Yeah.

Cara Lunsford (35:40.253)
and so we have to do something about the environment. So for example, like with nurse.com, one of the things that we've been working on, cause sustainability is a big thing for me personally, for me personally, being, having a safe, sustainable and supportive work environment that is like.

Dorrie K Fontaine (36:02.862)
Thank

Cara Lunsford (36:05.541)
for me, my focus and really for our teams at nurse.com, we're always trying to look at how can we impact that. And so recently we did a partnership with Top Workplaces and we said, okay, Top Workplaces does these surveys and these different institutions, not just healthcare, but different institutions can survey their workforce and

depending on how the results come back, they can be eligible for a top workplace logo that they can then put on their website or wherever they wanna put it. And so we had this opportunity come up where we could co-brand a nurse.com top workplace logo. And when I was talking to them, I said, well, here's the thing.

Dorrie K Fontaine (37:03.118)
it.

Cara Lunsford (37:04.773)
I'm gonna have to write those questions. So I worked with some of my colleagues and I put together a whole list of questions and I said, well, in order to even be eligible for this top workplace co-branded nurse.com logo, you have to really...

you have to do well in the, these questions here. And the questions were very specific around, do I feel, you know, that I can provide safe patient care? It seems like an easy question, but it's so interesting when you ask nurses, like, if you feel like you're able to provide safe patient care, if people resoundingly say, you know, on a scale of one to five, one being

never, you know, and five being kind of almost always or always. If you're getting ones or twos across the board from your clinicians who are at the bedside saying, I don't feel like I can provide safe patient care. That is something to look at. Like you have to look at that. It's a big red alert and it's an easy question to ask.

Dorrie K Fontaine (38:09.294)
Yeah.

Dorrie K Fontaine (38:22.158)
The big red alert.

Cara Lunsford (38:28.405)
And it's a necessary question to ask. and, and, and, you know, we, I talked, I asked a question about workplace violence. I talk, I ask about, do you feel like you have the supplies and equipment to do your job safely? How many times do people make the joke about, we have one bladder scanner for the entire hospital and we all fight over it.

Dorrie K Fontaine (38:28.514)
you.

Dorrie K Fontaine (38:37.452)
Yeah.

Dorrie K Fontaine (38:43.246)
Sure.

Dorrie K Fontaine (38:48.992)
Yeah, for everybody. Well, you know, you might be interested. You probably have seen it. Every couple of years, AAC and Critical Care does surveys. The last one was two years ago. They surveyed 9,000 nurses nationally. And they looked at their healthy work environment standards and did exactly this.

same type of question communication decision-making authentic leadership meaningful recognition which i know you're into with the daisy award support and all and what they found was if units said they were using the AACN standards you know that this is what we stand for they had much higher

Cara Lunsford (39:23.729)
Yeah, love the Daisy Award.

Dorrie K Fontaine (39:38.158)
positive in every area that you're talking about. Safe care, less moral distress, less intent to leave, if they were using these critical care standards. you know, it's pretty dramatic. Those are the ones that I tried to bring into academia too. So faculty would feel like they had something to aim for in providing a positive environment. So.

Cara Lunsford (40:02.919)
I would love it if you would share that. Thank you.

Dorrie K Fontaine (40:03.202)
You know, I think you're on the right track. I think you're on the right track. And I'd love you to look into the old Wichita critical care surveys. They've got, they've done them for 10 years now. And during the pandemic, you know, things kind of went like this, of course, but they're coming back. But I don't think fast enough. I don't think we're moving. We're not moving fast enough.

Cara Lunsford (40:13.883)
Yes.

Yes.

Cara Lunsford (40:31.185)
We aren't moving fast enough, you're right.

The consequences of this are really catching up anyone who has spent any time in the hospital as a patient or with a patient, like a family member. Like I said, have have Reg here who lives with us for two and a half years. And I've now taken him through a couple of major surgeries, an abdominal aortic aneurysm that was completely clotted and had blocked blood flow to both of his legs.

Dorrie K Fontaine (40:39.864)
Yeah.

Dorrie K Fontaine (40:54.082)
Yeah.

Cara Lunsford (41:05.873)
which was why he couldn't walk and we didn't know that. so major, major surgeries. And fortunately we were at UCLA and they were amazing, but we've ended up at some other places where I thought, man, if you don't have an advocate with you, you don't have someone.

Dorrie K Fontaine (41:15.021)
Yeah.

Cara Lunsford (41:29.137)
petitioning on your behalf and asking the right questions and saying no to a discharge when you're not ready. it was scary. It was very, very scary. And it's sad because I have a lot of compassion for the nurses and I'm like, I don't feel like it's their fault. I feel like they are in an impossible situation.

Dorrie K Fontaine (41:31.214)
Yeah, right.

Dorrie K Fontaine (41:50.616)
Yeah.

Cara Lunsford (41:58.409)
and we have to do whatever we can to try and correct those environments. So yeah, and we can't shame them. We can't shame the environments either. We can't shame the hospitals. It doesn't work. Shame doesn't work in general.

Dorrie K Fontaine (42:03.82)
Right. Totally agree.

Dorrie K Fontaine (42:13.804)
you have to have interventions that work and nursing has some national organizations, national collaborative for safe staffing and you know at the highest level of nursing organizations they really are struggling with okay what are the key things that

we should be doing for nurse staffing. I too have been in the hospital and I was there for major surgery and I had 50 % travelers. And now granted I was a dean at the, and I went to the place where I, you know, had sent students and I got great care.

The travelers gave good care. I was interviewing them at night. I'd say, well, tell me about you. Because that's that whole connection thing too.

Cara Lunsford (43:07.238)
Yes.

Dorrie K Fontaine (43:08.066)
You know, we want nurses to make sure they get to know the patient even when it's busy, but I have a good friend who says to me, you know, it really is about connection. So I would ask the nurse that night, I have this one gentleman, he was really good. And I said, well, 4 a.m. I said, tell me about you. He said, well, from Oklahoma, I've got an RV with four kids and my wife and we're traveling around.

trying to find a good place.

And I said, look, you're a great nurse. We need nurses. Why don't you just stop and stay here? Because you are fabulous. And he was kind of like stunned. And there was an aide in the room too who was wanting to go to school for nursing, another young guy. And he was like, great. Well, I want to get into nursing. I said, wonderful. Let me help you. So I think, you know, we all have lots of roles. That was my patient role.

But there's so many times when just making a connection. My good friend, yeah.

Cara Lunsford (44:17.895)
Well, that's what the patients, have that, I say this all the time too. And I know that people, not just nurses listen to this podcast, the public listens to this podcast. And I try to say, if you wanna be a part of the solution, and it's hard when you're in pain and when you're afraid and...

Dorrie K Fontaine (44:30.467)
Yeah.

Dorrie K Fontaine (44:43.843)
Yeah.

Cara Lunsford (44:46.511)
And I think a lot of times when people are a patient in the hospital, they're like, well, it's not my responsibility, right? Like I'm the patient here. I'm the one that's scared and in pain and, and not feeling well. And, but it's always our responsibility. And if we can show these, these acts of kindness and you can see people, when you see people, then you are seen. And what patient doesn't want to feel seen?

Every patient wants to feel seen, but you have to see your care provider too. Like you have to see them. You have to see them as a human with a family and struggles and trauma and everything that you have.

Dorrie K Fontaine (45:19.757)
I

Dorrie K Fontaine (45:31.534)
Right, I'll tell you a quick story of a good colleague. He was my legacy coach actually. He studies communication. He's written 300 papers about how docs should communicate. He had a stent put in. He was in a hospital. He was the second one. He was in the CCU small hospital. A nurse comes in at 4 a.m. and he looks at her and says, tell me about you.

And she said, well, I'm new here. I don't know anybody. I don't know anybody on this unit. And I'm living alone. I don't know anybody. And he just looked at her. And she had this long tattoo, words all the way up her arm. And he said, well, tell me about that. And she said, this is the last sentence my boyfriend told me before he died.

So there they are in the CCU at 4 a.m. He's scared, she's lonely, and he said they both just had tears in their eyes. So talk about a connection. So a couple hours later, she came back to take his blood, you know, do all the vital sign things, and he said it was like totally different. They were now in each other's lives for.

Cara Lunsford (46:53.319)
Yep. Yep.

Dorrie K Fontaine (46:56.142)
how do we heal together? And I just love that story. He and I are gonna write a paper about, tell me about you. I mean, you say that all the time to interviewees, but what if we did that like more often, you know, before we started to say things.

Cara Lunsford (47:05.241)
I love, yeah, I love that.

Cara Lunsford (47:12.121)
and actually want to know, right? Like, because I think that we have this, this, this, we say, how are you, right? Like a lot of times we say, how are you? But we never, but I think a lot of times it's what we expect or what people expect is a one word answer, or fine, or good, or okay.

Dorrie K Fontaine (47:16.61)
Yeah.

Dorrie K Fontaine (47:35.17)
Yeah, bye.

Cara Lunsford (47:39.969)
the minute they start to tell us more about themselves, I think people are kind of taken aback like, well, I and and that's that's too bad. And also, I think sometimes like with nurses, because they are struggling with time, the amount of time they have, it's almost difficult to open up the communication because they're like, well, I

Dorrie K Fontaine (47:47.32)
Yeah.

Cara Lunsford (48:09.243)
I have all these other patients I have to go see and now I've opened up this line of communication. The person's telling me their life story and I don't want to just leave in the middle of them being vulnerable with me.

Dorrie K Fontaine (48:17.26)
Yeah.

Dorrie K Fontaine (48:21.838)
Well you said something nice on a podcast about how, and I used to tell students to do this too, at the beginning of a shift, no matter how many patients you have, go sit with them, even for like a minute to just say, what's the most important thing I could do today?

Cara Lunsford (48:41.329)
Yes.

Dorrie K Fontaine (48:41.858)
And like you cited, they're not going to be putting the call light on every minute because you've already made the connection. I'm in charge of you. I'll be here for you. It's so simple, you know, but yeah, of course. Yeah.

Cara Lunsford (48:47.719)
They don't. Yeah.

Cara Lunsford (48:53.585)
Yes. It just brings the anxiety down. know, people are already anxious and once you feel seen, I don't think it's easy to feel unseen. And I, and, and that's, I think that that's, those are these like, I'm always trying to give people small things that they can do because a lot of times I think they, they're like, look, I don't have time to be.

Dorrie K Fontaine (49:08.504)
Facebook.

Cara Lunsford (49:23.661)
doing this and doing that and so you have to kind of give people bite-sized things you know that they can do.

Dorrie K Fontaine (49:29.486)
Yeah, right. That's why we wrote one of our books, Small Doses for Wellness. know, things you can pick. You can pick this book up at any page. A nurse could read it on the bus. And like, it's got little quotes and then things to do. One of them is, I'm in a good place. Not emotionally. It's just that I'm at a taco stand. There's a bunch of cute little things to just make you laugh.

Cara Lunsford (49:52.997)
Yeah, I love that. Yes.

Dorrie K Fontaine (49:57.038)
You know, to just kind of make you laugh. It's cute. I'd be happy to send you one of these. I'll get you a discount. No, no, no. I get a discount as an author. So I buy them like 10 at a time. Awesome.

Cara Lunsford (50:00.707)
I definitely want one. would, I'll even buy it. I'm a huge...

Cara Lunsford (50:10.963)
I would love one and maybe even what would be really nice is I would love for nurse.com to maybe buy a lot of them.

Dorrie K Fontaine (50:23.468)
Yeah, I that. I'll send you one first for you and then take a peek. We just bought them for all the hospital just bought them for all the nurses in the nurse residency program for the next year. And that's, know, hundreds and hundreds. So that was great. Of course, it's always hard to get money out of a health system, be honest. But we were persistent, not me, the royal way, you know. So thank you for that.

Cara Lunsford (50:39.675)
Yes.

Cara Lunsford (50:50.014)
Yes, yes. I'd love to, I would love to share it. I'm sure that we have lots of opportunities like we're doing a nurses week 365 campaign. So every month we give things away to nurses. And because we don't think that they should just be celebrated once, you know, for a week in May.

Dorrie K Fontaine (50:52.546)
That's very calling.

Dorrie K Fontaine (51:05.698)
night. Yeah.

Dorrie K Fontaine (51:11.342)
Great.

Cara Lunsford (51:16.923)
we need to pay more attention to them on a regular basis. And so I think this would be like such a great gift to be able to share with a bunch of nurses and maybe just every month we'll give away like so many of them would be really cool.

Dorrie K Fontaine (51:26.818)
Yeah, it will be, yeah.

Dorrie K Fontaine (51:35.148)
Yeah, I would love that. My colleague, a dean up at Boston University, for Nurse Week, he gave all his faculty the book with a cup with a teabag in it and a wine glass and said, here you go. This book is for you, whether you're winding down or gearing up. It was very cute. The faculty loved it.

Cara Lunsford (51:59.333)
I think that's great. It seems like it's right up for me personally, it's right up my alley because I really, I really love the small, the small bits, the digestible pieces of things that you can. It's funny because I have the calm app. And every time I turn the calm app on, it says take a deep breath and I'm like, and then I take my deep breath. And I was like,

Dorrie K Fontaine (52:11.01)
Yeah.

Dorrie K Fontaine (52:19.641)
yeah.

Dorrie K Fontaine (52:24.152)
Right.

Yeah.

Cara Lunsford (52:28.317)
Maybe I just need, I don't know if you remember this like old blonde joke where the woman like they take the headphones off. This woman has headphones on, she's getting her hair cut and they take the headphones. They're like, you have to take the headphones off. She's like, I really can't. And they were like, no, but we can't cut your hair if you don't take the headphones off. And so then she takes the headphones off and she like collapses and they pick it up and they hear breathe in, breathe out.

Dorrie K Fontaine (52:34.272)
yeah.

Dorrie K Fontaine (52:54.84)
yeah, that is pretty funny. No, breathing, you know, with all the self care that we are teaching, I also was part of a program in Wyoming in the pandemic. They were helping to provide resilience training for these nurses, social workers that were really on tribal lands and they were in rural areas and it was a big grant through the state.

And I work with some nurses out there and we had all sorts of tips and trainings and one of the gentlemen said, yeah, you know breathing. Yeah, it's like, you know PDR pause, breathe, repeat. Well one of the people on the podcast that worked with Tribal Land said, yeah PDR that's the beer we all drink out here. So then everybody remembered that okay pause, breathe, release.

Cara Lunsford (53:54.482)
And drink a beer. Pause, breathe.

Dorrie K Fontaine (53:55.843)
Yeah. Well, you don't want to really unencourage it, but you know, that's another, it's how you remember things, how you laugh, right? So, well, I'm happy to send you that book. I think you'll really will enjoy it. I'll sign it over to you.

Cara Lunsford (54:05.287)
Yes, yes, yes.

Cara Lunsford (54:15.59)
thank you. Yeah, if you'll sign again and actually sign it. thank you so much.

Dorrie K Fontaine (54:19.968)
I sure will, yeah. We're very proud. Natalie May and Tim Cunningham are my co-authors and we just decided this is what we should be doing in the pandemic.

Cara Lunsford (54:31.473)
Well, I think it's amazing and I feel like this is unlikely to be the last time I speak with you because I'll probably be stalking you.

Dorrie K Fontaine (54:40.116)
that's very kind. I don't have a website or anything, but I'm still very active with compassionate care and giving talks on well-being. What can we do to create more well-being?

Cara Lunsford (54:51.228)
I'd love that. Yes.

Well, maybe we can do a webinar and we can invite a bunch of people from our nurse.com audience and that would be absolutely amazing. Because I would love to spread, I'd love to spread more of what you're teaching and just see what we can do to support the incredible work that you're doing. just a huge big thank you to you for spending time.

Dorrie K Fontaine (55:04.686)
Sure. Yeah.

Yeah, that would be a lot of fun.

Dorrie K Fontaine (55:13.794)
Wait.

Yeah, that would be great.

it was an honor. I'm glad you asked about the Bedford Falls Foundation and their great work. And appreciate your support. Thank you so much.

Cara Lunsford (55:36.057)
Absolutely. All right, well, till next time, Dory. Thank you so much. Bye.

Dorrie K Fontaine (55:39.808)
Okay, thank you so much. Bye bye. Bye bye. Bye bye.