Cancer Clear and Simple
Welcome to 'Cancer Clear and Simple,' the podcast dedicated to simplifying cancer. Join us as we discuss the world of cancer, breaking down complex concepts for our listening audience. One of our goals is to equip individuals and families dealing with cancer by providing clear, and concise insights. Through personal stories, expert interviews and practical tips, listeners are enabled to make informed decisions. Whether you're a patient, caregiver, or just simply wanting information, tune in to 'Cancer Clear and Simple' for a easy-to-follow guide on understanding and coping with cancer.
Cancer Clear and Simple
Unseen Heroes: Caregivers’ Role in Healing
What happens when a nurse's intuition and caregiver's dedication intersect to shape the recovery path for bladder cancer patients? Join us on Cancer Clear and Simple as we welcome Dr. Brandon Sterling, an advanced practice registered nurse with a heartwarming journey from Houston, Texas, to earning a PhD in nursing from Texas Women's University. Learn how the influences of his grandmother and mentor, Dr. Michelle Robinson, steered him toward a career dedicated to the intricate and emotional world of urologic oncology. Dr. Sterling reveals insights from his dissertation on caregivers of cystectomy patients, shedding light on the unseen heroes in post-surgical care.
Navigating the pandemic brought unique hurdles for caregivers and patients alike. From restrictive hospital visitation policies to adapting communication methods with phone calls and video recordings, find out how caregivers innovated to ensure continuous support and education. Dr. Sterling provides practical advice for post-operative comfort, including the use of recliners and silk pajamas, while emphasizing the critical role of online platforms like BCAN's Inspire. These forums connect patients and caregivers with reliable advice and specialized healthcare professionals, essential in a landscape where access to quality care can vary greatly.
Our conversation culminates in appreciating the often overlooked yet vital role of caregivers in patient recovery. Dr. Sterling shares poignant observations from his research, highlighting how caregivers are crucial monitors of their loved ones' health, capable of detecting subtle changes that medical tests might miss. From monitoring hydration through urine color to recognizing variations in appetite and activity levels, these informal assessments can prevent severe complications and hospital readmissions. Dr. Sterling’s journey into nursing, sparked by childhood experiences and inspired by the nurses he encountered as a teenager, underscores his commitment to advocating for caregivers and advancing the nursing profession.
Welcome everybody to the Cancer Clear and Simple podcast. I am your host, joshua Wright. I'm a community project coordinator in the Cancer Health Disparities Initiative at the University of Wisconsin-Madison Carbone Cancer Center. This podcast explores cancer topics through the perspectives of effective community members, experts and supporters of the journey. Today we are going to be joined by Dr Brandon Sterling. So Dr Brandon Sterling is an advanced practice registered nurse, also has specialty in adult gerontologic acute care, also has worked in critical care and urologic oncology and Dr Brandon Sterling has a PhD in nursing. Welcome, dr Brandon Sterling. How are you doing?
Speaker 2:Thank you, Joshua, for having me. I'm doing fantastic.
Speaker 1:Awesome, Awesome. I'm very excited to have you here and I just wanted to kind of get an understanding of your background and where are you from originally and then where are you joining us from today?
Speaker 2:Thank you, Joshua. I am originally from well. I was born in Liberty, Texas, and I was raised in Houston, Texas. And I'm actually joining you today from Houston, Texas. That's where my home is, but today from Houston Texas. That's where my home is. But I've lived across the United States, New York City to California, and I settled on home because that's where the heart is.
Speaker 1:Yeah, yeah, understandable, understandable. And then is there anybody that you wanted to give a shout out, since you kind of lived a couple of different places and have a vast network. Anybody you want to recognize on today?
Speaker 2:Well, of course, yeah. Well, first I would like to recognize you, joshua, as well as your wife, dr Michelle Robinson. I'm always shout from the rooftops Anybody who will listen to me say how awesome Dr Michelle Robinson is. She was actually integral in helping me. It will influence me in getting my doctorate degree, and specifically the PhD. And then I also want to shout out to all of my staff that I work with my fellow APRNs or advanced practice registered nurses, physician assistants, nurses, medical assistants and even the faculty, because we all work collectively towards one goal and that's giving the best patient care. So I couldn't be here as an expert per se without all of their help and support. So I'm never at a loss to how much their support and how much their help has helped me along in this journey, and I'm eternally grateful for that.
Speaker 1:So thank you for giving me the opportunity, joshua in the work side of the process of this care and so also just wanted to tap in, get a little bit more about who is Dr Brandon Sterling and just if you could give us kind of a somebody who has inspired you along your kind of professional journey or maybe a personal journey. Who would you kind of come to mind in recognizing an inspiration as your journey?
Speaker 2:Well, I will say I mean, if we're going there as a little kid, I would say my grandmother on my mom's side, grandma Shirley, she was the matriarch of our family, and when I say family, we had a really large family. Remember, back then they didn't have all this technology so she had 16 children, 56 grandchildren, tons of grandkids, great-grandkids, but of all of them she really chose me as her favorite. There I said it. So all of her love and support really helped to shine this positive light on me and really helped me to pursue my dreams. And what I and me and my cousins we laugh about it all the time is just like her grit and her resilience and she passed that down to us and we always say that we have elements of her, but in a very professional way, because we all agreed if we would react and say the things that she said, we'd probably be fired.
Speaker 1:Oh yeah, no, I love it. I get where you're coming from, but it's all love to any family members of branding that. You know, hear this and know that he called out himself as being the favorite. You know we do not want to kind of infringe on those family dynamics. So here we are and I love that answer. That is so relatable, I think, for a lot of people and you know it kind of sets the stage. So you kind of recently graduated with your doctorate of nursing from Texas Women's University, correct?
Speaker 2:Yes, that is correct. Well, you know, time flies when you're having fun. So it's been about two years now.
Speaker 1:Oh see in the world the way it works. I would have never guessed it was that long ago, but thank you so much for sending us in the context of time. But I asked that because I want to get into your dissertation work. Can you talk a little bit about the name of your dissertation and what it is that you researched?
Speaker 2:Yeah, absolutely so. My dissertation was focused on caregivers of cystectomy patients in enhanced recovery programs and I mean, it doesn't roll off the tongue that easy, but a cystectomy is basically a surgery where the bladder is taken out due to a cancer diagnosis, and typically it's well, the gold standard of cancer care in this aspect of urology is for any muscle invasive bladder cancer, that's the gold standard, which is to take the bladder out surgically. So the way it all started is when I graduated nurse practitioner school and got my first job at MD Anderson, they were like, well, you're going to be working with urology. So my understanding of urology was okay, this is the urinary system, so perhaps I'm going to be working with urinary systems as a nurse practitioner. I was like, well, okay, this beats what I'm doing now Because my background is critical care. And then the more I learned about the role, the more I was like, oh, this is what I'm going to be doing. It's more of a post-surgical management, meaning that I took care of the patients after surgery, and the way that I got to my happy thought or my dissertation topic was just looking through the literature and having interacted with many of the caregivers of these patients after surgery was.
Speaker 2:There was a missing piece where, okay, yes, we're doing this enhanced recovery program, which is basically a fast track program to get patients out of a hospital faster, and it involves a lot of preoperative care or education before surgery.
Speaker 2:There are elements to it that happen intraoperatively or during surgery.
Speaker 2:That's mainly focused on the urology surgeon and the anesthesiology team, and then I would say that the largest part of it is the post-surgery or the post-surgery recovery which happens in the hospital and then eventually in the home. So when I did my literature review, I noticed that a lot of the literature, the missing piece were the caregivers. And my question to the world was well, how can you have this fancy, you know fast track program to get people out of the hospital, but we don't know what's happening in the home and we haven't really assessed or spoken to the cornerstones of that home care, which were the caregivers. So that's how I ended up exploring my happy thought, and that's how I ended up exploring my happy thought and that's how I ended up doing my dissertation, which was a qualitative study. Now, mind you, joshua, I have this vernacular or this knack for not having to do anything easy in life. There's always some type of added flavor to it. Per se, there's always some type of added flavor to it per se.
Speaker 1:I think they call those trailblazers. I think that's what they call them.
Speaker 2:So don't be shy or timid about that, perhaps, joshua? So while I'm in this PhD program, there was this thing in the news talking about this new disease called COVID-19, right. So traditionally when you do a qualitative study in nursing, especially if you're going to talk to a caregiver or patient, you want to be submerged in their environment, meaning you would go to their homes and you would conduct your interview in their environment, with the goal being that they would be in their environment comfortable, so they would just speak to you unfettered or unashamed, and just give it to you straight. So, due to the pandemic, all face-to-face research ceased because it wasn't primary care. So what I ended up having to do is do a lot of these interviews via telephone and or via either FaceTime or Zoom meetings or electronic meetings.
Speaker 2:And my dissertation chair who, let's say that she's up there in age, so she's seasoned she was like well, Brandon, how do you think that these caregivers who may be in advanced age, how do you think they're going to handle this? And I was like well, I don't know, but we can see what happens. And you know, the pandemic forced a lot of people to really embrace technology, especially the older generation, because, outside of FaceTiming and or perhaps having Zoom meetings. That's the only way they could connect with their grandkids or children, or see anybody for that matter. So it was actually. It actually turned out to be a blessing in disguise, because this seemingly local type study, where I was like okay.
Speaker 2:well, perhaps I can just reach out to a lot of folks here in the greater Houston area and conduct interviews.
Speaker 2:It turned into me partnering with Beacon or the Bladder Cancer Advocacy Network, where I was able to expand my study to reach all of the caregivers who are affiliated with Beacon or the Bladder Cancer Advocacy Network, and my local study turned into this national study and I even had one participant from Canada. So it was a blessing in disguise. And not only was I able to assess the experience of each caregiver regarding each element of the enhanced recovery program remember before surgery, during surgery, after surgery but I was able to even hone in on some of their experiences during the pandemic, which was very informational because again, we were forced as healthcare workers to progress our practices to where we included more telehealth and or, you know, virtual visits. So it was this, you know, sad situation, but it just all worked out for the best. I interviewed, I think, maybe 22 or 23 people from all over the country with. They're all had very unique experiences and I was able to complete my dissertation and complete my study.
Speaker 1:Okay, yeah, so let's dive in a little bit. I mean, you laid out a lot just now in terms of what your focus was, the context of in which it happened, and all of that stuff has got my mind churning and really just wanting to lift up and hear you know some of the kind of common things that caregivers go through and then from there, if we could kind of pick out a couple things that kind of stand out in that process, I'd really appreciate it.
Speaker 2:So Well, of course, I would say that the core to all of it is education, and one of the main themes from my study was that the patient as well as the caregiver, they had this dyad relationship where you really couldn't educate one without the other. I wanted to be in the forefront because a lot of patients well, they report a lot of their loved ones Once they heard the word cancer, you know they really couldn't understand or process anything else. So that's when they stated well, I then stepped in because they were so stunned and you know, I don't want to say in denial, but it was just like a shock to the system, to where, like anything that they were being told kind of went in one ear and out the other. So it was like this teamwork that needed to happen during the education process. And then one unique thing again during the pandemic is a lot of these visits happened where the caregiver could not be present in the clinic because of the visitation restrictions. So a lot of this was done over the telephone or they made video recordings. So again, you know, there there are a lot of. There's a section of our population, I will say, where they have to have the print out and they need to like, have a pencil or highlighter and you know, just work through it. But again, the pandemic forced them to embrace alternative methods because they weren't able to be physically present. So I would say, just having that teamwork and then being adaptable, that was key. And then another large component was in the post-operative period, where they were back in the home and a lot of them stated you know again, that teamwork was essential to where they were both learning their new normal, I want to say the new normal.
Speaker 2:After you have your bladder taken out, remember, they also have to make a way for you to urinate and we call that a urinary diversion, and that typically involves taking a piece of either the small bowel or the large bowel and reconnecting everything to the ureters, to where you can actually pass urine. So after you have any type of major abdominal surgery, especially if you're manipulating the bowel, after you have any type of major abdominal surgery, especially if you're manipulating the bowel, it takes about a good six weeks for the patient to learn like, this is my new normal. And when I say new normal, but where a lot of folks end up having is a urostomy, or basically it's an ostomy where it passively secretes the urine. So not only do you have, you know the surgery where they literally rearrange your insides, and now you have to take care of, basically, this new baby. So so.
Speaker 2:So so it's, it's, it's, this whole new experience and again, just having that teamwork where the patient of course they have to learn how to do it but you have that caregiver, where they take on that role, and then eventually it was like they would. They reported oh well, I was heavily involved in the beginning, but as they recovered more and as we learned the new normal, I put it on them or the patient you need to learn how to do this too, because I may not always be around to help you to do this care.
Speaker 1:Oh, wow. So that, okay, that's full circle in terms of where you started is the education piece and so now it's connecting for me in terms of just simple everyday eating habits, right, um, and being able to get in a new flow and a routine, um in the home sense, and then the transfer of knowledge from the caregiver to the patient um themselves, and how that does take some time and some practice in there. Were there any kind of things that were tips or keys or tricks in the caregivers that you were kind of hearing in this specific kind of post-operation surgery space?
Speaker 2:Absolutely. Now, one thing that I would establish, I would say the majority of the participants or the caregivers is they're like you know, you can give us as much information as possible, but again it's just like it's like taking this new baby home and then it's like okay, well, we have all the instructions, but you can give us an A through Z, however E may become first, and then you get the A. So a lot of it is just kind of hands-on training. And one of the more popular things I heard consistently they were like you know, when you go home, you have all of these tubes and drains and things and it's sometimes it's hard to get comfortable in the bed and a lot of them will, instead of the bed, well, we just we just put them in the recliner and that was easier to manage everything. And then another I would say another large subset of the caregivers were like well, you know, when you have all the drains and tubes, sometimes it's easier just to wear silk pajamas. That way everything can move around and it's a lot easier and a lot comfortable in the home setting. So it was. It's awesome because again, that gives us some insight on what happens in the home.
Speaker 2:But in addition to that, again I'm going to shout out the Beacon. They have this online platform called Inspire, where a lot of the caregivers were able to connect with other caregivers of cystectomy or bladder cancer patients and even patients themselves to kind of give those hints, tips and tricks. And of course there are groups on other platforms like Facebook and other social media things. But since this is a sponsored platform by a reputable organization, I always point patients and caregivers to that. That way you can kind of filter through the noise and some of the I guess you could say stranger type of advice where, because Inspire is monitored by professionals who know what's happening and what's going on you know what I'm saying so it's reputable versus a random Facebook group. You know what I'm saying?
Speaker 1:Sure sure, but the ways that I'm being informed about this, but the ways that I'm being informed about this, just the fact that cancer caregivers have spaces and are very intentional about connecting with one another in this BCAN space, the Bladder Cancer Advocacy Network, and you said shout that specific group out one more time. You said Inspire.
Speaker 2:Yes, within the BCAN they have a platform called Inspire, and then that's basically an online platform to where anybody who has any type of connection to bladder cancer whether it's patients, caregivers or even healthcare professionals there are platforms to where you can engage with each other and, again, exchange hints, tips and tricks, because one thing I've learned in interacting with patients, even through BCAN, is not all providers are created equal and not all education are created equal.
Speaker 2:And then I'll even sprinkle on the fact that all of that could also be contingent on your geographic location within the United States, because one thing we always push is you know you need to have access to a registered nurse who specializes in wound care, especially you have an ostomy, but sometimes in rural Montana you may not have access to a nurse who can come to your home and, you know, assist you with that wound care. You may have to drive an hour, hour and a half or even two hours to your local facility to get that type of care. So having those online platforms to where they can exchange information is priceless. And again, it's another one of those products of the pandemic to where people would traditionally meet in person, to where now you can just go online and share information and share you know, videos or whatever resources they may have.
Speaker 1:Yeah, okay, and I'm a little bit stuck. Please forgive my ignorance in this terminology, but ectomy is a removal of something, ostomy is the. As much as you can, if you can ease me into that understanding, because I just don't want to be a misunderstanding at this point.
Speaker 2:Oh, sure, sure, sure. So an ostomy is basically creating a conduit from something that happens internal to something that needs to pass externally. So in terms of bladder cancer and bladder cancer surgery, we create the urostomy, so that means it's basically an outside entity, or we built this piece of tissue that way you secrete urine, and another example is in colorectal rim. You'll hear the word colostomy. So basically, that's when you create that same conduit to where you can pass a stool through this, I guess appliance, external appliance, where everything is secreted and it's definitely man-made. So when I say ostomy, that means we've created it and that's how you can now eliminate from your body. So thank you for asking that clarifying question.
Speaker 1:Sure, sure. Thank you for taking the time to go over that. And so I'd just like to get into a little bit more of just examples of successes in just your caregiving, exposure and experience. Can you kind of go over one of the examples that you saw that it was like, okay, in this whole process you've described, of the back and forth that may happen, communication wise, what's one of those experiences that you felt something was learned that was beneficial on both sides, or just a aha moment, or something to that sort? I'm really excited to hear something to that effect.
Speaker 2:You know, joshua, you asked an excellent question and one of the primary findings from our research is that the caregivers were kind of a gauge of home success in the home. And when I say a primary gauge is because they knew their loved one more so than we did, because they were their spouse or brother or sister, so they could look at the patient and say they're doing well. And a lot of that just was based on their loved one eating more or having more activity, or one of I remember distinctly. They were like, well, the more annoying they became, the more I knew they were feeling better. And you know, these are these things, you know informal things that as healthcare providers we would never think to really put that as a gauge. Because you know, we're looking at vital signs, we're looking at the wounds, we're looking at the blood work, but the caregivers are, they're kind of that window into what's going on with them at the home in an informal manner and a lot of well, unfortunately, just due to the nature of the surgery, there is a high readmission rate and it's just due to multiple factors, one of the main things being dehydration. So those caregivers, we teach them it's like well, you know, we can look at labs and do all this. You know fancy formal stuff to assess hydration, but we teach the patient and the caregivers just look at the urine color. If their urine is clear, that means that they're hydrated, and if it's looking a little dark or amber, that's a good indication that they need to ingest more. So the caregivers were at the house, you know, like, okay, don't flush, or let me take a look at your pouch and then them being able to, you know, do that eye test or really gauge and look at the urine and look at the their family member you know that was an essential part of the in the home and then, depending on what was going on, they would notice oh, you know, they're not eating as much or not drinking as much, they don't have as much energy. And just by them calling the office or sending that message via the electronic medical record, that could prompt sooner or faster or even expedited interventions to where we could prevent a hospitalization.
Speaker 2:And those early indicators or those early reports.
Speaker 2:It's like, okay, well, instead of you coming to the emergency center, what we can do is bring you to the clinic and just set you up for an IV hydration and we can get you settled that way, versus you having to be admitted to the emergency room and go through the whole motions, it's like no, we can actually control this burn and if we can just bolster your hydration status and help prevent an infection, I mean that could be potentially life-saving.
Speaker 2:Because one of the more severe infections you can get, especially in the geriatric population, is what we call uro sepsis, with, where it can be, a urinary tract infection that's so severe that it causes, you know, body-wide shutdown, or it can, you know, make your blood pressure go down and can make actually make the rest of your organs shut down. So again, and that's what I always tell the caregivers you may feel like your role is small or even insignificant, but what you do at the house is so important because you are on the front lines of everything that we needed to know, especially in those first six weeks after surgery. So I would say that that was the biggest. One of the major pieces, or biggest pieces that came out of the research is like how important or how pivotal that caregiver is in the home setting and how they are our eyes and ears of the formal team or the nurses or doctors or the surgery team and by them reporting those things, like I said, it can save lives that it can save lives.
Speaker 1:That is a resounding wow for me in terms of what I didn't understand about caregivers and the role that they play as a bridge, as an intermediary. That really is visualized in my mind about, you know, seeing their loved one and caring for them on a minute-to-minute basis, right where you know they're being trusted at home, and then to take this all in in the challenges that we had around isolation and individual, like having to make decisions in that kind of way, but also, as you're pointing out, which I love hearing as well is being able to get directly to what it is that you need, versus having to go through an admittance process like that. That is very, very key and really points to the ways that we want to hear about getting specific care, right, you know it's like, um, I feel like sometimes when I go in it's, you know, having so many different steps just to get the to the point of what I was needing to get care for, and the caregiver can act as a person to expedite or really just cut out any of those unnecessary steps at times. Right, so you know it. Know it's not an emergency per se. However, we can make this call that's more specific to what is needed at this time and I just really appreciate that. That gives me a sense of calmness or peace in this situation and I want people to pick up on that and just say thank you, maybe to a caregiver.
Speaker 1:I want to, you know, call up my mom and be like hey, mom, you know, when I was sick, when I was a young kid, I appreciate you for, you know, stepping in and being that protector in that moment of vulnerability. But you know, just, I want to just give a second as we're, you know, kind of wrapping up. I want to hear more about you, know your journey as well. Just, I saw a glow or a twinkle about you in that explanation and I know that you've put in a lot of work. But can you kind of talk about your early? Uh, what symbols or signs were in your life that pointed you into this nursing field?
Speaker 2:symbols or signs were in your life that pointed you into this nursing field. Yes, before I touch on that, joshua, I think that the word that could sum up the caregiver experience is advocacy. They are the ones who are essential in advocating and, again, sometimes you would look at the formal numbers, whether it be the blood pressure, blood work and the medical team is like, you know, everything looks good. But it would be that advocate or that caregiver advocate who'd be like, yeah, you're saying that, but something isn't quite right. And then it could be like, okay, well, fine, if you don't feel comfortable, let's just bring them in for an observation. And then, lo, lo and behold, you know at midnight everything would just happen and it's like, whoa, how did you know that was going to happen?
Speaker 2:So, yes, that that advocacy piece is where, where sometimes the rubble hits the road to, where you know again, it goes back to that hits the road to where you know again, it goes back to that eye test, to where they see this person and interact with them. You know, all day, every day, and we only see this, have this little slice of time in interaction and you know, again, we're looking at the formal numbers. But they just know, and I wish there was a way that I could study and quantify that feeling, and but you know that I mean it's, it's, it's remarkable but yeah, that's next level Okay.
Speaker 2:That's right.
Speaker 1:Okay, Keeping keeping an eye out for those things.
Speaker 2:But to to to, to answer your question about how I ended up on this nursing journey. It really started for me as a child because I was raised in a single parent family home and I was the oldest of my mother's children, so I spent a lot of time taking care of my sisters. You know, my mom had to work and she had things to do and there we were, at the house and it's like, well, we can't really go hungry. So I learned how to cook at like nine and I learned how to do laundry and just keep a household while my mom was working. So I also would spend time with my grandmother, who was also a diabetic and she had hypertension and then heart failure, and I would, I would remind her to take her medicines. And then one day I got brave enough. I was like, well, I see that you're taking this insulin injection, can I get it to you? And she kind of looked at me like sure, like that's weird, but sure so.
Speaker 2:So it came to a point where it's like, man, I really enjoy taking care of my family. And it's like man, I really enjoy taking care of my family. And it's like, oh, so you can actually become a nurse and get paid to do this. I was like, oh cool, perhaps I should become a nurse and and and take care of folks. And it has just been this remarkable journey and I can say that I feel so fortunate to be here in this position.
Speaker 2:To where you know, I started out taking care of like one to two, maybe even three patients at a time working at bedside to you know, maybe taking care of 10 to 15 people working as a nurse practitioner, so now as nursing faculty, every person or every nurse that I teach, I'm able to influence them and hopefully touch, you know, a few other lives or even hundreds of lives. It just grows exponentially because you know each nurse. Throughout their career they take care of those folks. And for me to be able to pass down that old school nursing wisdom that I still remember I don't do it in the same traumatic way that I learned but in a more refined and supportive way, but still nonetheless, you know, passing down those clinical pearls to the next generation of nurses and it just there's no feeling like it in the world.
Speaker 1:So when was it that you kind of first were in the setting of like being a nurse? How was it? Like straight out of college or maybe before that?
Speaker 2:Well, joshua, you asked another fantastic question. So I was 17 in high school and I was in my health science course and the teacher was like well, what do you want to do, brandon? I was like I think I want to be a nurse. So she was like, oh, you're a guy, perhaps you should become a physician assistant. And I was like, actually, I have a cousin who's a nurse and I think I want to be a nurse. And she was like like I actually have a cousin who's a nurse and I think I want to be a nurse. And she was like okay, well, we can settle this debate. So I ended up she sent me up to go volunteer at LBJ Hospital here in Houston and back then it was called the Harris County Hospital District. Now it's called Harris Health and it's basically our safety net system here in Harris County, basically our safety net system here in Harris County.
Speaker 2:So here I am, 17 years old, going to this county facility and it so happened that I was in the emergency center there. So I saw a little bit of everything and I interacted with the nurses. They had a physician assistant on staff, the doctors, and I was just blown away on how the nurses they just ran this emergency center so efficiently and you know anything that will come in, they would call it, you know, like a level one to you know a sub toe. No matter what the situation was, the nurses always had control over the situation and I was like man, that's so cool, I want to be like them, I want to do that, and I guess you could say that's how I ended up going into critical care, just seeing that how they were like the calm ones, no matter what, and how they ran that operation. So that's how it all started, joshua, by me being this bushy tail, bright eyed 17 year old in the county emergency room working with the nurses.
Speaker 1:Yes, that just says so much about you know your passion from such a young age in doing this and it is very fulfilling to hear that you know this has been an ongoing journey for you and has led you to you know an ongoing journey for you and has led you to you know great accomplishments like this and I'm very excited to you know, continue to pay attention to what's coming out of the mind and the work that you're doing. And so, just as we continue to kind of wrap up here, do you have any kind of parting words or kind of tips or anything that you want to send out to the listeners in the audience?
Speaker 2:Sure, I would say that to the healthcare professionals. My tip is just listen to the caregivers. And even in my ICU days, a lot of nurses would get so anxious and want to kick the family members out and I would always be like, oh, absolutely not, let those caregivers stay at the bedside. Because, for example, you know, in ICU we would take care of patients with respiratory failure and I would walk in and I would see a patient's breathing pattern and I'd be like you know, I'm concerned. But then I would look at the family member and they're like, oh, this is how they breathe all the time and I was like, okay, good to know. Or I would kind of look concerned and then see the family member concerned. I was like, okay, so this is a change. We need to call somebody or pay someone.
Speaker 2:And for all of the caregiver listeners I would say that keep doing what you're doing. You are your loved one's biggest advocate and sometimes you have to shake the cage a little bit, especially if it means you have to. You know, take it up to the charge nurse or the facility administrators to be heard, but if they are not doing what needs to be done for your family member, do not be afraid to advocate for them at all levels and it'll get to someone eventually. Who, who will really matter and they will. They will address those concerns.
Speaker 1:I love to hear that you know getting their concerns addressed. Yeah, let's have a little bit more of that. Little bit more of that. I just want to give you another thank you for joining us today and being able to bring this part of the picture in the focus for us, and just wanting to say, hey, maybe we need to have a part two at some time, to have you back, because I feel, like you know, with each of these conversations, there's so much more that I want to learn about you as a person, and then also the things that you have to offer as far as care and treatment and all the things that are cancer related, that we're looking to get answers around. Just want to give a shout out to all of the listeners, everybody that's tuning in. We definitely appreciate you and want to see you next time, so please join us here again. On the Cancer Clear and Simple podcast, I am your host again, joshua Wright, cancer Health Disparities Initiative at the University of Wisconsin Carbone Cancer Center. Thank you so much. No-transcript.
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