Behind Closed Doors: The Key Role Nurses Play in Recognizing and Combating Human Trafficking

Podcast Transcript

Carol Pehotsky:

When we hear words like human trafficking, for a lot of us, our brains go to those media images, right, the Liam Neeson movie taken or Law and Order SVU. And oftentimes, with that comes a perception that human trafficking is a legal problem. But as we're going to talk about more today, there's a huge medical and healthcare component to human trafficking. Who better to address this global public health crisis than nurses, specifically forensic nursing? We're joined by Dr. Michele Reali-Sorrell today to talk about the specialty of forensic nursing.

Hi, and welcome to Nurse Essentials, a Cleveland Clinic Podcast where we discuss all things nursing, from patient care to advancing your career to navigating tough on the job issues. We're so glad you're here. I'm your host, Carol Pehotsky, associate chief nursing officer of Surgical Services Nursing.

My first exposure as a nurse to the concept of forensic nursing or the sexual assault nurse examiner was way back when I was in nursing school and really had the great opportunity to be exposed to some really powerful work being done in one of our local community facilities with a nurse who was a SANE nurse and explained to us as nursing students what that was, why it was so important, but also talked about it's very specific to sexual assault. And so, you know, sort of planting that seed in my head of, of what that is and, and when as a nurse I might need to call upon those resources, that was clear back in the early 2000s. As we think about human trafficking coming into sort of the more public consciousness, and as we expand our thinking on the topic, for me, what helped open my eyes to it is where I lived, in Cleveland, Ohio, as our city hosted more national events, events like the NBA Finals or the All Star game, or the baseball All Star game, or the Republican National Convention, big events like that where there was awareness at that time about how this could be a risk when national events come to our area was really what sort of what opened my eyes personally to how endemic this problem is.

So really, as we as a nation, and perhaps a world, evolve our consciousness around what this is, there's a burden on us as nurses to think about how we can help. And so, with that, I am delighted to welcome Dr. Michele Reali-Sorrell to this show today. She is our forensic nurse manager for the Cleveland Clinic Enterprise. Michele, thank you so much for joining me today.

Dr. Michele Reali-Sorrell:

Oh, thank you. I'm really happy to be here.

Carol Pehotsky:

Excellent. So, I would love to hear, to kick it off, is, is how did you get into the field of forensic nursing? You're so passionate about it. How'd you get here?

Dr. Michele Reali-Sorrell:

So, I was working in the ER years ago, and a patient had come in and she had been badly injured, and the police officer's comment was, "This is what happens when you are a drug addict, and you are a prostitute."

Carol Pehotsky:

Oh, gosh.

Dr. Michele Reali-Sorrell:

And I remember thinking, "No, that's not what happens. And this is a human being, and what your choices are doesn't matter, you shouldn't be categorized as less than." So, I thought, what can I do to help? What can I do to educate? And it started with, I need to first get myself educated and get involved. So, I decided to go back and take some classes and learn how to do forensic nursing.

Carol Pehotsky:

All right. You know, even in that evolution of time, you know, now we talk about sex worker versus prostitution, and really again understanding that human trafficking takes all forms, that's not what a lot of us heard growing up in the media, et cetera.

Dr. Michele Reali-Sorrell:

Correct. Yeah. So, we do talk about what is prostitution versus what is human trafficking, and I think that they can be misunderstood.

Carol Pehotsky:

Okay.

Dr. Michele Reali-Sorrell:

So, prostitution is when you choose to sell your body for some type of goods, whether it's food or housing or money. And then if you choose not to and you're forced to do it, it's trafficking. So, many times, we think that people are prostituting themselves, and it's not their choice, they have someone that is exposing them and forcing them into this lifestyle. And that pimp that they would refer to is the trafficker. So, we have to look at it differently in our world that not all prostitution is that, and many times it is trafficking.

Carol Pehotsky:

Sure. And so, with that, those other nuances, I guess I'd ask you the question too, is there a difference, you know, again, when I grew up, ha ha, in nursing school, it was the SANE nurse. Now we talk about forensic nursing. How are the same, how do they differ?

Dr. Michele Reali-Sorrell:

So, SANE nursing is sexual assault nurse examiner. It's definitely part of the forensic nurse role. We refer to ourselves as forensic nurses because we do more than just sexual assault evidence collection.

We take care of all victims of crime, whether it's intimate partner violence, domestic violence, child abuse, elder abuse. We do a lot of work in the community on educating, we're on committees across the state on human trafficking. We really are trying to be more than just doing that evidence collection.

Carol Pehotsky:

So, is a SANE nurse more sort of that point of entry versus that plus?

Dr. Michele Reali-Sorrell:

It's one of our jobs.

Carol Pehotsky:

Yes.

Dr. Michele Reali-Sorrell:

But it's not our only job.

Carol Pehotsky:

Okay. Okay.

Dr. Michele Reali-Sorrell:

Yeah.

Carol Pehotsky:

Fantastic. You highlighted it, but I'd love you to expand a little bit more on this, some of the common misconceptions about trafficking and abuse in general.

Dr. Michele Reali-Sorrell:

The misconception or the myth of human trafficking is that you're moving someone from one state to another or one country to another, and it's not what we're seeing. It is a global public health issue and making it a public health issue has allowed us to put more resources into it and look at policy and legislation. And it's not just a legal problem where it's just law enforcement involved, there is a medical component to this. So, it's hidden in plain sight, and we mean that if you were to go and look on Google of the people that are being trafficked, you know, the black and white pictures, younger people, restrained or locked up, and they would come running to you if you opened the door and said, "I'm here to help you," and that's not what we're seeing. Victims of human trafficking are living every day in their own homes or someone else's home. They have phones, they can come and go as they want, they go places, they can yell for help if they need it, and they're not. And there's a, a lot behind that, why they're not asking for help. And that's fear, they're being threatened physically, sexually, maybe their family's being threatened. There's that maybe a trauma bond between the person that's being trafficked and their trafficker. They might not even identify as being trafficked because there's some type of relationship going there and they might think that they have to do this, and it's not really identifying themselves as being trafficked. So, the misconception is that people will run and ask for our help, and they don't.

Carol Pehotsky:

Right.

Dr. Michele Reali-Sorrell:

Yeah.

Carol Pehotsky:

You know, and in preparing for this episode, you know, I'm surfing the net looking for things, seeing a lot of those images as well, but, you know, one interesting point that sort of stuck out to me was that, you know, with, with video streaming and the internet, somebody can be in their own home and still be victimized across the world.

Dr. Michele Reali-Sorrell:

Absolutely.

Carol Pehotsky:

And trafficked across the world. Any more thoughts on that and sort of the role that the internet plays in all of this?

Dr. Michele Reali-Sorrell:

So, the internet is incredibly powerful and wonderful if used correctly, but we have evil, evil in the world, so the internet is definitely an area where traffickers go, and they start the grooming practice. They mislead people on who they are and what their ages are, or their roles are. They prey on vulnerable populations, whether it's, you know, you’re in an unstable home life or maybe have some cognitive disabilities, intellectual disabilities, or maybe you're just lonely and they they, you form some type of relationship with them. So, traffickers are definitely looking online for their victims. And there's so much out there, there's so many apps. And what people are saying they are and who they are is not real, so they are luring our, e- especially our young people into this life.

Carol Pehotsky:

Sure. So, you know, for me, when I think about human trafficking, my brain automatically goes to sex work, but there's other types of human trafficking as well, right?

Dr. Michele Reali-Sorrell:

Correct. Yeah. Labor trafficking is a big deal as well. We might not see it right here in the Cleveland area, but where it is happening is maybe in more rural areas, if you think about human trafficking, is a business.

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

And as much as we want to, we have a lot of feelings and emotions around that, to disrupt it, we have to look at the business side of it and see why is it happening? And it's because there is a, a demand for humans to be controlled by someone else, whether that's through labor or sex trafficking. And someone else is making the money off of that person, so, there's a supply and demand. And the labor trafficking can be much more in rural areas, the hospitality industry, maybe in agriculture.

Carol Pehotsky:

What we might think of as quote "a migrant worker" end quote might really be somebody who's being trafficked into that work.

Dr. Michele Reali-Sorrell:

Absolutely. Yeah.

Carol Pehotsky:

Wow.

Dr. Michele Reali-Sorrell:

And it is a global problem. So based on where you live, you might see more of one versus the other.

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

But if you even look at sex trafficking and it is also a form of labor trafficking.

Carol Pehotsky:

Well, sure. Yeah.

Dr. Michele Reali-Sorrell:

Right.

Carol Pehotsky:

So, knowing that nurses and hopefully our listening audience, you know, represent ERs, schools, all sorts of places where I could be a nurse, knowing that human trafficking can present sort of some warning signs, what are some things that I as a nurse need to be on the lookout for to see if somebody is a victim of this?

Dr. Michele Reali-Sorrell:

That's a great question. There was a study done seven, eight years old already, they interviewed survivors of human trafficking in this research project.

Carol Pehotsky:

Oh, wow.

Dr. Michele Reali-Sorrell:

And what they found was 88 percent of those survivors disclosed they had seen and sought out medical care while actively being trafficked.

Carol Pehotsky:

Oh, my gosh.

Dr. Michele Reali-Sorrell:

And 63 percent of that was, were seen in an emergency department setting.

Carol Pehotsky:

Wow.

Dr. Michele Reali-Sorrell:

So, we are seeing it.

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

We are seeing patients here at the Cleveland Clinic that are being trafficked, but the, the problem is, they're not coming and saying, "Hello, I'd like to be seen, I'm being trafficked."

Carol Pehotsky:

Right.

Dr. Michele Reali-Sorrell:

They are coming in for medical problems. And whether that's because of they might have chronic disease like asthma, they're coming in for asthma exacerbation, or they might be coming in from an injury that ha- happened in a factory or, you know, something happened to them. So, they are seeking medical care, and we are seeing it in the clinic. So, understand that they're coming in for medical reasons, and so the questions we ask are super important. Are you safe at home is a really important question. But if you ask it, how are you asking it?

Carol Pehotsky:

Who's around when you are asking it too?

Dr. Michele Reali-Sorrell:

Right.

Carol Pehotsky:

Yeah.

Dr. Michele Reali-Sorrell:

So, often we let people come back.

Carol Pehotsky:

Yeah.

Dr. Michele Reali-Sorrell:

And so, you're going to say, "Are you safe at home?"

Carol Pehotsky:

Of course, they're going to say yes.

Dr. Michele Reali-Sorrell:

Yeah.

Carol Pehotsky:

Yeah.

Dr. Michele Reali-Sorrell:

They might not answer that. So, and so we're just asking about safety, and what does that mean? That means something different to everyone. It could mean is my community safe. Do I have rugs on the floor I might trip? Getting in and out of the shower, things like that. But we need to ask more than just about safety is, and so, what I say, "It's part of my clinical practice to screen all of my patients about safety, safety at home and safety at work." Because sometimes we know work can be a stressful, unsafe place.

Have you had any experiences that you would like to, or might need help, and how are you feeling safe, free from financial abuse, emotional abuse, sexual or physical abuse?" I think it's important to ask those questions, but you have to set the environment up before you ask a lot of specific questions. And so, you have to have a rapport with your patients, because if you're standing at your laptop, right, and you're asking all these questions, yeah, and you're like, "Hey, you know, are you safe at home?"

Carol Pehotsky:

Right. Yeah.

Dr. Michele Reali-Sorrell:

Our patients have given us feedback that we're not comfortable asking that question, or we're asking it with someone in the room, or we're not making eye contact, or we're not saying it sincerely enough. And survivors have said that, that they didn't feel safe disclosing to the healthcare provider, that we were judging them, or we were not a safe place.

Carol Pehotsky:

You've highlighted a great example of, it's asking the same question but creating a space where the, where the person can answer. So really, one of the things we should be taking away from this is, yes, I might need to document in the medical record somebody's answered the question, but how am I asking it?

Dr. Michele Reali-Sorrell:

Correct.

Carol Pehotsky:

So, I've asked the question, and independent of the answer, as a nurse, are there other things I should be assessing for that may tell me that something else is going on, especially in that instance where maybe the patient doesn't even recognize that they're being trafficked?

Dr. Michele Reali-Sorrell:

Right. So, there are definitely some red flags that we can see in human trafficking. I think one of the things that, if I look back it, they, they want their medical care because they're uncomfortable, they're sick, so that's making that the priority, making them the priority, their medical concern the priority. But then it's going back and looking at, are they presenting very scripted? Or are they looking to the person who's with them kind of for like, "Can I answer this or not?" If their injury or the reason that they're there just doesn't match up, they said they fell through some, a window and you would think that the cut was, would be clean and well approximated but it's, you know, looks like it's ragged and they might've been drugged from somewhere. You know, so the injury and the reason for that injury don't match up. If they don't have the medications that they need for chronic disease, and that could be something simple, right?

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

But they're not allowed to go to the doctors. So, they're not getting the care that they have. Yeah. I think some other things would be if they're coming in for frequent STDs.

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

And we, we look at that as perhaps that that person is just having, uh, you know, an unsafe lifestyle, but it could often be that it wasn't their choice.

Carol Pehotsky:

Right.

Dr. Michele Reali-Sorrell:

And so, I think that just looking at that, and not judging the patient, but looking for one red flag can mean nothing.

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

It's when they start to all add up. I think another thing for us to look at is patients that have drug or alcohol concerns. And we could say that they have addiction issues, however, why were they started? Sometimes the trafficker will start a person on drugs to control them, and so now they've become a drug addict, so not only are they being trafficked, but even if you were to get them out of that lifestyle, they now have an addiction issue. So, it's a big issue, why is someone addicted to alcohol, drugs, so again, one time, one flag is not but just to kind of look through the chart, see what other kind of red flags they may have.

Carol Pehotsky:

And highlights the importance of in all things we do, conveying a, a spirit of being judgment free. No matter what type of nurse I am, I can't give you the best possible care if we don't have this open and honest relationship where you feel like you can tell me what you took this morning, what's going on with you. But I have to, as the nurse, in my appearance, in my body language and the words I'm saying create that ease that says, "I'm here for you."

Dr. Michele Reali-Sorrell:

And that's what we talk about trauma informed care, and understanding that we have to meet our patients where they are, and what happened to them before they came into the office, before they came into the ER that day, where has their life been? So being, like you said, not judgmental and having conversations with our patients, sitting eye level with them, offering them something to eat or drink, and really just making them feel safe and respected is planting that seed. And I always say to people, you know, the healthcare system is the safety net of a community.

Carol Pehotsky:

Yeah.

Dr. Michele Reali-Sorrell:

And that's why they're built in communities, so that people will seek out health and care. And it should be a place where they go because they feel safe, they feel respected and they feel like someone will help them, regardless of what they look like, regardless of their jobs, regardless of what type of transportation they came in. And so, we as nurses have to remember that every person deserves that, and that trauma informed care approach is crucial, not just for forensic patients or victims of crime, but in everything that we do at the clinic.

Carol Pehotsky:

Yeah, and certainly that's probably its own episode itself because it's so, it's such an important topic. You know, as you're talking and, and sharing these points, it also is a great reminder that obviously we're expected to get an interpreter for a lot of reasons, but all the more reason why it's so important to not use quote "a family member" and end quote for interpretive services, because this could be somebody who is giving us a different story because we have failed to provide that patient with an appropriate way to communicate with us.

Dr. Michele Reali-Sorrell:

Carol, that's such a great point. And that's happened, right.

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

They'll say, "No, no, no, no, my, you know, they can interpret for me, I want them to." And they can give us pushback because they're trained to do that, like don't. And we just have to say, "It is our policy that we do this."

Carol Pehotsky:

Yes. Yep.

Dr. Michele Reali-Sorrell:

And if they get upset, they get upset, we have to bring our language line into the room, we have to access it, and we have to give them that opportunity. And yes, people that have a language barrier should absolutely have an interpreter there because we don't know what that person's saying to them or asking them.

Carol Pehotsky:

Yeah. So, we're very blessed in our organization to have your whole team, small but mighty though they are and forensic nurses. Can you spend a few minutes talking about, for organizations that have forensic nurses, what the resources are? And then the flip side of this, we probably have nurses listening that don't have a forensic nurse program, so what can they do to further help their community and their patients?

Dr. Michele Reali-Sorrell:

Sure. It is definitely a small group of nurses. It's a specialty and requires extra training and, uh, commitment. It's hard. It's hard work.

Carol Pehotsky:

Yeah.

Dr. Michele Reali-Sorrell:

It's emotionally draining.

Carol Pehotsky:

Yeah.

Dr. Michele Reali-Sorrell:

Every patient that we take care of has been a victim of some violent crime. So, I think if you're in a nursing area and it's interesting to you, you could always reach out to find out more information. But if you're working in a facility that doesn't have forensic nursing, what are your options? I guess it would be that there is evidence to be collected with a sexual assault, and any nurse can do that.

It's not ideal, but you can do that for your patient. It's what are your resources in your community?

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

Do you have a forensic nursing program somewhere where you can offer that patient a transfer to there?

Carol Pehotsky:

Mm. Yeah.

Dr. Michele Reali-Sorrell:

It's calling your social worker asking them to get involved and help. It's time sensitive, so, you know, it's usually 96 hours or less where patients have to get that care, so you really want to make sure that you're sending them or getting them a forensic nurse. Now, we're so fortunate, the clinic, you know, we travel to all five counties.

Carol Pehotsky:

Oh, gosh. Yeah.

Dr. Michele Reali-Sorrell:

Right. And so, we're really fortunate. And even in Northeast Ohio, we have, the other two hospital systems have forensic nursing. It's the rural areas and the smaller areas. And so, I would say as a nurse and nurse leaders to ask your organization could they sponsor it. It is definitely a need, and there are some, you know, funds to get the programs up and running.

Carol Pehotsky:

Oh, okay. There's grant funding available?

Dr. Michele Reali-Sorrell:

Mm-hmm.

Carol Pehotsky:

Oh, okay.

Dr. Michele Reali-Sorrell:

And a lot of organizations even will offer the free training.

Carol Pehotsky:

Well, that's fantastic.

Dr. Michele Reali-Sorrell:

Duquesne University is one of them.

Carol Pehotsky:

Really?

Dr. Michele Reali-Sorrell:

Does free training online and there are some organizations down in Columbus that will offer free training. So, there are options to get involved. And of course, you could always reach out to me, and I will, you know I will help you find that resource.

Carol Pehotsky:

Yeah, tell me a little bit more about the, the interventions a forensic nurse could put into place beyond evidence collection.

Dr. Michele Reali-Sorrell:

Sure. So, as a forensic nurse, we're building on our skill sets as nurses and we're doing a medical, legal exam, actually, a medical exam where we're focusing on the body and the injuries, and we're doing evidence collection on behalf of that patient.

That can be used long term. If we go to court, we often go to court and testify in the patient's behalf about what happened that day, why they came to the hospital, injuries. We do photography, so we photograph injuries of the patient.

Carol Pehotsky:

Oh, gosh.

Dr. Michele Reali-Sorrell:

We take care of children, elder abuse, intimate partner violence. And I think a lot of what we offer is the time we can spend with that patient.

Carol Pehotsky:

Oh, yeah.

Dr. Michele Reali-Sorrell:

You have four or five patients or eight patients, what, one, and one patient in the ICU, but as a forensic nurse, we only have that patient. And our average case can be anywhere between four to six hours.

Carol Pehotsky:

Okay.

Dr. Michele Reali-Sorrell:

And so, it's more than just evidence collection, it's providing that trauma informed care. Do they have safety issues at discharge? So, do we do safety planning and maybe have to help them find alternative housing?

Carol Pehotsky:

Sure, yeah.

Dr. Michele Reali-Sorrell:

Medications and follow up. Often, we start our patients on HIV medication, so there's a lot of education and training on what that goes into. For elder abuse or child abuse or intimate partner violence, we also do that safety planning. We do photography and document the injuries.

We talk about the follow-up clinic and getting them medical care. And we try and get them counseling, whether that's though our organization our outside, the Cleveland Rape Crisis Center or Journey, the Domestic Violence Center, or Canopy, the Child Advocacy Center, there's lots of resources in our community that we try and get them help with. We do a discharge callback as well and check on our patients to see if there's barriers that came up that they couldn't get the follow-up care that they needed. They come in and they're so traumatized, and we spend so much time with them, and they leave, and the retention of what we've probably talked about is about 10 percent.

Carol Pehotsky:

Oh, gosh. For sure. At least. If that, I should say. Yeah.

Dr. Michele Reali-Sorrell:

Yeah. Yeah. So, we really want to follow our patients and make sure that, you know, "Were you able to do this? How are you feeling today?" And then just keep reaching out and referring and letting them then know that the healthcare is that safety net for them.

Carol Pehotsky:

Yeah, they're brave enough to come in through our door it, it doesn't stop at evidence collection.

Dr. Michele Reali-Sorrell:

Right.

Carol Pehotsky:

It's really, you, clearly you and your team are creating a space where they, they feel cared throughout the journey.

Dr. Michele Reali-Sorrell:

Absolutely. The forensic nurse is, you know, doing the medical, the clinical, and then blending it with our legal teams, but we're also doing education and training, and we're trying to talk to people about safe relationships or other things that relate to their health and wellness.

Carol Pehotsky:

Comes back to meeting the patient where they are.

Dr. Michele Reali-Sorrell:

Yeah.

Carol Pehotsky:

Well, and to close us out a little bit, you know, when you talked about how to make patients feel safe, it, it's all, you know, any one of us as a nurse, so, so listeners, here's your assignment the next time you talk to really anybody, not just a patient, you know, as, as Michele said, unfortunately, this is, this human trafficking does not care about age or race or gender or socioeconomic status, and so how are we creating safe spaces for people in our life, for the patients we serve so they feel like they can trust us with this very important information so we can get them the help they need.

Dr. Michele Reali-Sorrell:

Yeah. I, I think that it's essential that we do this. The patients that we have seen aren't always in the emergency department either.

Carol Pehotsky:

Right.

Dr. Michele Reali-Sorrell:

They're in ambulatory care or coming in for a routine visit. They might be in labor and delivery coming in for an OB appointment. They might be at Cole Eye because there's an eye injury. So we're, we are seeing the point of entry for victims that we have identified across the board, so it's definitely coming in for medical care, and then it's making that somehow something didn't seem right, there was red flags, the nurse at the bedside contacted us and we came in. [inaudible 00:23:47] now is that you even have to ask all these questions.

Carol Pehotsky:

Right.

Dr. Michele Reali-Sorrell:

That you can contact my department, the for-, any of our forensic nurses, and we'll come in and work our magic as far as, you know, talking to the patient, offering them resources. One of the resources we can offer them is our CAT clinic, Care After Trauma.

And that's on Mondays either at Stephanie Tubbs Jones Health Center or Lakewood. So, we can come in and say, "Hey, we were asked to come talk to you. Do you have a primary care provider? We have this really specialized clinic, it's called the CAT Clinic, and we have a lot of time to help you and we have resources. We have a forensic nurse there, we have a victim advocate from our, Cleveland Clinic Police Department," right. And so, we try and get them a follow-up appointment and then start maybe backtracking a little bit about, "So, I'm sorry, what brought you here."

And we can spend a lot of time with them, where that's not possible with nursing today to spend three or four hours at the bedside just, you know, trying to build that rapport.

Carol Pehotsky:

Yep. And so, listeners, you've got another assignment, which is, if you work at the Cleveland Clinic, we've highlighted some resources for you. If you don't, you know, your assignment is to find out what resources do you have available in your organization? Can you advocate for different resources? Can you talk to your county boards of health to see what sort of resources they provide? We are very fortunate, as Michele mentioned, we have a victims advocate in our organization, and that role has been worth its weight in gold.

Dr. Michele Reali-Sorrell:

Absolutely.

Carol Pehotsky:

And so, what can you do in your facilities to really tap into that? Well, Michele, your passion just clearly shines through, so I can't thank you enough for educating me on this topic. I'm hoping we'll spend a few minutes with our speed round to lighten things up a touch, and help our listeners get to you know you a little bit more as a human being and a nurse. So, if, something you with you knew as a brand-new nurse, what would that be?

Dr. Michele Reali-Sorrell:

I go back, you know, 25 years ago, and I honestly think that I didn't realize how emotional our role is and how impactful we really are on a patient's experience in life where either it's the most happy time or maybe the worst time, that I didn't really pay attention to the impact that I would have on a person's experience in life, especially during illness.

And I think that it's something that we can never lose track of, that no matter what's going on in our department, that person is coming to us for help. And how we treat them is very impactful. We might be the nicest person that they had an encounter with that day.

Carol Pehotsky:

Sure.

Dr. Michele Reali-Sorrell:

We, gosh, hope we're never the worst encounter they had for a day, right.

Carol Pehotsky:

Yes.

Dr. Michele Reali-Sorrell:

So, I just, I don't think I realized the depth of the impact that I would have on someone's life as a nurse.

Carol Pehotsky:

Okay. And what brings you joy?

Dr. Michele Reali-Sorrell:

Oh, gosh, my family.

Carol Pehotsky:

Yeah.

Dr. Michele Reali-Sorrell:

Yeah. I know that's a cliché, everyone says that. But, you know, my three children and I really, they're such wonderful young adults, and I'm just thrilled that they are, you know, living their best lives. And so just being around my kids.

Carol Pehotsky:

Wonderful.

Dr. Michele Reali-Sorrell:

Yeah.

Carol Pehotsky:

Thank you so much for joining us today.

Dr. Michele Reali-Sorrell:

Uh-huh. Thank you.

Carol Pehotsky:

As always, thanks so much for joining us for today's discussion. Don't miss out, subscribe to hear new episodes wherever you get your podcasts. And remember, we want to hear from you. Do you have ideas for future podcasts or want to share your stories? Email us at nurseessentials@ccf.org. To learn more about nursing at Cleveland Clinic, please check us out at clevelandclinic.org/nursing. Until next time, take care of yourselves and take care of each other. The information in this podcast is for educational and entertainment purposes only and does not constitute medical or legal advice. Consult your local state boards of nursing for any specific practice questions.