Diversity, Equity and Inclusion in Healthcare and Nursing

Podcast Transcript

Carol Pehotsky (00:05):

We hear the terms diversity, equity, inclusion, and increasingly, belonging, throughout our conversations and our travels. But do we really understand what those terms mean and how important they are to the nursing care we provide? I'm joined today by my friend and colleague, Dr. Myra King. Dr. King is a clinical nurse specialist. Her practice specialty is intensive care in our Heart, Vascular, and Thoracic Institute, and she serves as a manager of our clinical nurse specialist team. She has some wonderful insights on how we can move from concept to practice.

(00:40):

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.

(01:01):

Welcome back everyone. Today's topic is diversity, equity, inclusion, and belonging. You know, often I refer to myself as an older nurse, or perhaps (laughs) somebody who's, who's been in this profession a minute or two. And even looking back on the topics we talked about in nursing school, or even my, my entree into the profession, there's a lot of conversation in our classes and in the education modules, we had to take around cultural competence, but that's really as deep as it got.

(01:32):

And what a wonderful thing it is that 20 years later, we're getting deeper and we're really talking as a profession as well as nurses delivering care to patients, well beyond cultural competence to really talk about how do we look like the patients we serve and give the patients and the caregivers we serve a voice. So, with that, it's my great pleasure to welcome my friend and colleague, Dr. Myra King today. Dr. King, Myra, if I may-

Myra King (01:58):

Absolutely. (laughs)

Carol Pehotsky (01:59):

(laughs) ... is a practicing clinical nurse specialist here at Cleveland Clinic in the ICUs and the Heart, Thoracic and Vascular Institute, as well as, uh, a manager of our clinical nurse specialist team. Myra, welcome.

Myra King (02:09):

Thank you for having me. I'm so excited. I'm, I'm delighted to be here.

Carol Pehotsky (02:12):

Excellent. You know, we go way back.

Myra King (02:14):

Yes, we do.

Carol Pehotsky (02:14):

I, I would like to say.

Myra King (02:15):        

Yes.

Carol Pehotsky (02:15):

And it's been such a pleasure. I have learned from you throughout our, our friendship and our, and our colleague experience together. And so, I'm so excited that our audience gets to learn from you as well. You have a fantastic story about how you got into nursing and your nursing journey. So, I hope you'll start us off with a few tastes of your journey so far. And what makes you excited to be a nurse still?

Myra King (02:36):

Absolutely. You know, I was reflecting on that question. I was thinking about kind of where I started in nursing.

Carol Pehotsky (02:36):

Mm-hmm.

Myra King (02:41):

And it really goes back to when I was in high school.

Carol Pehotsky (02:43):

(laughs)

Myra King (02:44):

And I decided to get some community volunteer hours as a high schooler, and-

Carol Pehotsky (02:44):

All right.

Myra King (02:49):

... I became, I don't know if you remember, Candy Stripers.

Carol Pehotsky (02:49):

Oh, yeah. (laughs)

Myra King (02:49):

(laughs) Which that's what we used to be called.

Carol Pehotsky (02:49):

Yep.

Myra King (02:51):

Candy Stripers, which were volunteers in the hospital environment. So, we would go into patients’ rooms, and we would help deliver trays and we would deliver ma- newspapers and I loved that. I loved the ability to serve patients. I loved the-

Carol Pehotsky (02:51):

Sure.

Myra King (03:07):

... ability to feel like I was helping them and that I was building a relationship with them. And that was my first exposure-

Carol Pehotsky (03:13):

Yeah.

Myra King (03:13):

... to the hospital environment. I began to look at nurses and look at what they-

Carol Pehotsky (03:18):

Mm-hmm.

Myra King (03:18):

... did to help to build relationships with patients. And I was like, "I think that's what I want to do."

Carol Pehotsky (03:18):

All right.

Myra King (03:24):

So, I would say that I didn't find nursing, but that nursing found me.

Carol Pehotsky (03:24):

Okay.

Myra King (03:28):

And so, I started off in the cardiovascular intensive care unit here at Cleveland Clinic, and I think-

Carol Pehotsky (03:34):

Oh, that was your first role?

Myra King (03:35):

That was my first role.

Carol Pehotsky (03:35):

Oh, okay. Wow.

Myra King (03:37):

Yeah. I was a new graduate.

Carol Pehotsky (03:37):

Yeah.

Myra King (03:38):

That was 26 years ago.

Carol Pehotsky (03:38):

(laughs)

Myra King (03:39):

Oh, my goodness. I can't believe how, how quickly that time has gone.

Carol Pehotsky (03:43):

Sure.

Myra King (03:43):

Um, and I fell in love with the patient population and decided to, up until now, really devote my career-

Carol Pehotsky (03:43):

Yeah.

Myra King (03:49):

... to that patient population. It was about seven years into my career where I started to realize this love that I have for supporting our nurses, being a preceptor at the bedside...

Carol Pehotsky (04:02):

Mm-hmm. Sure.

Myra King (04:02):

... educating them. And so, I decided to move into a role as a nurse educator.

Carol Pehotsky (04:08):

Yeah.

Myra King (04:08):

At the time we were called clinical instructors.

Carol Pehotsky (04:10):

Yes. (laughs)

Myra King (04:11):

(laughs) Now they're nursing professional development specialists.

Carol Pehotsky (04:14):

Mm-hmm.

Myra King (04:14):

And I absolutely also love that role. I was able to support nurses at the bedside-

Carol Pehotsky (04:14):

Mm-hmm.

Myra King (04:19):

... and educate them as they care for patients. And then I did that for a couple of years and realized that in addition to teaching...

Carol Pehotsky (04:27):

Mm-hmm.

Myra King (04:27):

... I also love to promote best practices at the bedside.

Carol Pehotsky (04:31):

Yeah.

Myra King (04:32):

I love to ensure that we were advancing nursing practice.

Carol Pehotsky (04:35):

Mm-hmm.

Myra King (04:35):

I realized that almost everything that I loved about nursing was, was embodied in the clinical nurse specialist role.

Carol Pehotsky (04:35):

Ah.

Myra King (04:42):

And so, I was very fortunate to be able to go back and become a clinical nurse specialist.

Carol Pehotsky (04:47):

Mm-hmm.

Myra King (04:47):

Which is one of the four advanced practice nurse roles.

Carol Pehotsky (04:50):

Yes.

Myra King (04:51):

I've been doing that ever since; it's been about 15 years.

Carol Pehotsky (04:51):

Wow.

Myra King (04:54):

And then, you know, it, it has been an amazing, amazing journey. And as you stated about, gosh, 10 years ago, I moved into a leadership role.

Carol Pehotsky (05:02):

Has it been that long? (laughs)

Myra King (05:04):

It really has. So, I have this distinct honor-

Carol Pehotsky (05:06):

Yes.

Myra King (05:07):

... of, of leading and serving a brilliant group of advanced practice nurses.

Carol Pehotsky (05:10):

Yes.

Myra King (05:11):

And so, it's been a great journey.

Carol Pehotsky (05:12):

Yeah.

Myra King (05:12):

Like, I have just been so privileged and so blessed and it fuels me every day. So, yeah, I get to live out my why every day, which is just wonderful.

Carol Pehotsky (05:20):

Oh, my gosh. All right, everybody, pause, rewind, write that down...

Myra King (05:24):

(laughs)

Carol Pehotsky (05:25):

(laughs) ... and now we'll go forward. So, getting into the topic of the day, going to start with the word diversity.

Myra King (05:31):

Mm-hmm.

Carol Pehotsky (05:32):

Right. It's a word that we hear a lot of, whether that's in our social media life or our walking around life or our health care life. But what does it mean to you in health care?

Myra King (05:42):

You know, when I think about the word diversity, I think about celebrating and respecting the differences that we all have.

Carol Pehotsky (05:49):

Okay.

Myra King (05:49):

Right? And I think about realizing that it's important to have representation.

Carol Pehotsky (05:54):

Mm-hmm.

Myra King (05:54):

So, representation from people with different demographics, different backgrounds, whether it's race, religion, ethnicity, sexual orientation...

Carol Pehotsky (06:02):

Mm-hmm.

Myra King (06:02):

... age, you know, abilities, all of the differences and making sure that we are representatives of the society of the patients in which we serve. And I think that, you know, sometimes people think about diversity, and they think about inclusion and, and they feel as though those words are interchangeable. So even though it's important...

Carol Pehotsky (06:02):

Mm-hmm.

Myra King (06:22):

... that we ensure that we have a diverse team...

Carol Pehotsky (06:22):

Okay.

Myra King (06:26):

... that we diversify the nursing workforce, for example.

Carol Pehotsky (06:30):

Mm-hmm.

Myra King (06:30):

It's also important that we take it a step further and that people feel included.

Carol Pehotsky (06:36):

Ah.

Myra King (06:36):

So, inclusion is-

Carol Pehotsky (06:36):

Sure. (laughs)

Myra King (06:39):

... really taking that step further and saying, "Listen, we're going to create this environment where people feel valued, where they feel as though they're respected. Their input matters." And I love this quote by a DEI consultant, her name is Verna Myers. And she said that diversity is inviting people to the party, whereas inclusion is inviting them to dance, so-

Carol Pehotsky (06:39):

Okay, there you go. Yeah.

Myra King (07:04):

... we're going to invite you to the table, but you're at the table now, we're going to invite you to share your input and we're going to respect and listen to that input. So yes, diversity is important, but we really need to make sure that we also are including people and that we're treating them equitably.

Carol Pehotsky (07:18):

Right. Sure. It's not just a seat at a table. It's saying, and we'd like to hear from you while you're sitting with us.

Myra King (07:23):

Absolutely.

Carol Pehotsky (07:23):

Okay.

Myra King (07:24):

So, listening their input, and then really listening. Not listening to respond.

Carol Pehotsky (07:29):

(laughs) Yeah.

Myra King (07:29):

But listening to truly understand and incorporate their ideas into our plans, into our projects. We know that that will improve outcomes.

Carol Pehotsky (07:38):

Absolutely. So, you've touched on a lot of this already, but just to really hone it in for our audience, clearly diversity inclusion plays a really important role in a healthy work environment in health care teams of nurses and physicians working together. So, what are some of the first steps that as a nurse I should be thinking about or taking? So, I'm not necessarily a leader, but I'm a, I'm a nurse, I want to make sure that the unit I'm working in is inclusive, is diverse. What are some things that I can do as a bedside nurse?

Myra King (08:09):

I think that's a really important question because I don't think that we oftentimes think about how important it is that we create welcoming atmospheres-

Carol Pehotsky (08:16):

Sure. Mm-hmm.

Myra King (08:17):

... for the nurses that are entering our units, right?

Carol Pehotsky (08:17):

Mm-hmm.

Myra King (08:19):

And so, it's getting to know our co-workers.

Carol Pehotsky (08:19):

Mm-hmm.

Myra King (08:22):

It's getting to know them beyond the gate. care that they give at the bedside.

Carol Pehotsky (08:26):

Sure.

Myra King (08:26):

But really, who are they as people? What is their heritage, right?

Carol Pehotsky (08:26):

Okay.

Myra King (08:31):

What are their values? What's important to them? What's their family like? And inviting them into conversations that we have.

Carol Pehotsky (08:37):

Mm-hmm.

Myra King (08:38):

I think, unfortunately, nurses are known to, a- and I'm, I, I know that we're trying to get away from this, but-

Carol Pehotsky (08:38):

(laughs)

Myra King (08:45):

... you know, we eat our young, right? So, we ca-

Carol Pehotsky (08:45):

Yeah.

Myra King (08:47):

(laughs) And that goes for all nurses, right? That we, you have to somehow come into our unit and prove yourself.

Carol Pehotsky (08:52):

Yeah.

Myra King (08:52):

And that's really not. Guess what, they've gone to nursing school. They've passed...

Carol Pehotsky (08:55):

Right.

Myra King (08:56):

... the NCLEX, if that's the testing-

Carol Pehotsky (08:57):

All the hoops have been jumped through. Yep.

Myra King (08:59):

Exactly.

Carol Pehotsky (08:59):

Yep.

Myra King (09:00):

So now we need to hold their hand and-

Carol Pehotsky (09:00):

Mm-hmm.

Myra King (09:03):

... to take them along this journey of becoming a nurse.

Carol Pehotsky (09:06):

Mm-hmm.

Myra King (09:06):

It may not mean that this is the unit for them. Perhaps it may, might be better suited in another clinical environment.

Carol Pehotsky (09:11):

Sure.

Myra King (09:11):

But at the end of the day, they are a nurse, and we want them to feel valued.

Carol Pehotsky (09:11):

Mm-hmm.

Myra King (09:15):

We want them to feel respected. We want them to feel as though they matter. So as a bedside nurse, really making sure that I'm including my coworkers, building relationships with my coworkers, and that I don't gossip and talk about them and have a toxic relationship-

Carol Pehotsky (09:31):

Sure.

Myra King (09:31):

... toxic environment-

Carol Pehotsky (09:31):

Yeah, yeah.

Myra King (09:32):

... which sometimes can be the case.

Carol Pehotsky (09:34):

It seems so simple, and yet...

Myra King (09:35):

Yes. (laughs)

Carol Pehotsky (09:36):

... we still have work to do in that area. (laughs)

Myra King (09:37):

We still have work to do in that area.

Carol Pehotsky (09:38):

And as I'm thinking, receiving that, not listening to respond. (laughs)

Myra King (09:38):

(laughs)

Carol Pehotsky (09:43):

But, you know, you think about the experiences that a lot of nurses unfortunately have had coming into the profession. So, it's not just, I'm not going to be mean to you.

Myra King (09:43):

Mm-hmm.

Carol Pehotsky (09:52):

It really is saying, I want you to feel like you are your whole self here.

Myra King (09:52):

Mm-hmm.

Carol Pehotsky (09:56):

So, so how is, as a preceptor, can we do that? Right? The new graduate nurse might be scared anyway.

Myra King (10:02):

Mm-hmm. Right.

Carol Pehotsky (10:02):

May not feel comfortable offering much about myself. So now I'm a preceptor.

Myra King (10:06):

Right.

Carol Pehotsky (10:06):

How do I really create that inclusive environment and say, "I want to hear from you?"

Myra King (10:10):

Well, I think it's asking the questions.

Carol Pehotsky (10:12):

Mm-hmm.

Myra King (10:12):

Asking those probing questions like, "How are you showing up today? What questions do you have for me? I'm here to support you along this journey." And making yourself available to them, not judging them, right?

Carol Pehotsky (10:12):

Yeah.

Myra King (10:23):

But really making them yourself available to them. We need to make sure that our nurses feel like we care about them.

Carol Pehotsky (10:23):

Mm-hmm.

Myra King (10:30):

We talk all about, and it's so important that we treat our patients like we want to be treated.

Carol Pehotsky (10:37):

Absolutely. Yeah.

Myra King (10:37):

That we treat them equitably and we provide them with the resources that they need. We also need to translate that to how we treat each other-

Carol Pehotsky (10:37):

Mm-hmm.

Myra King (10:45):

... as nurses, whether it's a new nurse, whether it's a coworker that we've been working with for years.

Carol Pehotsky (10:45):

Mm-hmm.

Myra King (10:49):

That we make them feel that we treat them fairly.

Carol Pehotsky (10:49):

Mm-hmm.

Myra King (10:53):

And that we make them feel that they are a valuable member of the team, right?

Carol Pehotsky (10:53):

Sure.

Myra King (10:57):

That's how you build community. And we talk about community nursing-

Carol Pehotsky (10:57):

Yeah.

Myra King (11:00):

... with our unit, that we are all connected. And when you hurt, I hurt. When you succeed, we all succeed.

Carol Pehotsky (11:07):

Yeah.

Myra King (11:08):

Right? And that's absolutely what is needed in the, in the units in which we work.

Carol Pehotsky (11:08):

Mm-hmm.

Myra King (11:13):

And we can do that by ensuring that all of our nurses and all of our caregivers, right-

Carol Pehotsky (11:18):

Mm-hmm. Yeah.

Myra King (11:18):

... that is a part of our nursing team...

Carol Pehotsky (11:20):

Absolutely.

Myra King (11:20):

... feel equally valued and that they're, that they're seen, that they're heard and that we're open to supporting them in any way that we can.

Carol Pehotsky (11:20):

Mm-hmm.

Myra King (11:28):

So that, that's really, really important, right?

Carol Pehotsky (11:28):

Yeah.

Myra King (11:31):

And then we check our own implicit biases.

Carol Pehotsky (11:33):

Well... (laughs)

Myra King (11:34):

Right?

Carol Pehotsky (11:34):

Yeah. All right. So [inaudible 00:11:37].

Myra King (11:36):

We all have them.

Carol Pehotsky (11:36):

Yeah. Mm-hmm.

Myra King (11:37):

Okay. We all have these, these biases about people based on how they look or where they come from, or maybe religious affiliation that they may have that we know that-

Carol Pehotsky (11:45):

Sure. Something going on in myself that has nothing to do with them. Yeah, absolutely.

Myra King (11:48):

So, something could... That's like, "Maybe this is based on my experiences that I've had in the past."

Carol Pehotsky (11:52):

Mm-hmm. Right.

Myra King (11:52):

So, we bring that into our work environments, we bring that to the table, and we have to be cognizant of that so that we make sure that those implicit biases, those beliefs are not impacting negatively the way in which we are interacting with other nurses-

Carol Pehotsky (11:52):

Sure.

Myra King (12:09):

... and other members of the health care team.

Carol Pehotsky (12:11):

Yeah.

Myra King (12:11):

It can happen. And so-

Carol Pehotsky (12:13):

Sure.

Myra King (12:14):

... we need to check it at the door and be aware of it.

Carol Pehotsky (12:16):

And, and I think everybody thinks, "I don't have any biases."

Myra King (12:16):

(laughs)

Carol Pehotsky (12:19):

Or "I don't show it." But it's absolutely visible.

Myra King (12:23):

Absolutely. Yeah.

Carol Pehotsky (12:24):

I was reading something that said there's something like over 130 different types of biases.

Myra King (12:24):

Mm-hmm.

Carol Pehotsky (12:29):

So, so listeners. (laughs)

Myra King (12:31):

Yes. (laughs) 

Carol Pehotsky (12:32):

You can spend some time investigating that or just acknowledge that we all do have those biases. So, so what, what internal work should we be doing to identify what they are?

Myra King (12:40):

Absolutely. And then not only identifying them, but also identifying how they may be impacting-

Carol Pehotsky (12:46):

Right.

Myra King (12:46):

... how we're treating our patients...

Carol Pehotsky (12:46):

Yes.

Myra King (12:48):

... or how we're treating our coworkers. What is my response based on those biases? And so, recognizing them and then associating that with our behaviors, our language and our interactions is important.

Carol Pehotsky (13:01):

Yeah. You know, s- some of nursing is very much a, um, I see something, I have to rea- react to it, but a large part of what we do, there's that moment to apply that filter... (laughs)

Myra King (13:01):

Yes.

Carol Pehotsky (13:10):

... and to think about, "Okay, how is this going to be received?"

Myra King (13:14):

Mm-hmm.

Carol Pehotsky (13:15):

Am I making the people around me, the caregivers around me, feel like they have a voice?

Myra King (13:21):

Right. Absolutely. And I think too, it's important that our caregivers know that they have a voice in things that matter to how they practice. So that goes-

Carol Pehotsky (13:21):

Yeah.

Myra King (13:30):

... back to share governance and-

Carol Pehotsky (13:30):

Mm-hmm.

Myra King (13:32):

... and practice councils and being able to speak up at meetings. Like, we want to hear your input because what-

Carol Pehotsky (13:32):

Right.

Myra King (13:38):

... you have to say is important to how we are going to implement practices-

Carol Pehotsky (13:43):

Yeah.

Myra King (13:43):

... our units and policies. And when people know that they are seen and then they are heard, they actually kind of are encouraged to speak up more.

Carol Pehotsky (13:51):

Absolutely. Yeah.

Myra King (13:52):

They actually say, "Hey, I, I, I guess I can."

Carol Pehotsky (13:52):

Yeah.

Myra King (13:55):

"I, I think I'm kind of important."

Carol Pehotsky (13:56):

Mm-hmm.

Myra King (13:57):

And then I have experienced that in my own career.

Carol Pehotsky (13:57):

Yeah.

Myra King (13:59):

Where I am in the many rooms where I'm the only or one of the only people that look like me.

Carol Pehotsky (13:59):

Yeah.

Myra King (14:05):

And it took a long time for me to get the courage to speak up.

Carol Pehotsky (14:05):

True. Yeah.

Myra King (14:11):

To find my voice and to understand that what I had to say and what I had to contribute was important.

Carol Pehotsky (14:11):

Mm-hmm.

Myra King (14:19):

That I contribute a perspective-

Carol Pehotsky (14:22):

Mm-hmm.

Myra King (14:22):

... that's unique and different than what others can contribute.

Carol Pehotsky (14:22):

Absolutely. Yeah.

Myra King (14:27):

So, I can't deprive others from what I have to contribute because I don't feel like I, I don't have that courage, or I don't feel like I'm going to be heard.

Carol Pehotsky (14:35):

Wow.

Myra King (14:35):

So being able to find your voice-

Carol Pehotsky (14:37):

Yeah.

Myra King (14:37):

... when you're in the, in those situations is so important. But we also have to create the environment that is conducive-

Carol Pehotsky (14:44):

Right.

Myra King (14:44):

... to people speaking up and feeling comfortable in those situations. So, I'm grateful that I found my voice. I still struggle with this sometimes, right? But it is a lifelong process.

Carol Pehotsky (14:54):

Yeah. So, ladies and gentlemen who are listening, I think Myra is underselling herself a little bit.

Myra King (14:54):

(laughs)

Carol Pehotsky (14:58):

If you were to think of, I mean, thinking about all the nurses you've educated and all the policies and the practices that you personally have elevated...

Myra King (15:06):

Mm-hmm.

Carol Pehotsky (15:06):

... we, we absolutely benefit from hearing your voice.

Myra King (15:06):

Thank you.

Carol Pehotsky (15:09):

So, you mentioned that that's been a journey for you. Any, any highlights along the way or pearls of wisdom you would say to other nurses or health care providers of any type that are in that space where they-

Myra King (15:23):

Mm-hmm.

Carol Pehotsky (15:23):

... there aren't people who look like them at the table and, and they're trying to figure out, "How can I be brave. What are the next steps?" Any, any nuggets to share?

Myra King (15:31):

Yeah, I think the first thing you have to do is just take that step of realizing like, "First, I'm going to come to the table."

Carol Pehotsky (15:31):

Mm-hmm.

Myra King (15:38):

I am not going to sit on the sidelines and be silent, right?

Carol Pehotsky (15:42):

Right.

Myra King (15:42):

That I'm going to actually come to the table. That's the first step. And then while I am there, I am going to speak up about things that matter. I'm not going to be silent and I'm not going to worry about judgments or what other people think of me.

Carol Pehotsky (15:56):

Mm-hmm.

Myra King (15:56):

But really that's their business, right? What other people think of you is their business, not mine. (laughs)

Carol Pehotsky (16:00):

That's right. I've said that to my teenager several times. (laughs)

Myra King (16:00):

It's a great philosophy.

Carol Pehotsky (16:00):

It's great.

Myra King (16:04):

Truly, that has been transformative-

Carol Pehotsky (16:06):

Yes.

Myra King (16:06):

... for me.

Carol Pehotsky (16:06):

Yeah.

Myra King (16:07):

Because I've grown up really caring about what other people-

Carol Pehotsky (16:09):

Sure.

Myra King (16:09):

... think about me. And that can stall your progress so much. But when you say, you know, I, I cannot, that's them.

Carol Pehotsky (16:17):

Mm-hmm.

Myra King (16:17):

Um, if there are aspects of me that I need to address, okay, fine. But really-

Carol Pehotsky (16:21):

That's based on your own self-reflection, not... Yeah.

Myra King (16:24):

That's based on your own exa- my own self res- reflection.

Carol Pehotsky (16:24):

Mm-hmm.

Myra King (16:25):

But really, I'm going to have confidence and I'm going to have the courage to speak up. And, and understand the value that you bring to the team that ultimately will improve outcomes.

Carol Pehotsky (16:25):

Yes.

Myra King (16:36):

And it could improve the lives of other people. So, when you see that, and you see that-

Carol Pehotsky (16:36):

Mm-hmm.

Myra King (16:41):

... value in yourself-

Carol Pehotsky (16:42):

Yes.

Myra King (16:43):

... right? Like y- it starts with you seeing that in yourself. Others will also see it. So, I really-

Carol Pehotsky (16:43):

Because people are always watching. (laughs)

Myra King (16:48):

Yes, people are always watching and they're always listening.

Carol Pehotsky (16:52):

Yes.

Myra King (16:52):

Right.

Carol Pehotsky (16:52):

And you've set such a great example for so many-

Myra King (16:55):

Oh, thank you. (laughs)

Carol Pehotsky (16:56):

... PCNAs, clinical nurse, techs, nurses. I mean, the list is endless.

Myra King (17:00):

Thank you.

Carol Pehotsky (17:00):

So, we've, we've spent most of this time so far talking largely about the health care provider.

Myra King (17:07):

Mm-hmm.

Carol Pehotsky (17:07):

Now, let's flip it to patients.

Myra King (17:07):

Mm-hmm.

Carol Pehotsky (17:08):

So, while we want to make sure the care that we deliver is also including the patient's voice.

Myra King (17:08):

Mm-hmm.

Carol Pehotsky (17:14):

Making sure that we're sensitive to each individual's needs, how does having a more diverse, inclusive workforce help patients? And how does all this translate into confidence and trust with our patients?

Myra King (17:27):

Diversifying the nursing workforce is really crucial...

Carol Pehotsky (17:30):

Mm-hmm.

Myra King (17:30):

... to addressing health inequities. Even the future of nursing report that was published, you know, in 2021, I believe it was, really speaks to that.

Carol Pehotsky (17:30):

Yeah.

Myra King (17:40):

Because when patients come into our health care facilities and they walk into our hospitals, they walk into our ambulatory settings, and they see people-

Carol Pehotsky (17:47):

Sure.

Myra King (17:48):

... that look like them-

Carol Pehotsky (17:49):

Yeah.

Myra King (17:49):

... that have similar traits...

Carol Pehotsky (17:51):

Mm-hmm.

Myra King (17:51):

... then they start to feel as though, "Listen, I can trust."

Carol Pehotsky (17:55):

Mm-hmm.

Myra King (17:55):

And this has been shown in research. Research shows-

Carol Pehotsky (17:58):

Over and over. (laughs)

Myra King (17:58):

Over and over that improves patient satisfaction and improves communication between patients. It improves building relationships.

Carol Pehotsky (17:58):

Mm-hmm.

Myra King (18:08):

And we know that mistrust of the medical community has been a pervasive problem for decades, right?

Carol Pehotsky (18:08):

Mm-hmm.

Myra King (18:14):

And due to a variety of reasons.

Carol Pehotsky (18:16):

Right.

Myra King (18:16):

Whether it's racism and healthcare that was present as, just as it was in society.

Carol Pehotsky (18:21):

Mm-hmm.

Myra King (18:21):

So how do we kind of rebuild that trust, right? It didn't happen overnight. So, it's not, as we reverse the mistrust that exists-

Carol Pehotsky (18:30):

Mm-hmm.

Myra King (18:31):

... it's not, it's not going to happen overnight.

Carol Pehotsky (18:31):

Right.

Myra King (18:32):

So, it's going to be a process, but it really does start with, Listen, let's make sure that our workforce represents the patients that we-

Carol Pehotsky (18:32):

Mm-hmm.

Myra King (18:40):

... care for, right? And then as we do that and we have health care workers that represent our patient populations, they can also help us uncover the needs of those patients that we may not otherwise see.

Carol Pehotsky (18:53):

Sure, or they might not tell us.

Myra King (18:54):

Right or they may not tell us.

Carol Pehotsky (18:54):

Mm-hmm.

Myra King (18:55):

Or they may not trust to tell us.

Carol Pehotsky (18:55):

Right, right.

Myra King (18:57):

So, whether it's race and ethnicity or LGBTQ community, really being able to have those healthcare workers is crucial, right? So, we can address the health disparities that we know continues to be pervasive in our country.

Carol Pehotsky (19:09):

And really, the receiver of that information could be really anyone in the healthcare continuum if they've s- created that trust with the patient.

Myra King (19:15):

Absolutely, yeah.

Carol Pehotsky (19:15):

Everyone from somebody who welcomes you at the door...

Myra King (19:15):

Sure.

Carol Pehotsky (19:18):

... to the physician who's the last person who sees them, maybe.

Myra King (19:21):

Absolutely. Anyone can create that trust, right?

Carol Pehotsky (19:21):

Mm-hmm.

Myra King (19:24):

It doesn't matter how you look, but it definitely is building the trust is about building relationships.

Carol Pehotsky (19:30):

Yeah.

Myra King (19:31):

It's about listening. It's about being open. It's about showing respect and showing that the input of others matters.

Carol Pehotsky (19:31):

Mm-hmm.

Myra King (19:39):

So, if it's patients, like, "I want to incorporate your values, your beliefs, what's important to you into your plan of care." That's person centered care.

Carol Pehotsky (19:39):

Right.

Myra King (19:50):

That's showing cultural humility. And you mentioned, you mentioned cultural-

Carol Pehotsky (19:50):

Yes.

Myra King (19:54):

You mentioned cultural competence.

Carol Pehotsky (19:55):

(laughs) Yes.

Myra King (19:55):

Which cultural competence is really important.

Carol Pehotsky (19:57):

Sure.

Myra King (19:57):

We get to kind of learn about the different-

Carol Pehotsky (19:59):

Mm-hmm.

Myra King (19:59):

... cultures and we are committed to that. But cultural humility takes it a little bit further.

Carol Pehotsky (20:05):

Yeah. Sure.

Myra King (20:05):

Because it says, "Listen, I'm going to be open to continuing to learn. So, this is a lifelong process."

Carol Pehotsky (20:11):

Mm-hmm.

Myra King (20:11):

I'm never going to be truly competent about anybody else's culture, right?

Carol Pehotsky (20:11):

Right.

Myra King (20:16):

Or their experiences, but I'm going to be open to learning.

Carol Pehotsky (20:19):

Mm-hmm.

Myra King (20:19):

And I'm going to be willing to put my ego aside. So, what I feel is important. I'm going to be able to put that aside. I'm not going to feel like I am better or superior...

Carol Pehotsky (20:29):

Right.

Myra King (20:30):

... than someone else. So cultural humility is really where we are-

Carol Pehotsky (20:33):

Mm-hmm.

Myra King (20:33):

... we're aiming for as healthcare workers to address healthcare disparities. So, it's, it truly, truly is important.

Carol Pehotsky (20:42):

Yeah, wow. So, we talked about biases and the fact that really all of us...

Myra King (20:42):

Mm-hmm.

Carol Pehotsky (20:47):

... the condition of being human comes with having biases. Let's say I'm a nurse, I walk onto the floor, we're all getting started for the day, and perhaps I, I observe, hopefully not, but perhaps I observe either a coworker that's really showing intolerant behavior, or it's a patient...

Myra King (21:05):

Mm-hmm.

Carol Pehotsky (21:06):

... what can I do? I mean, lots of things we could do, right, in that situation. But we want to keep that relationship with the patient.

Myra King (21:06):

Right.

Carol Pehotsky (21:11):

Right? Patient is showing intolerance.

Myra King (21:12):

Mm-hmm.

Carol Pehotsky (21:13):

We still need to deliver care to them. (laughs)

Myra King (21:13):

(laughs)

Carol Pehotsky (21:16):

We need to set some boundaries. What are some suggestions you might have in that scenario?

Myra King (21:20):

You know, I always start with being self-reflective...

Carol Pehotsky (21:23):

Mm-hmm.

Myra King (21:23):

... first, right? So, we walk into the situation and before we walk into the situation, we pause-

Carol Pehotsky (21:23):

Mm-hmm.

Myra King (21:28):

... and really consider, "How am I showing up in this situation? Do I have biases?" Am I interpreting-

Carol Pehotsky (21:35):

Okay.

Myra King (21:36):

... uh, or, or judging-

Carol Pehotsky (21:37):

Yeah.

Myra King (21:37):

... this patient based on the way the patient looks-

Carol Pehotsky (21:40):

Mm-hmm.

Myra King (21:40):

... or their socioeconomic status or things that I know about them? And really taking the moment to pause and be self-reflective in that situation just to ensure that you are aware how you're showing up.

Carol Pehotsky (21:51):

Okay. Yeah.

Myra King (21:52):

So, it starts with being self-aware.

Carol Pehotsky (21:54):

(laughs) Not making a part of the problem.

Myra King (21:55):

Not making, not become a part of the problem. Um, and then it moves to, okay, now that I'm, I'm ready to-

Carol Pehotsky (21:55):

Mm-hmm.

Myra King (22:01):

... address this, I have to speak up. I have to address the behaviors.

Carol Pehotsky (22:01):

Mm-hmm.

Myra King (22:06):

We're not addressing the person necessarily, but we-

Carol Pehotsky (22:06):

Ah.

Myra King (22:09):

... are addressing the behaviors.

Carol Pehotsky (22:10):

Yes.

Myra King (22:11):

We address the person then they can become defensive. So, you are acting in a way that is impeding our ability to provide quality care that we hope to provide to you.

Carol Pehotsky (22:11):

Right.

Myra King (22:21):

Can you, can you talk to me a little bit about more where you're coming from, right?

Carol Pehotsky (22:21):

Mm-hmm.

Myra King (22:25):

What's making you, um, react this way because I want to understand?

Carol Pehotsky (22:29):

Okay.

Myra King (22:29):

So now you are raising the awareness to that individual about their behaviors. And maybe they aren't 100% aware. Maybe there's something-

Carol Pehotsky (22:37):

Yeah.

Myra King (22:37):

... underlying it-

Carol Pehotsky (22:37):

Mm-hmm.

Myra King (22:38):

... that we need to be aware of.

Carol Pehotsky (22:38):

Mm-hmm.

Myra King (22:40):

So, trying to dig deep into why are they upset? Maybe their concerns are legitimate, and we need-

Carol Pehotsky (22:40):

Right.

Myra King (22:45):

... to address those concerns.

Carol Pehotsky (22:47):

Mm-hmm.

Myra King (22:47):

So again, starting with self-awareness and then moving into addressing the concerns. I think it opens the door to improve communication.

Carol Pehotsky (22:55):

Yeah.

Myra King (22:56):

And so there are many strategies out there that we can implement-

Carol Pehotsky (23:00):

Mm-hmm.

Myra King (23:00):

... in trying to better communicate in those situations and de-escalate the situation.

Carol Pehotsky (23:00):

Right.

Myra King (23:05):

So, one of my favorites is the use of the CUS acronym. (laughs)

Carol Pehotsky (23:08):

I know we use that; we use that all the time. (laughs)

Myra King (23:10):

Yep, yep. There are many others that are out there, but what I really love it because it's simple-

Carol Pehotsky (23:14):

Yep.

Myra King (23:15):

... and it basically says, "Listen, I'm concerned-"

Carol Pehotsky (23:17):

Mm-hmm.

Myra King (23:18):

"... about what's happening right now. And again, exploring, can you tell me more-"

Carol Pehotsky (23:18):

Right.

Myra King (23:21):

"... about what's happening and where you are?"

Carol Pehotsky (23:21):

Mm-hmm.

Myra King (23:24):

And so, C is concern. And then U is, "I'm really feeling uncomfortable."

Carol Pehotsky (23:28):

Right. Owning the feeling. Yeah. Mm-hmm.

Myra King (23:30):

I'm really feeling uncomfortable in this. Owning the feeling, naming the feeling. I'm really feeling uncomfortable, and this is really impeding the ability to have a safe environment.

Carol Pehotsky (23:30):

Mm-hmm.

Myra King (23:37):

So that is a great way to kind of open up a discussion about getting at what is the underlying concern, right? And so, I think those are, are great strategies to start with.

Carol Pehotsky (23:49):

Mm-hmm.

Myra King (23:50):

Trying to understand what's underlying the situation. And while obviously we get to a point where we might need to solicit the help of others-

Carol Pehotsky (23:58):

Yeah.

Myra King (23:58):

... and bring others into the situation to get their perspectives and to help handle the situation. So, I always would encourage nurses that when they find themselves in this situation, specifically with patients, right?

Carol Pehotsky (23:58):

Mm-hmm.

Myra King (24:09):

That they really say, okay, if they feel as though they are in an unsafe situation-

Carol Pehotsky (24:09):

Yeah, absolutely.

Myra King (24:13):

... we need to hurry up and we need to get help.

Carol Pehotsky (24:13):

Mm-hmm.

Myra King (24:15):

We need to, you know, go through, go that route of getting help. You never want to stay in an unsafe situation. But it also could be, you know, mean I'm going to reach out to the ombudsman so that they can help me navigate the situation.

Carol Pehotsky (24:15):

Right.

Myra King (24:28):

... and to create some guidelines...

Carol Pehotsky (24:30):

Mm-hmm.

Myra King (24:30):

... and some boundaries around behaviors-

Carol Pehotsky (24:33):

Right.

Myra King (24:33):

... we have in that discussion.

Carol Pehotsky (24:34):

Yeah.

Myra King (24:35):

That's equally important when we are talking about behaviors that might show up in the workplace from coworkers.

Carol Pehotsky (24:40):

Yeah.

Myra King (24:40):

Like, maybe they're saying inappropriate-

Carol Pehotsky (24:43):

Mm-hmm.

Myra King (24:43):

... uh, things.

Carol Pehotsky (24:43):

Mm-hmm.

Myra King (24:43):

Maybe they have jokes that are inappropriate. Uh, you have to speak up in that moment.

Carol Pehotsky (24:43):

Mm-hmm.

Myra King (24:49):

You have to address it. You have to raise awareness.

Carol Pehotsky (24:52):

Mm-hmm.

Myra King (24:52):

That, like, this is not okay.

Carol Pehotsky (24:52):

Right.

Myra King (24:54):

When you fail to speak up, you know, what you what you permit you promote and then, again, you have to solicit the help. We have plentiful help, whether it's your nurse manager, your A&M.

Carol Pehotsky (25:04):

Mm-hmm.

Myra King (25:04):

If, if it's, uh, an employee, maybe human resources. (laughs)

Carol Pehotsky (25:08):

Absolutely. Yeah.

Myra King (25:09):

We all have these policies, escalation policies, but prior to that-

Carol Pehotsky (25:09):

Yeah.

Myra King (25:13):

... is trying to deescalate the situation but trying to understand it.

Carol Pehotsky (25:16):

Yeah. Excellent. Okay. So, we've talked about the intolerant patient. We've talked about seeing some of this behavior in our coworkers. Sometimes it's, it's perhaps a little less in your face.

Myra King (25:28):

Mm-hmm.

Carol Pehotsky (25:28):

Right? It might be the heavy sigh when where's conversations about DEIB.

Myra King (25:34):

Mm-hmm.

Carol Pehotsky (25:35):

Somebody says, "How long do we have to keep talking about this?" So, we're on the receiving end of maybe something like that. How should we respond to that?

Myra King (25:42):

That's a really good question. I actually had someone recently say something along the lines of-

Carol Pehotsky (25:42):

Oh, gosh.

Myra King (25:47):

... like, "Really, is this still important? Is this still pertinent? How long do we have to talk about it? We've been talking about it for, for decades." And my response was, "I know it's exhausting. I know it's a lot of work. I, I know that it can even seem repetitive at times, but I also can relate to and imagine that those who are on the receiving end of health inequities are also tired."

Carol Pehotsky (26:13):

Yeah.

Myra King (26:13):

They're also just still struggling to stay above, above water. And so as long as we have healthcare disparities...

Carol Pehotsky (26:22):

Mm-hmm.

Myra King (26:23):

... a l- as long as we are struggling to move the needle-

Carol Pehotsky (26:25):

Mm-hmm.

Myra King (26:26):

... as it relates to healthcare disparities, then we have to keep having these conversations.

Carol Pehotsky (26:31):

Yeah. The problems not solved.

Myra King (26:31):

And we... The problems not solved.

Carol Pehotsky (26:31):

Yeah.

Myra King (26:32):

Right? And we have to create educational opportunities, awareness, and then action planning around this topic to be able to move the needle in healthcare inequities. I reflect on a quote by Martin Luther King that really resonates with me about creating this beloved community, right?

Carol Pehotsky (26:32):

Ooh, I like that.

Myra King (26:50):

Which is our North star.

Carol Pehotsky (26:51):

Yeah.

Myra King (26:51):

That we are moving towards a journey of creating a beloved community. And so when we think about what that means...

Carol Pehotsky (26:59):

Mm-hmm.

Myra King (26:59):

... is that we are fostering sense of belonging. That we are valuing and respecting and showing dignity and treating people fairly. And so, if in order to get to that North Star of a beloved community, whether we're talking about the communities in which we live, whether we're talking about the community of the nursing community-

Carol Pehotsky (26:59):

Yeah.

Myra King (27:20):

... the nursing profession-

Carol Pehotsky (27:20):

Yeah.

Myra King (27:21):

... the communities on our units, then we have to keep having the conversation and we have to keep leaning into this space...

Carol Pehotsky (27:27):

Mm-hmm.

Myra King (27:28):

... until we have made the meaningful progress.

Carol Pehotsky (27:31):

It's a conversation, but it's also the action plan.

Myra King (27:33):

Absolutely.

Carol Pehotsky (27:33):

Yeah. Okay.

Myra King (27:34):

Yeah. Yeah.

Carol Pehotsky (27:34):

That's great.

Myra King (27:34):

Actions behind our words.

Carol Pehotsky (27:35):

Yeah.

Myra King (27:36):

So, it's so important. But I do have faith.

Carol Pehotsky (27:39):

Yeah. Okay.

Myra King (27:39):

That we will get to, right...

Carol Pehotsky (27:39):

Okay.

Myra King (27:41):

... this beloved community that we hope to get to if we hold hands and we do it together.

Carol Pehotsky (27:46):

One of the ways you have given back to our, our profession and to our patients is really getting involved in, in policy and, and really speaking up at an advocacy level.

Myra King (27:57):

Mm-hmm.

Carol Pehotsky (27:57):

And before, before the mics turned on, we talked a little bit about what the American Nurses Association is doing in this space. So, can you educate us a little bit more on policy and advocacy around the nursing profession with diversity, equity, inclusion?

Myra King (28:10):

Sure. I think nurses oftentimes are reluctant to lean into the space of politics and advocating for policy.

Carol Pehotsky (28:17):

Sure.

Myra King (28:17):

But I think it's so important-

Carol Pehotsky (28:17):

Mm-hmm.

Myra King (28:19):

... that we realize that we have an impact outside the walls of our, our hospital, right?

Carol Pehotsky (28:19):

Mm-hmm.

Myra King (28:23):

That we can reach out into our communities, and we can have an impact. So, as it relates to policy...

Carol Pehotsky (28:29):

Mm-hmm.

Myra King (28:30):

... it's being able to advocate for those policies that promote health equity.

Carol Pehotsky (28:35):

Mm-hmm.

Myra King (28:35):

And that could be things like, you know, I'm going to advocate for policies around air pollution, which disproportionately...

Carol Pehotsky (28:42):

Mm-hmm.

Myra King (28:43):

... impacts marginalized communities.

Carol Pehotsky (28:43):

Mm-hmm.

Myra King (28:45):

I'm going to advocate for policies around housing and around transportation and all of those things that we know impact social determinants of health.

Carol Pehotsky (28:45):

Absolutely. Yeah.

Myra King (28:53):

So are plentiful of policies-

Carol Pehotsky (28:53):

Mm-hmm.

Myra King (28:55):

... that are out there. Sometimes it's just, I'm going to vote for, right?

Carol Pehotsky (28:55):

Yeah.

Myra King (28:59):

I'm going to be an active voter.

Carol Pehotsky (29:00):

Yeah, absolutely.

Myra King (29:00):

Or I'm going to advocate-

Carol Pehotsky (29:02):

Mm-hmm.

Myra King (29:02):

... on behalf and, and rally on issues that we know impact health equity. So, we are calling nurses to lean into that space-

Carol Pehotsky (29:02):

Yeah.

Myra King (29:10):

... of policy. Another big policy that's out there is improving access to care.

Carol Pehotsky (29:10):

Mm-hmm.

Myra King (29:15):

So, you know, expansion of Medicaid and Medicare, but also the removal of barriers for APRNs-

Carol Pehotsky (29:21):

Oh.

Myra King (29:21):

... for advanced practitioners-

Carol Pehotsky (29:21):

Yeah.

Myra King (29:22):

... to practice at-

Carol Pehotsky (29:24):

Mm-hmm.

Myra King (29:24):

... their full scope. Um, so full practice authority where they can improve access to care.

Carol Pehotsky (29:28):

Yeah, absolutely.

Myra King (29:29):

Particularly in rural areas...

Carol Pehotsky (29:30):

Mm-hmm.

Myra King (29:31):

... or underrepresented communities. So those are all policies that are important to improving health inequity.

Carol Pehotsky (29:37):

Mm-hmm.

Myra King (29:38):

But also, as you mentioned, being involved in professional organizations that also have those charges.

Carol Pehotsky (29:44):

Yeah.

Myra King (29:44):

They can be an excellent vehicle-

Carol Pehotsky (29:46):

Mm-hmm.

Myra King (29:46):

... to promoting health equity because I'm going to support those-

Carol Pehotsky (29:46):

Mm-hmm.

Myra King (29:50):

... organizations, I'm going to become a member of them. And specifically, I was recently introduced to the National Commission to Address Racism in Nursing.

Carol Pehotsky (29:50):

Okay.

Myra King (30:00):

And this is, was led by the American Nurses Association-

Carol Pehotsky (30:00):

Mm-hmm.

Myra King (30:03):

... the National Black Nurses Association, the National Coalition of Ethnic Minority Nurses Association, and the National Association of Hispanic Nurses. And they really have this charge of-

Carol Pehotsky (30:14):

Yeah.

Myra King (30:15):

... bringing awareness to racism-

Carol Pehotsky (30:15):

Mm-hmm.

Myra King (30:16):

... and, and nursing and how that has impacted-

Carol Pehotsky (30:19):

Oh, my gosh.

Myra King (30:19):

... health inequities-

Carol Pehotsky (30:20):

Yeah.

Myra King (30:20):

... in our communities-

Carol Pehotsky (30:20):

Mm-hmm.

Myra King (30:21):

... and health disparities.

Myra King (30:22):

And so, they have an excellent educational series...

Carol Pehotsky (30:26):

Okay.

Myra King (30:26):

... that I was able to attend. And it was amazing to listen to these experts in the field of-

Carol Pehotsky (30:26):

Mm-hmm.

Myra King (30:32):

... DEIB now, diversity, equity, inclusion and belonging, and really give some pragmatic ways in which I can address and reduce health inequities and realize implicit biases that can impact the care that we give to patients. So those organizations have just, j- it was just a phenomenal-

Carol Pehotsky (30:52):

Yeah.

Myra King (30:52):

... phenomenal work. And there are many organizations-

Carol Pehotsky (30:52):

(laughs)

Myra King (30:54):

... that are out there...

Carol Pehotsky (30:55):

Right.

Myra King (30:55):

... that I don-

Carol Pehotsky (30:56):

[inaudible 00:30:56].

Myra King (30:57):

Right. There are many organizations. There are many opportunities.

Carol Pehotsky (30:59):

Yeah, no kidding.

Myra King (31:00):

You just have to find the organization that fits what is important to you and then support that organization. And then of course, obviously being involved in the community.

Carol Pehotsky (31:00):

Mm-hmm.

Myra King (31:07):

Whether it's volunteering, whether it's being involved in the volunteering at the food pantries or community fairs or giving educational or seminars to the public and to improve preventive screening. So, all of those are ways in which we can be advocates for our patients outside the walls of our healthcare organizations.

Carol Pehotsky (31:27):

Well, we've just scratched the surface. (laughs)

Myra King (31:29):

Absolutely.

Carol Pehotsky (31:29):

And I feel like we could keep talking-

Myra King (31:30):

Yes. (laughs)

Carol Pehotsky (31:31):

... for several episodes.

Myra King (31:33):

Yes.

Carol Pehotsky (31:33):

I'll, I'll wrap up this topic with one last question though.

Myra King (31:35):

Mm-hmm.

Carol Pehotsky (31:36):

So, we've mentioned that we haven't dug into it, you know, diversity, equity, inclusion and belonging.

Myra King (31:36):

Yes.

Carol Pehotsky (31:41):

So, what does the B, what does the belonging add to the conversation and how can we measure it and enhance it?

Myra King (31:49):

So, the belonging is a concept that has recently been added-

Carol Pehotsky (31:53):

Mm-hmm.

Myra King (31:53):

... to the diversity, equity, inclusion movement.

Carol Pehotsky (31:55):

Mm-hmm.

Myra King (31:55):

And it is an important aspect-

Carol Pehotsky (31:58):

Mm-hmm.

Myra King (31:58):

... of this whole discussion. So earlier I talked about the difference between diversity and equity, right?

Carol Pehotsky (31:58):

Mm-hmm.

Myra King (32:04):

So, diversity is making sure we have representation.

Carol Pehotsky (32:06):

Yep.

Myra King (32:06):

Inclusion is making sure that people, that we create these environments where people are valued.

Carol Pehotsky (32:06):

Mm-hmm.

Myra King (32:12):

And that we solicit their input.

Carol Pehotsky (32:12):

Mm-hmm.

Myra King (32:14):

And the sense of belonging is the effect of those two. It's really, okay, now I'm going to go to the person and say, "We tried to create this environment..."

Carol Pehotsky (32:25):

Ah.

Myra King (32:25):

"... but is that really how you're feeling?"

Carol Pehotsky (32:26):

(laughs) Sure. Yeah.

Myra King (32:26):

You know, "How are you-"

Carol Pehotsky (32:26):

Okay.

Myra King (32:29):

"How are we doing in this space?"

Carol Pehotsky (32:30):

Mm-hmm.

Myra King (32:30):

Are we making you feel like you are valued, that you belong to this community of nursing? How well are we doing? What are opportunities?

Carol Pehotsky (32:38):

Okay.

Myra King (32:38):

So, we can do a lot-

Carol Pehotsky (32:40):

Yeah.

Myra King (32:40):

... to create environments.

Carol Pehotsky (32:40):

(laughs)

Myra King (32:41):

But if we aren't effective-

Carol Pehotsky (32:43):

Right.

Myra King (32:43):

... and successful...

Carol Pehotsky (32:44):

I don't like dancing.

Myra King (32:45):

... in making people-

Carol Pehotsky (32:45):

Then inviting me to dance is not great.

Myra King (32:48):

... feel that. Right, so I'm not gonna... (laughs)

Carol Pehotsky (32:48):

(laughs)

Myra King (32:48):

Exactly. Then it's like, okay, so now I have to really make sure that I check in with you and say, "Do you-"

Carol Pehotsky (32:48):

Ah. Okay.

Myra King (32:53):

"... feel like you belong? And if not, what can we do to make sure that we improve or upon our interventions that we're doing to create a sense of belonging?" So that sense of belonging is when you feel like you are connected...

Carol Pehotsky (33:07):

Mm-hmm.

Myra King (33:08):

... to a community.

Carol Pehotsky (33:09):

Okay.

Myra King (33:09):

So, we think about on a nursing unit...

Carol Pehotsky (33:09):

Mm-hmm.

Myra King (33:12):

... that you are truly a member of that team, that you are an equally valued-

Carol Pehotsky (33:17):

Mm-hmm.

Myra King (33:18):

... and respected-

Carol Pehotsky (33:18):

Yes.

Myra King (33:18):

... member of the team. That you are part of this, that community. And so, belonging is rooted in love, is rooted in kindness.

Carol Pehotsky (33:27):

I love that.

Myra King (33:27):

It's rooted in compassion, and so it, it, that, which are fundamental, right?

Carol Pehotsky (33:32):

Absolutely.

Myra King (33:32):

Are fundamental to our needs. It's actually part of the Maslow's (laughs) hierarchy of needs.

Carol Pehotsky (33:36):

Absolutely.

Myra King (33:37):

Right?

Carol Pehotsky (33:37):

Yeah.

Myra King (33:37):

Love and belonging.

Carol Pehotsky (33:37):

Right.

Myra King (33:38):

So, it truly is something that we all need. It measures, it's that barometer.

Carol Pehotsky (33:43):

Mm-hmm.

Myra King (33:43):

So, when we think about our employee surveys...

Carol Pehotsky (33:45):

Yeah.

Myra King (33:45):

... engagement surveys, we ask those questions.

Carol Pehotsky (33:48):

Mm-hmm. Yep. (laughs)

Myra King (33:48):

We're truly asking. So how well are we doing, right?

Carol Pehotsky (33:51):

Right.

Myra King (33:51):

How do you feel like your voice is heard? Do you feel like you, you, your opinions matter? All those questions come up on surveys.

Carol Pehotsky (33:51):

Right. Yeah.

Myra King (33:58):

So, we look at that and we measure it. And then we come up with action plans when we see that there are opportunities. And we also know that we can measure by retention, right?

Carol Pehotsky (33:58):

Yeah. Mm-hmm.

Myra King (34:05):

Like, people, the sense of belonging inherent is, like, "I belong-"

Carol Pehotsky (34:09):

Yeah.

Myra King (34:09):

"... here and I'd rather be here than anywhere else."

Carol Pehotsky (34:12):

They vote with their feet, yeah.

Myra King (34:13):

So, I'm going to, I'm going to stay where I am...

Carol Pehotsky (34:14):

Mm-hmm.

Myra King (34:14):

... because I'm a part of this team.

Carol Pehotsky (34:14):

Mm-hmm.

Myra King (34:16):

So, we can look at surveys, we can look at retention.

Carol Pehotsky (34:19):

Mm-hmm.

Myra King (34:20):

All of those things, and it ultimately will improve patient outcomes. So, we look at-

Carol Pehotsky (34:20):

Yeah.

Myra King (34:24):

... our outcomes as well.

Carol Pehotsky (34:25):

It's just, it's just asking that next question that says, "I've done these things, how, how are you receiving them? What can we do better?"

Myra King (34:31):

Absolutely.

Carol Pehotsky (34:31):

I love it.

Myra King (34:32):

I love it.

Carol Pehotsky (34:32):

Fantastic.

Myra King (34:34):

(laughs)

Carol Pehotsky (34:34):

Well, (laughs)

Myra King (34:34):

It's a lot.

Carol Pehotsky (34:36):

This is end of part one. No, I'm... (laughs)

Myra King (34:38):

Right. (laughs)

Carol Pehotsky (34:38):

This has been fantastic, Myra. I can't thank you enough for joining us today. Before we call it a day, we're going to flip to our speed round...

Myra King (34:45):

Yes.

Carol Pehotsky (34:45):

... where our audience gets to learn a little bit more about you as the full, well-rounded human being you are, in addition to being an amazing nurse.

Myra King (34:52):

Yes. (laughs)

Carol Pehotsky (34:52):

So, with that said, what's something you do for you to recharge?

Myra King (34:57):

So, my husband and I, we really love to see sunsets.

Carol Pehotsky (35:02):

Oh, okay.

Myra King (35:03):

So, we make it a priority as much as we can to go and see the sunset and to go for walks in the park and to spend that quality-

Carol Pehotsky (35:10):

Nice.

Myra King (35:10):

... time. So really being outdoors-

Carol Pehotsky (35:13):

Okay.

Myra King (35:13):

... is, is, is something that I do frequently. Sunsets and sunrises, that's our thing. But really making the time to spend with family and with loved ones also is important to me. So, yeah, those are things that I do to unwind.

Carol Pehotsky (35:25):

Oh, it's wonderful.

Myra King (35:26):

Yes.

Carol Pehotsky (35:26):

Sunsets more than sunrises for myself.

Myra King (35:28):

(laughs)

Carol Pehotsky (35:28):

But yes, I respect that. (laughs)

Myra King (35:29):

Me too, actually.

Carol Pehotsky (35:32):

And what's something about you that surprises people?

Myra King (35:36):

You know, I think it's a, I always mentioned about when I was in high school...

Carol Pehotsky (35:36):

Mm-hmm.

Myra King (35:40):

... how I had this propensity to be a rapper.

Carol Pehotsky (35:44):

(laughs) Really?

Myra King (35:44):

So, I love to rap. (laughs) Right. I'm not that good at it as I used to be, but I, I actually was a part of one of our high school, uh, assemblies where-

Carol Pehotsky (35:44):

Really?

Myra King (35:53):

... I wrapped in front of the whole school.

Carol Pehotsky (35:53):

Oh, that's awesome.

Myra King (35:57):

And, you know, I kind of wrote these raps and I was kind of like, you know, Mrs. Rock box, if you will.

Carol Pehotsky (36:01):

Cool.

Myra King (36:01):

So, I was really...

Carol Pehotsky (36:01):

(laughs)

Myra King (36:02):

(laughs) People are surprised at that, that, that is something that had a propensity for. But I absolutely loved it. I kindly still actually do love rap. So yeah, I think that that, that's something that people will find surprising about me.

Carol Pehotsky (36:12):

So, part two will be done in full, rapid beat box. Got it. (laughs)

Myra King (36:16):

(laughs) Exactly. Exactly.

Carol Pehotsky (36:17):

All right. Well, thank you so much for joining me today. Our audience has gotten so much out of this conversation with you.

Myra King (36:22):

Thank you for having me.

Carol Pehotsky (36:27):

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.