Embracing Evidence-Based Practice as the Standard of Care

Podcast Transcript

Carol Pehotsky (00:04):

As nurses, sometimes we might have a visceral reaction to hearing phrases like evidence-based practice. And, uh, sometimes it can conjure memories of research, and difficult to understand articles, and data, and studies, and maybe a research paper n- assigned in nursing school, but at the end of the day, where would nursing be without evidenced based practice?

I'm joined today by L- Dr. Lorraine Novosel to talk about the importance of evidence-based practice in ensuring our patients get nothing but the best care.

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.

Welcome back, everyone. The topic for today's conversation is evidence-based practice in nursing. And as a nurse who's been practicing in some form for 20 years, when I think back to this topic... And back in 2004 when I graduated, what would've been breaking news, evidence-based practice then, I certainly hope is now part of the routine (laughs) care that we deliver our patients. 

I had the opportunity to sit with periop leaders at a gathering a few years back, and what a joy it was to sit with those leaders, who had been in the nursing profession 30, 40, 50 years... To even hear their stories about making their own saline, and (laughs) sterilizing gloves, and glass bottles, and things that inspired a little bit of, "Oh, no" in me. I could probably have those same stories with nurses of today, who are graduating today. And so, what a fascinating topic to talk about. Thank goodness that our profession continues to evolve and grow. 

And so with that, I'm delighted to introduce you all to Dr. Lorraine Novosel. Lorraine is a nurse scientist at the Office of Nursing Research and Innovation at Cleveland Clinic. Lorraine, welcome.

Dr. Lorraine Novosel (02:02):

Hey, Carol. Thank you so much for having me here.

Carol Pehotsky (02:04):

Thank you so much for joining us. So you have a really rich background that led you up to your current role as a nurse scientist, so I'm hoping you'll share with our audience a little bit about your nursing journey, and when and how you got excited about evidence-based practice?

Dr. Lorraine Novosel (02:16):

Oh, thank you. Great question.

(02:18):

I am a PhD prepared nurse scientist, but my path to research, I think it kind of happened... It was serendipity,-

Carol Pehotsky (02:26):

Okay.

Dr. Lorraine Novosel (02:26):

... to be very honest with you. I have always been the type... I've been curious and I always look for new challenges.

Carol Pehotsky (02:33):

Okay.

Dr. Lorraine Novosel (02:33):

I have been an advanced practitioner s- for many years, and said, "Okay, let's try something new." So, it's not so much that... I don't think I went looking for the research career,-

Carol Pehotsky (02:42):

(laughs) Okay.

Dr. Lorraine Novosel (02:42):

... the research career-

Carol Pehotsky (02:43):

It found you? (laughs)

Dr. Lorraine Novosel (02:44):

... It kind of, it kind of found me. Exactly. But to add to what you were just talking about, you said 20-some years. If you don't mind, I'll just say a handful of years ago,-

Carol Pehotsky (02:53):

Okay, that's fine (laughs).

Dr. Lorraine Novosel (02:54):

... okay? So I think back to myself when I was the new bedside nurse,

Carol Pehotsky (02:54):

Mm-hmm.

Dr. Lorraine Novosel (02:58):

... and I had started my very first nursing position... Was in pediatrics, caring for very critically ill-

Carol Pehotsky (03:05):

Mm, wow. Okay.

Dr. Lorraine Novosel (03:06):

... children. And I recall I had subscribed to a nursing journal, and I r-

Carol Pehotsky (03:10):

Oh, very good. Good job (laughs).

Dr. Lorraine Novosel (03:11):

... very clearly remember getting that very first issue in the mail.

Carol Pehotsky (03:14):

Mm-hmm.

Dr. Lorraine Novosel (03:15):

And as I looked at that, I started to say, "Oh my goodness, what is this? Where are the pictures? There's-

Carol Pehotsky (03:15):

Mm.

Dr. Lorraine Novosel (03:20):

... no color. There's no graphics in there."

Carol Pehotsky (03:22):

No easy way to translate, yeah.

Dr. Lorraine Novosel (03:24):

You know, a lot of dense, heavy wording and a few tables. And then I realized, "Okay, this is a research journal."

Carol Pehotsky (03:24):

Mm-hmm.

Dr. Lorraine Novosel (03:31):

And in hindsight, what I was looking for, probably, as a new nurse was CliffNotes version of how to-

Carol Pehotsky (03:36):

Sure.

Dr. Lorraine Novosel (03:36):

... care for the critically ill pediatric patient.

Carol Pehotsky (03:39):

We just got done with textbooks and things with color and checklists, and-

Dr. Lorraine Novosel (03:42):

Exactly.

Carol Pehotsky (03:42):

... what's, what's the working nurse's version of that? Sure.

Dr. Lorraine Novosel (03:44):

So I looked at that journal, and I said, "Oh, this isn't for me, the new bedside nurse. That is for that other nurse. You know, the one who's-"

Carol Pehotsky (03:51):

(laughs) Whoever they are.

Dr. Lorraine Novosel (03:52):

Whoever they are, but it's the nurse who's no longer wearing white.

Carol Pehotsky (03:54):

Oh.

Dr. Lorraine Novosel (03:54):

It's the nurse who-

Carol Pehotsky (03:56):

Hm.

Dr. Lorraine Novosel (03:56):

... most likely had their own office at the end of the hall,-

Carol Pehotsky (03:59):

That was what you felt reading it, sure.

Dr. Lorraine Novosel (04:00):

... you know, and someone who certainly had a much higher educational level than I did-

Carol Pehotsky (04:01):

Mm.

Dr. Lorraine Novosel (04:05):

... at the time.

(04:06):

You know, when we practice... Looking back to that point in time, we did the best we could.

Carol Pehotsky (04:10):

Of course, yeah.

Dr. Lorraine Novosel (04:10):

When we had questions, we asked those nurses who-

Carol Pehotsky (04:11):

(laughs)

Dr. Lorraine Novosel (04:14):

... were, we were working with,-

Carol Pehotsky (04:14):

Yep.

Dr. Lorraine Novosel (04:15):

... who were more experienced. I relied on what I learned in school, what I observed from others,-

Carol Pehotsky (04:20):

Mm-hmm.

Dr. Lorraine Novosel (04:20):

... my experiences and intuition,-

Carol Pehotsky (04:22):

Mm-hmm.

Dr. Lorraine Novosel (04:22):

... and quite honestly, based on tradition.

Carol Pehotsky (04:24):

Yeah.

Dr. Lorraine Novosel (04:25):

You know, that is just-

Carol Pehotsky (04:26):

That's what we had. Yeah.

Dr. Lorraine Novosel (04:26):

I wasn't alone. 

Carol Pehotsky (04:26):

Mm-hmm. Mm-hmm.

Dr. Lorraine Novosel (04:27):

That is just simply how we practiced. But today, EBP, you know, is the s- expected standard of care, and distancing oneself or distancing yourself from research-

Carol Pehotsky (04:27):

Mm-hmm.

Dr. Lorraine Novosel (04:39):

... is no longer an option, (laughs) you know?

Carol Pehotsky (04:39):

Great point. Yes. Yeah.

Dr. Lorraine Novosel (04:43):

And so nurses practicing today, they must have at least a foundational-

Carol Pehotsky (04:47):

Mm.

Dr. Lorraine Novosel (04:48):

... understanding of research. How to understand research,-

Carol Pehotsky (04:48):

Sure.

Dr. Lorraine Novosel (04:51):

... and how research fits in with this whole big thing called EBP.

Carol Pehotsky (04:51):

Mm-hmm.

Dr. Lorraine Novosel (04:55):

It is expected today. It is a different world.

Carol Pehotsky (04:57):

Yeah, very. Thankfully, right? (laughs)

Dr. Lorraine Novosel (04:59):

Thankfully. Absolutely. Absolutely.

Carol Pehotsky (05:01):

And so, to dig into that a little bit more... Again, h- w- we're hoping that the people who are listening are everywhere from somebody who's maybe not even started nursing school yet, but thinking about it, all the way through somebody who's pretty advanced in their career, or really deep in their specialty. So knowing that we all probably have a slightly different understanding of what evidenced, uh, based practice, or EBP, is, versus research, you know, what's sort of your candid description of the difference between the two?

Dr. Lorraine Novosel (05:26):

Oh, okay. Great question as well. 

(05:29):

The generally accepted version of evidence-

Carol Pehotsky (05:29):

Mm-hmm.

Dr. Lorraine Novosel (05:32):

... based practice, you know, is the ability to identify and appraise the best available evidence,-

Carol Pehotsky (05:32):

Mm.

Dr. Lorraine Novosel (05:38):

... and then taking that and integrating it with knowledge, and with clinical practice, and patient preferences-

Carol Pehotsky (05:45):

Oh, sure. Yeah.

Dr. Lorraine Novosel (05:45):

Okay?

Carol Pehotsky (05:45):

Yep.

Dr. Lorraine Novosel (05:46):

And delivering that evidence-based care. 

(05:48):

I like to talk about EBP as more of an umbrella term,-

Carol Pehotsky (05:53):

Okay.

Dr. Lorraine Novosel (05:53):

... that encompasses all that we as nurses do. 

(05:58):

So, EBP is actually... In my eyes, it's a process, okay?

Carol Pehotsky (05:58):

Okay.

Dr. Lorraine Novosel (06:03):

All EBP starts with a question,-

Carol Pehotsky (06:05):

Mm.

Dr. Lorraine Novosel (06:06):

... or a problem, okay? The next step is then to search the evidence,-

Carol Pehotsky (06:11):

Mm-hmm.

Dr. Lorraine Novosel (06:11):

... to critically appraise the evidence, and then to synthesize the evidence. And then you ask yourself, "Okay, is there adequate evidence, strong evidence to guide my practice?"

Carol Pehotsky (06:23):

Sure.

Dr. Lorraine Novosel (06:23):

And if the answer is yes, then that is going to take us down the road for a quality improvement project-

Carol Pehotsky (06:29):

Mm-hmm.

Dr. Lorraine Novosel (06:30):

... or an evidence-based practice project.

Carol Pehotsky (06:32):

Mm, mm-hmm.

Dr. Lorraine Novosel (06:33):

If there is not yet a sufficient body of strong evidence,-

Carol Pehotsky (06:37):

Sure.

Dr. Lorraine Novosel (06:38):

... then next step then, is research.

Carol Pehotsky (06:39):

Mm.

Dr. Lorraine Novosel (06:40):

So I see EBP as a process, and it-

Carol Pehotsky (06:40):

Okay.

Dr. Lorraine Novosel (06:42):

... actually is an umbrella term. At the ground roots level, EBP is more of that translational, where researchers-

Carol Pehotsky (06:50):

The checklists, the pictures you were looking for (laughs).

Dr. Lorraine Novosel (06:51):

Yeah, s- yes. Researchers are generating the new knowledge,-

Carol Pehotsky (06:56):

Mm-hmm.

Dr. Lorraine Novosel (06:57):

... where then... This is at the other end of the continuum, it's that translation. Taking that knowledge,-

Carol Pehotsky (06:57):

Mm-hmm.

Dr. Lorraine Novosel (07:01):

... and applying it to the patient that is sitting in front of you.

Carol Pehotsky (07:05):

Sure.

So, let's go back to... You talked about appraising, and critiquing, and synthesizing the evidence, so somebody who's a little less comfortable in that space... Obviously there are courses in this, there's all sorts of approaches, but what are some nuggets you'd give to somebody who says, "Yeah, I, I get my organization's journal and I read it, but I really don't know if that's valid, applicable to my patients." What, what s- advice would you give them?

Dr. Lorraine Novosel (07:32):

Well, there are numerous resources out there that explain, and there are different hierarchies of evidence,-

Carol Pehotsky (07:32):

Mm-hmm.

Dr. Lorraine Novosel (07:39):

... so I don't think it's fair today to talk about one-

Carol Pehotsky (07:44):

Sure (laughs).

Dr. Lorraine Novosel (07:44):

... particular framework.

Carol Pehotsky (07:45):

Yes (laughs).

Dr. Lorraine Novosel (07:45):

Right. 

(07:46):

You know, but one thing I certainly have learned through all of my years and my experiences working with nureses, pretty much across the country, talking with colleagues and, you know, I've been a faculty member for many years, talking with students and new nurses, and certainly the nurses-

Carol Pehotsky (07:46):

Mm-hmm.

Dr. Lorraine Novosel (08:01):

... that I work with today. One thing I've learned. Well, EBP today-

Carol Pehotsky (08:01):

(laughs)

Dr. Lorraine Novosel (08:06):

... is the cornerstone of nursing education across programs-

Carol Pehotsky (08:10):

Mm-hmm.

Dr. Lorraine Novosel (08:10):

... and across degree levels. I really venture to say that few nursing students graduate feeling confident-

Carol Pehotsky (08:18):

Mm.

Dr. Lorraine Novosel (08:18):

... in their ability to read... Just read and-

Carol Pehotsky (08:21):

I think that's probably [inaudible 00:08:22] statement, yes.

Dr. Lorraine Novosel (08:21):

... understand research,-

Carol Pehotsky (08:25):

Yeah.

Dr. Lorraine Novosel (08:25):

... let alone,-

Carol Pehotsky (08:26):

It makes them practice.

Dr. Lorraine Novosel (08:26):

... let alone appraise it, synthesize,-

Carol Pehotsky (08:28):

Yeah. Mm-hmm.

Dr. Lorraine Novosel (08:28):

... and then determine, "Hey, is this something that I should be or we should be-

Carol Pehotsky (08:32):

Right.

Dr. Lorraine Novosel (08:32):

... incorporating into clinical practice?" 

(08:35):

So to nurses, I always say, "If this is you,-

Carol Pehotsky (08:38):

Mm-hmm.

Dr. Lorraine Novosel (08:38):

... you're not alone."

Carol Pehotsky (08:38):

(laughs) Yeah, that's right.

Dr. Lorraine Novosel (08:38):

Please know that-

Carol Pehotsky (08:38):

Yeah.

Dr. Lorraine Novosel (08:39):

... you're not alone,-

Carol Pehotsky (08:39):

Yeah.

Dr. Lorraine Novosel (08:41):

... okay? It is a skillset, as you just said. It's a skillset that develops only with time-

Carol Pehotsky (08:46):

Mm-hmm.

Dr. Lorraine Novosel (08:47):

... and with practice.

Carol Pehotsky (08:48):

So we've caught the attention of, I'm sure lots of people in this audience, who said, "Okay, well, I'd like to get better." What are some resources that somebody might be able to undertake? We know we have lots of wonderful resources here at the Cleveland Clinic, but especially for a nurse who is not part of our organization, what are some things they can do to practice and hone that practice?

Dr. Lorraine Novosel (09:08):

Well, there are a lot of opportunities out there. And again, it's something, I think that... It's a skill you only develop when you're doing it. So you can read, and read, and read about it, but-

Carol Pehotsky (09:16):

Ah, okay.

Dr. Lorraine Novosel (09:16):

... until you're actually doing it, it-

Carol Pehotsky (09:16):

Applying it. Sure.

Dr. Lorraine Novosel (09:18):

Applying it's a different story. I think journal clubs-

Carol Pehotsky (09:21):

Mm.

Dr. Lorraine Novosel (09:22):

... are a great way to begin.

Carol Pehotsky (09:23):

Okay.

Dr. Lorraine Novosel (09:23):

And I have noticed over the past probably three to five years, more and more professional organizations... At least those organizations that I'm a member of, have started their own journal clubs.

Carol Pehotsky (09:33):

Mm-hmm.

Dr. Lorraine Novosel (09:34):

One a month, you-

Carol Pehotsky (09:34):

Mm-hmm.

Dr. Lorraine Novosel (09:34):

... can meet virtually. Here's the study, here's the published research article.

Carol Pehotsky (09:39):

Mm-hmm.

Dr. Lorraine Novosel (09:39):

Review it. We'll, we will all come together during the journal club-

Carol Pehotsky (09:42):

Nice.

Dr. Lorraine Novosel (09:42):

... to review it, to critique it.

Carol Pehotsky (09:44):

So, then they can hear other people and their thoughts.

Dr. Lorraine Novosel (09:46):

Exactly.

Carol Pehotsky (09:47):

Oh, that's wonderful.

Dr. Lorraine Novosel (09:47):

Exactly. I think that is great way, and I think, you know, that's available to a lot of nurses.

Carol Pehotsky (09:48):

Mm-hmm.

Dr. Lorraine Novosel (09:53):

Here at Cleveland Clinic we have several activities in place-

Carol Pehotsky (09:56):

Mm-hmm.

Dr. Lorraine Novosel (09:56):

... for journal clubs, that nurses can learn that way as well. 

(10:00):

Certainly ask and talk to experienced nurses.

Carol Pehotsky (10:03):

Mm-hmm.

Dr. Lorraine Novosel (10:03):

Nurses are very willing to share their experience,-

Carol Pehotsky (10:06):

Mm-hmm.

Dr. Lorraine Novosel (10:06):

... their wisdom, and help others grow. They really are.

Certainly there are self-study modules,

Carol Pehotsky (10:12):

Okay.

Dr. Lorraine Novosel (10:13):

... where nurses can learn the skills and learn how to apply those skills in critiquing the literature. Look for EBP Champions, and seek assistance from others.

Carol Pehotsky (10:24):

Mm-hmm.

Dr. Lorraine Novosel (10:25):

You know? Especially here at Cleveland Clinic.

Carol Pehotsky (10:25):

Mm-hmm.

Dr. Lorraine Novosel (10:27):

We are very a resource-rich environment.

Carol Pehotsky (10:30):

Yes.

Dr. Lorraine Novosel (10:31):

Take advantage of it.

Carol Pehotsky (10:32):

Yes, absolutely. And, and like a lot of things, uh, almost everything in nursing, it's better when done as a team.

Dr. Lorraine Novosel (10:36):

Absolutely. I'm hard-pressed to think of anything that we do today in healthcare that is done at the individual level.

Carol Pehotsky (10:43):

Right.

Dr. Lorraine Novosel (10:44):

We don't do anything alone, and that's a good thing.

Carol Pehotsky (10:46):

It (laughs) absolutely is a good thing.

Dr. Lorraine Novosel (10:47):

And it's-

Carol Pehotsky (10:48):

That's high reliability at its finest, when we're not r- leaving the point-end of the stick for somebody to figure it out on their own.

Dr. Lorraine Novosel (10:48):

I think so.

Carol Pehotsky (10:48):

Yeah.

Dr. Lorraine Novosel (10:54):

I agree.

Carol Pehotsky (10:54):

So I'm somebody who always benefits from hearing about examples, and going, "Oh, okay." So going back to yours and my's, (laughs) uh, journey to this moment today, what are some things that now are commonplace, that really came out of an evidence-based viewpoint... And where are some areas where we're maybe kind of traditional still as nurses, and we need to think about where else should we take this next?

Dr. Lorraine Novosel (11:17):

Great question. And a couple of examples that come to mind, specifically in nursing. I'm not going to date myself,-

Carol Pehotsky (11:17):

(laughs)

Dr. Lorraine Novosel (11:24):

... I'm not going to date you, Carol, but I remember... And maybe you do too, maybe not. The use of an indwelling urinary catheter-

Carol Pehotsky (11:31):

Mm-hmm.

Dr. Lorraine Novosel (11:32):

... to manage incontinence, to prevent skin breakdown, was just standard practice.

Carol Pehotsky (11:36):

Oh, yeah. Mm-hmm. Mm-hmm.

Dr. Lorraine Novosel (11:38):

I will ask you,-

Carol Pehotsky (11:39):

(laughs)

Dr. Lorraine Novosel (11:40):

... what is the train of thought? What is the evidence today about, "You're incontinent? We're going to, uh, you know,-

Carol Pehotsky (11:45):

Oh, heavens no. Really, me-

Dr. Lorraine Novosel (11:46):

... put an indwelling-"

Carol Pehotsky (11:47):

You know, we, we're blessed to have these nurse-driven protocols here in our organization, and other pieces, to really assess, is that... Like a lot of things, the safest thing for the patient? And what is the risk of that incontinence versus the risk of that indwelling catheter?

Dr. Lorraine Novosel (11:58):

Absolutely.

Carol Pehotsky (12:00):

How'd I do?

Dr. Lorraine Novosel (12:00):

Y- oh, you're-

Carol Pehotsky (12:01):

Was it good?

Dr. Lorraine Novosel (12:01):

... perfect.

Carol Pehotsky (12:01):

Okay, whew. (laughs)

Dr. Lorraine Novosel (12:01):

A- absolutely. 'Cause we now know inserting an indwelling urinary catheter, it puts patients at risk for infection.

Carol Pehotsky (12:07):

Mm-hmm.

Dr. Lorraine Novosel (12:08):

Okay? It increases the length of stay in the hospital,-

Carol Pehotsky (12:08):

Mm-hmm.

Dr. Lorraine Novosel (12:11):

... and it raises costs significantly.

Carol Pehotsky (12:14):

Well, yeah,-

Dr. Lorraine Novosel (12:15):

That's one example.

Carol Pehotsky (12:16):

... evidence-based care is more affordable care.

Dr. Lorraine Novosel (12:17):

That's one example. Another example that I can think of off the top of my head, falls.

Carol Pehotsky (12:21):

Okay.

Dr. Lorraine Novosel (12:22):

Okay?

(12:23):

Do you remember back when there was a m- more liberal use of patient restraints-

Carol Pehotsky (12:30):

Oh, absolutely.

Dr. Lorraine Novosel (12:30):

... to prevent falls?

Carol Pehotsky (12:30):

That's, that's right where my brain goes when I think about this and how far we've come. Yeah.

Dr. Lorraine Novosel (12:34):

And especially... You know, I feel very strongly about caring for our older adults.

Carol Pehotsky (12:39):

Mm-hmm.

Dr. Lorraine Novosel (12:39):

Older adults and-

Carol Pehotsky (12:40):

Mm-hmm.

Dr. Lorraine Novosel (12:40):

... younger individuals as well, they can fall out of bed.

Carol Pehotsky (12:43):

Yeah.

Dr. Lorraine Novosel (12:44):

I'll be honest with you, about 15 years ago... If you had 20 minutes, I would tell you the short story,-

Carol Pehotsky (12:44):

(laughs)

Dr. Lorraine Novosel (12:49):

... but even at my age, I fell out of bed.

Carol Pehotsky (12:50):

Oh, no.

Dr. Lorraine Novosel (12:51):

Separated my shoulder. It was just a, a-

Carol Pehotsky (12:53):

Oh, oh, really, really fell out of bed. Oh, no.

Dr. Lorraine Novosel (12:54):

Really, really fell out of bed.

Carol Pehotsky (12:55):

Yeah.

Dr. Lorraine Novosel (12:56):

But should I have been restrained-

Carol Pehotsky (12:58):

Mm.

Dr. Lorraine Novosel (12:58):

... to prevent me from falling out of bed?

Carol Pehotsky (12:58):

No.

Dr. Lorraine Novosel (13:00):

But we used to do that.

Carol Pehotsky (13:00):

Oh, yeah.

Dr. Lorraine Novosel (13:00):

We used to do that, okay?

Carol Pehotsky (13:01):

And then people would sustain worse injuries-

Dr. Lorraine Novosel (13:04):

We u-

Carol Pehotsky (13:04):

... because of the restraints. Yeah.

Dr. Lorraine Novosel (13:05):

Exactly. We used to believe that we had a moral duty to protect individuals from falling out of bed,-

Carol Pehotsky (13:11):

Mm.

Dr. Lorraine Novosel (13:11):

... for restraints. You know, and restraints have been used for a lot of other reasons.

Carol Pehotsky (13:15):

Mm-hmm.

Dr. Lorraine Novosel (13:15):

We know now, the harms of restraints.

Carol Pehotsky (13:18):

Mm-hmm.

Dr. Lorraine Novosel (13:18):

They are very well-documented. The liberal use of restraints is not evidence-based practice.

(13:23):

Another example that I can think of is Trendelenburg position.

Carol Pehotsky (13:27):

Okay.

Dr. Lorraine Novosel (13:28):

And this goes back many years ago.

Carol Pehotsky (13:29):

(laughs)

Dr. Lorraine Novosel (13:30):

And I know when I was in nursing school, patient's going b- bad? Think shock's going on? Trendelenburg, right?

Carol Pehotsky (13:37):

Mm.

Dr. Lorraine Novosel (13:37):

But if you look back on the history of Trendelenburg... And I had an opportunity... It may seem like an odd topic-

Carol Pehotsky (13:37):

(laughs) No, I'm with you. (laughs)

Dr. Lorraine Novosel (13:42):

... for you, but I actually had an opportunity to look this up not too long ago. This goes back to the 1800s.

Carol Pehotsky (13:43):

Okay.

Dr. Lorraine Novosel (13:49):

And there was a physician, his last name was Trendelenburg,-

Carol Pehotsky (13:54):

There you go.

Dr. Lorraine Novosel (13:55):

... who, you know, created the position so he could get a better look at pelvic organs while he was operating. So, obviously he was a surgeon.

Carol Pehotsky (14:02):

That still sometimes happens today, right?

Dr. Lorraine Novosel (14:02):

Okay?

Carol Pehotsky (14:02):

You need that gravity to pull things back, yep. (laughs)

Dr. Lorraine Novosel (14:04):

So, we're looking back at the 1800s. I found, during World War I... So, think back to when World War I was. We're talking-

Carol Pehotsky (14:10):

We're not that old, ladies and gentlemen. (laughs)

Dr. Lorraine Novosel (14:12):

No, we're not. Thank you. Thank you for clarifying.

Carol Pehotsky (14:12):

But, yes (laughs).

Dr. Lorraine Novosel (14:15):

You know, he started to recommend it for, uh, s- treatment of shock, okay?

Carol Pehotsky (14:19):

Mm-hmm.

Dr. Lorraine Novosel (14:21):

About 10 years later... So still we're looking at like the late 1920s,-

Carol Pehotsky (14:24):

Okay.

Dr. Lorraine Novosel (14:25):

... 1930s, almost 100 years ago, that same surgeon... Who recommended it for the use of shock, found that it was not effective.

Carol Pehotsky (14:33):

Oh. And yet-

Dr. Lorraine Novosel (14:33):

So I know when I entered nursing school,-

Carol Pehotsky (14:34):

(laughs)

Dr. Lorraine Novosel (14:36):

... Trendelenburg was still used, right?

Carol Pehotsky (14:37):

Still a thing, absolutely. Yep.

Dr. Lorraine Novosel (14:39):

We now well know the multiple dangers of doing that,-

Carol Pehotsky (14:39):

Mm-hmm.

Dr. Lorraine Novosel (14:42):

... for hemodynamic, you know, compromise, there's increased intracranial pressure, altered respiratory mechanics... E- especially for patients who are obese, and the list goes on, and on and on.

Carol Pehotsky (14:53):

Right.

Dr. Lorraine Novosel (14:53):

So, three examples right there.

Carol Pehotsky (14:55):

Wow. Including one that's, um, 100 years old. 

So let's say I'm a nurse and I'm looking at the evidence, and I see that... I'm reading something, I'm appraising the evidence... Even the article itself says, you know, "This is meeting criteria for a well-r- thought out, and researched and stated idea," and I look around myself at the hospital and there's a gap between what I just read... It's breaking news, and what I'm seeing. 

So I understand it, I know it's the right thing to do, w- what are some of the next steps I should take? I can't go against policy necessarily, but what are some things that I can do as a nurse to help change my practice, but also the practice of those around me?

Dr. Lorraine Novosel (15:32):

I think the very first step... Now, we never make or want to change practice based on the findings of one study.

Carol Pehotsky (15:39):

Mm-hmm.

Dr. Lorraine Novosel (15:40):

Having said that, I don't like to use terms that, "We never do this," or,-

Carol Pehotsky (15:40):

Sure.

Dr. Lorraine Novosel (15:45):

... "We never do that."

Carol Pehotsky (15:45):

Right.

Dr. Lorraine Novosel (15:46):

So, there are always exceptions here. So that exception might be this very huge-

Carol Pehotsky (15:51):

Mm-hmm.

Dr. Lorraine Novosel (15:52):

... multi-site,-

Carol Pehotsky (15:53):

Right.

Dr. Lorraine Novosel (15:53):

... international, thousands and thousands of patients.

Carol Pehotsky (15:56):

Yep.

Dr. Lorraine Novosel (15:57):

Okay. But for a lot of the studies that are published... You know, and nurses, they find things, they read things.

Carol Pehotsky (16:06):

Mm-hmm.

Dr. Lorraine Novosel (16:06):

I love that it piques their curiosity and their interest,-

Carol Pehotsky (16:09):

Yeah.

Dr. Lorraine Novosel (16:09):

... but the first thing you wanna do is to do a little bit more digging.

Carol Pehotsky (16:14):

Mm. Mm-hmm.

Dr. Lorraine Novosel (16:14):

Have others found the same-

Carol Pehotsky (16:17):

Sure. Yes.

Dr. Lorraine Novosel (16:17):

... findings in the past? So-

Carol Pehotsky (16:18):

Is it in one study, or?

Dr. Lorraine Novosel (16:19):

Exactly.

Carol Pehotsky (16:20):

(laughs) Yeah.

Dr. Lorraine Novosel (16:20):

We don't wanna change practice based on the results of one study. 

So the first thing, and, and nurses... You know, I th- think there are a couple of things that historically... Myself included in the past, raise the hairs on the back of your neck when you talk about research-

Carol Pehotsky (16:24):

(laughs)

Dr. Lorraine Novosel (16:34):

... or you talk about statistics.

Carol Pehotsky (16:35):

Sure (laughs).

Dr. Lorraine Novosel (16:36):

Am I-

Carol Pehotsky (16:36):

Yeah, yeah. (laughs)

Dr. Lorraine Novosel (16:37):

Yeah. You understand there. You know, but you, we need to develop a comfort level going into the-

Carol Pehotsky (16:37):

Mm-hmm. Mm-hmm.

Dr. Lorraine Novosel (16:42):

... literature, tap into the resources of librarians-

Carol Pehotsky (16:45):

They're amazing people.

Dr. Lorraine Novosel (16:46):

They are amazing-

Carol Pehotsky (16:46):

Yes.

Dr. Lorraine Novosel (16:47):

... people.

(16:48):

You know, so the first step you wanna do, is is this the only study-

Carol Pehotsky (16:51):

Mm. Mm-hmm.

Dr. Lorraine Novosel (16:52):

... Even, uh, though it was a strong study,-

Carol Pehotsky (16:52):

Right.

Dr. Lorraine Novosel (16:54):

... that have other researchers come to the same conclusion?

Carol Pehotsky (16:57):

Sure.

Dr. Lorraine Novosel (16:58):

So you really wanna look at the totality of the evidence-

Carol Pehotsky (16:58):

Mm-hmm.

Dr. Lorraine Novosel (17:00):

... base out there before you make that decision, okay?

Carol Pehotsky (17:00):

Sure.

Dr. Lorraine Novosel (17:03):

And again, it involves tapping into others.

Carol Pehotsky (17:06):

Mm.

Dr. Lorraine Novosel (17:06):

You know, you need library resources. Maybe you don't have library resources.

Carol Pehotsky (17:10):

Right.

Dr. Lorraine Novosel (17:10):

A lot is available on PubMed,-

Carol Pehotsky (17:12):

Yes.

Dr. Lorraine Novosel (17:12):

... but a lot of research isn't indexed in PubMed.

Carol Pehotsky (17:16):

Yes, and-

Dr. Lorraine Novosel (17:16):

A lot of journals.

Carol Pehotsky (17:17):

... going to Google and just typing your-

Dr. Lorraine Novosel (17:18):

You'll find some.

Carol Pehotsky (17:19):

... question may or may not result in hard evidence versus a company's website, et cetera. So, really knowing what-

Dr. Lorraine Novosel (17:27):

Exactly.

Carol Pehotsky (17:28):

... you're pulling up when you're researching.

Dr. Lorraine Novosel (17:28):

Exactly.

(17:29):

So again, we don't practice in silos or in isolation-

Carol Pehotsky (17:33):

Mm-hmm.

Dr. Lorraine Novosel (17:33):

... anymore. Tap into your resources. Find someone that can help you do a little bit more digging-

Carol Pehotsky (17:39):

Mm-hmm.

Dr. Lorraine Novosel (17:39):

... into the literature. Gather your evidence base. Look at the total body-

Carol Pehotsky (17:39):

Mm-hmm.

Dr. Lorraine Novosel (17:43):

... that you're looking at right there, and then start, you know, talking with your shared-

Carol Pehotsky (17:43):

Mm-hmm.

Dr. Lorraine Novosel (17:47):

... governance councils. Look at your policies in your practices, and your procedures. Is it time for an update here? There is a s- organized way, structured way, to do this, because we all really can't... I don't want to say willy-nilly, but we can't willy-nilly-

Carol Pehotsky (18:01):

You shouldn't want to jump into something, and say, "I've decided today I'm going to try this new thing (laughs) that isn't-

Dr. Lorraine Novosel (18:04):

Exactly.

Carol Pehotsky (18:05):

... supported by policy 'cause I read one article. (laughs)

Dr. Lorraine Novosel (18:07):

Exactly.

Carol Pehotsky (18:07):

Yeah.

Dr. Lorraine Novosel (18:08):

You know, the, the mechanisms are in place-

Carol Pehotsky (18:10):

Mm-hmm.

Dr. Lorraine Novosel (18:10):

... to do this in an organized fashion. I don't ever want to squash a nurse's interest and-

Carol Pehotsky (18:16):

Right.

Dr. Lorraine Novosel (18:16):

... excitement,-

Carol Pehotsky (18:17):

Mm-hmm.

Dr. Lorraine Novosel (18:17):

... I wanna capitalize on that.

Carol Pehotsky (18:17):

Mm-hmm.

Dr. Lorraine Novosel (18:18):

Because as I've said probably more than once already, nurses shy away from research.

Carol Pehotsky (18:19):

Right.

Dr. Lorraine Novosel (18:23):

It's that term.

Carol Pehotsky (18:23):

Yep.

Dr. Lorraine Novosel (18:24):

It's like, "Oh, gosh. That's for that person-

Carol Pehotsky (18:26):

(laughs)

Dr. Lorraine Novosel (18:26):

... over there."

Carol Pehotsky (18:27):

Yeah.

Dr. Lorraine Novosel (18:27):

We have to find a way-

Carol Pehotsky (18:28):

Mm-hmm.

Dr. Lorraine Novosel (18:29):

... to reduce the fear,-

Carol Pehotsky (18:30):

Yes.

Dr. Lorraine Novosel (18:31):

... embrace we're all doing this together, and we all are learning from each other, and let's do it together.

Carol Pehotsky (18:36):

Sure. 

And really when it comes to it, it... Yeah, you, you've gathered this information. You know, w- we've had previously episodes where we've talked about shared governance and-

Dr. Lorraine Novosel (18:44):

Mm-hmm.

Carol Pehotsky (18:45):

... change management. And so, dear listener, you know, listen to all those again if you're thinking, "Okay, I, I, I need to do something I don't know how." It's really tying in, like you said, your resources, other people around you, what you can find. 

And for those of you who are magnet or are on your magnet journey, a great... I'm sure there's people in your organization that can help you further... Whether it is true formal research, if it's a quality improvement project to see, does this work in our facility? There are people in your facilities,-

Dr. Lorraine Novosel (19:12):

Mm-hmm.

Carol Pehotsky (19:12):

... especially if you're on that journey, who want to help you, who want to bring that forward.

Dr. Lorraine Novosel (19:15):

Right. 

(19:15):

And it all starts with that question,-

Carol Pehotsky (19:16):

Yes.

Dr. Lorraine Novosel (19:18):

... why are we doing this? This doesn't make sense to me. Is there a better way to do this? 

Carol Pehotsky (19:18):

Mm-hmm.

Dr. Lorraine Novosel (19:23):

It starts with that question. And nurses, they're day in and day out... I challenge all of the listeners to go home today from your shift, and think of one thing that you questioned, "Why did you do this?

Carol Pehotsky (19:23):

Mm.

Dr. Lorraine Novosel (19:35):

... Why was I told to do this? Why are we implementing-

Carol Pehotsky (19:37):

Sure.

Dr. Lorraine Novosel (19:37):

... X, Y, or Z?" It's creating that culture of curiosity, and no question is ever a bad question.

Carol Pehotsky (19:44):

That's right.

Dr. Lorraine Novosel (19:45):

It's not.

(19:46):

You know, we spend a lot of time in our office working with nurses across the enterprise,-

Carol Pehotsky (19:51):

Mm-hmm.

Dr. Lorraine Novosel (19:51):

... looking at the r- literature, finding out what's out there. Sometimes we come to the decision that, "Mm, this has already been studied-

Carol Pehotsky (19:58):

Right, extensive enough that-

Dr. Lorraine Novosel (20:00):

... to the nth degree.

Carol Pehotsky (20:00):

Yeah.

Dr. Lorraine Novosel (20:01):

... It's pretty much set in stone."

Carol Pehotsky (20:03):

Mm-hmm.

Dr. Lorraine Novosel (20:04):

I don't want that to s- be a dead end, though.

Carol Pehotsky (20:05):

Sure.

Dr. Lorraine Novosel (20:06):

'Cause there's always a way... What can we do? What can we still add?

Carol Pehotsky (20:09):

Mm.

Dr. Lorraine Novosel (20:09):

What is the tweak?

Carol Pehotsky (20:11):

Okay.

Dr. Lorraine Novosel (20:11):

What is the one other thing that hasn't been looked at-

Carol Pehotsky (20:14):

That's additive to-

Dr. Lorraine Novosel (20:14):

... within-

Carol Pehotsky (20:15):

Yeah, mm-hmm.

Dr. Lorraine Novosel (20:15):

... this whole topic? So, there's potential all over the place.

Carol Pehotsky (20:20):

Yes. And those of you who listened who braced at some of our examples, rest assured, when you are a 10, 15, 20-year nurse, you will also have those examples. That's the beauty of that inquisitiveness that really, sometimes comes with being a nurse... Is-

Dr. Lorraine Novosel (20:33):

Mm-hmm.

Carol Pehotsky (20:33):

... as we're assessing, as we're diagnosing, we're also hopefully turning those same thought patterns to our policies, to our practices. That same sort of thought process, that says, "What's happening, and what do I need to do about it?"

Dr. Lorraine Novosel (20:44):

Absolutely. And 10 years from now, I think I will be amazed-

Carol Pehotsky (20:49):

Mm.

Dr. Lorraine Novosel (20:49):

... to see what comes out,-

Carol Pehotsky (20:51):

Right.

Dr. Lorraine Novosel (20:52):

... where things that we are doing every day... Day in and day out-

Carol Pehotsky (20:53):

Mm-hmm.

Dr. Lorraine Novosel (20:56):

... right now, with the best of intentions, and-

Carol Pehotsky (20:56):

Right (laughs).

Dr. Lorraine Novosel (20:59):

... based on the evidence that we have today.

Carol Pehotsky (21:00):

That we have available, yeah.

Dr. Lorraine Novosel (21:01):

Because we do practice by the evidence today.

Carol Pehotsky (21:03):

Mm-hmm.

Dr. Lorraine Novosel (21:05):

We know it's going to change.

Carol Pehotsky (21:06):

Right.

Dr. Lorraine Novosel (21:06):

I'm just curious to see where things stand 10 years from now, that you and I may say, "Oh my goodness, there is no way-

Carol Pehotsky (21:14):

Right,-

Dr. Lorraine Novosel (21:14):

... this is going to b-

Carol Pehotsky (21:15):

... between AI, and all of these other things out there-

Dr. Lorraine Novosel (21:17):

You got it. I think we're going to be pleasantly surprised,-

Carol Pehotsky (21:19):

I hope it's pleasant, yes (laughs).

Dr. Lorraine Novosel (21:20):

... as long as it, as long as it improves patient care.

Carol Pehotsky (21:24):

Right.

Dr. Lorraine Novosel (21:24):

Because at the end of the day, these are your family members, my-

Carol Pehotsky (21:28):

Sure.

Dr. Lorraine Novosel (21:28):

... family members, children, friends... It's going to be us,-

Carol Pehotsky (21:33):

Mm-hmm.

Dr. Lorraine Novosel (21:34):

... I want to know that the care that I'm receiving today is up-to-date and it is the best available evidence as of today. 

(21:45):

Where we stand currently, there has been some improvement.

Carol Pehotsky (21:48):

Mm-hmm.

Dr. Lorraine Novosel (21:48):

The needle has moved-

Carol Pehotsky (21:50):

Mm-hmm.

Dr. Lorraine Novosel (21:50):

... slightly. For many years the standard was, well, it takes 17 years-

Carol Pehotsky (21:51):

Yes, right. (laughs)

Dr. Lorraine Novosel (21:55):

... to go from, you know, the,-

Carol Pehotsky (21:57):

Idea to... Yeah, mm-hmm.

Dr. Lorraine Novosel (21:58):

... the publication of that... The seminal,-

Carol Pehotsky (22:01):

Mm-hmm.

Dr. Lorraine Novosel (22:01):

... you know, ground-breaking research... 17 years, to the point where it meets the bedside,-

Carol Pehotsky (22:07):

Right.

Dr. Lorraine Novosel (22:07):

... clinical care.

(22:08):

A study was published, s- I think within the past five years... It w- it's relatively recent. They got that needle down to 15 years. 

Carol Pehotsky (22:08):

Okay.

Dr. Lorraine Novosel (22:15):

So if you're a glass half-full or-

Carol Pehotsky (22:15):

Mm-hmm, that's right. (laughs)

Dr. Lorraine Novosel (22:17):

... a glass half-empty... If the glass is half-full, wow,-

Carol Pehotsky (22:20):

Yeah.

Dr. Lorraine Novosel (22:21):

... I'm so happy,

Carol Pehotsky (22:22):

That's right. (laughs)

Dr. Lorraine Novosel (22:22):

... we've moved the needle. But 15 years. Think back to your life,-

Carol Pehotsky (22:22):

Mm-hmm.

Dr. Lorraine Novosel (22:26):

... where you were, where you were living,-

Carol Pehotsky (22:27):

Right. Mm-hmm.

Dr. Lorraine Novosel (22:28):

... what your children were doing 15 years ago... And think today that, you know, depending on what study you look at, it is something along the lines of only 4 our of every 10 individuals get evidence-based care-

Carol Pehotsky (22:42):

Oh, dear.

Dr. Lorraine Novosel (22:43):

... Or worse, they're getting care that we know today is ineffective or even harmful.

Carol Pehotsky (22:49):

Oh, gosh.

Dr. Lorraine Novosel (22:50):

You know, you put it in perspective.

Carol Pehotsky (22:52):

Yeah.

Dr. Lorraine Novosel (22:52):

This has to be a ground roots effort.

Carol Pehotsky (22:56):

Mm-hmm.

Dr. Lorraine Novosel (22:56):

There's so much new knowledge being produced out there every day. We can't absorb it all by osmosis. It doesn't happen.

Carol Pehotsky (23:02):

(laughs)

Dr. Lorraine Novosel (23:03):

Nurses with evidence-based practice have this... Not only nurses, but-

Carol Pehotsky (23:07):

Mm-hmm. Right, yes.

Dr. Lorraine Novosel (23:07):

... evidence-based practice is the standard of care.

Carol Pehotsky (23:09):

I'm talking about nursing practice, but exactly, yes.

Dr. Lorraine Novosel (23:10):

Exactly. It's the standard of care in healthcare.

Carol Pehotsky (23:12):

Mm-hmm.

Dr. Lorraine Novosel (23:12):

This is ground roots, up.

Carol Pehotsky (23:14):

Mm-hmm. Mm-hmm.

Dr. Lorraine Novosel (23:14):

You know, the research is coming down very, very slowly, being translated.

Carol Pehotsky (23:19):

Mm-hmm.

Dr. Lorraine Novosel (23:19):

Nurses have that opportunity to speed that up from the grassroots level, up. And this is something, it takes all of us. We all have to be engaged in this, because we have to do better.

Carol Pehotsky (23:29):

What a beautiful call to action. I can't possibly top that.

I got goosebumps when you talked about really making sure that... If it were us, if it were our loved ones, we'd want that best care too.

Dr. Lorraine Novosel (23:38):

Absolutely.

Carol Pehotsky (23:38):

All right, so, so audience members, you've all been changed wi- (laughs) with some homework. 

Before we call it a day, though, we're gonna move on to our speed round. So, first question. What's the best advice you've ever received?

Dr. Lorraine Novosel (23:51):

Oh, Carol.

Carol Pehotsky (23:52):

(laughs)

Dr. Lorraine Novosel (23:54):

I would have to say, don't take yourself out of the running.

Carol Pehotsky (23:59):

Okay. Tell me more about that.

Dr. Lorraine Novosel (24:01):

Meaning there have been periods in my life where... "Mm, I shouldn't apply for that job. I don't-

Carol Pehotsky (24:06):

Oh.

Dr. Lorraine Novosel (24:06):

... meet all of the-

Carol Pehotsky (24:08):

Mm, okay.

Dr. Lorraine Novosel (24:08):

... qualifications." "I'm not sure I should do this. I don't feel comfortable doing that."

Carol Pehotsky (24:13):

Okay.

Dr. Lorraine Novosel (24:15):

You're never going to know until you try.

Carol Pehotsky (24:16):

That's right.

Dr. Lorraine Novosel (24:17):

I may not be qualified, I may not have the confidence, but I'm not going-

Carol Pehotsky (24:21):

Let somebody else tell you that. (laughs)

Dr. Lorraine Novosel (24:22):

Let's... Exactly. Exactly.

Carol Pehotsky (24:22):

I love it.

Dr. Lorraine Novosel (24:24):

Let somebody else. Don't take yourself out of the running.

Carol Pehotsky (24:27):

And, and look at you.

Dr. Lorraine Novosel (24:28):

You, you lose-

Carol Pehotsky (24:29):

Yeah.

Dr. Lorraine Novosel (24:29):

... a lot of opportunities that way, and you never know where these doors are going to lead you to.

Carol Pehotsky (24:29):

That's right.

Dr. Lorraine Novosel (24:33):

You never do.

Carol Pehotsky (24:34):

That's right.

Dr. Lorraine Novosel (24:34):

Don't take yourself out of the running.

(24:36):

I may be taken out, and I have been taken out many times-

Carol Pehotsky (24:39):

Sure. Oh, yeah.

Dr. Lorraine Novosel (24:39):

... in my life,-

Carol Pehotsky (24:39):

Mm-hmm.

Dr. Lorraine Novosel (24:40):

... but let somebody else do it.

Carol Pehotsky (24:42):

That's right.

Oh, that's fantastic. 

All right. And then, what's something about you that surprises people?

Dr. Lorraine Novosel (24:48):

Well, the, I think this is t- a two-fold answer.

Carol Pehotsky (24:50):

Okay.

Dr. Lorraine Novosel (24:50):

That's a little bit on that nerdy, geeky side, okay?

Carol Pehotsky (24:50):

(laughs)

Dr. Lorraine Novosel (24:54):

Kid in a candy store when I have a data set in front of me.

Carol Pehotsky (24:56):

Oh.

Dr. Lorraine Novosel (24:56):

Now, that's kind of like-

Carol Pehotsky (24:57):

I mean,-

Dr. Lorraine Novosel (24:58):

... odd.

Carol Pehotsky (24:59):

... we all have those things-

Dr. Lorraine Novosel (25:00):

Okay.

Carol Pehotsky (25:01):

... that check the boxes for us. Yep.

Dr. Lorraine Novosel (25:01):

Okay, but, you know,-

Carol Pehotsky (25:01):

(laughs)

Dr. Lorraine Novosel (25:02):

... it goes hand-in-hand with research. But also, I love the symphony,-

Carol Pehotsky (25:06):

Oh.

Dr. Lorraine Novosel (25:07):

... and I'm... I don't wanna say a closet player,-

Carol Pehotsky (25:10):

Ooh.

Dr. Lorraine Novosel (25:11):

... flute-

Carol Pehotsky (25:11):

Oh.

Dr. Lorraine Novosel (25:11):

... and piccolo.

Carol Pehotsky (25:12):

Oh, how nice.

Dr. Lorraine Novosel (25:14):

Yeah.

Carol Pehotsky (25:15):

I'm a clarinet-player.

Dr. Lorraine Novosel (25:15):

You are?

Carol Pehotsky (25:15):

Yeah.

(25:16):

Well, that's wonderful.

Dr. Lorraine Novosel (25:16):

Did you ever look into joining the band?

Carol Pehotsky (25:18):

I have been in community bands. Right now it's-

Dr. Lorraine Novosel (25:20):

There you go,-

Carol Pehotsky (25:21):

... not working out very well, but-

Dr. Lorraine Novosel (25:21):

... uh, the scheduling.

Carol Pehotsky (25:22):

... are you, are you playing in a band?

Dr. Lorraine Novosel (25:23):

Not at the present time. But-

Carol Pehotsky (25:24):

All right.

Dr. Lorraine Novosel (25:25):

... the t- those little-

Carol Pehotsky (25:25):

Now we've given ourselves some homework here. 

Dr. Lorraine Novosel (25:26):

... community bands,-

Carol Pehotsky (25:27):

Yes.

Dr. Lorraine Novosel (25:27):

... where you realize you may be one of the youngest members in the band,-

Carol Pehotsky (25:30):

(laughs) That's right. (laughs)

Dr. Lorraine Novosel (25:32):

... but I love it.

Carol Pehotsky (25:33):

Wonderful.

Dr. Lorraine Novosel (25:34):

Thank you for asking. (laughs)

Carol Pehotsky (25:35):

Well, one last question. So we don't normally do this, but at Cleveland Clinic... Because we have such wonderful resources, we actually are able to offer some coursework around evidence-based practice that's opened up to all nurses. Would you mind sharing a little bit more about that for our audience, please?

Dr. Lorraine Novosel (25:49):

Oh, thank you for asking. Since I joined Cleveland Clinic a little over three years ago, I've been tasked with chairing one of our,-

Carol Pehotsky (25:49):

Mm-hmm.

Dr. Lorraine Novosel (25:56):

... our several workshops that we put forth continuing education for nurses. And we do offer a two-day evidence-based practice workshop,-

Carol Pehotsky (26:04):

Mm-hmm.

Dr. Lorraine Novosel (26:05):

... titled Searching, Critiquing, and Synthesizing the Evidence. So-

Carol Pehotsky (26:09):

Oh, we talked about all of those. Yeah. (laughs)

Dr. Lorraine Novosel (26:10):

We talked about all of that. And actually, we have our next offering coming up in June. It's a two-day workshop, June 6th and 7th-

Carol Pehotsky (26:11):

All right.

Dr. Lorraine Novosel (26:18):

... of 2024. It is an all-day event, breakfast and lunch included. Again, it's a workshop, so it is hands-on.

Carol Pehotsky (26:26):

Oh, wonderful.

Dr. Lorraine Novosel (26:27):

We start by that, what is the question?

Carol Pehotsky (26:27):

Mm-hmm.

Dr. Lorraine Novosel (26:29):

And then we walk you through, with your computer and your laptop, "Okay, let's search the evidence. Let's critique it together."

Carol Pehotsky (26:36):

Wonderful.

Dr. Lorraine Novosel (26:37):

And then, "Okay, you may have 10 high-quality studies. Let's synthesize them."

Carol Pehotsky (26:37):

Okay.

Dr. Lorraine Novosel (26:43):

"One may say X, one may say mm-mm. For that question, why is the why to go.

Carol Pehotsky (26:49):

Mm-hmm.

Dr. Lorraine Novosel (26:49):

And the other one may say, "No, take path C." So, how do we reconcile-

Carol Pehotsky (26:54):

Wonderful.

Dr. Lorraine Novosel (26:55):

... sometimes disparate literature? So,

Carol Pehotsky (26:57):

Very good.

Dr. Lorraine Novosel (26:58):

... see any offerings of... I believe it's 13 and a half-

Carol Pehotsky (27:01):

All right.

Dr. Lorraine Novosel (27:02):

... CEUs, so it's worthwhile.

Carol Pehotsky (27:02):

Well, Cleveland is lovely in June, ladies and gentlemen. So hopefully you will join us for that workshop.

And Lorraine, thank you so much for joining me today.

Dr. Lorraine Novosel (27:08):

Carol, it's been enjoyable. Thank you for the invitation.

Carol Pehotsky (27:14):

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.

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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.