Nurses protect their patients' well-being. But who’s looking out for the nurses? The U.S. is currently facing a shortage of Registered Nurses and things are expected to get worse. Nickia Jackson created CT Nurse Wellness to reverse that trend. Good at Heart host Randye Kaye sat down with Ms. Jackson to learn how her nurse-led consultancy group enhances nurses' wellness.
WSHU: I'm Randye Kaye, the host of Good at Heart, where we have conversations with people who quietly make the world better. Nurses are here to help us, but how's the wellness of our nurses? I have a guest here. Who are you, and what do you do?
Nickia Jackson: Thank you so much for having me, Randye. So I am Nickia Jackson. I am the CEO and founder of CT Nurse Wellness, a nurse-led consultancy that works with both nurses and leaders to ensure we're incorporating well-being so nurses can not only thrive, but also have organizations that support their well-being.
WSHU: That is a broad mission. I'm going to ask you my first question; I'm very curious about this. I know people in the medical profession have a lot of stress. Can you say that's true? So the first question is just: Tell me more about this. Who do you help and how?
NJ: Yes, so I help nurses. As a nurse, I understand what it means to carry a lot for others, and you tend to fall at the bottom of that list. And it is important for healthcare professionals, and particularly nurses, that they have the tools and support and resources that they need to be able to care for themselves, so that they can show up best for the people who they care for.
WSHU: Is there a lot of burnout in the nursing industry?
NJ: So yes,
WSHU: Yeah, I hear your sigh.
NJ: You hear the sigh as I'm breathing in the midst of it all. So yeah, and burnout, I will say, is real. I've experienced burnout myself. This is a part of the kind of origin story of this work that I'm doing. So burnout is real, and I honestly want us to have a different conversation around burnout because burnout tends to focus a lot on the resiliency and the resiliency of nurses, and that tends to lead to more of a focus on what the nurse needs to do as an individual, and granted, it's extremely important that nurses do the things that allow them to live well emotionally, physically, and spiritually. But it's also important for us to look at the conditions that we're asking nurses to be resilient in. So I think both of those conversations need to happen. It's not just the nurses being resilient; it's also what the conditions are that we're asking nurses to be resilient in.
WSHU: Okay, so you're working at it from both ends, inside out and outside in, to maybe change the culture and the responsibilities. Tell me a bit about you. You know, what kind of nursing have you been doing? Why did you get into nursing? What's your story?
NJ: Yeah. So, interestingly enough. So I've been a nurse. Oh, goodness gracious, 25-plus years.
WSHU: Really?
NJ: Yes. I was a baby when I started.
WSHU: Yeah. Of course. We're we're all we're all babies when we started.
NJ: Yeah, it’s baby nursing. So I worked in a variety of areas. So starting in critical care, I was an ICU nurse. I did recovery room nursing, and then when I decided to transition from the bedside, because, you know, we all know when it's time for us to make changes, I got into more of the, like, performance improvement. So kind of working on how to best support the organization. So I was more into the quality and safety, performance improvement.
WSHU: So more management or training? What does that mean, performance improvement?
NJ: So it really is the focus on, you know, understanding the things that may not quite go right in hospitals, and how do we, you know, prevent those things from going right. So my thinking at the time was, like, how do I best support, you know, when we have these adverse events or issues that unfortunately do happen in healthcare? How do I help prevent those? So I did a lot of work in that particular area for a long time. That was how I ended my nursing career.
WSHU: You only know your own story, but since you were doing performance management, you probably know, like, what is the drive that makes people want to go into nursing, and then what's the reality of it that can contribute to oh this isn't what I thought it was going to be.
NJ: Yeah, I will say for me, because you did ask about just my own origin story, so I will say for me, coming from a family, I had people who worked in the healthcare profession, and then I also experienced it from the family member side. So I, you know, watched as my grandmother would take care of her mom. So I would visit the nursing homes and watch just those interactions and be present in a very different way. I can remember, if I could share just one brief story. There was a time when my great-grandmother, who was in this nursing facility, had a number of strokes, so she was nonverbal. So it was kind of sad to go visit her. There was this one time when my grandmother and I went there, and we would always go, and we would sing songs and, you know, try to cheer her up, and I wasn't sure exactly what she gathered from our interaction. But there was this one time, and I remember we were singing the song, you know, like the hip bones connected to the, you know, the thigh bone. And I couldn't have been more than like seven, and I remember I was doing that, and then I kind of moved, and I was like, "Oh, I think I broke a bone." And my great-grandmother laughed out loud, like So. Really, and she had never really been verbal or responsive, but it was like in that moment, it was like, "Wow, like she's she is present, like even though she may not be, you know, able to, you know, verbalize in words, but she's taking in what it is that we're seeing, and it was something about that experience that was kind of like, wow, like okay, like recognizing that I can have an impact in a way that that led me to have more interest in pursuing this profession.
WSHU: Okay, and since you work, do you work with student nurses at all? People who are studying. What drives them to want to do this? It's a hard profession.
NJ: It's a challenging profession, and I think for the most part, people get into it because they want to care for other people. I mean, I think that's the basis of the work, but not realizing that there are a lot of other factors, that you're not just coming in to care for someone else. There's a lot of other, you know, politics and other things that are associated with that. So I think the intentions are good, but I think the disconnect is what they may be learning in nursing school, and then the reality of what they're experiencing when they're actually in these workplaces is very different, and that is the reality. It's not as supportive, and there are things that I think about even when I started, when I was like clinical as a nurse, that we just tolerated. That was just this was just what it is.
WSHU: So let me ask you. This is all part of the first couple of questions. What are some of the best things about nursing? Most rewarding things about nursing, and name two or three specific challenges that really can surprise people and make them go, "Oh my gosh, did I make the right decision?"
NJ: Yeah.
WSHU: Tell me the good stuff first.
NJ: Yeah. So for me, the biggest part that I miss was the connections with families. Even in the challenges of, like, you are with people sometimes at their most vulnerable, right? They are experiencing probably the biggest challenge of their lives, and then you have an opportunity to be that bridge or to be that comfort and support for them during that period in time. And having worked in an ICU setting, I dealt a lot more with families, and I will say that was the biggest piece for me that I would leave at the end of the day and be like, "The day was crazy, but the ability to just connect with this family and provide them with whatever support that they needed during this difficult time, whether it was just information or just saying, 'Hey, this is the plan for today." Because a lot of times, it's just I just need the information to help settle my own nervous system. So I would say the ability to really connect with people and families, you know, during the most challenging times, like you have these connections and bonds with people that you know you won't get in any other profession, right? You don't normally get a chance to experience that. I think overall, I think just the work that you're able to do is so it can be so rewarding. Because when you watch people just progress- progress in a way where they are healing or just being able to come to terms with whatever that next phase of life is for them- maybe that ability to connect as well is some of the things that I loved about when I was clinical as a nurse.
WSHU: I will say as a former patient, I'm sure future patient as well, but we're in between right now. You know, the doctors make a big difference too, and there are some with better bedside manners than others. But it's the kindness of the nurses that always stays with me. Just even the way they do the intake on the computers. I remember one of them when I was getting anesthesia for a surgery, and she's like, "You ready for your spa treatment?" She made a joke, and I appreciated that. So you know, the connection. I think that sounds like that's the secret sauce. It's special sauce.
NJ: It definitely is. It definitely is.
WSHU: What are the unexpected challenges that CT nurse wellness that you're working to fix or help? Fix is a big word; you're working to alleviate or support.
NJ: It's a big fix. Clearly, there's a lot. Some of the things that have been passed down. As I said, I've been in nursing for a long time, and some of these things that we were just so accustomed to doing because we've been almost like ingrained to, you know, like the patient first, patient first, and it's important that you are caring for the patient. But the reality is, you have to put yourself first, and I mean, and it's not a selfish thing, but we have been so conditioned to think of that as selfish, to the point where we're in this. And I can think of stories of when I was working in an ICU, and I would get to the end of my 12-hour shift, and I'd be like, "Man, I didn't go to the bathroom."
WSHU: Even just when you say 12-hour shift. What?!
NJ: Yes, yes. But can you imagine at the end of a 12-hour shift saying I didn't go to the bathroom? And then the sad part would be you would tell your colleague, and they would be like, "Yeah, well, I didn't go to the bathroom, and I didn't eat lunch." Now we're one-upping each other. So then it's like I didn't go to the bathroom, I didn't eat lunch. Oh, and then yeah, both of my patients, you know, were in crisis, so it becomes that whole yeah discussion.
WSHU: Negativity feeding on negativity.
NJ: Well, and that too, and then it becomes less about, like, well, let's talk about the fact that you went through a 12-hour shift and you didn't go to the bathroom. So for one, like you're not doing the basic care for yourself. Like, so that means I didn't hydrate. I wasn't taking care of my own basic needs. So we've been so conditioned to put down our own needs, and it's like this martyrdom thing that we have going.
WSHU: Mothers have it too.
NJ: Yeah, we do. It's that exact same thing, right?
WSHU: I think all caregivers do, you know, of any sort. Caregivers, we think it's the noble thing to do to ignore ourselves to help other people, and I will not bring up the airline mask, oxygen mask cliché because it's overused.
NJ: Yeah, but it’s the reality. You have to do that. And I think for many of us, we had been so conditioned to think that there's something wrong with that. That it's, oh, me being selfish. But if I'm not caring for myself, then I can't be my best for you because, you know, if I'm not eating, I'm not hydrating, I'm not doing the things that allow me to show up. Then yeah, you're gonna get you know a lesser version of me.
WSHU: Right. So that's the inside-out attitude shift. What about the outside in? I know we could talk for hours about the culture, but can you name a couple of things that is part of your mission to make, let's say, make administrations aware of, so that nurses will stick around longer and be happier at work? Is that a good way to phrase that question?
NJ: Yeah, I think that's a great way to phrase it. I will say, we're healthcare organizations. I mean, they're businesses. I mean, that's the reality of what we're dealing with. But what also is true is that they're in the business of people. You have people who work for you for these organizations, and when you're in the business of people, people have to also be at the forefront of the work that you're doing. Because if you don't care for the people who are caring for the people? Then everything else just kind of…
WSHU: Yeah. And training a new employee is expensive. And jarring.
NJ: It is. It is. There's a lot to be said. I mean, there's so much in the realm of statistics in terms of the research on that turnover, what it costs to train like a nurse each time, so it is. So I feel that well-being and wellness kind of gets lumped into this nice-to-have, a perk. But the reality is, it's foundational. It's foundational to the work that any organization does. Because if your people aren't well, then how are you expecting your people, especially in this arena, when the focus is on how do I provide safe, quality care to a community and to a population, without making sure that the people who are doing that are at the forefront of this work?
WSHU: Exactly, and you know I'm sure we could say the same for doctors and med students that are pulling a 36-hour shift.
NJ: Absolutely.
WSHU: That's another conversation. But CT Nurse Wellness, you recently had a day for nurses, and you also just presented at a conference. So tell me a little bit about how this work plays out with what you and I don't know if you have other people who are doing what you're doing, what your organization does. How are you trying to make a difference?
NJ: Yes. So there are a multitude of avenues. One of the avenues is through the CT Nurse Wellness Summit, which we just had on October 10th. It was in partnership with Quinnipiac University, the School of Nursing. So it was held there on the North Haven campus.
WSHU: And nurses came.
NJ: And nurses came.
WSHU: How many came?
NJ: Nurses came? We had goodness gracious, I can't think of the exact number, but we had a really good amount of nurses who were there.
WSHU: Like a dozen or 100?
NJ: It was probably like about 50 plus who were in attendance,
WSHU: That's great.
NJ: And I will say that the feedback because it's all day. It's a day of not just talking about wellness, but actually being able to experience some practices. So we had sound healing facilitation. We had Qigong. We had Yoga. We had a whole wellness lounge set up. So throughout the day, if you were like, “I just need a moment”. We had Reiki practitioners who were present, as well as a massage therapist. And there were some people in the massage place who were like, “hey, I'm gonna take some time here.” But then we also talked about how do we move past it just being about the day? In your current organization, what are some things that you feel are going well? What are some challenges of things that you're actually seeing? So how do we again expand the conversation beyond it just being a one-day event? And the feedback that we received from nurses was just like they felt t seen; they felt held. Someone actually wrote to me and said, “I felt valued. I felt like this was a space that was just created for me that I felt supported”, and you know I was almost like teary eyed in a sense. So my thinking is like, how do we bring this same thing to organizations so that your people can come to work and say, "Yeah, I feel like the work is the work, but I still feel like I am supported. I feel valued. I feel a sense of belonging.” Because all of those things are extremely important, and I think for organizations we can't minimize that. I think they're sometimes so heavily focused on the operations, which, yeah, it's a business; you have to make money. But honestly, I feel like if you focus on the people, the operations will work themselves out because the people feel like they're invested in the work.
WSHU: It sounds like you might be creating ambassadors for your work by letting them experience being seen and held and valued. I always say seen, heard, and valued, but I love seen, held, and valued. Maybe that's a womanly thing. I don't know. So my next question is: How can people help you and your mission to get out there?
NJ:. I would say the first way is connecting through me, through my website ctnursewellness.com. So if you know nursing leaders, people who are at the C-suite level. I'm open to having those conversations. Of having me come in, talk about some of these other ways that we can, again, create conditions that allow nurses as well as other healthcare providers to actually thrive and not feel like there's this constant pull of like, oh, is it my well-being or is it the job? We don't want people to have to feel like they have to choose between their own health and this work. There has to be a middle ground here because, I mean, this is what we're experiencing in healthcare. We talk about a healthcare crisis, and the reality is there's not a nursing shortage. Nurses are still keeping their licenses. They're just making choices not to work in environments and conditions that are not supportive of their well-being.
WSHU: Very, very telling. And this sort of burnout is across many venues, but here for nurses. So you want C-suite people to get trained and educated as to the value of this and how to do it.
NJ:.Yes,
WSHU: And they can do that by coming to your website.
NJ:.Yes, yes.
WSHU: Nurses themselves can come to your website…
NJ:. Absolutely!
WSHU: For tips. Are there any plans for support groups or anything like that?
NJ:. So that's some continuation of the work. So beyond the CT Nurse Wellness Summit, it's really to build more community around. So how do we actually have support? So it's not just about it being a one-time event, but we are building community. So here are resources. There are some other opportunities to be able to engage with others. Because the one thing that I notice is that nurses a lot of times feel like they're in it by themselves, like it's just me. But when you have a sense of community, it feels like okay, “I can do this. I'm not alone”, and I think that within itself just feels so. It feels liberating to people, and I hear that a lot from nurses. I mean, I talk a lot to nurses because I do this sort of thing.
WSHU: And they feel alone a lot of the time.
NJ:. Yeah, yeah,
WSHU: Interesting. OK, and you're doing something about it. So I have two final questions for you. They're a little more personal. One is: what inspires you? It could be a quote. It could be a person that you grew up with that inspires you. I know you talked about your grandmother and your great-grandmother. It could be a philosophy. What inspires you?
NJ:. Yeah, so I will say one of the philosophies that has been, I think, guiding me throughout this, that allows me to continue to show up in the space, with family and all the other obligations that we have, is that reminder that until I am good to myself, I can't be good to anyone else. So that's kind of like the driving force of the work. So even when I'm feeling like, oh, there's this one other thing like I got to do, I'm like, yeah, I got to make sure that I'm doing my check in for me first before I'm making any other efforts. So that has been, I would say, one of the biggest guiding forces for me.
WSHU: Has there ever been a role model in your life that modeled that for you? Are you coming from, like, I haven't been working like this? It's just like you coming to that conclusion.
NJ: I think I'm coming to the conclusion because I mean I was raised by single grandmothers. So that's a whole other that's a whole other podcast episode.
WSHU: We'll book you for next month.
NJ: Yes, yes, for next month. But so I came from that, you know, having to be strong all the time. There was a lot of unpacking of things that I think I had to do along this whole journey. And I mean, grateful for, you know, for them and where they were and how it got me to where I am now, but there was, yeah, there was definitely a lot of unpacking of that that I had to do for myself along this way and journey.
WSHU: Yeah, and nurses are not just women, so male nurses are in the same situation. But you know a lot of times we we don't learn that growing up. We just see sacrifice, sacrifice, sacrifice. I saw my own mother burn out. I remember hearing a story one time, and this is more about motherhood, but I think it relates.
NJ: Yeah, caregiver roles. W
WSHU: Yeah, yeah. Been there, am there. It was a story of a mom with like a bunch of kids, and she would go into the kitchen once a day and just lock her kids out of the kitchen, basically, and just have a cup of tea. Well, I think they were old enough for it to be okay. Have a cup of tea with a couple of cookies, and her kids would knock on the door and say, "What are you doing?" And she goes, "I'm making you a better mother."
NJ: I love that.
WSHU: Isn't that nice?
NJ: Yeah.
WSHU: I mean, just take a moment. And with my own grandchildren, I will sometimes say, "Time out for me." If they're misbehaving, sometimes I need to walk away.
NJ: Absolutely.
WSHU: And just give them the time to calm themselves down, rather than, you know, I will walk away and take a few deep breaths and even a few deep breaths. I do take that moment.. So yeah, so the final question is…
NJ: So needed. I just wanted to say what you were saying on that, how that piece is so, so needed, and that's really a sign of a lot of just emotional intelligence. And the ability to self-regulate. So having the ability to know. “I'm feeling a little overstimulated. I need to take some time for myself,” and I think that's important for all of us because we all have those moments, right? With whatever role you're in.
WSHU: There are times when you can't do it in the middle of surgery. Yeah, you go, sorry, I need to take a deep breath. You know, there's times, and were, we have to postpone that time. But sometimes, even knowing that time is coming, like when people are looking forward to vacation. Anticipation is one of the keys to happiness. So even knowing that a break is coming can be helpful. And in cultures, too, I think the first step is to recognize the need for our people to be emotionally healthy and feel seen and heard and held and valued and that they're important enough to take care of themselves.
NJ: Absolutely.
WSHU: So my final question is: Why do you think we're here on Earth?
NJ: Wow, we're going deep now, Randy. We're going deep.
I will say I am a believer that we are spiritual beings having a human experience. I feel, for me especially, being on this journey, that there's a greater meaning and purpose in our lives. Many of us choose to follow that. Some, you know, may choose otherwise. But I do feel like we're here not just to work and retire and pay bills and, you know, just expire. I feel like our lives are meant for so much more. And for me, I think the biggest driving force for me is that I didn't want to live my life, and I don't want to live my life with regrets. I don't want to live with like, you know, man, if I had done the thing, maybe. You know, could have, would have, should have. But how about, yeah, how about I just do the thing, and then hey, if it may work out, okay, you know, that's great; if it doesn't. All right, I'll just pivot in another direction. But for me, it's like recognizing that there is something else that's greater for us in whatever your beliefs may be. But I do believe that we are spiritual beings having this human experience, and part of this is that we're supposed to experience life, not just exist. We are supposed to live.
WSHU: We’re supposed to live. I love that, Nickia. Thank you so much. I've so enjoyed this talk.
NJ: Oh, thank you so much. So appreciate you taking the time, and I've enjoyed our conversation here, Randye.
