CARE OUT LOUD
Interview with Carole Kenner - Part 2
Mary Coughlin:
I, you know, what's running through my head is now and we mentioned it earlier and I forget what the acronym stands for, but you were at an Align meeting.
There was an Align meeting in Hawaii. That's a relative, is that a relatively new organization also?
Carole Kenner:
Yeah 2017. Around that time, we really tried to pull together the North American groups. That's really what it was. Anybody, any nursing group that had something to do with newborns, small and sick newborns.
So it was a one. It was the Academy of neonatal nurses. It was the NaNN National Association of neonatal nurses. It was caring for Hawaiian neonates. That is a part of COINN and then COINN. So that we would say, what are the issues that we are facing in North America, that we can come together and talk about and look for ways that there can be synergies, it's not all about competition mean coin certainly not.
Not pulling in members from other organizations. We all say we don't care what organization you belong to some of us belong to all of them. But the reality is what we want is that the leadership comes together. And talks very seriously about issues that are really concerning us today and right now it's the workforce.
It's the, the, the burnout, the lack of resilience in our workforce, the turnover rates. And just the impact in general in patient care. This zero separation of families is another thing that, while that's a global issue, we also talked about it here as the aligned group. So that's what that is, the alliance.
Mary Coughlin:
It actually feels like a segue into a connection that I, that I'm seeing just based on what you're, you're sharing between the work that you do and trauma informed care. You know, I think. Because the trauma informed care paradigm although initially I was really focused about its relevance for the baby, and then of course the baby family, but the more you dig in and the, or at least the more I dug in and the more I kind of uncovered to try and understand where this trauma is coming from and how it's perpetuating itself, I think, you know, It, it all begins with the clinician and the trauma that they're experiencing.
And I'm sure many of our colleagues may not refer to it as trauma. But you know, burnout, compassion fatigue you know, workplace bullying, you know, all of those things have a traumatic impact on us. And that affects how we show up to those that we serve and whether or not we show up at all. I mean, cause I know in the wake of COVID, we've had a mass exodus from the nursing profession at large. And even many of our neonatal colleagues have left the profession as well. And so that speaks to that underlying trauma trauma experience that these professionals are, are enduring. So it sounds like, you know, you know, talking about this across all of these different professional organizationsis a real opportunity to uncover, you know, hopefully some solutions and some strategies to address the, the trauma of the healthcare professional, of the neonatal nurse.
Carole Kenner:
Yes, yes, I, I agree with you. I mean, I think We haven't labeled it trauma informed care until recently, but again, my own research has always been transition from hospital to home. I still work with colleagues around the world that are looking at that, especially as the impact of coven. Then again, we're, we're talking about that Mary with the Gravens group with the infant and family centered developmental care that I'm now involved in and the framework there.
Talking about the stress stress and coping, not only of the families or the baby, but of the caregiver and the professional staff. So I think that that's really important. It's funny. I just had an article accepted. I'm, I'm one of three authors. I'm not the lead author that also talked about deans and the trauma that the deans nursing deans saw and felt and experienced during the pandemic. And it wasn't an easy article to get accepted for publication because the emphasis has been on students. It's been on faculty to a small part, but we also saw Tremendous turnover burnout in nursing deans.
And so we talked about some strategies, just like you do in the neonatal world of trauma informed. How do you build resilience? What do you need to do? How do you get Some work life balance. And so, you know, and for some people that don't know my, my dichotomy at the moment, it's not only the neonatal world, but I am a Dean at the College of New Jersey, the School of Nursing and Health Sciences.
So I have public health, kinesiology and nursing. And so I see this in our students. I see this in faculty and I see it in our, in my colleagues. And we talk about that. We have to talk about that, that this is this lived experience for the last two, almost now three years has had a significant impact on us.
And, and most of us I think would say. It's almost like that baby in the NICU where you've got all these sounds and noise and lights and things that are different than when you were in utero and now during the pandemic it was all these things bombarding you on how to go and move online and you're teaching how to do things that to support nurses virtually how to pivot.
You know, in a moment's notice have to be on call 24 7 is what you feel like. Not that people were forcing people to do that, but you felt like you had to respond immediately during this crisis. Well, you can only do that for so long.
Mary Coughlin:
Right. I, you just made me think of that expression overwhelming an individual's capacity to cope.
And and when you do that people will do everything they can to adapt and attempt to cope. But oftentimes those coping mechanisms become maladaptive over time, right? You, you end up burning yourself out, trying to adapt to a situation that is, is, is extremist. So I think, yeah, you're, you're absolutely right.
If, I mean, if you're breathing. you are vulnerable to, you know, feeling this extreme toxic stress, you know or trauma, whatever language feels appropriate. I think, you know, we're all vulnerable to this. And so I think collectively, regardless of what you call it we need to get back to, I think, you know, kind of like the primacy of of nursing, right?
It's about caring and healing and, and creating a, an environment that facilitates that. And it has to begin with the healer, because if the healer isn't feeling whole, then how can they serve, you know, to the best of their ability? Yeah. So, I mean, I, you know, I have, I had one of these questions, but you really, I mean, you're already doing this work, which I just am again so blown away and blessed that I have this time to share with you about how your work is impacting the world.
I mean, it's just, it's enormous, you know, and what an incredible legacy you know, for a career in neonatal nursing that you have touched, not just patients and families and colleagues, but literally the globe government institutions and, and healthcare policies and standards. It's just. That's just really amazing.
I mean, to me, you represent what it is to care out loud with every fiber of your being. And I, I'm just, I'm just, I'm honored to know you. I'm honored to that you're sharing your time with us. And I just would love, you know, to kind of pull, pull all of this together and get a sense from you. If is there one big thing?
Is there, you know, is there something left on your list? You know, I mean, your, your thing, you know, you've been rolling through your professional career and every time you see a need, you're responding to it. You're collecting a group of folks and you're addressing it and then you're moving on to the next thing.
Where are you at with this, you know, You know, this moving, you know evolution of your professionalism, how, how is it unfolding for you? And is there some more that you feel you're, you're called to do?
Carole Kenner:
Always more to do, but, you know, I'm honored to know you and look how far you've come and where you've come in your career to create the, the real understanding of trauma informed and then going on to create the certificate and, and the credentials in that area.
To demonstrate why that's so important. So to me, Mary, part of this is also continuing to build that network. But for me, also, it's the session planning, who's going to continue to carry this on to feel as You know, as compelled, not just as I do, but we've got such a wonderful working COINN board that, you know, I can't imagine people taking the time that they take to make these things happen.
And especially during the pandemic and and You've seen us in action at some of the conferences, we're not ones that sit back and somebody else's rolling these programs out or whatever we're all in there rolling up our sleeves. So, to me, there's A lot of work that still needs to be done, but we have to do the leadership development, and we have to nurture people to create that next line of people that are going to take over from from us.
I think that that's really important and I, I, At a recent conference did moderate a session of nurse leaders and it really disturbed me and I said this then that almost collectively, they said, well, we were told at one point in our career or in our lives that you couldn't be a nurse, you shouldn't be a nurse, you couldn't do this, you couldn't do that, got a lot of rejections, all of us have, I certainly have And Yet, we excelled. We all ended up to be places where we didn't anticipate, and we called it, I, I labeled the panel, the accidental leader, because it wasn't one of us that said, when I came out of nursing school, I wanted to be the leader of a national organization, or I wanted to work globally to set standards.
It was, we saw a need, and we saw an opportunity. And we had mentors that believed in us and again going to to your work, Mary, I think the next frontier for us is to really take this trauma informed and say, we've got to apply it to ourselves and we've got to teach resilience to those coming behind us Or they will burn out sooner than what we're seeing at the present time. That worries me a lot, Mary.
Mary Coughlin:
I agree with you a thousand percent. And that is the next item on the agenda is, I mean, recognizing and, and, and understanding the mechanics and the psychology and physiology of trauma is important, but it's equally important to understand then.
So what's the. The, you know, an antithesis of that, it's resilience and how do we cultivate and foster that And I think a lot of that work is the work that, I mean, I, I'm a bit of a theoretical nerd and I love Gene Watson's work and all that caring science and the really understanding a lot of the Self actualization work.
You know, I think people because of the cut the culture that we're brought up in in our society. We let our purpose and our passion be oftentimes managed by external forces. And really, what we need to do as nurses is to honor our internal resources and really understand and believe that all that we need is within us.
You know, that, you know, when you were saying Nobody, you know, planned it to be the leader of X, Y and Z and create all of these, you know, different things that we've done. That wasn't the primary goal. It was responding to a gap. It was responding to a need it was addressing a challenge and that's what we do and you kind of step in And that's when that I think that strength that lies within is invited to step out. And the more we do it, the more we understand and believe in our own ability Capacity and that fuels I think our resilience, but I think many of our frontline colleagues don't have that that space in their lives to be able to see that and appreciate it within themselves, because oftentimes they're burning the candle at both ends.
And so helping these new nurses, you know that are coming out of nursing school, giving them the tools. That they need to be able to be empowered advocates, you know, for themselves, and in doing so, then be a better advocate for those they serve. I think that that's a an opportunity to help these new nurses have all of the tools, not just the skills and, and, I mean, you know, no disc, but you need the skills.
I know you need the science. I know. But you also need those tools that are going to help you be resilient in the face of these challenges, have that courage to stand up and say, Hey, you know what, this isn't right. We need to do this differently and be leaders in their own, right. Many of the nurses that I do speak with, and I talk to them about being leaders and being healers and some of this language, and they look at me like I just landed from Mars, say no, no, no, no.
I'm just, I'm just. The nurse, right? And it's, it's we need to address that, you know, as leaders in nursing really help these new nurses and the legacy nurses as well, but definitely these new nurses realize you are a leader. There are formal and informals and just by stepping into this role, you are a leader and a healer and Yeah, right.
Carole Kenner:
Yeah, but I think we also have to address the other elephant in the room Mary and that we're still predominantly a female profession. So many of us suffer for the imposter syndrome and focus on what we do wrong or the mistake we make not all the things that we bring to the table, and I think we have to turn that around.
I also feel very strongly that it's the time now to not wait. To be invited to these tables, but to push your way in to the table, you know it's really important, but our communication style as women is different than men. It, and that's okay. I like working with the mix, but that also means that we have to learn how to communicate across genders and across hierarchies.
This is a lot of what I, I, I think about in my early career, but I also think about in, in countries now where this, this hierarchy and the status between doctors and nurses, between males and females is so strong. That that we have to give them the tools to to really help move forward and and to understand, you know, you have a different set of skills.
Typically, if you're a woman, and that you may come and confront problems differently doesn't make it right or wrong man woman, whatever. It just means that we have to acknowledge that. That's still an issue for for many of us that that it is still an uneven table.
Mary Coughlin:
Yeah. Yeah. I mean, that's that whole thing about systematic trauma right and the gender hierarchies and inequalities that does oppress People's and peoples of different genders and different ethnic backgrounds and that sort of thing. So I you're absolutely right. And how, how do we address that, you know, then how do we in these educational environments. How do we cultivate a level of empowerment and it has to be two pronged right you know at that front edge of the profession, but also at the In the systems level, you know with the hierarchy with the with medicine with other whatever, whatever other hierarchies are in play. How do we break down some of that framework or structure, you know, you're right. Yeah.
Carole Kenner:
I mean, I think that's one of the things you talk about it and also for those of us that have gotten to this point of a recognized leader in the profession of telling our stories that there's not always been a smooth path.
And, and how what, what did we used to bounce back from some pretty Awful times. Probably. I don't think there's one of us that could have gotten to the positions that we're in that hasn't had some pretty horrendous days.
Mary Coughlin:
And I think you're right. I mean, sharing those stories can inspire others because it may look all nice and easy. You know, looking from the outside in, but yes, you know You know, living, understanding what brought me to where I am today was not all roses and for and it can't be for anybody. I mean, we're all human beings. And that's probably another big piece of the illusion that people can have about these trajectories and opportunities that they have just to fully step into their purpose, their power and your passion is to understand that it is a lot of the challenges and the bad You know, experiences.
I'm just kind of air quoting it because I mean in out of pretty much every bad experience is an opportunity for you to turn that around and use that challenge use that trauma use that pain for for better, you know But in, in everything, you know, like, I mean, coming back to that first story that you shared about when you first came into the NICU and the doors locked and how, you know, and you're the nurse and how scary that was for you, you used that knowledge to help the family, you know, to really help make those connections.
And so I think that's another important piece for us as nurses and, and as humans to recognize that we're all in this together. You know, we have that shared experience and to stop fooling ourselves and thinking that someone's got it better than another person, because that's not the truth of it. And I think in breaking down those silos, the best Intervention.
It's not the best word, but the best intervention, I think, is exposing our vulnerabilities, you know, being courageous about that and helping people see that. Yeah, it is. It's hard work. And but if you're committed to this work, and you can see a better way, then it's your responsibility to
to live that and to to, yeah, to demonstrate that.
Carole Kenner:
But if we're good role models, Mary, then people will follow. And I, I think that that was a key. I mean, number of years ago Several of us started talking about here we were from Ohio, which is not a huge state by comparison to a lot of our states and at that point in the mid 90s, there were eight sitting national nursing presidents of different specializations.
And so we started talking about, well, why do you think that happened? Well, there were three major deans of the three largest programs in the state. And I'm speaking of nursing programs that Basically told their students and their faculty, you need to get involved, you need to give back to the profession.
And so it was an expectation, and it was as important as bed making one on one right to be involved, whatever that involvement meant. And so, we started networking. And here we went, you know, all of us off to. Move up the career ladder in leadership, but it was because we had role models that said, this is what you have to do.
Mary Coughlin:
Yeah, yeah, but to be even to be a role model. Well, I mean, I think you're a role model whether you whether you want to be a role model or not. Right. I mean, if you're, you know, because people are looking to you, regardless of what your station is, but to be an intentional role model. Right. And really mentor those that you're, that you're with, that you're partnering with or collaborating with that's where the, the real opportunity is to ignite that fire or it, or stoke the fire within these new professionals to really step up and see that they are limitless.
You know, you can do this work. You can, you know be a champion across whatever situation you want, as long as you believe in yourself and I believe in you, right? You know what I mean? And, and so you need to believe in yourself. That's just so powerful. And I think you're right. I mean, we need more leaders to inspire others more educators for sure to inspire it.
And then, and it's but it's not as easy as just saying that because many of these leaders, many of these professors and other in other roles, maybe feeling the weight of fatigue, right, burnout and all these other things. So it's a very complex situation. But I think Thank you. I think you and I have done a pretty nice job identifying all of the facets and now really the the next step is to try and work on this, you know, and just continue to have these discussions, let people hear these words and hopefully be called and you know, to call to step into what their purpose is and, and their, their mission in, in life too.
Yes. Oh, my gosh. I have to be honest with you. I literally could talk to you forever. But I do also want to be respectful of your time. And I am just so incredibly grateful, Carol, that you've spent this time with me. And I'm, I'm honored by this. And just thank you so very much.
