Becky Transcript
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Mary Coughlin: [00:00:00] I'm just going to kick us right off then and dive right into how did you arrive at your current role, Becky?
Becky Chuffo Davila: So I was thinking a lot about this. You know, I started back as a NICU nurse in 1985. And at that time, we really did not invite parents in. No. We didn't want them in. Yeah. And it's, I don't think all of us felt that way and I felt like it was a disservice, an injustice.
And I felt like we excluded them and it bothered me since that time. Wow. And so I think. I have worked on trying to include families into whatever we're doing, and [00:01:00] because it's their child, not our child, and so I think that was a big part of where we are.
My whole career has been leading me.
Mary Coughlin: Yeah. Yeah. Well, you know, I totally get that too. I mean, when you said that in the eighties, that was when I also entered you know, neonatal nursing. And it was just the way it was, you know?
It was just what it was. And when the parents came, you know, very happy to work with them and educate them, but then they'd be gone, you know, for what felt like eons. And, also being. New to neonatal nursing too. I didn't have that wider lens of thinking very holistic.
I was really, you know, focused on the pathophys and that sort of thing. So I love the way you shared that it, it just bothered you.
Becky Chuffo Davila: Yeah. And I wasn't a parent then because I was very young when I. And [00:02:00] I didn't even have my own children yet, but it felt very,
Mary Coughlin: very wrong.
And I think, you know, even like evolving as a nurse practitioner, so how, you know, how did that transition going from bedside nurse to nurse practitioner influence or educate maybe, you know, how you felt about the parents and their role.
Becky Chuffo Davila: I think by the time I went to the university of Iowa I already had my doctorate, so I was the program director for the NNP program there. And I also worked. Full time in the NICU. So being a level four NICU I think I had more authority and presence that I could say, I want these parents, you know, you have with your education, you have you're coming with experience.
And I think it was [00:03:00] easier for me to teach the nurses to say, you know, It's going to be so much better if we have these parents involved early on. So it just seemed to all fall into place. But I think the biggest thing was when I was the director of the NNP program, I was so fortunate To meet Dr.
Lisa Segret. So she always says it was serendipity because here we are working on getting a speaker for a conference That we had at the university and Lisa and I sat down in her office and we're working on how to try to get speakers and I said, Lisa, what do you do? And she said, well, I'm a psychologist, but I, I'm here in the College of Nursing because I do work on postpartum depression.
And I do it for, mothers [00:04:00] who have delivered and then I have people go into the home me about it. I wanted in the NICU. She goes, Are you joking with me? I said, Absolutely not. And from that day. We founded our partnership and we have worked together ever since.
Mary Coughlin: How long has that been?
When did you guys first meet? So, 2003. Wow, so you've really been just translating that feeling that you described at the beginning into this real bonafide, tangible mission and passion. Yes. Forgetting parents into that space and even expanding that right to really support their mental health during crisis.
Becky Chuffo Davila: Yes. And then, of course, when I became tip certified. I said to myself, Mary has [00:05:00] given this a name for me because I needed a name, like I knew exactly what I wanted, what I was doing, it's their trauma and to help them get through it by providing listening visits,
Mary Coughlin: how did that sit with Lisa.
Becky Chuffo Davila: Oh, she thought it was amazing, because she didn't know about trauma informed care, like, you know, Lisa comes from the research. And I am the clinician, so we formed this partnership as the PhD, the DNP coming together. We actually got an award as the first collaboration of research and clinician together. And that was at the College of Nursing at, at Iowa. So I, I'm very proud of that because.
Having that other aspect where Lisa brings [00:06:00] in that mental health knowledge. And I bring in everything I've ever done with babies and parents.
Mary Coughlin: Well, I mean, what a pioneering initiative. I mean, when you think about the breadth of experience that you have, right? And all of the families that you've walked alongside and you've, I mean, you've borne witness to their suffering, their struggles.
And I think we all feel like we want to help, we want to support them, but sometimes you just don't know what you don't know. So can you talk a little bit more about how, you and Lisa then really kind of came together to form this unique Intervention. For a super vulnerable traumatized population.
RighT?
Becky Chuffo Davila: Just so give some context Dr john packs and his partner who was a a home visitor. And this was in the UK. Hello. [00:07:00] And they developed listening visits, which was delivered by home health visitors, which when you look at the UK, the home health visitor was very much like a BSN prepared nurse.
They developed the EPDS. The Edinburgh Post Natal Depression Scale. So, they developed that, and then they screened these moms, they were mild to moderately depressed, and then they did this intervention. So the intervention is like two parts.
You form this trusting relationship, And then you have the mother works on what she feels she needs to do in order to feel better. So it's not the listening visitor telling mom, you should do this, you should feel this, you should, you know, it's what mothers [00:08:00] want to do. how they can feel better. But they bring out all these feelings first because there's a trusting relationship.
And this is one thing I wanted to bring up, Mary, that when I first started presenting that nurses were able to do this, I got so much backlash from social work, psychology. My partner is a PhD psychologist, and we are not doing therapy. Right. Nurses doing what they've always done. Talked, listened, I went to Lisa and I said, Oh my gosh, people are saying such mean things like nurses should never be doing this
she said, You don't get upset. You write an article.
Mary Coughlin: Ha ha ha. You go Lisa. Yeah, right? I, well I think, that [00:09:00] probably comes from this place of how we, we look at our roles and we're so super siloed, And I love how you, you articulated that though, this is what nurses always do.
We have these conversations and if it's really directed by the parent, by the person who's really kind of, I think of, you know, just maybe blowing off steam, you know, just kind of like sharing the, all of these feelings with someone, a trusted someone, that trusted someone. Yeah. I mean, I would imagine if the nurse hears something that kind of maybe rings a bell or, you know, a red flag, you know, can follow up with.
Exactly, exactly. But a lot of what is shared is really just that human experience of, of fear, of anguish, of grief, of, of trauma.
Becky Chuffo Davila: Trauma. Yes. And that's exactly what I was saying, that when you look at the most trusted [00:10:00] medical people, who's number one? Nurses. Yeah. And nurses are those ones that the family will tell those feelings to.
They won't do it during medical rounds. No, it's, I, I see it constantly. And that's why in our last research project, we brought those. Bedside nurses in those ones that wanted to do a listening visits because not every nurse wants to do it, they should, because some nurses are very tangible, they want to get in there, they want to do their thing.
They don't want to be more of the touchy feeling, which is fine. Nurses and I totally get it. But then there's other nurses who just had that extra~ that ~ [00:11:00] wanting to be with that parent in that moment. And those are the nurses that are the ones that we said, you know, we let them come to us and say this.
They've all whoever wanted to be in the research study said this is exactly how I feel. I want to do this.
Mary Coughlin: I mean, it really just feels like an opportunity to just really live fully into all the aspects of what it is to be a nurse, although I totally get those nurses to that are just, I mean, I'm an adrenaline junkie too, and it's a real world.
To be able to do these calculations and do these life saving things. And, and yes, that you're a good nurse, you know, I mean, but there's many facets of what a good nurse looks like. And so I love how you just described, you know, that spectrum.
Becky Chuffo Davila: And some people, you know, think it's [00:12:00] very psych, mental health, but you know what? What I have found with all these years of my research is that it actually pulls together more people, like I had a, for example, I, when I did the open trial, I had a mom that she had years of abuse. As a child as with her partner, she just wanted to talk about these things, but I knew I couldn't be the only one to help her.
Yes, I knew that. So I got people involved. I got social work involved. Social work did magic. Just magic. And I cannot thank them enough for how they came in and got this woman a place to live. She never missed an appointment because they always had the car there to pick her up.
And the child is 13 [00:13:00] this year. So I am just, I can't believe how much we all came together to help this person who was so vulnerable.
Mary Coughlin: She could have been lost, both of them. Absolutely. I mean, that's what's happening and we're not seeing it because maybe we don't have the structure and, and we don't have maybe the time.
Is this a practice that is, embedded now in the NICU where you're working or is it still kind of in a research model?
Becky Chuffo Davila: Yes, it's still in this research model because we still haven't figured out like how does the nurse who wants to do this get time to do because each visit's about 45 minutes.
Yeah, so you, it would be very tough to leave your bedside position and then go do this for 45 minutes. So we, we [00:14:00] are trying at this point to see how this would work. And how we could just embed it in. Now, places, other places. Around the world. So social workers or the psychologist in the NICU is carrying this out.
So, is that another way to implement? You know, at our place just like many others we don't have a designated psychologist. Now, some places are very lucky. They have that in their NICU, but many don't. And some have parent support groups. I mean, our social workers do the support groups, but we don't have like peer support.
So that is another option. And I think all these things, that's where I'm trying, you know, as you come to not, I [00:15:00] don't believe I'm at the end end of my career yet, but you know, you think about what, what can I do to make sure that this is going to be carried
Mary Coughlin: out? Yeah. It, well, it sounds like you're looking at all of the different aspects though.
And I mean, that certainly makes sense. And it sounds like your journey to become a trauma informed professional may have expanded your view, of how important this is, but also how it may be integrated into the current processes, maybe the current infrastructure of the unit.
Is that fair to say?
Becky Chuffo Davila: Because right now I do have another hospital that has reached out in Iowa, that we, they wanted to implement it into their care. So, I'm hoping that some, something we learn out of this next venture is a [00:16:00] way to do that with The nurses that are going to be carrying this out.
So it's going to be a nurse and social work. I'm hoping that that's going to be just like trauma informed care. It's all services. It's not just, you know, nursing. And that's where I actually see this.
Mary Coughlin: Yeah, I mean, it feels so aligned right with the principles and, you know, it's, it's, you said it at the very beginning, it really hinges on the capacity to create or cultivate a trusting relationship.
Exactly. Which conveys safety, right? I mean, that makes that feel safe being heard. Huh.
Becky Chuffo Davila: And the family, not that, you know, you, you want you know, hospitals look at things [00:17:00] like press gaming, you know and when you have a parent that feels that they're, they can open up. That they think that the person they are working with are taking care of their infant the best that they possibly can, then, then you know that they're The whole time they're in the NICU is going to be, it's such a journey, but the journey will be less stressful.
We know when you look at all the research shows that moms and I I'm going to include fathers because at first we decided with moms because that's what it was looking with with postpartum depression, but we know dad suffered just as much and sometimes more in a different way. We want to make sure that.
[00:18:00] They're taking care of their, their mental health because what happens when they go home, right? These babies will not thrive when they look at their psychosocial developmental, how they're developing at home. Unless the mother and father are okay. Then we're going to lose something with those babies and their growth and
Mary Coughlin: their progress.
Everything, right? I mean, everything. If we can't acknowledge and respond to that traumatic experience, and it comes in all different shapes and sizes, right? I mean, some folks can be wicked resilient in one aspect of the experience, but there may be other dimensions, and so we have to realize, I think, It's not a one size fits all, right?
It seems like if you create the space for listening, right, then they're [00:19:00] telling you, they're telling you how you can support them. Telling you what they need.
Becky Chuffo Davila: I said, Oh my gosh, Lisa, you know, when I talked to Lisa, I say I go and I talk about it.
I'm like, it's such a no brainer, right? What is, you know, that to listen to what somebody is saying, this is what, you know, my grief is coming from. I didn't have a normal pregnancy. I didn't have a normal delivery. It's coming out in maternal child nursing. We went through and looked at four different moms who experienced this, and they come from different walks, different backgrounds, different education, different, socioeconomic, but they're all, they want to talk about what brought them there to the NICU.
And what, you know, one of the moms just so eloquently said, [00:20:00] it felt like I had an operation and then it was over, but I never saw my baby, like the baby was gone. And you said it didn't feel like having a baby. Yeah. It felt like this was totally different. Like they put me out.
I was under, you know, and it's so Just what we may think. Oh, it was a C section. That's not what she feels. It's totally different. So, you know, that's where I'm like, you know, too, when I teach nurses, nurse practitioners, what for us might be This is baby so and so that has this defect, blah, blah, blah.
That's, that I know we have to discuss like that because we have to talk about their, their needs of a medical. Yeah, [00:21:00] right. And that's what I am a nurse practitioner, but you can't forget the other. This is the baby that is born with a diaphragmatic hernia, with a gastroschisis, with, you
Mary Coughlin: know, all of these.
Yeah, their hopes, their dreams, their aspirations everything. And I think sometimes we get, we do get so caught up in the pathophysiology. That we, you know, we kind of lose sight of that you had said earlier about the mental health thing and it made me think of there was this really interesting white paper put out by the American Psychiatric Nurses Association that said all health is mental health.
And, and it really struck me because I mean, just the example that you just shared that I'm bigger than the, you know, than my diagnosis, you know, there's more to me than my uterus. And nobody's paying [00:22:00] attention to all those other bits. I can get lost and overwhelmed and drown in those Traumatic experiences.
Those traumatic feelings are those feelings of not being seen. And so it's For me, it feels like, you know, opening the door to this idea of listening, you know, I mean, active listening to someone else can really help us start to build the skills that we need to engage human to human. Because I think I hear from a lot of folks like well, I don't want to talk about it because I don't want to get them upset.
And I don't, you know, I don't know what to say. And I'm also scared. I might not tell you that. But as the nurse, I don't know what to say. And I'm afraid I might say the wrong thing. So I'd rather say nothing. Yes, and we're leaving these folks even feeling more isolated and more alone,
Becky Chuffo Davila: exactly, Mary, exactly, because that's it.
They feel so [00:23:00] uncomfortable to bring up those subjects and so it does take practice. Yeah. It does take practice. Yes, I, I can't tell you, I've been doing it so long that, you know, there are sometimes even with looking at palliative care, we have such a wonderful team with palliative and pain, but those discussions of death, And dying.
And, you know, those are tough and some people just do not want to go there. They don't want to make the family upset. But, but that's what they need. They need to know that it's okay to let go sometimes. That you're doing the most loving thing for your child. And that's never, never easy.
Mary Coughlin: Well, and I think we sometimes think that we're not be, you know, if we're not strong, then we are [00:24:00] adding to their pain.
But in fact, when we're vulnerable, it actually feels like. almost like a pillow, you know, just came to my mind, like that. I do see you. I'm with you. I understand that this is painful. Neither of us can do anything about this wicked, bad, sad situation, but you're not alone. And sometimes that is, that's just what they need.
You know, in those
Becky Chuffo Davila: moments. So a shoulder to cry on a hand. I've done a visit where we said nothing. She, she just laid on my shoulder and cried and held my hand. Yeah. How
Mary Coughlin: powerful is that? But you have to prepare folks for this, right? I mean, to in order to really, I mean, I'm going to say do to do a listening visit.
It's really about being. More vulnerable, more authentic, stronger, but not stronger, like in tough, but stronger in being able to lean [00:25:00] into, you know, the suffering and the vulnerability. So how do you prepare folks for this experience? I mean, is it You know, roll of the dice, you know, I hope this works, or is there some, you know, education or preparation for the nurses that are in your research project to build a skill so that they feel comfortable stepping into that space?
Becky Chuffo Davila: Yep. So we definitely, so we talk about postpartum depression. We go through all the didactic and Lisa does a lot of that. And then I role play. With because I wasn't sure when I first started because I was the one to do in the open trial. I did all the visits So I had no idea what was coming my way.
Right. What I do is to prepare the nurses. I do simulation with them. And we, yes, and we go through [00:26:00] scenarios. Now we did implement this in all counties of the state of Iowa. And we have nurses and social workers that go out to the home to help these moms. And so I did all the simulations with them.
To prepare them now, I can't prepare everyone for everything because it's hard to say what will come up. But I think just by i've done it for a long time. So I think I have a lot of things in my tool belt that This could happen. This could happen. This could happen now.
I did have one time When a father, so a mom was very depressed. She was moderately, but I could tell it was getting worse. And the father called me one morning and said, I'm scared for her. So we immediately went [00:27:00] into we're getting this done, this done, we got her to the ER. So, but I think by her talking, I think we caught her because I don't think that dad would have even noticed.
If we didn't have these visits that were ongoing and he knew he could call me. She got the help she needed. She was in the ER. She got much better. She's doing wonderfully with her child. So, but see, those things can happen. So you have to be prepared of what if this happens.
Mary Coughlin: Are there, are there this is so fascinating.
Are there like core characteristics or core. I mean the word pillars is coming into my mind core pillars that the individual who is going to be that listener. Huh. can kind of fall back on? Are there, you know things that they can work on to prepare themselves? Cause I [00:28:00] get it.
The scenarios can run the gamut. So there's some, are there some qualities that I can hone that can help at least build up my preparedness or my readiness for these encounters? Yeah,
Becky Chuffo Davila: I think it has to be a nurse that is very knowledgeable about medical things because parents do want to sometimes talk about those.
So yes, you have to feel comfortable in your role and not to speak out of turn, like make up something if you're like, I don't know. I, you know, this is something maybe we could, you could bring up at rounds, you know, to help them facilitate but that they feel comfortable in their knowledge of NICU and disease processes.
[00:29:00] Also that they feel that they can open up to like take in things, but they, that has to be a self knowledge. When we look at characteristics of listening visit people that you have to have those certain qualities. Yeah, you have to be open, you have to be embracing, you have to be able to feel empathy.
And I think when you talk about in your book with trauma informed, it's the same thing that compassionate. understanding of that family. When you talked about in one area that burnout not only happens with people that, you know, are in these kinds of, you know, job roles, but, you know, Also, it's also if you wall yourself off, don't let those feelings in.
Have I [00:30:00] cried? Parents? Yes. Yeah. They know I'm feeling what they're feeling. It's okay. You know, you got to be, not that they should be caring for me. No, no, there's something that's way different. But if they're sharing something. That they, it's so powerful, but that doesn't cause me to be burned out, you know, it's other.
Yeah. the nitty gritty of, you know, policy and procedures. No, it's all the red tape, but
Mary Coughlin: not the parents. No, I mean, I find like actually getting it and, and it, I mean, nobody wants to feel sad, but the work that we do is sad. And I think when you can feel with someone else, And, and maybe make them feel even the tiniest bit safe or seen in that moment.
Even though I'm feeling sad, it fills my cup up [00:31:00] because I feel like I'm making a difference in this little moment. I'm helping this person navigate this. Whatever's happening, you know, so that's that's exactly the thing. It's you're right. It is the red tape. That'll make you go cuckoo house right But but actually touching someone else's hot and helping them Move through something can be so rewarding.
Becky Chuffo Davila: Yes. I have, I have you know, all through these 40 years, I have realized that in myself that that's the part that has kept me going all these years. Yeah. Well, I mean,
Mary Coughlin: you just absolutely everything from, from your early beginnings as a bedside nurse to the incredible work that you're doing now.
exemplified what it means, at least to me, to care out loud. But I would love to hear what you have to say about that, Becky. What does it mean to [00:32:00] you to care out loud?
Becky Chuffo Davila: Well, I thought about this and I, I'm very fortunate to have all my experiences. I get to write papers. I get to go to conferences and talk and I get, that's where I'm, you know, it's not always easy, you're nervous, you're preparing.
But it's the message I want to get out and I'm like, if I have to put myself into a place where, you know, I don't feel that comfortable. It's okay, because I need to let people know. This is the message you need to care for families. You need to include them in the care of their very precious babies. And however that looks [00:33:00] in make you pick you wherever you need to.
We need to foster this. And I, I just feel like that's how I'm carrying out loud. I teach students this. I tell people at conferences. I tell parents about it. And so just carrying out loud that way.
Mary Coughlin: Literally listening to you. I got this like total body goose flesh.
I mean, cause you're especially how you articulated, you know even if you're feeling nervous, you know, you have to spread the word. It's mission driven and, and the wisdom that you've unlocked in the work that you're doing. Is too important to keep it small. It can't stay small. It has to be spread all over the face of this planet, and folks need to begin to lean into what it means to be [00:34:00] authentically present and actively listening to those that were here to serve 100%
Becky Chuffo Davila: Yes, and I think that's when I became trauma informed professional, that's when it came full circle for me because I read your book over and over and over because that's, this is part of my mission.
This is what I believe in and I, I just hope that others to come after me. Carry this and so then, you know, I started thinking more about that. Like, I got to get the, you know, I love having to teach and teach, but not just that, but to impart some wisdom. You know, it's not all about electrolytes. It is.
I mean, we need to talk about electrolytes, [00:35:00] nutrition, everything. Respiratory care, but we got to talk about those families and we got to talk about getting them to a place where they can go home and care for their, their very special babies.
Mary Coughlin: Your passion is so palpable and you're talking about a legacy, getting this out into the world and setting folks up for success and having this be hardwired into the experience of NICU, PQC, whatever it is, in the care of people that are experiencing trauma.
They need to feel seen. They need to feel heard. And so the work that you're doing is just so profoundly important and relevant. And I would absolutely encourage anyone who's listening to today's podcast, make sure you get your butts to Boston in October. So you can hear more from this incredibly profound and wise woman.
And before I close this out, [00:36:00] Becky, I want to ask you, Is there one nugget of wisdom or insight that you've gained? I mean, you've articulated it several times, but is there one thing that we could close out today's conversation with a pearl of wisdom from Becky?
Becky Chuffo Davila: Ah, well, that I think I would like to talk about a certain mom who I worked with and what she wrote to me later. Afterwards, they went home she felt that this program, the visits should be everywhere, should be instituted. She believed that this could be for mothers and fathers. This is a wonderful program. It helped her get through her darkest moments. She felt that without having an outlet, or [00:37:00] someone to speak to, very openly that she didn't think she could have made it through. So, I always carry that with me, that what we're doing is that important.
That important and I, I believe that the nursing is the way that needs to facilitate this and carry this out, but also embracing all those other services. To get to the root. I think nurses do that. And then we can. expand and bring in all those people that need help.
Mary Coughlin: I mean, you're talking about saving lives literally, you know, and, and we spend the most time with the families.
We spend the most time with them. I mean, we're perfectly poised for this. Not adding more to our plates. But I think it's through our attunement and our assessment and our [00:38:00] awareness that we can. We can recognize how we can either ourselves personally help these folks.
Or, engage others. To help, oh, God bless you. Thank you so very much. Becky, this was incredible.
Becky Chuffo Davila: Oh, and it's such an honor to be asked to speak with you, Mayor.
Mary Coughlin: Oh, thank you so much.
