YOTNM Ep 5: Talking with Dr. Ernest Grant, President of the ANA

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 Molly McCarthy, Microsoft CNO and Dr. Ernest Grant, President of ANA, discuss current events and the history and impact of nursing. 

Molly: It's so great to have you here todayDoctor Grant. President of the American Nurses Association as part of Microsoft's Year OThe Nurse and Midwife celebration. And were especially grateful to have you here during nurses week and nurses month. And wanted just to give you an opportunity to introduce yourself today.  

Dr. Grant: Well, thank you very much Molly. I appreciate the invitation and looking forward to our conversation that we're going to have. As far as introducing myself for my backgroundI started in nursing a long long time ago. Actually, I started out my nursing career as an LPN or licensed practical nurse, or in some parts of the country, license vocational nurse.  And I originally wanted to actually go to Med school and become an anesthesiologist. But being the youngest of seven kids and with a single parent, my father died when I was five. So, even though I had the grades, you know it could possible to get a few scholarships. I probably would not be able to get enough to, you know, to go through basic four years of college and then Med school after that. Somy high school guidance counselor suggested, ‘Well, why not consider nursing and maybe you become a nurse anesthetist. And then if you still wanted to go to Med school, you can work your way through as a nurse anesthetist. And then he said, ‘well, you might not like nursing, so take this one year course.  And if so you can easily transition into a two year or four year program. So I did that and about six months into the LPN Program, I realized that nursing was my calling. So I forgot all about, you know going to Med school. But I did realize also that I wanted to be able to do more for my patient then the limited role that the LPN had at that time. So I knew I wanted to get my RN (registered nurse) degree. So I know sooner graduated from the LPcourse and then started taking courses towards completing my Baccalaureate degree. And then once I completed the bachelors decided for the Masters and then always had in mind about getting the  doctorate as well. So while getting them all. 

Molly: Great. That's great. What do you, so where are you practicing today or tell me a little bit about what you're doing today. You know with ANA and in your everyday life.  

Dr. Grant: Well, today I have the extreme pleasure of serving as the President of the American Nurses Association. We represent the 4.3 million registered nurses in the United States. And, but prior to that, the position here at ANA is a full time position. But I spent 36 1/2 years working as a staff nurse and then eventually nurse educator at the University of North Carolina hospitals in Chapel Hill. Where I headed up the burn centers - burn prevention program. And was also and still am adjunct faculty with the School of Nursing and the School of Public health. So students have always been entangled in my in my career which I love working with students. And looking at the future of the profession and helping to mold that. So I still do that and sort of a limited fashion but yes, I spent 36 1/2 years as the Director of the outreach and Prevention program, and as I like to tell people I saw my job as putting my colleagues out of work, because if no one was getting burned, there was no need for any burn nurses.  

Molly: Right. Right.  

Dr. Grant:  And sometimes when our admissions were very, very low, my colleagues who come to me and say you're doing your job too well, we're not getting this.  Soso it was either feast or famine, but it was a wonderful careerI never even to this very dayI've never regretted choosing Nursing as a profession I can look back every day even today and see that I've made a difference somewhere. And that's what keeps me going 

Molly: RightWell, your backgrounds just extremely impressive and your drive. Really, we call it at Microsoft a learn it at all rather than a know it all. We like to be learn it at all 

Dr. Grant: Yes, yes.  

Molly: So how did you get involved with ANA? I know that you're the first male president for ANA, which is quite an accomplishment. I know you know, diversity. We're looking for more diversity in nursing. And so what, what really attracted you to be, to serve in this role?  

Dr. GrantWell, OK, so as you mentioned, I am the first male president of the American Nurses Association. First one, let's see when I assume the presidency ANA was 122 years old. So to go that long without having a male president is just unprecedented. And I'm also the third only, the third African American to hold the position of president. But my journey to ANA started actually back in 1985 when I was graduating from my undergraduate program. A colleague of mine at the time that I was working with, about two weeks before my graduation, she came up to me and she said, ‘do you consider yourself a professional nurse?’ and I said, well, of course you knowYeah, I'm graduating. I'll have my bachelorette degree in etc. And she says, well, no, you're not really. Yes, you are professional nurse, but you’re not truly a professional nurse unless you join your professional Association. You've got to be a member of your professional Association. And she stressed a word active member and that is something that I have always continued to say whenever I have talked with people about joining their professional organization. Because you need to have a voice and to say of how your profession is practiced. Because if you don't do it, someone else with a degree far removed from nursing is going to be making those decisions for you. So I started out ,the way ANA works, is that you are a member of your state Nurses Association as well as a member of ANA. And so I started out at the state level; was appointed to a few committees and sometimes people see leadership skills in you that you don't see yourself 

Molly: Right.  

Dr. Grant:  And that was recognized And you know, some people said, oh, you ought to run for this office or that office. And no, no, no I can't. Now pleaseyou know you'd be great at it. And you know [I] had a few little successes in etc. And then eventually offices at the state level migrated to serving on committees within ANA. And then you know eventually serving in various offices within ANA. And I knew at that time that I wanted to be president of the ANA, but I didn't realize that I'd be the first male President. I thought that would have happened long before I, you know, I got there. But, uh, you know, as fate would have it, you know it, it turned out that you know that I was elected as the first one. And what a time to be president. 

Molly: Right.   

Dr. Grant: Today, for a number of reasons not only because of what's going on with COVID-19, but you know with all the you know the milestones that is going on, we're about ready to celebrate our 125th anniversary as an organization. And of course, you know this is the Year of the Nurse and Midwife 2020. And then there's also the nursing now campaign that is going on also. So it's really great to be at the, you know, the helm at this point in time. 

Molly: Yeah, it's it's very interesting how you know going into this year Year of the Nurse and MidwifeI think from my perspective in terms of how we wanted to celebrate and things that we had planned, you know, has really taken kind of a 180. Very different than how we plan but really grateful for everyone on the front lines quite frankly and how you know from a technology perspective, we at Microsoft can support them. Really, when you think about this year and you mentioned COVID-19, from your perspective, what do you, what do you think right now are the biggest challenges for nurses in the US in light of COVID-19 

Dr. Grant: Well, there are several big challenges. A really great question. There are several big challenges. Obviously the biggest one is making the decision to go to work. You know, because when you consider as we're hearing, even though this is being recorded in in late April, we're still hearing that nurses are not getting or not having enough proper PPEs or personal protective equipment. And they're having to make the decision, Do I go to work and possibly contaminate my coworkers, you know, contaminate other patients. And worse yet possibly bring this virus home to my family. You know who may be vulnerable as well. Because you know, we have a lot of blended families. If you were. There may be an older adult or young children living in the home also. And as you pretty well know, a lot of them have decided to either stay, isolate themselves or quarantine themselves from their families to reduce that risk. So that's one big problem. The other one is I really worry about the psychological and mental health strain that this is putting on nurses. When you're seeing multiple patients die during your shift where as normally we may see that you know maybe one or two deaths a month, you know in particular units or whatever. Sometimes you may have as many as 6 to 12 death within a 12 hour period. That within itself can be, you know, very you know, just disturbing. Because there's no one to really, you know, to perhaps have that outlet too, or to go to and or hopefully people will realize that they're having these stresses or PTSD symptoms and will seek help you know. So that's a second thing. And of course the third thing is one of my biggest fears is that you know, they may feel like is this what I really want to do as a nurse? Possibility they may want to leave the profession. I think 99 % of them it is, we are professional, we rise to the challenge. They just want to be assured they have the proper equipment to do the work that they need to do. And as we're seeing more and more PPEs come down the pipeline or the supply chain, I think we'll see some of those fears beginning to abate a little bit. You know that, uh, since they are getting the proper equipment now, they're able to do the work that is being asked of them. But those are three really top things that I see right now. That is really challenging for the nursing workforce right now. And I do want to say that I'm extremely proud and happy of the work that my colleagues are doing on the front line.  And we at ANA are advocating on their behalf in so many ways: talking with Congress; talking with the task force. You know, putting out webinars and things like that. That will also help to educate them as to what they need to know about this virus and you know how to do best practices as we learn new things as well.  

Molly: Great, yeah I know that actually one of my follow up questions, it was really around the point you made, that second point around the mental health of our nurses, our clinicians, really any one who’s in the stressful environment as we know. Leading into COVID-19 just there was tremendous press, and recognition of clinician burnout in general. And so I think that having COVID-19 on top of this just really exacerbates that component. And I'm just wondering what, if anything, are you with ANA working on around this or thinking about? I know I've seen a lot more recently, you know, around telehealth and mental health, but do you have, you know thoughts on how we can potentially work with our nurses? Not so much today, but as you mentioned, the PTSD that's you know coming in once the initial kind of onslaught is done? But like the post period, like the summer, in September or October, and even you know, thinking about and this is just another question, so my apologies. But as we move into this period with new graduates and bringing them on and it's just, you know a very changing dynamic. So any thoughts around some of these points?  

Dr. Grant: Let meI guess, first answer the first part of the question.  Yes, ANA is putting some things in place that will help with the psychological and mental health of the health care providers. You may be aware that we have started a COVID recovery fund for nurses. And part of the funds that is raised is specifically earmarked to help with the Psych and mental health needs that they may have. And let me back up for just a second, because, you know, having been in multiple disasters myself, you know with the 9/11 incident; the few incidents that we've had in North Carolina that you know involved either explosions or the Pope air base disaster or even those that have been weather related or whatever. You know the difference between those and this crisis that we're in now is that you had the incident happen. You rallied your forces and you could see the end, you know, the light at the end of the tunnel. You knew that probably within you know, six weeks to three months or so things were sort of beginning to turn back to normal.  With this crisis, right now we don't quite see the end of the tunnel. You know, so it's going to be this continued stress as we learn more and more about this, you know, this virus every day. We can anticipate that yes, it's a possibility it may begin to slack off a little bit during the summer, you know, with the heat and such, but you know, but still, there still is going to be those people who are still sick. Maybe not needing intensive care, but you know still warrant care in the hospital. So the question is, is it possible that people will get the down time if you will. 

Molly: Right. Right.  

Dr. Grant: the psych down time in order to ensure that they are able to have that. The other thing is of course getting people to recognize that there is that psych mental health need that they have. Sometimes we're too proud to admit that or you don't by admitting that you’re admitting that, perhaps you may be weak or whatever, and that's not the case at all. We want them to be able to do, you know, to be at their level best. So they need to seek out that information or the resources that are there so that they can recover and be able to go back to work and doresume their duties as opposed to letting that continue to pile up. And as it does, we know that that’s not going to be good because we know mistakes are made You know they could turn to maybe alcohol or something like that to relieve that and that's not the answer.  

Molly: Right.  

Dr. Grant: That's not what we want to have happened, so that's why it's important that we have these programs and things in place. 

Molly: RightYeah. And so I'm going to switch gears a little bit to think about, talk a little bit about, just you know, I've read so much in the press actually just read an article that came out yesterday in the Washington Post talking about the role of nurses in this pandemic and the transformation within the healthcare system. And I personally I've been with Microsoft for seven years and I was telling someone I've seen more transformation from into a digital world happen in the past seven weeks, then I have in the past seven years. And maybe it's longer than seven weeks now, but. So I'm just wondering from your perspective and how your lens with the pandemic, with nurses and with technology, how do you see our roles evolving beyond like the traditional bedside nurse? Or just even with, you know, bringing technology in. So for example, I know we've been working with different nurses around, just virtual rounding with families, for exampleTo potentially save even save PPEyou know giving the patient communication tools in their room just to reduce that exposure and contact. Not that we want the patient isolated by any means, but even just to have that contact with family through technology. And it's exciting for me. You know, I've been in technology for so long, but just to see this change take place. For people to become more comfortableI guess with the technology. And so I'm just curious to hear from you. I know, you knowyou worked in burns, so technology might not necessarily be where you spend a lot of your time, but I would love to hear your opinion. 

Dr. Grant: Actually, technology was right up there and still is. Uhm, and I guess perhaps the, if there is one quote unquote, good thing that could come out of this crisis is the fact that we knowwhen you think of technology and particularly Telehealth, Telemedicine, etc. I think this crisis has elevated that or has sped that up. You know so and so for the role of the nurse, particularly the advanced practice nurse, as a lot of states have relaxed the restrictions that were in place on their practice so that they have a broader scope of practice and be able to, you know the practice to the full extent of their education. You know this is wonderful because now they are able to combinethat those relax rules, technology in, etc to provide better care, have greater access to individuals perhaps than what they could, perhaps under the you know the old way if you will, whereby patients coming to them were actually coming to the patient. So you're actually able to see more people you know, as that comes about. Now, the downside to that is of course areas where there's a disparate care or technology is not quite there yet May not have the broadband in certain areas to really do that, but I think, as we realize that you know this is going to provide more greater opportunities, I think those stumbling blocks, if you will, are going to be out of you know, gotten rid of soon and where there is lack of broadband in, etc. It will be there to provide that. So I think overall what we're going to see is just a large amount of, you know, uh, you know interdependence, if you will, on Telehealth, Telemedicine, Technology in order to provide greater care. And it's a whole new wave, so in actuality I think we would probably are going to be seeing more specialization, if you will, in those particular areas. Not only on the nursing perspective, but also on the physician perspective as well. And so its just going to be a matter of, maybe two or three years as opposed to as it was slowly creeping long before the crisis happened. What may have taken, where we are right now is probably going to take another 10 years, you know, to get there so you know, so were there. And also, I guess I'll just serve notice as well is that we are part of a task force that is looking at keeping those relaxed rules in place. You know, if the advanced practice nurse can practice in emergency situations, why is it not good during normal times. So you know we've made some great strides and want to keep moving forward. And I think for the whole profession of nursing period it is, this is our time, you know. It's ironic, this is the year of the nurse and it wasn’t mentioned at the beginning, it wasn't what we  really thought it was going to be. But I think given the attention that we have now from the public and that they are on our side and they recognize and see what we as nurses do. Uhm, you know that we've got to capitalize on that and really move forward and not look back and not go back to where we were before. We really do have to seize this opportunity. This is a once in a lifetime opportunity 

Molly: RightI'm with you. It is. It’s our time. And to your point around the relaxed regulations, just having the ability to work to the top of our license, whether that's an advanced practice nurse license whether it's registered nurse license, etc. I think that was one of the original goals, even of The WHO's Year of the nurse and midwife, so we can push that as well as really increase our investment in nursing as a profession and in education etc. I do wanna just wrap up with one final question as we think about the time of the year. It's April 29th and what would have been graduation for so many. Seniors in college, high school, etc. I'm just gonna maybe put you on the spot and ask you, what advice if you were to give a new graduatewhat advice would you give to someone right now entering the nursing profession?  

Dr. Grant: For someone entering the nursing profession right now or even graduating, you know the new graduates. I would say wow, what a time to be either entering nursing or starting your nursing career. They are on the forefront of a huge wave of change. And I sometimes doing some of the talks that I give I always use the term that I want people to be a change agent and this is the time to do that. There's a whole new world that's opening upthat's embracing technology that's embracing, you know, innovations. And also embracing the profession itself. You know, uplifting our standards and who we are. And so to go back to what I said before, this is our time. You know what better time to be coming into a profession, specially with young, fresh ideas which we really need to embrace. To bring us into the 21st and even the 22nd century.  You know, this is, this is truly awesome. I think of Florence Nightingale was to look back you know it was to come to us now and look at what she had started a little over 200 years ago. I think she would be truly impressed that you know that the profession has arced up as much as it has. But we still have a ways to go.  You know, and so for someone considering nursing as a career or that is starting their nursing career, you could symbolically say we're passing the torch to you. It's your time now and is your time to make that difference. And I think were, they are, ready to do that to take on that challenge.  

Molly: Great, I appreciate your comments and just want to say thank you so much on behalf of Microsoft, and all of my colleagues within the healthcare industry. Just want to say thank you and appreciate everything you are doing for all the nurses on the front lines.  

Dr. Grant: Thank you. Thank you for having me.  

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