All About Nursing (24)

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Welcome to All About Nursing with your host, Dr. Joyce Bachelor. Executive nurse advisor, Dr. Bachelor, will present the significant role nurses play in providing healthcare in a multitude of healthcare settings.

Listen to some of today's key nurses who work in practice in academia settings and talk about the challenges they face in today's modern medical world. Welcome to the host of All About Nursing, Dr. Joyce Bachelor. Welcome back everyone.

You're listening to All About Nursing on the BBM Global Network and Tune in Radio. I'm Dr. Joyce Bachelor, the host of the show, Dr. Sydney Sonik, who's currently serving as a Chief Executive Officer for the Texas Nursing Association.

She was giving us some highlights of her career. I worked several years also coordinating academic experiences. Our goal was to be the learning environment of choice because we wanted to hire students that had positive experiences, not just nursing students, but all clinical disciplines, the requirements of the country. And I learned a lot from that in terms of really how to nurture professionals in their early years and provide a supportive environment that will really nurture that process.

Then I went to Austin and I was looking for a physician in a hospital that I had been accustomed to, but I was also working on my doctorate. I had to be conscious of what role I gave it to accommodate was still being able to complete my schoolwork. I noticed that TNA, I've always been a member of ANA in my state affiliate, and so I probably had transferred my membership to Texas. I noticed that the Texas Nursing Association had a position for Director of Practice.

I was very excited about that opportunity, applied and was hired and had a wonderful opportunity to work with Jim Willman, who now is retired, but he was the Director of Government Affairs and really mentored me in that role in learning about policy. After that, I talked for a little while and now I'm back at TNA as the CEO. That's really wonderful. Thank you so much for sharing that.

This is all about nursing, about your choice bachelor. We're live on the BVM Global Network, into an N-Radio, and it's time to take a short break. We'll be back. French Rastafarian Baker Chef Ughmat is a fourth generation baker and has worked in 11 countries across three continents.

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I'm Dr. Joyce Bachelor, the host of the show. And prior to the break, I was starting to hear, we were all starting to hear from Dr. Sydney Zonek, who's the host of the show.

And I'm here from Dr. Sydney Zonek, who's currently serving as a Chief Executive Officer for the Texas Nursing Association. And she was giving us some highlights of her career and how she ultimately began to work at the Texas Nursing Association. I thought it was great when you started sharing that you had the opportunity to be mentored by Jim Wilman.

He certainly was very influential for Texas Nursing Association serving as the attorney for us for a long, long time. And he certainly had had amazing knowledge and his relationship skills were just incredible. So you were telling us a little bit about the fact that you were in that practice role. And then I'm assuming that then the Chief Executive Officer role came up in and you decided to apply.

Is that how that occurred to you? Yes. So I had moved away from that role and I was teaching and Dr. Billy Brown, the founding dean for UT, Austin School of Nursing, contacted me and so I invited me to apply.

If anyone knows Billy Brown, you know, you don't think he's a boy. So, yeah, I thought, well, I'll throw my gun in the ring and we'll see what happens. And went through the process and was selected and it's a combination of my career. That's awesome.

For those of you that may not know Dr. Billy Brown, she, as Cindy said, was the dean at UT Nursing School for a period of time. But she's also been inducted into the American Academy of Nursing as a living legend just based on the amazing accomplishments she's had in her lifetime. So when you do get a call from her, I'm sure that the answer is always yes.

I think that sounds like a great idea. So you currently serve in the role of the Chief Executive Officer for Texas Nursing Association. How is this role similar or different from other leadership positions that you've had? You know, I mentioned I've been through various leadership positions throughout my career.

And actually I was surprised by the uniqueness of this role. So, Lauren, I didn't realize there was a whole specialty of association management. It's a different animal with its own base of knowledge, skills, practices, governing rules. Last year I achieved certification in association management.

And I didn't know what I didn't know before I really engaged in the process to prepare for the exam. And it really was a valuable journey. And then I found the top leadership positions experience dual reporting relationships in a matrix structure. I never reported to an ever-changing board where my boss is an entity rather than an individual.

An entity is dynamic as board members come and go as they serve their terms. I had close relationships with the President and that position is elected so that also changes. So the relationship and the ability to build relationships is incredibly important in this role. Also as a CEO, I have overall responsibility.

That means that you're not used to working collaboratively with finance and HR and different department heads. But this means that finance reports to me. And I need to have a looking understanding not only of the budget but about the assets and appreciation and non-profit tax laws and investment practices and safeguards to prevent fraud. All those things that I didn't even know what I didn't know.

And my responsibility for HR, determining what is our philosophy? What is our workplace philosophy? And what are the risks that the association is willing to take both financially and human resource perspective and otherwise? So that the CEO role is really much broader than anything I had before.

And ultimately, we're a membership organization, so I'm responsible to over 13,000 members who have ultimate authority over biologues that govern the association. And so effective communication becomes critical, but also challenging. We have that much of a group and it's a very diverse group. So those are some of the things that have been very different.

And I think that the same are some of the general management foundation and leadership foundation that I had that translates over. But there have been several new things. I've been in Texas now since 1994 when I first started in my chief nursing officer role there at Seton. I had the opportunity to work closely with TNA and was also impressed in how the leadership of the Texas Nursing Association was very deliberate in trying to build relationships with the Texas Hospital Association and the Board of Nursing.

And I was struck that this just seemed like the most ideal way to go. And I think that's been one of the strengths that we've had in Texas is having the leaders from these various organizations able to sit down in a room, even when we agreed to disagree on something, we can still have the dialogue. So I was listening to you thinking about all the stakeholders that you have to certainly be aware of, but Texas also has a big role at the national level since we are a big state. And one that people seem to listen and pay attention to.

Is that what you have found since you've been in your role? I mean, I'm sorry. Have you found that people do want to hear about what Texas Nursing Association is doing from because we are such a big state and we tend to be pretty vocal on issues at the national level? Very, very much so.

We have a real presence and we've been very successful. I've practiced in other states and when I moved to Texas, I was so impressed with the Practice Act. And I was so excited to work at TNA. Because TNA was the organization that really advanced that.

And a lot of it has been because TNA traditionally has had a very strong relationship with the Hospital Association. We don't agree on everything, but we looked at where we have opportunities to come together. And because of that, we've been able to advance policy initiatives that other states have struggled with because they haven't been able to have that partnership. And that's another board of nursing.

That is another very valuable and important relationship. Again, working with folks, as you know, at any level doesn't mean you always disagree. It looks for where you have common ground and how you can advance that together. Yeah, absolutely.

I think that's been very important for us. And I know that Texas has been the leader in terms of moving towards staffing regulations rather than mandated ratios and some other really important legislative issues. So I was just curious, Zane like, why this position at this point in your nursing career? Well, in any way, this has been a combination of my career.

I've always often said I'm kind of a Jack Wall and master of done because I've had so much diversity in my career pathway. Yet that variety has actually prepared me well for this position. Since we're not a specialty organization, we represent nurses regardless of the preparation, their specialty, their practice site. So that broad base really serves me well in appreciating practice challenges in multiple domains.

And it's to some level of experience and virtually every area of nursing practice at some time in my career. And that background helps me understand the practice issues that nurses bring forward. As a career long number of ANA and my state constituent association, I've been involved at advocacy at the state legislature since my first year as a nurse. When I approached my local group and I said, I want to be involved and I said, well, what is it you want to do?

And I said, well, do you have a legislative representative? And I said, what's not? I said, I'll do that. And I got involved.

I had a lot to worry, but the work was not totally unfamiliar. That's great. It just seems like when I remember transitioning into the role, it seemed like it was a very natural fit. And there wasn't a whole lot of downtime in between, which was really important because again, I think Texas Nursing Association has really had a great reputation and a lot of cloud at the national level.

People usually want to know what our state's doing. So it seemed like the timing was just perfect for you, which is wonderful. Do you think that there were any other key things that really helped you get ready for this role? I think my overall involvement, my leadership background, having a broad base of experience, I think really appreciating nursing practice and being aware of what's going on in development, like the different IOM reports since 1999, and all those things that have really influenced nursing practice, that awareness of the greater environment, I think was very helpful for me in preparing for this role.

That's wonderful. We'll talk a little bit more about that, but right now we're coming to you live, the Deem and Golden Network, and Twin and Radio. This is the All About Nursing Show of Dr. Joyce Bachelor, and we'll continue this conversation.

We come back. I'm your host, Dr. Joyce Bachelor, and all about nursing. We're live on the Bebeam Golden Network in Tune and Radio.

Before the break, I'm your host, Dr. Joyce Bachelor, and all about nursing. We're live on the Bebeam Golden Network in Tune and Radio. Before the break, Cindy had started to tell us a little bit more about her career and how she became the Chief Executive Officer, and has really found all the different experiences that she had and had described previously, really set her up to be ready to take on this kind of special role.

So it might be nice to transition else, Cindy, to have you tell the audience a little bit more about the Texas Nursing Association, and what does it do, and why is it important in terms of nursing, and what's important for the public to know about the Texas Nursing Association. Okay, well, the Texas Nursing Association is a state association that was founded in 1909 by a group of 17 nurses who felt that there needed to be some regulations around nursing education and nursing practice. Ten years later, they passed the first nursing practice act, which is an incredible feat when you consider that they didn't even have the right to vote at the time. Oh, well, yeah.

I never knew that. That's interesting. And knowing how difficult it is to pass bills in the legislature, that was quite a feat. So the association, session after session after session after session, has gone back to improve that nursing practice act.

So the one that we have today doesn't look like it did in 1909. And that's important because, and this is a story I tell particularly to the graduates, is that when you graduate, you're given a life and you pass the boards. Like if that's a big deal, you pass the boards, you're given a life and practice. Well, where did that license come from?

And what does that mean? And you inherit a scope of practice that's defined in the nursing practice act. And it just didn't just happen from nowhere. It happened from nurses that went to the Capitol year after year after decade after decade after decade, working to improve that practice act for your generation.

And I believe that the responsibility of every nurse as part of how we take care of our profession is to belong and participate at some level in your professional organization to take care of your profession and advance that nursing practice act. And many of us will have specialty organizations we belong to. I have several, but my home is ANA and my state association currently is PNA. Because that is where nursing is regulated.

And specialty organizations are very important. They tend to be most active at the national level and they tend to be most focused on very precise, confined specialty areas. The ones that regulate your practice, the issues that regulate your practice are the issues that your broader association, ANA and PNA, are involved with. So, PNA, a few years ago when I came on board, the board revisited its mission statement, which is currently empowering Texas nurses to advance the profession.

So, we look at our role is to help remove barriers and to help nurses be able to do what they do best in their environments. Rather than, you know, we don't try to do it for you. So, Joyce, you mentioned, um, nurse to patient staffing ratios. That's dictating a model to nurses.

And we, and we see that as contrary to our mission. Because our mission is instead, how can we best empower nurses to determine the appropriate staffing levels in their own environments? And we believe that's best done through a staffing committee where they can engage where nurses and leaders, nurses in practice at the bedside, nurses in quality management can all get together and figure out how do we best tackle this challenge of providing the right resources at the right time to meet patient needs and not dictate what that will be. That's not empowering.

That's dictating. And so our policies tend to be those that support nurse involvement, kind of a shared governance in their environments to advance the profession. And again, we represent all the nurses. So, indeed, nurses need to belong to their specialty organizations.

But they also need to belong to their state organization because that's the one that gets involved in the regulatory arena, partly because we're the largest. So, we're able to. We have the resources. We have the expertise.

We have the track record being involved in a broad legislative initiative. There may be some specialty initiatives, but the broad ones are the ones who meet your nursing association to be involved with. Yes. And I was actually involved with the first group that developed the staffing regulations rather than the mandated ratios.

And I was struck at that time because that was a while back that they in those regulations, we even had to put something around where the chief nursing officer needs to report. And I thought that was kind of odd until I learned that not all organizations had their chief nursing officers reporting in at the top to the CEO or COO. And I was really impressed and dumbfounded in some ways that there were hospitals within the state that had their CNOs reporting in down at the director kind of level where making changes would be extremely difficult. So, I got to see early on that it was important to be able to look at Texas overall and I've always been intrigued with how big Texas is being from Connecticut originally.

So, it's amazing in terms of what the organization doesn't have to address because it is so highly variable and diverse. So, you said a little bit about why nurses should be involved in a professional organization such as the Texas Nursing Association. But why should nurses also care about being involved in policy? You know, to a lot of nurses at Shield Cycle, that's out there that doesn't have anything to do with my patient.

And so, I don't need to be involved. And I can get that. It can seem like a world way. When you read about what's in the paper about what's happening at the Capitol.

I think the best answer that I have ever seen is in the 2010 IOM report, the Future of Nursing Leading Change of Dancing Health. By the way, it's the most down-loaded report ever in the history of the Institute of Medicine, which is now known as the National Academy of Science. The most downloaded report ever, Dr. Donald Berdowick had an appendix.

And maybe I can talk more after the break about that. That'd be great. So, we are coming to you live in the BIM Global Network and to an end radio. This is all about nursing, and I'm Dr.

Joyce Vachal, the host of the show, and we will be right back. Carol Anne is a popular speaker at conferences across North America. She has appeared via TV, radio, and print globally. Now you can tune in weekly to get a dose of her inspiration plus down-to-earth advice to cope with even the most difficult aging parents.

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You are listening to all about nursing live from the BIM Global Network and Tune In Radio. I'm Dr. Joyce Vachal, the host of the show. This is prior to the break, Zindi Zondik was starting to tell us a little bit about why she believes it's so important for nurses to be involved in policy.

She was starting to explain the future of nursing report that was the most downloaded report ever, that the Institute of Medicine, the National Academy of Medicine is involved with. The first day that the report actually went live, it was being downloaded by so many people that it crashed the system. I know there were a lot of people very interested in what was coming out of that report, which is all evidence-based and backed up by research. We're still working on those recommendations.

So maybe you can continue on with what you were describing, Zindian, why nurses need to be involved. One of my favorite parts of that report was actually the appendix. Dr. Donald Burwick, he commented about the future of nursing, and that in that future, every nurse needed to be a leader, not just nurses and leadership positions.

It was a part of every nurse's role. He said that every nurse, when they come into their work environment and encounter patients, they need to be thinking, what can I do today that will improve the care I provide? From the very local level to the broader level of processes, what is wrong, how could we do this better, how could we improve the care? And if every nurse, not just those in leadership positions.

So it doesn't matter where you stand or sit, we all have a role. And some of that is policy. There may be a policy in your organization. What is the best practice?

What is the new evidence on a particular procedure? Or some of the very basic things that we do that we learn about how long you use it to monitor and to ensure you get the right temperature? To a broader level, like your community. Recently, nurses in San Antonio participated in advancing a city ordinance that would require individuals to be 21 to be able to purchase tobacco.

Nurses got involved at the local level. They testified in a city council hearing, and the ordinance was passed. It wasn't purely because of the nurses, but in part they had a part in advancing that policy. So it's at all, so it's at all different levels.

We do it at the state legislature, and we do it in Congress, and we do it globally through the International Council of Nurses. So there are all kinds of opportunities for nurses to get involved in policy. And it's important for a couple of reasons. If policy is going to happen, it's going to happen.

The legislature meets policies that are devised in organizations, whether or not nurses are there. So it's going to happen. And how much better would it be if nurses' voices were incorporated and heard within that policy development? And that's a big point in the Iowa report, was that nurses' voices have value, nurses' experiences, their background, their knowledge base needs to be part of those processes.

And we need to be sure to look at opportunities to involve nurses. But nurses think they've stepped up. And say yes. Yes, I have this little thing that went.

Whenever I saw something that got passed, and I would think, who are these people that I either needed to learn to accept what they were coming up with, or figure out who was involved and how to get involved and have my opinion starting to be heard. So I think that you're raising great points because I do believe that nurses can make a difference. I thought it would be kind of interesting to also share, as we're talking about being involved, what are some of the top issues and concerns that the Texas Nursing Association is addressing in this legislative session? Well, it probably will come as no surprise that for practice authority for APRMs is a top issue.

It has been for several sessions. Political dynamics really have more to do with what happens than actual merit of the proposed legislation. So you couldn't have a more meritorious bill than for practice authority for APRMs. The research is very solid.

Yet the medical association's power, largely due to its membership penetration, that is the fact that about 90% of physicians are members of TMA, while only 5% to 6% of nurses belong to TNA, is unwealed. But we have several changes in this session. There had been a physician who was the chair of Health and Human Services in the Senate, and that was a end of story done deal in terms of getting any kind of bill through the Senate. So when it's changed, we also have a new speaker in the house, and it creates new opportunities to introduce new strategies.

So again, there's a lot of strategy going on now. We have a coalition of a lot of business partners and community partners that are taking a very active role in putting forth money to help us lobby this effort. So it's a tough road, but we're hopeful. Another major effort is a bill that focuses on preventing violence in the workplace, and it would require facilities to implement reporting, training, and safety teams to better understand and reduce incidents of violence against health care workers.

We know from a survey in Texas, conducted by the Center for Nursing Workforce Studies, that one of two nurses has experienced its violence. That's not acceptable. There are things that can be done. There are a lot of organizations that are already doing wonderful things.

We have a grant program, and those will be announced probably this next week or so about the awardees for the Innovative Grant Program to develop violent prevention strategies and workplaces. We will continue this effort as one of two top of mind issues to nurses in Texas, according to the surveys that we've done. We're also looking for increased funding for the Nurse Faculty's Lonely Payment Program. We know we have nursing shortage, we're expecting to have 60,000 nurses short by 2030.

We need faculty. Part of the problem is, you know, the availability of faculty, so the Nurse Faculty Lonely Payment Program will help incentivize nurses with graduate degrees to go into teaching. We want to make that program more flexible to allow them to receive more dollars in the loan repayment, as well as be available to full time as well as part-time faculty. We also want to restore the nursing shortage reduction funding.

It was cut 40% last session to $20 million, and we want, we were planning to introduce additional flexibility to that program to make it more workable for many of the schools that have access to it. PMA also participates in a number of interdisciplinary coalitions. We have the Public Health, the Women's Health, the Mental Health, coalitions that advance issues that are of general concern regarding health care and tax care. So we're active in those, as well as their own particular nursing issues.

And then there are some specialty nursing groups, like the school nurses. They have a number of issues in terms of access to emergency medication to provide to students trying to notify parents whether or not there's a nurse within the school district. There are some of those specific nursing issues that we are also supporting. You know, it's interesting that the advanced practice nurses are still fighting on getting their full scope of authority access to care is such a hot topic.

And in the state of Texas, as you know, again, a big advocate of supporting this, because there's so many rural hospitals and so many underserved areas that the advanced practice nurses were not able to really care for people in those areas. The number of people that would be without assistance is just mind-boggling. So I think it's pretty exciting to see all of the different efforts that you're working on. I did have an opportunity to talk to someone from the American College of Nursing just this week.

And as we were having our dialogue, she was telling me about the staggering numbers of faculty that will be retiring within the next 10 to 15 years. And we don't seem to have a real good plan on succession planning for people in these roles. And as you were describing some of the challenges in Texas, all I kept thinking is there are three new hospitals that are going to be built in the city of Austin. Where we live alone and never mind the rest of the state.

So it's definitely an area of concern. So thank you, love. Right now, this is all about nursing. Dr.

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It's important to remember that over 6,000 bills are filed every session and less than 20% passed. And usually, nursing has enjoyed a much higher percentage most years. It's important to remember that most of those successes have resulted from incremental approaches. That means you don't begin with your platinum bill with all bells and whistles of everything you want.

I get that pass the first shot. Instead, you may start there, but you understand that you're going to have to negotiate in hopes of moving all farther down the field. Each session, a few yards further. And eventually, there's nowhere else to go but to touchdown.

And I believe that's where we're at with full practice authority. We've kind of shaved off little pieces of it the last time it was 2013 when we removed some of the restrictions around numbers that could be supervised and simplified some of that. But really, there isn't much shaving to do. Really, now we need to head to the touchdown.

But I think we need additional sessions to get to where we really want to go with workplace violence. I expect we'll be negotiating some aspects of that bill. We also probably have further work to do to understand how we can best use resources to solve a nursing shortage. Schools are coming up again, like you mentioned.

The faculty shortage is very real and very challenging. And so what is the best way to really approach that and make a difference? So evaluating progress really means more than looking at just the final result. It means looking at whether we may have missed a vote by leaving out a CCC holder that had been one year, years ago on another issue.

But out of the blue, we had some stakeholders come forth and oppose a bill that we've watched out and agreed bill. So it comes up as you learn that you had a blind around and you didn't realize that you left out a CCC holder. And you learn from that as you move forward and include them. So evaluation is not just because of the bill passed or not.

It's all the learning along the way that can set you up the next session. And again, the incremental approach knowing what's the next increment or are you ready to go for the touchdown? That's wonderful. That's a great way to describe it too because sometimes it takes several different legislative sessions.

And it can be impatient sometimes, but your approach you're describing is very very important. I was curious, influencing legislation at the Capitol can sometimes feel intimidating and overwhelming. How can nurses who may not be in traditional nursing leadership roles get involved to really shape the policy? Well, I think it's very important to appreciate that leadership experience is not required to get involved in policy.

You remember, I said that my first introduction was my first year as a new grad RN. I said, I'll be the legislative representative. So I certainly didn't have leadership experience. This passed Monday and Tuesday.

Last today, PNA hosted its 10th anniversary of our nurse day at the Capitol. It's a structured opportunity for nurses from across the state to learn about current policy issues that I discussed tonight and to meet with their legislators. We had over 400 attendees, which was a record for us. And about 90 of those were pre-licensured nursing students.

Oh, that's wonderful. Yes, we were very excited. And most of them probably came with no idea of what was in store for them. And probably a little intimidated.

But in my conversations with them, they were in awe. They were on fire. They were wide eyed about a world. They didn't know existed.

And they felt empowered to be part of the professional work of policy. And using and understanding that link between policy and its role in enabling them to take care of their patients and to take care of their profession. So you don't have to have experience. And there are tools to help you.

On a TNA website, there's an advocacy 101 that kind of goes through how you can get involved. And really it's about relationships. Nurses are very good about relationships. Every patient you've ever cared for has been about a relationship.

You don't have to wait and go down to the Capitol to build a relationship with your legislator. Actually, the best time is to meet with them when they're not in session and they're in your community and to introduce yourself and not with an ask, but with the offer to say, hi, I'm Cindy. I'm a registered nurse and I live in your district. I want to be a resource to you.

When you think of these legislators, they're facing water issues, transportation issues, education issues, health issues, task issues, they can't be an expert in all of those fields. So they rely on others. They have staff that develop expertise in different areas. And they have constituents that they rely on to hear what is going on in your world, what matters to you, how can I support you?

Because that's their job. This is for you. So if you go to them and say, hi, I'm a registered nurse. I want to be a resource for you.

If you have questions about healthcare, if you have questions about the population and the health challenges that they have, I want to be that resource. Here's my card. Here's my name. Here's my number.

Reach out in that way. And then when you have an ask and say, I'm like your support on this bill. We have an access to care issue and we have an unnecessary barrier where HRMs cannot practice the full extent of their license and experience and education because of antiquated laws. They're going to be more able to listen because you've already established your relationship.

And you do that every day with your patients. When you introduce yourself and you let them know who you are and how you're going to be a resource and help you them. It's the same thing. It translates very well.

No, I think that's a great way to summarize all of that. So thank you so much. This is all about nursing. I'm your host, Dr.

Joyce Bachelor. We're live on the VVM Global Network, get to it in radio. And we'll continue this conversation when we come back. Do you battle with weight loss?

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Prior to our break, Cindy was telling us about the wonderful number of people that showed up at the Capitol for the nurses to really be able to talk about the legislative issues and learn a lot more about how to shape policy. So I think that's pretty exciting and 90 pre-licensure RNs is very exciting because it is their future. We're talking about, as you were talking, I was also thinking about the work that's going on to try to have nurses not be so invisible in the media, as well as we're the most trusted professional, how do we become the most influential and certainly work that's going on to get nurses on boards coalition, which has also been discussed a little bit more so on prior shows. So I was curious, Cindy, if there was one takeaway, you would want listeners to have.

What would that be? First of all, I want to comment on what you said. I think what you just identified were the numerous opportunities for nurses to get involved and to be influential. And in all different levels, so whatever fits you at the time, there are all kinds of opportunities.

One takeaway, there's a quote from Margaret Meade that I really liked. It's never doubt that a small group of thoughtful committed citizens can change the world. Indeed, that's the only thing that ever has. And to me, that quote speaks to empowering yourself.

Don't believe, refuse to believe that you cannot have a difference, that you are impotent. You are not. You need to grasp the power that is yours. Nurses are viewed as the most ethical and honest profession.

When I understood the capitol yesterday, I was sitting in the cafeteria and a man who was sitting next to me saw my button and said, oh, you're a nurse. And started telling me the story about the wonderful nurses that took care of his grandson and saved his life. People believe you, they respect you, they honor you. You have power.

Use that power. Influence for the profession, for your patients, for yourself. It's there for the taking. And there are many avenues to exercise it.

I think that's wonderful. I think that's great advice. I think that it's interesting that you brought that up this evening because we have talked on prior shows about how even though we're three and a half to four million strong in terms of numbers, we're still invisible in the media and people don't know. Or don't always think about getting a nurse to be on one of their boards.

And I've been selected to be on a board this past year. And it's been really awesome because the person who's in charge of the company is just like sold on the value of having nurses on boards. And he's starting to find other boards for nurses to be on because he's seen the kind of expertise we bring. And I sort of sat there as he was talking and smiling to myself thinking, wow, I mean, it's 2019.

At least somebody's getting this. But I was really thrilled that that's the case in this particular situation. And I think that if people are listening to us and they are in charge of companies or school boards or other entities and have issues, they should be thinking about how to get some nurses involved because I think that could be another opportunity. Do you have any idea for people?

Like is your office an area that they could also call if they had questions about what's going on in the legislative arena or the website you might want to refer them to? Is there anything else like that that you would want to share tonight, Cindy? They can certainly come to the TNA website and certainly there's a contact there. If anyone has questions or comments or wants to get involved, please, please contact the fair and Joyce and you're working on a board and that's another area I would comment is that there's a big corporate board.

There's a school board. There's local things in your community. They need they need you. I was struck with a nurse being put on a board for one of the airports and I thought, now, why would you do that?

Well, that airport now has an urgent care center. And I guess they've done the financials on it that they in fact have enough people traveling that might need to stop in and get some kind of symptoms staying care, which I thought was fascinating. But they also looking at the healthy food choices at the airports and other things that we may not think of. But again, people bring in those perspectives about how to have a culture of health and how to make some difference and so I thought it was pretty exciting to hear some of the changes that are coming as a result of nurses being engaged on those boards.

I really want to thank you. This is very sharing all this with us, Cindy. And obviously, it sounds like you're doing a great job with the Texas Nursing Association's course on bias. I live here in the state and know what the work that you're involved in.

And for the audience, you have to know too that Cindy has to put up with people like me that always have a lot of opinions. And so I thank you for being on the show and for doing such a great work. So you are listening to all about nursing, live in the medium global network and tune in radio. I'm Dr.

Joyce Batch the host of the show. Tune in next week. Thank you. Thank you.

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