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Welcome to All About Nursing with your host, Dr. Joyce Vacheron, executive nurse advisor, Dr. Vacheron, who 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 and practice in academia settings and talk about the challenges they face in today's modern medical world.
Please welcome the host of All About Nursing, Dr. Joyce Vacheron. Good evening. I'm your host, Dr.
Joyce Vacheron, all about nursing. I'm alive on the BBM Global Network and TuneIn Radio. I'm really delighted to have a very special guest with me this evening, who is Dr. Jeff Adams.
He's a colleague of mine that has just been really doing some amazing work. I'd like to share a bit more about his background. Dr. Jeff Adams is an experienced consultant, researcher, and innovator, focused on influencing optimized outcomes for the workforce and health systems.
His expertise highlights the importance of influence, intern, intra-disciplinary perspectives, and a collegial approach to optimizing leadership, work environments, and outcomes. Dr. Adams is a principal emeritus at Jeff Adams LLC. His Adams influence model, also known as AIM, and related published models of instruments are widely used to frame practice, research, education, policy theory, media, and industry initiatives.
Dr. Adams serves as a chairperson for the American Academy of Nursing's Expert Panel on Building Health System Excellence, coordinate students, faculty, and organizational leadership research nationally with the American Organization of Nurse Executives Foundation Research Board. Dr. Adams has worked with over 15 healthcare organizations nationally, and he has held formal innovative academic practice leadership roles with Massachusetts General Hospital, Brigham and Women's Hospital, Dana Barbara Keans for Institute, Massachusetts Institute of Technology, and Arizona State University.
I can tell you that's a pretty modest introduction for Jeff, considering all of the amazing work that he's been doing. But so thank you for being on the show this evening, Jeff. Sure, thank you. Thank you for all this great work with you and Dr.
King. So I would like to start off this evening with you, just give us a little bit of background on when and how did you decide to become a nurse? So for me, I think if you're seeing more decided than that's why I was going to become a nurse, I admittedly started as an undergraduate at the University of Michigan, and I absolutely thought that I was going to be an engineer, a biomechanical engineer, and I realized, you know, halfway through my academic career that wasn't what I wanted to do. So thankfully I made my way around campus and I interviewed almost every different area of the university, and the nursing time that I jumped out was for a lot of reasons, just that it's not a bunch of me.
So there's so much opportunity, and whatever my interests was after nursing school was so possible. So I think that was really how it would become a... And I think it's great because one of the things that we've been doing on a variety of the shows is really helping to educate all of the different places that nurses work, all the different kinds of positions, and the impact that nurses are having all over the country because we are located in every part of the continuum. And you can't get bored in this profession.
There's always something new going on that you can take on as a new role if you're interested. So thank you for sharing that. So maybe you can give us a little bit of background and just highlight some of your career, some of the things that you've been involved in that you're particularly very proud of. Sure.
So, you know, admittedly, like I shared, I started my education even at the University of Michigan, and for giving it by a name drop throughout our conversation, which was a number of these people are people that you know well. But thankfully throughout my career I've just been able to connect with some amazing, amazing nurse leaders that helped guide my trajectory. And I think that's an important part of my experience. And for all nurses or all persons around the country and around the world that want to study nursing, that's an important thing to think about that is just to reach out to those people that you see out there that are doing exactly what you want to do.
And you know, obviously get your questions and your self-organize before contacting them. But those people really want to speak with you also and help foster your career and your development. So I think that's an important part of what I learned going on in early. So I started after Michigan, thankfully it was funded by the team at Michigan.
It is through Hinshaw at the time who started the National Institute for Nursing Research. He essentially said to me, you know, as part of your graduate studies, you want to go to Penn and you want to study with this person on the agent, because what she's doing is something that no one else in not only nursing but in health care hasn't done before. That's really looking at the role of work environments and burnout and getting in on the ground floor. So this is maybe 20, 25 years ago that I was kind of pointed in that direction.
And just being there and being in that environment at Penn University Pennsylvania, I was learning again, really showed what a research institute should be or how it could work or how it could work. So that was a very helpful point in my career. After I moved on from working with Linda, I thought this is another wonderful opportunity. And again, something where you don't find nurses, you know, you don't think of nurses.
But I was in this consulting world where I had the opportunity to work in over 40 different hospitals, looking at their information systems and helping them. And then there was a lot of information systems working with nurses to, you know, optimize the work that they were doing on their information systems and their practices and increase and enhance their beliefs and their roles as not just, you know, caregivers, but a bigger part of the healthcare industry. And that's an important part that kind of said we'll talk about as you get on, I imagine, in conversation. But that too was just an amazing opportunity to get in on the ground floor for consulting or information technology.
But also really place, you know, see how different institutions in different regions in the United States and the world, practically healthcare difference. I would think that would be pretty amazing to do because as you said, there are really big differences even between East Coast, West Coast, and then of course I'm located in Texas and we're kind of out there on our own sometimes with very innovative work that goes on. So that's pretty exciting. It's a great, great, but in a bit of the, you know, I did some work one of my proposals with this little hospital in Salinas Valley, California is known as the breadbasket of the United States.
It's known as the Tellable of the United States. There's a lot of proboscis grown in Salinas itself. Like they have the highest per capita Spanish-speaking population. And the nurses are, there's no BSN program even within 50 miles out of the hospital.
And so this is in a beautiful area of the country. Monterey might be one of the most beautiful areas of the world. And you know, these nurses were just doing some amazing things. And so one of the great things that happened where we are working on with them is enhancing the belief in nursing its leaders within the organization and within the institution.
And so the nurses that I worked thankfully directly with, 90% of them were back to finish their BSNs and many of them have gone on to get their doctors in need on to really change work. But that experience, both of them are here for others. It's just an amazing. Well, this is all about nursing and I'm Dr.
Joyce Bachelor. We're live on the Began Global Network and in radio. And it's time for us to take a short break. Dr.
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Get his book now, online or by visiting thecultureofexcess.com. Welcome back everyone, you're listening to all about nursing, life, the BBM Global Network and tuning in radio. I'm Dr. Joyce Bachelor, the host of the show.
Before the break, Dr. Jeff Adams was telling us a bit about his career and how he became a nurse and some of the experiences that he's had along the way. I've been very impressed listening to your story, Jeff, and hearing the kind of mentors that you were able to take advantage of to really launch your career. These are nurses that are very well known in the industry.
So it's been pretty interesting to listen to all that. You were telling us a little bit about the experience you had with Salinas Valley and really what a small hospital could do with the assistance that you gave them. So maybe you'd like to go back to that and continue to tell us a little bit more about that. Well, sure.
I mean, the work and thanks, Joyce. The work is doing it, as I shared, probably the most rewarding experience because for a lot of these, it's because you really saw clinicians, direct care clinicians who were under-resourced for a lot of reasons and really cared about not only their education themselves, but their patients, and figuring out a different way to optimize their contributions within their care delivery. So that experience really kind of solidified my, my furthering of my commitment in nursing, but really changed how I thought about nursing in the United States. And that really led me to this next stage in my career, which was within the CCC general hospital and, you know, finishing my doctoral education at Boston College.
And really involved scenarios. I can't trust this enough. I was really lucky to work with, you know, amazing mentors again, Joyce Clifford, and Jeanette Bericin, and Claudia Vanis. And again, these are all people that are well, well known in healthcare and nursing in the United States.
Dorothy Jones is my dissertation chair. And they really gave me opportunity. I remember sitting down with Dorothy Jones and Jeanette Bericin, and they said, hey, you know, we want free for new. It's just to think, just to think how to do this better.
Now I will say that that's not going to be available for all before millionaires in the United States, but really finding those mentors that really help you deliver on what you care about. So one of the things that my favorite quote is, leadership is getting people to do what you want them to do because they want to do it. And that was from President Eisenhower. And it was something that I have written up.
It's been a little plain next to my, you know, on the Bessite table because I believe that. And I think that as we talk about influence on my interest in the clinical and disease forward, that kind of thing for that holds true. As part of my work at MGH, I was the director of the Central for Clinical Inpatient there. And that led us to a lot of collaborations that really need institutions on finding and developing amazing interventions.
And one question was, I work with the Massachusetts Institute for Technology where we contributed to their development in thinking around the, so when I was at MIT, I worked with the Institute for Social Journal of Technology, which again, that's just happened to be in the right place at the right time where they were building a battlefield super soldier suit. And you think, yeah, that's natural for nurses to figure out how to build a battlefield service suit. But really, our interest in it was really focused on a part of the suit. Now, this suit, as we're talking about, it's just an amazing thing.
It can make you liveable, it can set broken bones, you can deliver medication suit. And that's just some of them. I mean, this is just an amazing thing. It can make you jump over walls with an empty towel and literally a size kitchen.
Our interest was in contributions were really around this idea of medication delivery. How do you deliver medications through a suit? More applicable to nurses is really thinking about how can we, instead of a whole suit, think about an arm band, and we might be able to deliver insulin through an arm band so that people don't add a regular pace so people don't have peaks and troughs to their insulin levels. Now, this is still a couple years, a couple of times from ever making it out there.
But it's something we're working on. It's just an amazing opportunity for nurses to just be there, see these amazing things happen. So from MIT and MDH, I also had this wonderful opportunity. As I was like you Joyce, we were Rubble and Johnson and the second nurse fellow, and really that fellowship really took the experience that we've had or I've had during my career, and really helped to focus and foster them so that you were both aware of the leadership skills you had, but then also helped to frame and structure them so that you might be able to contribute to the next generation of amazing leaders better differently.
Yeah, and that's great because we have talked about that on a couple of the other shows about the executive fellowship and the push that we had in terms of really broadening the boundaries that we normally would find ourselves in close to, but breaking out and really spanning those boundaries, thinking very differently. And so I think that really does fit then with the work that I know you have such a strong interest in around the ability to influence. And so maybe you could share a little bit about some of the work that you're doing around influence and some of the challenges that your team is addressing. Sure.
We are in significantly, like I have one of the most organic teams in the world. We work closely. So just speaking as the chairperson of the executive panel of the Building Health Care Systems Excellence panel at the American Academy of Nursing, we're really focusing on enhancing influence of nurses nationally, internationally. And as doing that, we recently assembled a team or a small collective of the nation's leaders in nursing to really strategize about how to do that.
There are other groups that are doing some similarities. I know means a lot to say that we're the only ones working on making nurses more common and more influential. But we're starting this with a purpose and a purposeful strategy to do that. And certainly, it's really important to share that kind of information with you too.
That's great. We are coming to you live from the Think Global Network and Tune in Radio. This is all about nursing about your joy spatular. And we'll continue this conversation when we come back.
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Jeff Addams had started talking a little bit about the work that he and others are doing related to his influence model and really trying to enhance the ability of nurses to influence changes that are needed in healthcare. So I'd like to go back to that, Jeff, and have you tell us a little bit more about the work that your team is doing and some of the things that they're trying to impact? Sure. Well thanks for that.
And I think that's important part. We were talking a little bit at the break about them. But really, all we're talking about right now is a we. It's not just the four million nurses, it's not just me and you, but it's really all of us who enhance the role of nurses to make the healthcare of the nation better and different.
So we really framed a lot of our work in that group around the concept of authority, communication, trade, knowledge, and status and time of timing and really understanding that relationship both that we as individuals and nursing as a group have and understanding that the people that we're trying to influence have those same factors and understanding what those influence factors are with factors. And that really helps us to start and play in that conversation. Another piece along that line is how we did it. And this is somewhat theoretical, but I think that it's really important to start with a framework when you're trying to take on a big or giant project.
We also framed this around this grand challenge strategy that the American Nurses Association is using for helping their self-adhesion campaign, the anti-tobacco groups have really strategized using a grand challenge campaign to how you get your kids to use people around. How you put cars, you think cars, that was a grand challenge campaign. And really that strategy is around each one of us, those little micro efforts make a big effort over a long period of time. So one of the things that our group has really placed an emphasis on are simple things, like instead of maybe saying doctors and nurses, perhaps talk about nurses and nurses because we're all, you know, many of us are doctors and there's a very little doctoring that goes on in healthcare.
I think personally I think doctoring is more a modaborist or a doctoring up your Sunday. But I think practicing medicine is a very important part. So really that thinking about how we even speak about nursing is an important piece of this idea of enhancing nursing. Another important part in this same context is really think about, so right now in the United States there are more nurses than nearly every other licensed professional group combined.
So it's mind-boggling to think about. So that physician, physical therapist, social workers, nutritionist, all of those combined and those are just the sampling of them. There are more nurses. So if you think about redeploying or deploying differently healthcare delivery in the United States, nurses can really change the health of the nation very, very fast.
We often talk about 1% of the United States is a nurse and 2% of all women in the United States is nurses. So just staggering numbers to just comprehend and think about. I think that this is linking in with the work that's getting launched with the National Academy of Medicine, the future of nursing 20, 20, 20, 30 report which I think is really looking at the whole issue around how to really position nurses to radically change the way we do healthcare going forward. So I think the timing on what you're describing is great.
Well, I'm certainly in touch with the leaders, two half-millers and others of that. The National Academy initiative around referring to nurses roles for that exact future of nursing 20 is for exactly that reason because we really do need to start or have the opportunity to start thinking about a different use of our healthcare workforce. We had spent a lot of time thinking about what nurses can do and what nurses are doing. There's a big, there's a vast difference in every state and every organization.
And some of those policies, big or small, we're not totally sure why they exist admittedly in a state like Massachusetts. We had an enormously strong education program with amazing nurses working here. Yet at the same time, organizations themselves limit their social practice for nurses and the state has a fairly restrictive social practice here also. So really, I think that something is going to get our arms around.
What are the opportunities that nurses can do? So think about it, 1% of the US population is theirs. Every nurse could care for 100 people over the course of a year. If we just thought about it, we're refrained about that argument about the role of nurses in the United States.
I think that's a really great point, Jeff, and we'll talk a bit more about that. Right now, we're coming to you live from the BBM Global Network in Tune Radio. This is all about nursing show, now Dr. Joyce Bachelor, and the host of this show will be right back.
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Adams was telling us a little bit more about the influence model that he's been involved in and the number of nurses that we have in the country and the fact that if we were to rethink how we perhaps deliver care, access to care could really become a mute issue because nurses could really change the way that care is delivered. And so I'd like to go back to that, Jeff, and have you talked a bit more about that concept and then perhaps the opportunities that you think nurses and clinicians and people have over the next decade. Where are we going? So I think you touched on, you know, in that introduction, so it's wonderful.
This idea of the well-known concept in healthcare has been the triple or the quadrupling and really focusing on how we improve the access to care, how we improve quality of care, and we decrease cost of care. That's the triple. And the important thing to think about when we talk about that is that triple aim is built around this idea of a triangle. So if you spend a lot of, well, if you increase cost, you can also, you can only teach cost so much.
But if you increase cost, what do you do to quality and for access, those strengths, those are goals to really titrate those three things in a perfect harmony. And that's a really difficult thing when you're talking about the global, you know, multi-trillion health, multi-trillion health care of the United States. Now this fourth aim or the work environment or the work of clinicians or wellness or clinicians is a newer focus, but kind of what I shared earlier and thankfully I was in that environment at the University of Pennsylvania 25 years ago. And since that time, nurses have really taken the lead to enhance and influence the betterment of work environment.
And there's a lot of reasons around why that is. There's just traditionally been employers of hospital. And now more and more, we're seeing physicians be employees of hospital. And we're combining this matter differently now to physicians, formerly good, prior.
And so that idea where I think physicians are on board with that, essentially not only of course of working environment or burnout, they're something that nurses have been at for a really long time. And you know, thankfully we have the opportunity to dialogue with a bunch of physician groups to say, hey, we're really good at this. Kind of follow our lead along this idea of work environment in the country of Wayne. Now, going back to this idea back up to care in the billion nurses and delivering better care, I think that the golden opportunity not only for us as nurses, but for the United States as care recipients, we have to figure out a way to deliver care not only to increase the value of care, which would be quality over cost or cost of the quality, the idea of increasing a value of care, which would be way more efficient having nurses prevent illness or delay illness or increase care in the community, rather than waiting for people to show up in hospitals.
And I think, you know, admittedly, if I'm using a surgeon, I'm going to a surgeon. If I need a nurse, I probably need a nurse well before I need a surgeon. And I think that's important thing for all of us to think about, because care delivery is not, shouldn't be focused in the United States around a building, around a hospital. So, delivery is every part of our lives all day long, as opposed to, I'm sick, I need to go somewhere.
So, really thinking about how we can do that to better, with nurses, you know, and efforts, I think it's a great opportunity for a country. Yes. You know, and I think as employers are passing on healthcare costs and there's higher deductibles in co-pays, the concern that many of us have is that people are waiting to be seen because of that expense that they are worried about. And to your point, it's going to actually end up costing more because people are delaying than getting in there and trying to do the proactive things and keeping things under control.
And so, it goes back to what you're describing with wearables. They have to monitor people and intervening much more so, rather than, you know, like routinely, rather than waiting till someone's in a crisis of some sort. I think that could be very exciting to help people take better control of their own health and wellness. And I think we're going to see that with the younger generation already, looking at apps in ways that they can back-shape things.
And I think as employers also put incentives in there that if you're doing that, all the right things, you get some kind of a premium discount or a bonus check or something, I think maybe we'll see more changes in that direction. So I was curious if you wanted to say anything else around the opportunities that you see going forward or if you would like to go back to talking a little bit more about how influence innovation, advocacy and work environments are really related because I think that's a really important topic for this evening. Well, let's talk about that first and if we have time toward the end, I can share more about opportunities. As we talked about one of our earlier issues within the extra panel at the American Academy nursing really focused on this idea of what these leaders do or what the nurse leaders need to do to make outcomes better around the quadrupling.
And when we analyze the data, and I would like to give credit to John Bull to the nurse at Virginia Commonwealth University, he helped us to analyze those data. He really found and looked at this idea that around three ideas really that influence innovation and advocacy were what nurse leaders needed to make a difference or enhance the quadrupling. Now, all of us have worked in great work for great bosses and some of us have worked in not great bosses and some of them have been in the exact same job. The ideal though of those great bosses if you look back, you knew that they were influential, you knew that they were innovative and you knew that they advocated not only for you, but for their whole spot for the people that worked with them and those three things really make work environment amazing.
And so I think that's an important thing for all of us to think about that. Nurses really need to focus on influence, innovation and advocacy and we're looking to make our work environment stronger. That's a great summary, Jeff. And well, this is all about nursing.
I'm your host, Dr. Joyce Vadchelor. We're live on the B-Binkle Network in Tune Radio and we'll talk about that in just a little bit, but right now it's time to take a short break. Attorney Renee Marie Smith is changing the way we sell real estate.
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Joyce Bachelor. Before the break, Dr. Adams was telling us about work that he's been leading and looking at three major areas of that are really important competencies for leaders to have, which are influence, innovation and advocacy. As you were talking before the break, I was listening, thinking about how I've had both the bosses that did that and then bosses that did not do that and the consequences because the impact leadership has at the top of an organization is very real.
So maybe you'd like to pick up on that, Jeff and kind of go from there. Sure. I think all about, and I think it's important part for all nurses and all of these are three people. All of you know, we've all heard all nurses are leaders.
I think so really enhancing one's own influence, really thinking innovatively and really advocating for those things that you strongly believe in. No matter what your role is really, really an important part of your own career development. Yes. But also your job and life satisfaction.
So I think that's an important part. Like you said, Joyce, we've all been in those roles where you're kind of rolling your eyes and I really want to spread to feel like your bosses there for you or your bosses smarter than you. It's one of the things that we had joked about in my earlier job where you just want to feel that your boss or the people you're working with are influential really changing things and you're not just going to work to collect a paycheck. Generally, this idea of innovation, it took me as a director of innovation or a center for innovation, particularly a long time to figure out what the heck you've been talking about when we're talking about innovation.
There's a description of innovation that we have in healthcare which is just delivering a little better structure of care really around this idea of the sibling. But then others, not in healthcare, think around this idea of innovation about doing something completely new and never having some strength within a current system. I think for nurses, it's really important to address and think and expect innovation in both contexts. There's no reason that things have to be like they all we are, if it can be better.
So when I think that's an important part for all of us to really believe in ourselves and the people that we work with and for that we can be innovative and really change things. And advocacy is exactly that, it's pushing those new boundaries. It's really, like in nursing, advocacy is a really interesting concept. So we talk about this idea of how will we be coming more and how do we advocate more.
Many of us have received or seen different political advocacy groups in nursing. And one of the challenges is to be influential and to advocate really surrounds this idea of money. As much as it's paying someone to think about or talk about money and policy development in advocacy really matters. In nursing, we just aren't as wealthy or have the same number of the numbers of financial resources that other groups do in healthcare.
So that's a real challenge that are discussed. But by the same token, nurses have four million people. So if you think about that differently, that our resources are our numbers, our numbers of people. Well, finances may live in different areas.
Our numbers are numbers of people. And one of the things around the advocacy that I'd like to see and one of the things we're working on, how do we motivate those four million nurses to contribute to the community? To really make a difference in healthcare in the United States. Again, think about 1% of the U.S.
population is a nurse. What can 1% of the population do to the policy in the United States that really makes a difference around nursing and healthcare? What is important to think about? I think it's an exciting thing to think about.
And I know the numbers that you're describing. And I know that there have been a couple of occasions when nursing has really come together. I think the most recent one being when Ms. Colorado was talking and somebody made the comment about why would she have a status quo?
She's just a nurse. That drew people together pretty quickly to take that on. And there was a lot of pushback when it occurred. So I take that example and then you think, well, if we could do that on some other big issues, that would be pretty incredible.
What are some of the challenges that you've experienced as you've been leading this work, John? Well, I think you really have to be in touch on something, so a lot of times, such as nurses that the nurses who have stepped with scope issues or there was recently a congress person or state senator in Washington that talks about how nurses play hard, though. The issue there is a lot of us and a lot of others have spent a lot of our time saying how terrible that is. If someone could have said something like that.
And really easy to think about it and own it. That person probably really saw it. In some act, like a nurse might play hard. That's not us.
I think that's not us. So really think about how are we portrayed or how are we understood as nurses that that's even possible for some of them. Now, for us to deliver care, or for people at no nurses, know that that's an absolute ridiculous statement. And of course we're upset that someone kind of minimized these efforts that we put in.
But at the same time, there's somebody else that actually believes that. And she happens to be in Congress, in the same Congress. So what do we do and what should we be doing as opposed to saying, hey, that's wrong. To educate not only that person, but all of the country about the role in the contributions of nurses.
And I think that's been one of our biggest challenges, is understanding how and why the role of the contribution and the value that nurses bring different than other professions. Some of that might be somewhat gender-related, some of that might be somewhat historical, some of that might be organizational policies or fiddle voice networks. I think that that has been the tradition up until now. And I think it's a wonderful opportunity to link in with existing efforts around women's movements and women's efforts.
Because this has happened to be a largely women's profession to really push that new agenda for people to think about nurses and the contributions of nurses. Yet, and we actually have had a show in the past where we talked about the Goodall report and the fact that nurses in the media, we went from being 4% to 2% in terms of our visibility. And I think to your point, we need to own that and start looking at how do we proactively build these relationships and reach out and educate people that are in these different public offices so that they know that we have that kind of expertise that they'll call on us when different kinds of challenges come up and they need that kind of expertise. And so I think getting those kind of competencies built into nursing education is going to be critical as we continue to go forward.
So that's really exciting to hear some of that. What are some challenges that you go ahead. I'm sorry, Jeff. Well, I would say that one of the wonderful things in that area is within the American Nurses Association and the American Association, the American Academy of Nurses, there's really been a new and spoken emphasis on enhancing our policy relationships.
The newest, the newest CEO of the American Academy of Nurs, I know you know very well, Joyce and she's a long tradition of policy and working on the Hill in BC. And so she's new in this role at the American Academy of Nurses, but her relationship in how to advance policy are different than new diversity in nursing or I think that we've obviously been in nursing. So I really look forward to how she's going to sponsor and job and make those relationships for us to report. Yeah, no, she's a dynamic leader and I'm very excited.
And I think she would tell you that there's this relationship. So we need to get better at being out there and proactively building some of these relationships and goes back to your influence and innovation advocacy and having people understand the expertise that we bring to the various tables. So I really love that. Are there challenges that you foresee that we might need to really be thinking proactively about?
Well, I do. I mean, I think that nurses have, so there's a couple things. So really need to, so nurses, one of the good things about nursing is you can do anything. One of the challenges of nursing is you can do anything.
Yes. So really focusing and honing in and giving our arms around what it is we as individuals, what our groups, what our organizations can and should do to better the health of the nation, I think it's a really important but a very challenging endeavor. We over time have been, you know, we, for a lot of people we follow the money and if for a lot of people we follow, you know, different needs that our organizations have. And you know, they're in line to the challenge of what is an organization need versus what is the nursing profession needs versus what does the United States or world needs and really linking those things up so that we can focus and contribute, not only in the way that we want to, but in a way that we need to.
Well, that's great. And I was curious. There's a lot of different people that are listening to the show this evening. Some maybe nurses, some maybe thinking about coming into the profession, but it's a mixed audience.
What are two or three things that you would like to really highlight that you think are important for our listeners this evening, Jeff? So one of the things is not really even related to influence or innovation. I mean, they're all interrelated, but this idea of one of the things that's one of my pet products is something I really believe in is this emphasis on the two eligible in the United States. So two eligible are those persons that receive Medicare and Medicaid and they are by far the most expensive part of our population.
So when we're talking about the quadripleme, that group really has a difficult time to receive access to care. They have a difficult, they're very costly to care. And thus their quality of care kind of falls off. Admittedly, giant health care systems don't want most people in their population because they're very expected to work with them or for.
I think that an unbelievable opportunity for nurses, for innovators, for advocates, for us to really think about who are and how are the most vulnerable people in our country or in our world and how do we provide better care for that group? And I think that really links a focus for what we can do within our, within nursing and with something that other students should think about you. Well, I want to thank you so much for being on the show this evening, Jeff. It's been delightful to hear about the innovative work that you're leading and sharing some of your experiences.
So thank you so much. You are listening to All About Nursing live from the BBM Global Network in TuneIn Radio. Dr. Joyce Bachel, the host of the show, and TuneIn next week for another wonderful opportunity to hear more about how nurses are making a difference.
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