All About Nursing (33)

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Welcome to All About Nursing with your host, Dr. Joyce Batcher. Executive nurse advisor, Dr. Batcher, will present the significant role nurses play in providing health care in a multitude of health care 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 Batcher. Good evening.

I'm your host, Dr. Joyce Batcher on All About Nursing. Then we are live on the BBM Global Network and TuneIn Radio. I'm delighted this evening to have two of my distinguished colleagues on, and I'd like to tell you a bit about each one of them.

So the first person I'd like to introduce is Dr. Deb Zimmerman. She is the Chief Nursing Officer and Vice President of Patient Care Services at Virginia Commonwealth University Health System. Deb served in the United States Army Nurse Corps as practice as a nurse practitioner, and for the past 20 years has served in executive positions in New York and Virginia.

Deb was privileged to serve on the American Nursing Credentialing Center, Magnet Commission for eight years, and as a chair for two years. She is currently a member of the Board of the American Organization of Nurse Leaders, Co-chair of the American Academy of College of Nursing, and the American Organization Nurse Leaders Academic Practice Partnership Committee, and the Chair of the American Organization of Nurse Leaders Foundation, and fellow of the American Academy of Nursing. Deb loves her role as the Chief Nursing Officer at VCUHS in Richmond, Virginia. She and her husband, Gary, have one daughter, Danielle, and two brief of her grandchildren.

My second guess, who I'd like to introduce, is Dr. Judy Beale. Dr. Beale has retired as of May 19 of this year, after having held many different leadership roles in her 46 years as a nurse.

She most recently served as the President, I'm sorry, as a professor and Dean of the College of Natural, Behavioral and Health Sciences, and the Chief Academic Nursing Officer in the School of Nursing at Simmons University, with responsibility for seven different academic programs. And prior to this, she had been teaching at the Boston University and Skidmore College. She's been a major leader in nursing education since 1978. At Simmons, she was instrumental in building some very innovative early models of academic practice partnerships locally and then globally.

In Boston, they had a unique model called the Hospital as Client, with the Hospital of Financing, the Academic Progression of Nurses in RN to BSN and RN to MSN programs, which grew from one partnership five years ago to eight. With Foundation funding, she's now been able to partner with the University of Cairo to replicate an accelerated second degree back of the Laureate of Science Nursing program for unemployed university graduates. And so she has just significantly advanced workforce capacity and elevated the level of professional nursing practice in Egypt. And so both of my guests and Dr.

Beale is also Robert Richons, the next executive nurse fellow, and has numerous leadership positions and different organizations that she's held and numerous publications. I think if you were to Google either one of them, you'd be spending quite a bit of time just reading about the amazing contributions that they made. So welcome to both. So I would like to start with just getting a little bit of background and let's start with you, Judy, to talk a little bit about when and how did you decide to become a nurse?

Well, I never read Jerry Ames, a student nurse. And I really decided sort of late, I would say, my freshman year of college. I had gone to Wheaton College in Norton, Massachusetts thinking I was going to be an English major because I loved reading and I was a strong writer. I had volunteered in the hospital in my high school year as a candy sliver, an event working in the hospital laundry.

I loved coming up to the floor, working with patients. I was so impressed with the nurses, how smart they were, how caring and compassionate they were with patients. But I had a real fear, it just kind of sounds funny. I had a real fear about blood and bodily fluids.

So instead of just starting to go directly into nursing my freshman year in college, I waited and I finally came to my census my freshman year fall and decided I was going to transfer to Skidmore College and go into nursing and have not regretted one single second of the most wonderful 46 year career that anybody could possibly have. That's wonderful. That's not unusual to hear that people have those kind of fears until they get into the practice setting. We have lots of ways as you both know to really help transition people as they're practicing those different kinds of skills.

So Deb, how about you if you could share with us a little bit about when and how you also became a nurse? Well, I did read those Terry Ames book and I actually come from a long line of nurses. So it was a natural thought for me to become a nurse. I loved hearing the stories or exemplars that my mother shared at home and the difference that she made in the lives of her patients.

And I did read those Terry Ames stories. I had a momentary change when I thought I might want to be a saxophone player. However, my music teacher steered me away from that profession. And at the same time, I read a magazine, one of those teenage magazines about this new specialty with a nursing starting out of the University of Colorado about being a nurse practitioner.

And I remember running for my bedroom talking to my mom and saying, this is what I really want to be. I want to be a nurse practitioner. So she then helped me with her colleagues and my other relatives look at different nursing programs and cost was not one of the factors. And I ended up back in 1976 when they allowed women into the military academy.

They offered women ROTC scholarships. So I ended up accepting an ROTC scholarship with obligation to go on active duty as an Army nurse after I graduated. And that was my kind of military training for leadership as well as joining the Army and see the world. So after I graduated, I became a second lieutenant in the Army but still had that desire to become a nurse practitioner.

So I combined for about 20 years leadership and practicing as a nurse practitioner until I became a chief nursing officer. And then I needed to really choose in the path I chose with leadership. Thank you for asking. That's awesome.

I was curious, Judy, do you have one or two highlights that you would like to share that you've experienced during your career? You know, when you are about to retire, you think a lot about this and I have to say Joyce, really know. I have loved every aspect of being a nurse. I love being a nurse.

I went directly from my undergraduate background to graduate school. Unlike dead, while I was educated as a nurse practitioner, I never really liked that. I really started off in the newborn ICU as a staff nurse and interestingly enough, then went into some management positions as a nurse manager and I was a pediatrician at the end of the day. As I'm retiring, I'm starting to volunteer one day a week in the newborn ICU here at Boston Medical Center.

So I feel really excited about going back to my roots, not as a staff nurse this time, but as a cuddler. Oh, that's wonderful. But I got introduced to nursing education when I was a nurse manager and I just fell in love with teaching. And fell in love then with my teaching experience later on with leadership in academia.

Well, that's great. So this is all about nursing and I'm Dr. Joyce Bachelor. We're live on the BDM World Network in TuneIn Radio and it's time for us to take a short break.

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You're listening to all about nursing, live in the BBM Global Network and TuneIn Radio. I'm Dr. Joyce Bachelor, the host of the show. Before the break, I had introduced my two very distinguished guests, Dr.

Deb Zemmerman and Dr. Judy Beale, who have both begun to share a little bit about their careers, like how they decided to become nurses and a couple of highlights. Just before the break, Judy was sharing with us that she's now beginning to really enjoy her retirement and reflecting on her career and being able to get back to some basics by volunteering now in a neonatal ICU. I would imagine that seems like an awful lot of wonderful time that you can share, Judy.

It goes with a lot of what I hear a lot of nurses doing, which is really being interested in getting back. Is there anything else you'd like to share? Otherwise, I'll move on to Deb. I just want to say that I think one thing that I've learned over my many years is that to take opportunities that when they present, because I never ever thought I would want to teach.

I never thought I would want to get a doctorate. And I've learned to never say never over the years. And I realized when I was working as this nurse manager in Kiatrix that I was the only nurse on the unit that loved it when the students came. And that's what introduced me to teaching.

And once I got into teaching, I knew I had to get a doctorate. I knew I was destined for academic leadership and took opportunities that mentors had given me. So being open to opportunities and new endeavors is so critical. That's awesome.

Thank you for sharing that. How about you, Deb? Do you want to share a couple highlights, though, that you're most proud of in your career? Sure.

When I was a Chief Nursing Officer in New York, I was on the board of what was then called the New York Organization of Nurse Executives, and now the New York Organization of Nurse Leaders. And Barbara Zetel, who was then the Secretary over the board of nursing, asked me if I would facilitate the crafting and introduction of legislation which would require nurses to obtain a baccalaureate degree within five years of or ten years of entering practice. That has now become more commonly known as the BSN intent. At the time, I was absolutely a political novice.

And in fact, because I knew from such an early age, it was going to be a nurse, when everyone else was learning how a bill became a law, I didn't necessarily necessarily needed to know that and really had no clue that you had to really use two bills in each of the respective houses. And what I learned as part of that 14-year journey is that resiliency and the need to be involved in the role of nursing and being succinct in their message, and the willingness of politicians as well as the public to hear what nurses, what was important to nurses. And I also, during that 14-year journey, because the bill actually was just passed last year into legislation, and it was first introduced back in 2006, I think, is that if you don't succeed, how can you accomplish a goal if the avenue in which you are first moving towards does not look as if it will be successful? So my next opportunity, Justice Judy has kind of said, like, take advantage of the opportunities that come forward.

I was asked to sit on the magnet commission, and by then, Lincoln had published her research demonstrating the value of education. And what I was able to help introduce to the magnet commission, which then became a magnet standard, is the value of education and how magnet organizations needed to serve as role models and education truly mattered. And for me, learning how a bill became a law, how to take a concept or idea and move that forward, and how to, when you face obstacles, go around and create another pathway was something that was very important. And then to realize that maybe it wasn't all about the law anyway, and really nursing could change what educational standards really were about.

We really didn't necessarily even need a law is what I believed at one point and has truly become my passion and why I enjoy so much working with JUPL and as a member of the Board of Directors of the American Association of Nurse Leaders, my passion is really that synergy and partnership with our academic leaders and the American Association of Colleges of Nursing. And I think it's important that to point out again and reinforce what you were saying is the kind of progress we're seeing across the country, which I think for the public as a whole, to know that the commitment of nurses returning to school for the baccalaureate degree, if they've chosen a diploma or an associate degree program initially really has become the norm. And even here in the state of Texas, we're really excited because when we first started, we were in the 40 percentile and we're up into the really closer to 60 percentile. And then on top of a big state is a pretty big number that has really moved over time.

So, you know, thank you for your perseverance and your leadership on that, Deb. It's very exciting. I think it'd be great if you could also just share a little bit more about the current role you're in. What kind of responsibilities do you have as the chief nurse of the, because you're both the chief nurse and vice president of patient care services for your organization.

And what kind of responsibilities do you have in this role? I currently am the chief nursing officer for our health system and our health system. So I have about three hundred three thousand registered nurses and then a licensed assistant personnel and other support team members. So probably totaling somewhere around thirty five or four thousand employees in total.

Across the care continuum, we have two acute care facilities, a pediatric skilled nursing facility and see about a million patients a year in our ambulatory practices, which, you know, from a geographic perspective across the state of Virginia. So, no, I, I, my hope is that I set the standards and, you know, for professional practice. And our goal is really to raise up the health and wellness and nurses to really achieve their full potential in impacting the patients that we serve. That's awesome.

And we'll continue this conversation. That's time for us to take a break. We are coming live to you from the P.B. Global Network and Tune in radio for the All About Nursing Show.

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Just before the break, Deb's Interman was telling us a little bit more about her role as the Chief Nurse and Vice President of Patient Care Services for her big healthcare system in Virginia. I was struck when you said over a million people that you served, that went with your ambulatory and maybe you'd like to show a bit more about the responsibilities of the role and the kinds of things that you're working on. Well, as the, thank you, Joyce, as the largest of the professions, it's our obligation as nursing leaders and as nurses to really understand the needs of the population that we serve. The understanding of where our communities are with the social determinants of health and how can we as a largest profession truly impact the health of our communities.

What we recognize is that our traditional paths were sometimes siloed and we have gone through periods of nursing shortages and not necessarily having the specialties when we need them to serve the population. So the challenges that we face is that we are, for us in Virginia, a growing state, but across the United States, we're living longer with chronic illnesses. And we need to, as a profession, be able to cross the continuum of care, to partner better with our communities and our patients so that what we can do is really have an impact that truly matters. And sometimes we as nurses underestimate the impact that we have, even though year after year we're continually rated and ranked as the most trusted of all professions.

We're truly at a wonderful juncture and it really is wonderful to partner with Judy where we can look at where we are and then create a vision and then implement that vision for the future. Thank you so much for sharing that. So Judy, maybe you could show a bit more about the kind of work that you were involved in with after retiring with 35 years at Simmons University of Boston. That's a pretty impressive long time employment there.

So what kinds of things are you most proud of and what did you, what would you like to share? Sure. I started out after having received my doctorate from Boston University and having taught undergraduate clinical nursing there for five years. I went to Simmons after the birth of my seven child who's giving me my third grandchild next week.

Oh, congratulations. And very exciting. And I started off teaching part time because I really didn't smoke it. So I was a vote about nursing.

You can, you know, work part time full time and a variety of different roles. I started teaching graduate students how to do research. Again, I had many wonderful mentors who introduced me to professional association work, which I had had long and the opportunity to give back to the profession that I loved so much through philanthropy or through my time and many mentors who gave me opportunities. I remember one, a former boss said, I have a great opportunity for you.

Why don't you write the self study for accreditation? Well, I'm thinking great opportunity. She doesn't want to do this. But it was a great opportunity.

And it gave me the foray into academic administration. And I then eventually became a dean when I retired two and a half weeks ago. I was the dean at the principal for curriculum oversight accreditation standards maintaining the standards of education for over 3000 students and about 200 faculty at Simmons. And it was a very exciting time to be, as I agree with Deb, exciting time to be a nurse.

And I think when I look back on my legacy, the fact that I have influenced thousands of professionals through their education, their formative education. I'm very proud of my work at the American Association of Colleges of Nursing. And the work Deb and I have been doing around academic practice partnership really ensuring through my role as an educator that we are developing a highly educated workforce to prepare well-educated nurses for what's going to continue to be a part of the work that we have done. And I think that what's going to continue to be a shortage of nursing for many, many years.

And I work together with developing and fostering these academic practice partnerships across the country is so critical to achieving the goals of having a better educated workforce. Because educators can't do it alone. Practitioners can't do it alone. We really need to join forces together.

So it's been such a wonderful opportunity. Such false feelings, ascendants, and a true feeling of love and admiration for nurses and for the profession. And I feel very blessed to have had such a wonderful career and very blessed to have had you. And Joyce, you're on this committee with us too on the Divine's report.

So it's been a great journey. And one should you continue to do? And it's pretty impressive as I'm listening to you that while you were 35 years at Simmons University, you were doing a lot of very different sorts of things over that 35 years. And obviously needing to become innovative and change as the way we teach students continues to change simulation labs and things like that are so much more prevalent and commonplace today.

But we didn't have some of these kinds of technologies available to us when we were training years ago. So it's pretty exciting that you've been able to do so many different things in that capacity. You've mentioned the work that is going on between two major organizations. Maybe you could just say a little bit more about what the two major organizations are so that we can talk a little bit more about that in this segment, but also later in the show.

I can start. I just want to add that not only simulation, but online distance education. We have close to 2000 online students in the family nurse practitioner program. So, and the other trend that we see in the second degree second degree standard age.

So individuals who change their career trajectory and their life and decide to become a nurse and so the need to develop programs for them. As I said, I was President of the American Association of Colleges of Nursing, which is the voice of academic nursing for the country. We have over 800 members and I can continue this a little bit later if you can get to the entire story. Perfect.

So we are coming to you live from the BBM Goldwell Network Intune in Radio. This is all about nursing and Dr. Joyce Banchal, the host of the show, and we will continue this conversation. We come back.

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Joyce Bachelor, the host of the show, just prior to our break, Judy Beale. Dr. Beale was sharing with us a little bit about the changes that she saw over her 35 years in her role with Boston College. I thought it would be great if you could just talk a bit more.

We talked about the impact of online and simulation and you started to talk a bit about second degree students. So you could just give a little more about that, Judy. Sure, we're seeing a nursing education, a real trend of, and I think this really happened, started to pick up significantly post 9-11 where people thought that they really wanted to give back to society and to the world and a lot of career changers. I remember one young woman coming to me and saying, I was in the World Trade Center the day before 9-11 and I woke up the next morning and I said, and she said, I could have died.

I really wanted to be a nurse. I want to give back. And she was in her mid-term and we have programs now for those kinds of individuals who work. And we call them mid-career changers and they come to us with work experience, life experience, and they really are wonderful, wonderful candidates for nursing and really have advanced, helped us advance the profession in a significant way.

And Deb and I were just saying earlier that they say, are wonderful. You graduate to employ because of this life experience and work prior work experience. So another exciting trend we're seeing in nursing education. And the introduction to we had talked a little bit about the fact that you have a, you played a key role with the American College of Nursing and also working on innovative academic practice partnerships.

Maybe you could just share a little bit about what the American College of Nursing is about for our audience in general to better understand what the organization is responsible for. Sure. I have served on the board of the American Diversity and Apology for Nursing or AACN since about 2012 and I'm most recently with the President-Elect. It is the National Voice for Academic Nursing and its major goals are to establish quality standards for nursing education, including schools and implementing those standards, influence in the nursing profession to improve healthcare, promoting public support for professional nursing education research practice.

And we do so, as I said, we have a healthy health policy government relationship arm to the association. We use national consensus-based process to develop competencies for all levels of nursing curriculum. We do leadership development for faculty and for new dean. And it's a very vibrant association that started off in 1969 with 121 member institutions now have over 825.

And one of the things that we are doing in AACN is partnering with AOL. The DEB can tell you a little bit more about on this academic practice initiative, partnership initiative. Thank you so much. So, this is Deb, and I am really honored to serve on the board of the American Organization of Nurse Leaders.

I actually represent kind of the Mid-Atlantic region, Mid-Atlantic and Southern states, such as Virginia, West Virginia, North Carolina, Delaware, D.C., Maryland, and Kentucky. Our mission at AOL is to shape healthcare through innovative and expert nursing leadership. And our vision is through nursing leadership and one voice advancing health. We have five top priorities, and one of our most significant priorities, which really relates to my relationship with Judy, is to lead and influence the healthcare workforce and to partner with academic stakeholders so that we can be better able to predict and prepare nurses to practice and really help understand what are the emerging models of care that will be needed in the future so we can help prepare those nurses for future healthcare needs.

And what we want to be able to do is to be able to conduct research on our leadership and then to be able to help promote and support the elements of a healthy work environment as well as a healthy community. Our group, our partnership, has really been of a long standing. Would you say ten years, Judy? Well, when we started, the work started when I was doing my RWJ, Robert Wood Johnson, Executive Executive, and I brought the idea for this work to the AAC in board in 2012.

So, yes, you're right, almost eight years. Yeah, and the two organizations realized that together we're stronger, together we're able to better understand the needs of our community. The needs of our communities that we serve and how can we collaborate so that we can really create a workforce that we need for those that we serve. So, we have multi-telephone calls where we talk about this work and, you know, we have had a strategic last May.

We all gathered in Washington, D.C. and really developed a strategic plan and a call to action and what we are promoting. And first began at the national level and have now asked the state of academic nursing and academic practice leaders to come together to create opportunities for joint forums between the deans and nurse executives at the state level. First is really to discuss, to understand the needs of the states and the communities and then how ten nurses come together to better meet those needs.

I think what you all are talking about is very exciting and I am excited to be on the group with working with you all. And I know that we've been looking at the needs for nurses, looking at the potential of the impending nursing shortage, but also looking at the aging of our workforce, both on the practice and the academic side and how do you prepare people to teach in the future to practice in the future. So, it's very, very exciting. We'll share a bit more about that after the next break.

So, this is all about nursing. I'm your host, Dr. Joyce Bachelor. We're live on the BBM Global Network in Tune Radio and it's time for us to take a short break.

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Welcome back everyone. You're listening to all about nursing from the BBM Global Network and Tune Radio. I'm Dr. Joyce Bachelor, the host of the show.

And just before we took our break, we had a great description of the two major organizations that both Deb and Judy work with, the American College of Nursing and the American Organization of Nurse Leaders. Deb was describing the importance of the two organizations working together to really look at how we prepare nurses for the future. And so I thought it might be great since it'd be helpful for the audience to understand a little bit about the history about how these two organizations started to come together and realize that the need to work collectively was really an imperative. So maybe you could do that with us, Judy.

Sure, I can start. I just want to say before I start about the history, what I think is so wonderful now is that the American Organization of Nurse Leaders changed their name this year. It used to be the American Organization of Nursing Connectives, and it was predominantly nurse leaders from practice. And by changing the name now, we're really modeling academic practice partnerships because there's so many more academic missions who are members of this organization.

So kudos to you all Deb, for really practicing what we've been preaching for really since 2012. I had a great pleasure, we had a great advantages of being a faculty member. It's that every eight years you get to take a tobacco, which is basically taking a semester off. I spent it in Texas doing my, doing a Robert W.

Johnson and then subsequently got elected to the Board of A and we started moving this work forward on a national level. We had a steering committee, a task force to look at this between practice leaders and academic leaders and AONE and we're very involved in that. And then the work became more and more critical and more and more important to both academicians and practitioners. And we decided that we were going to become a steering committee.

And then more recently we have become an advisor to the past year, year and a half I think, correct. So that's what Deb and I co-chair the Academic Practice Partnership Advisory Committee. So Deb, maybe you could tell us a little bit about what the group has been working on and some major accomplishments. Sure.

You know, it is just a wonderful group of people who come together on a regular basis. And what the team wants to do or has a strive to do is really model at the national level. And like I mentioned earlier, really, you know, created what we call a call to action. The group, we had had two major conferences or symposiums or maybe even summit is probably a better word.

The first was held last October in Washington, D.C. And we brought together partners from academia and practice and asked them to share with 700 deans and chief nursing officers and nursing leaders about their partnership, how they interface with one another to promote innovation, how they advance the preparation of students and looked at the creation of new models of care, how they looked for and created opportunities for employing faculties and advancing practice for nurses and even joint appointments for many nurses who are in practice the opportunity as we advance the education of nurses and practice to continue to as teachers and wonderful for our students to really have nurses who are expert in current practice to be educators. So really creating models so that there was crossover of both faculty and clinicians who aren't practiced, you know, and how models, what do those models really look like? And looking at how can we advance research so that the practice of our nurses, the practice of our leaders are really based on the evidence and how do we take research and then translate that into practice so our nurses are using the latest evidence in their practice.

We discussed the role of nurse residency and graduate nurse fellowships and how to look at where there may be a prediction in workforce shortages and specialties and how can we collaborate to really ensure that there are nurses with that level of expertise for the future. And I'm going to give you an example. It is most nursing programs no longer have curriculum surrounding perioperative nurses. So what we have seen across the country is chief nursing officers are academic nurses and practice both practice and academia coming together and saying we have an aging population which will require more surgeries.

So how do we prepare this expertise and they've created residencies and internships and special practicums for nurses who may be interested in the specialty and then after they graduate that education continues into a formalized nurse residency and then they are then expert in that and it is preventing shortages where, you know, in different specialty same thing in ICU and in other areas. So that we had wonderful experts in October as part of the American Association of Colleges of Nurses National Conference share those partnerships. And then we replicated at the American Organization of Nurse Leaders Conference in San Diego a very similar type of experience where nurses in practice and academia shared their great collaboration and we made sure that we had nurses from smaller community and rural hostels share how they formed those relationships when they weren't as natural as big academic colleges and cities. So overall I think it was a wonderful opportunity and we've had a wonderful call to action to spread that across the United States.

Thank you so much Deb. This is all about nursing and your host Dr. Joyce Bachelor. We are live on the BBM Global Network Intune and Radio and we'll continue this conversation when we come back.

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I'm your host, Dr. Joyce Bachelor on All About Nursing and we're live on the Vegan Golden Network in Tune & Radio. And prior to our break, Dr. Deb Zimmerbin was doing a phenomenal job of describing the kind of work that the joint groups between American College of Nursing and the American Organization Nurse Leaders has been doing to look at academic practice partnerships.

It's very exciting to see the two organizations really working on extremely important goals. And so you had started to share some of the things that have been accomplished so far. Are there other goals that you would like to describe and maybe Judy, you could give us a little bit more about what's next. What do you guys hope to accomplish as we go forward?

Sure. Thanks for asking. I think Deb has done a great job talking about the campaign, the call to action for states and academic practice partners to really implement these best practices that we have identified, best practices of how to develop and sustain an academic practice partnership and to really think about expanding internationally. And this is why this is so important is that as we are facing a workforce shortage in nursing, so anybody who's thinking about going into nursing, this is a great time to do so because we are anticipating continuing shortages.

We need to really think about new models of care, new models of education, new rules of developing new new, I think just these programs, like the residencies, I think about in perioperative, not only nursing education, not really then preparing, preparing off of situations, but a huge number of nurses who are older nurses are going to be retiring. So how are we going to do this together? And bringing the brilliance of this committee together, the great idea to then so creative in our problem solving and so critical to the future of our profession. And I would say that there's some urgency here, correct me if I'm wrong, in terms of why this is so important, maybe you would like to share a bit more about that for our audience that's listening.

Maybe you could do that Deb. Yeah, the beauty of this is we are a profession that is four million strong and I follow the numbers of nursing like many follow the stock market reports. So what we're learning though is as a population that is living longer with chronic illnesses, we need more nurses. And just as Judy said earlier, it is a wonderful profession and the numbers who are choosing to move into nursing with background as bench sciences, engineers, professional athletes, social workers, it is absolutely amazing.

But the health and wellness of the United States really needs us to be forward thinking and realize that the status quo is no longer acceptable. It is really up to us to say with an aging population, we want to live well, we want to contribute, we want to be active and nurses have the best skill set to understand the public and the population create and partner with communities and academia and practice so that we can work collaboratively to raise up the health and wellness of those that we serve. It is an imperative, we need science research and together we can accomplish all of this. I think the two of you have just done a phenomenal job this evening.

I was just going to say towards the end of our show, the two of you have done a phenomenal job of really showing that nurses are really trying to make sure that we're preparing things for the future and the synergy between the two major organizations, very exciting to see. And I think to your point, Deb, the four million nurses really being aligned and helping impact is going to be something that we have to continue to push on. So thank you both for being on the show. You are listening to all about nursing life and the PVM Global Network and Tune In Radio.

I'm Dr. Joyce Batchler, the host of the show. I hope you'll tune in again next week. Thank you.

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