Ep16: Pain Management and Nurse Coaching- Megan Filoramo MSN, RN, FNP-BC, HWNC-BC, AP-PMN

Ep16: Pain Management and Nurse Coaching-Megan Filoramo MSN, RN, FNP-BC, HWNC-BC, AP-PMN Transcript

Nicole Vienneau  00:01

Welcome, everyone, to Integrative Nurse Coaches in ACTION! This is Nicole Vienneau, your host, and I’m also a Board-Certified Integrative Nurse Coach. And today we welcome Megan Filoramo, from New Jersey, who is a Board-Certified Nurse Coach and Nurse Practitioner. And she is also all the things — we’re talking CEO, founder, web designer, PR person, etc, etc. — from Nursing Beyond the Job. Welcome, Megan.

Megan Filoramo  00:34

Thank you so much for having me, I feel so accomplished after that intro.

Nicole Vienneau  00:40

You are accomplished! That’s why you’re here, so you can share all the amazing things you’re doing for your community through Nurse Coaching.

Megan Filoramo  00:49

Sounds great.

Nicole Vienneau  00:51

So, we always ask our guests to take a step back in time to tell us a little bit about why they became a Nurse.

Megan Filoramo  00:59

Okay, it’s not a super exciting story. I grew up knowing I would go to college and knowing that I would either be a Nurse or a teacher. I have a large family of teachers, but somehow, I decided on Nursing, and I went to Nursing school, got out of Nursing school, and started as a Nurse. So that’s — you know, I started on an ortho and surgical floor, like many of us do — and that’s kind of the history of my starting in Nursing.

I was in the hospital for five years, and then when my son was born, I actually went into pain management as a Nurse. And really, honestly, I think I did that not only because I really felt like pain management was an important part of Nursing, but it was also no weekends and no holidays.

So, I literally was looking for something where I could be home a little bit more on the regular. That’s what worked for me at that time. So, here I am, a lot of years later, still in pain management. I didn’t really expect to stay there forever, but I went on to get my Nurse Practitioner and I am now still working in pain management.

Nicole Vienneau  02:09

You knew that you wanted to be a Nurse.

Megan Filoramo  02:11

I did. I really think that I connected with doing something that involved a lot of people and a lot of interaction. And I come from a big family, so I think maybe that taking care of things and taking care of people — I’m at the older end of my family, so I think maybe that prompted that, I’m not really sure. But I’ve always felt that I enjoy doing stuff with people and for people.

Nicole Vienneau  02:40

That makes you the amazing Nurse that you are. So, what brought you into Nurse Coaching?

Megan Filoramo  02:45

So, that’s kind of a funny story, actually. Because, you know, I had my Nursing job and then I went back to school for my NP, and, you know, there’s a lot of growth and change in all of that, you know. And a couple years into that, I was just kind of getting frustrated. Just, kind of, in general.

I had some stuff going on in my own personal life. I had a really long commute which, interestingly, is still my same commute, which I don’t feel is long anymore. But I was really just, kind of, getting over it all.

And somebody introduced me to podcasts, of all things, and they’re like, “Oh, you should really listen to podcasts on the way to work. Like, it’s much more interesting than the radio.” And so, I did, I started listening to podcasts. And I really gravitated towards, like, the self-help, coaching kind of podcasts because I was struggling in my own life.

So, what I realized, I really was listening to predominantly coaching podcasts, how to coach, how to coach yourself, and I found the whole thing fascinating. It was like the missing piece, right? And I had two hours a day to be educated, every day, in the car. Through that, I then joined an online self-coaching program, and just for my own benefit, for my own personal health and healing.

I kind of felt like I was at a crossroads because I really was like, I want to be a coach. Like, this is amazing. But I was really struggling with this idea because I have my advanced degree in Nursing, and I was still paying my student loans at that point.

So, I had invested a lot in being a Nurse and being a Nurse Practitioner and I love that, but I really felt like this was a huge kind of missing… It was putting a structure around what I felt was kind of missing.

I was struggling with it because I’m like, I don’t know, is coaching legit? Like, you know, I was looking into it and there’s no overseeing body. Anybody can call themselves a coach and put it online and say they’re a coach and hang up a shingle, and I’m like, yeah, I want to be legit, right?

So, when I found out that there was Nurse Coaching, it was like I was handed the golden ticket. I’m like, wait, there’s structure and there’s Nurses that do this, and we can figure out, together, what the quality of this means. It was just phenomenal. And I was like, I’m all in.

And then I saw all of the cohorts were a week, in person, and I’m like, but I am in clinical practice, I can’t give up a week without big repercussions. And around that time, there were… I’m in cohort 28. Cohort 28, they had two weekends that they were doing. Intensive weekends instead of the week.

It was geared towards school Nurses, that’s who they were kind of trying to help out with that. And I was like, oh my God, this is perfect. But then I couldn’t afford it. So, I find something that worked, and then I couldn’t afford it.

And I was like, well, I took all my little coaching tools that I learned on my podcasts, and I coached myself into asking my employer to pay for it. So, I pitched it to my employer at the time, and I was like, you know, this is important for pain management patients, I really see how limiting beliefs can really impact everything we do. And miraculously, they gave me the okay.

They were going to cover the full amount and that was like two days before cohort 28 started. So, I got on the phone with Susan Luck and I’m like, “Is this for me? I’m not a school Nurse, can I still come?” Two days later, I was in Boston, joining group cohort 28.

So, it was amazing to me because all these things that I had realized that I had been doing for my own life, then I realized like, oh, wait, I can apply this to work. It was really like the perfect blending of it. It was instantaneously amazing, the difference that it made in my clinical practice.

So, I know I’m kind of jumping right into that, but I tried to take some of these little tidbits and these little things that I was learning and bringing them right into my day-to-day Nursing practice, which is interesting, because, you know, I see a new… I see patients every 15 minutes.

And in that 15 minutes, you know, you’re diagnosing new problems, I was managing their medications, I was setting them up for different procedures, or, you know, different referrals, we were talking about their cat that was dying. I mean, all of the things in 15 minutes.

And I still had to somehow figure out how to kind of put some of these tools in place. I felt like I was doing the speed dating of coaching, right? Like, you have 15 minutes, go! And I would just throw things in there and try and kind of help them question the things that they were just assuming to be true.

It’s amazing the change that has made, and then fast forward to COVID, and we went all remote. I’m certainly not complaining about it, I feel tremendously blessed that I was able to maintain my practice and not be exposed. And I have great respect for all of the Nurses who are at the bedside.

But what I found is that my patients, who I was dealing with now online, were tremendously isolated and all of their support systems were taken away. They didn’t have physical therapy, they didn’t have acupuncture, they didn’t have distraction with their family, they didn’t have anything except our little times on the computer.

And what came from that, miraculously, is that I was able to start a coaching group at work, online, with all of these people who, a year before, would never have shown up online. And now here we are a year later, we still meet every Wednesday.

I have a group of anywhere from three to eight patients at any given time and it’s just been great to see, kind of, just how they support each other, and how it’s been a great little petri dish for me to figure out what I’m doing, you know, and to do it in such a great environment.

I think I probably answered 25 questions that you didn’t ask, but that’s my little spiel about kind of how I ended up in coaching through podcasts and where it’s brought me now.

Nicole Vienneau  09:02

I love it! I love hearing all of this. I enjoyed how you called Nurse Coaching the golden ticket.

Megan Filoramo  09:10

Yeah.

Nicole Vienneau  09:11

And then your courage in realizing this is something you wanted to do. Nurse Coaching called to you so much, you knew you couldn’t afford it, didn’t have the time, but yet, that fell — the time piece fell into place — and then your courage in asking your employer, say, “Hey, this is what I want to do. Will you help me in achieving that goal?” And they say yes! And all those pieces fall into place and off you go to get your Nurse Coaching training.

And then as you’re learning, you start implementing all of the tools you’re learning into your practice and you’re seeing its effects. You’re seeing its effects. And then your resiliency and then realizing, okay, we can’t be in person anymore, but we’ve got to make it work online, and then just learning those things and making it work. I mean, you’re really just, you know, just showing up, you’re showing up! And it was so fun to hear your story because…

Megan Filoramo  10:08

Well, thank you!

Nicole Vienneau  10:09

Yeah, it’s very inspiring to hear.

Megan Filoramo  10:12

It’s funny when you say it, because hearing it back, which is half of what… that’s 90% of what Nurse Coaching is, right? Just hearing back what we just said. It’s funny because it really… it’s all about that, like that little snippet of how I did that is really what we try to help other people with, right?

Like, my thought was, I don’t have the money and if you left it there, then I would just not have the money, I wouldn’t have this certification, I wouldn’t have any of this.  But it’s the same thing that we see with our patients. Like, I don’t have the time, or I don’t have the knowledge, I don’t have the…

But all of that can be figured out if we just decide, okay, well, I’m going to figure out how to get the money or I’m going to figure out… And just reflecting it back, like, when you say that, what can come up for you.  It’s interesting, because before I asked for my employer to pay for it, I was listening to a coaching call, I wasn’t even getting coached, I was listening to a coaching call.

Somebody was talking about an expensive something and the coach said, “Well, did you ask somebody else to pay for it?” And it was like… mind blown, like, why don’t we just ask? I mean, worst case scenario, you’re exactly where you are right now, right? So, there’s really nothing to lose from it. And I think hearing things back like that can be so helpful, even if you’re not the one who’s being coached.

Nicole Vienneau  11:33

And that’s one piece of why we do this podcast, is to hear other people’s stories, to hear fellow Nurses and their journeys, and what they’re doing with Nurse Coaching. Because when you do hear it, you realize, oh, maybe that can open up for me, or maybe I can do that.

Or listening to fellow Nurse Coaches from the Integrative Nurse Coach Academy and International Nurse Coach Association, the graduates from this program, I am inspired. I’m like, let’s move on to the next opportunity!

Megan Filoramo  12:09

It makes you challenge the… like, hearing that somebody else has done it makes you challenge your assumption that it can’t be done. The assumption that you have to keep doing things the way you were doing it. It doesn’t even occur to you until you hear somebody else say, “Oh, I don’t do it that way.” You’re like, “Wait, what? Then maybe I don’t have to do it that way either.”

Nicole Vienneau  12:25

Exactly. Which then brings me to what you’re doing for your communities, specifically with Nursing Beyond the Job. Tell us a little bit about your practice in this business.

Megan Filoramo  12:38

So, this is funny, because I never really saw myself as a business owner, or a business starter, or an entrepreneur. You know, when we go into Nursing school, we know we’re going into a specific trade or, you know, it’s not business, you don’t… generally, people who pick Nursing as an 18-year-old, don’t think they’re picking business, right?

It just so happened, of course, that I was really trying to get this up and running, and I was thinking about starting a business after finishing the Nurse Coach training and when I was preparing for the exam and right before COVID hit.

And really, the pandemic gave me some time to build this and really kind of focus on what I wanted to do. Because I was… for a while, I was like, maybe I want to do pain management because I really see the limiting beliefs in pain patients, and I think probably anybody who’s worked with people in chronic pain know exactly what I’m talking about.

But when I thought about it a little bit more and I was looking at what was going around, I really saw that Nurses — there was a parallel between pain patients and Nurses, and the parallel was the suffering from the circumstance. If I’m picking somebody to serve, if I’m picking somebody that I feel will have the greatest impact in the world, that’s Nurses.

And so, I decided I really wanted to focus on helping Nurses get all the things that they want. And, you know, Nurses are really suffering because there are a lot of things going on right now. And always, right? There’s always been a lot of suffering, I think, that can come with Nursing.

But I think that comes from the thought of, we can’t take care of our patients 100% and take care of ourselves. It’s like a mutually exclusive belief that we have, and it’s just wrong. We can have both. We can take care of our patients and we can take care of ourselves. And we don’t have to suffer. And not to mean that it’s not going to be hard, because Nursing is a tough profession.

But I really decided that these are the people who need me the most. And this is the biggest impact I can have on patient care, if you can help the people who are taking care of patients. I just see so many Nurses who are looking for support.

If people want something above and beyond bedside Nursing, it should be from a place of anticipation and exploration and excitement, not burnout and fatigue and frustration.

So, I decided to really structure my business around helping Nurses and coaching Nurses into seeing, kind of, what their possibilities were, and how they can be a fantastic Nurse, and a fantastic mom, and a fantastic entrepreneur or athlete or whatever they want to be… a painter… you know, whatever it is, that one doesn’t have to sacrifice for the other. So, that’s kind of where I am with Nursing Beyond the Job, you know, I’m really focusing on that.

And what’s funny is then there’s teachers who are trying to come along for the ride, and you know, other people are like, “Wait, wait, I want that, too!” I know 2020 is year of the Nurse, I think now 2021 has to be a year of restoring the Nurse, you know, and building her back up. And just having it be something that not only that we can say with pride, but that we can say with enjoyment.

Nicole Vienneau  16:13

The whole concept that you can take care of a patient, as a Nurse, and you can take care of yourself, you can do both, you can do both of those things, that really speaks to me, and I know speaks to many of our listeners here. Because some of us are finding difficulty in that combination of caring for self, caring for patients, and so, do you have any tips and tools to help our listeners achieve that?

Megan Filoramo  16:43

Of course. The question is, can I smoodge them down? One of the things that I think can be very hard, and that a lot of Nurses struggle with, is giving good care, the idea of good care, right? And so, we get to work, and we have too many patients or they double booked us, or our medical assistants aren’t there, or the administration has decided you have to write your name in three languages on the whiteboard, or whatever.

You equate the frustrations with that with giving good care, right? You don’t have the supplies you need. And the truth is, is that we can give good care with the best tools we have, right?

If you’re looking at some clinic in Africa, where the Nurses are making things out of paper plates, you’re not going to be like, “Oh, they’re not giving good care,” you’ll be like, “Oh, look how creative they are.” Right? They’re doing the best they can with the tools they have. And I think part of it is to remember, we’re doing the best we can with the tools we have.

Because when you start to feel like you’re not doing a good job, and that somebody is preventing you from doing a good job, that’s where burnout begins. That’s where you really get to… because you have this… you’re working so hard, and you’re telling yourself it’s not enough. The highest level of care with the tools and situation you have is always good enough. So, I think that’s one tip.

The other thing that I always do, which has really helped me, is to just remember why I’m there, to really focus on what can I do for the patient right now? Or even what can I do for my co-worker? How can I show up in the way that I want to show up, regardless.

Because, again, then you’re building up yourself. When you come out of work and you’re like, “Wow, that was a terrible situation and a lot of things went wrong, but I showed up like a champ,” then you’re not spending the rest of the evening trying to recuperate, you know, your mental stability from all of that.

And I think the only other thing that I would say about that is to try and figure out how to approach whatever you’re doing from a place of love. Maybe compassion is a better word, some people like compassion better as a word. I think a lot of times we’re like, well, this situation is horrible, or I don’t want to be doing this or whatever.

And the truth is, is that if we approach something from a place of love, it’s not because necessarily the other person deserves love or the situation deserves love — which maybe it does, maybe it doesn’t — but it’s because we get the benefit of feeling that.

When you love something, you’re the one who benefits from feeling the love. What the other person experiences could be anything, right? We all know that things can be misconstrued to 100 different ways, right?

But I find that at work, at home, even when it comes to like, running to the store or like, okay, well I’m going to do this because I love what I’m getting from it, or I love the outcome, or I love to be the person who shows up and picks up the groceries. And it sounds a little higher level, a little woo-woo, but when all else fails, feeling loving always feels better than not.

Nicole Vienneau  19:56

Thank you for those incredible tips. Doing the best you can with the tools you have, remembering your why, and expressing that in the way you show up. And then approaching from love, or compassion.

Megan Filoramo  20:16

And I think, especially, self-compassion, right? Just knowing that you’re doing the best you can. You can’t do better than the best you can. You can wish you could do better than that, but it’s just not possible.

Nicole Vienneau  20:26

Thank you for that. So, in my introduction, I kind of played around with all of your titles in Nursing Beyond the Job, all the things that you’re really doing in your business.

Megan Filoramo  20:40

Oh, God, where do you start? Right, so I’m doing all the things. I am just so happy for the internet, right? There’s so… we can find out anything we need to. It’s just such an amazing tool. And so, basically, kind of like podcasts, I started out with, well, how do you put together a lead magnet? How do you build a website?

How do you… And I just have kind of approached this the same way I approach school, like, oh, this is the next thing I’m learning. You know, you learn about the endocrine system, you learn about lead magnets. You learn about, you know, the cardiac system, you learn about QuickBooks, or how to do accounting, or how to get an LLC.

This is where it’s been a little tricky, to go back to being a beginner, right? I haven’t been a beginner in something in a long time. It’s much more comfortable to not be a beginner. But there’s some satisfaction with it, right? Like, as you learn these new things, it’s like, so overwhelming at first, and then you think, oh, well, it’s just… I can watch the video again. It’s fine.

Like, I’ll figure this out, and I’ll mess up some stuff along the way, and maybe I’ll misspell my name on the website when I first put it up, but you know, it’s fine. It’s all good. And, you know, just kind of having fun with it has been key for me. But it’s like one of those things that they say, you don’t know what you don’t know, right? And then as you learn a little bit, you’re like, oh, I didn’t even know I needed to know that.

And just finding the resources. There’s so many free resources out there. I’ve tapped into the Small Business Development Center, which is a federal program. So, everybody could look it up in their states. It’s free business counseling for small businesses.

And I literally sat with somebody who walked me through registering my business, and I sat with a lawyer who talked to me, and all of it was free. And I’ve been part of educational things through them and just networking with them. And it’s been a fun journey of learning how to do all this stuff.

And, you know, back to the self-compassion, you just got to kind of laugh it off when stuff goes horrendously wrong, and you think it’s the end of the world. And then you show up the next day and you’re like, okay, well, I can spell my name right today, you know, and we’ll take it from there.

Nicole Vienneau  23:09

Love it. Yes. So, how did you spell your name? Now that everybody wants to know.

Megan Filoramo  23:15

It was a typo. So, it came out as Megna instead of Megan. So, like, I sound so exotic. Megna.

Nicole Vienneau  23:25

I almost want you to write a blog on that one.

Megan Filoramo  23:27

Right? Right? Listen, every week I got to come up with something new, so that could definitely fit in there.

Nicole Vienneau  23:33

Okay, Megan… I mean Megna… I mean Megan (laughter)… how can people find you or work with you?

Megan Filoramo  23:41

So, I have a website: nursingbeyondthejob.com. If you put in nursingbeyondthejob.com/guide, you will get emailed my free guide: Three Steps to Love the Job You’re in and Come Home with Energy to Spare. And it’s just a little workbook of a tool that you can learn that can really just kind of help you get through your day. Because, you know, I don’t want everybody to have to try and escape their lives. We want to build a life that we don’t want to escape, right? And so, nursingbeyondthejob.com/guide will get you that.

I’m on Facebook, on Nursing Beyond the Job. I’m on Instagram, Nursing Beyond the Job. It’s a trend. I’m going with that with all of them. And then on LinkedIn, I’m as Megan Filoramo. So, any of those ways.

I do have a weekly newsletter, I have a weekly blog, and then, actually, currently launching my program: Six Weeks to Love the Job You Can’t Afford to Leave. So, that is, you know, I really, really want to support all the Nurses in the job that they’re doing now.

Not everybody has the flexibility to just jump off to another job. But we don’t have to suffer with where we’re at. So, there’s lots of places to find me. Just keep putting in Nursing Beyond the Job and you’ll find me somewhere.

Nicole Vienneau  25:01

There you go. That’s a good way to think about it. We will for sure be putting all of your details into our show notes so people can find you easily. But I will really look forward to hearing about the six-week program you’re doing to support fellow Nurses in the job that they’re in.

Well, thank you so much for being on Integrative Nurse Coaches in ACTION! You are certainly actioning all of the things you’ve been learning throughout your life, so we thank you for that, Megan.

Megan Filoramo  25:32

Thank you so much. I really appreciate being here.