75: Evidence-Based Practice and Nurse Coaching- Jill Arzouman DNP, RN, ACNS, BC, CMSRN, NC-BC, RYT-200

75: Evidence-Based Practice and Nurse Coaching- Jill Arzouman DNP, RN, ACNS, BC, CMSRN, NC-BC, RYT-200 Transcript

Nicole Vienneau  00:00

Welcome, everyone, to the Integrative Nurse Coaches in ACTION! podcast. My name is Nicole Vienneau. I am a Board Certified Integrative Nurse Coach and your host, and I’m excited because I’m getting to speak with Dr. Jill Arzouman. 

She’s the System Director of Evidence-Based Practice and Implementation Science of a large healthcare system. She’s also a Board Certified Integrative Nurse Coach. And I thought it would be amazing to have her on the podcast, one, because she’s an incredible human and an amazing person and full of such wisdom. 

But I also thought it would be really interesting for us to hear how different Nurses are using their Nurse Coaching skills within different areas of practice, and I think this is very valuable information for all of us to hear. So we welcome Jill.

Jill Arzouman  00:57

Thank you so much, Nicole. I’m happy to be here, happy you asked me. 

Nicole Vienneau  01:00

Yes, and I’m excited to chat with you, because I know it’s going to be an exciting conversation. So we’d love to take a trip down history lane and just understand a little bit about your history, especially why you decided to become a Nurse.

Jill Arzouman  01:17

Well, that’s very interesting question. I’ve listened to a few of the podcasts, and I love everyone’s stories. I was not going to be a Nurse. I wanted to be— I thought I want to be a medical technologist and work in a lab. And in my undergrad program, I took a class called Introduction to Medical Technology. 

At the end of that class, my professor said, you don’t want to do this. You’re much more of a people person, you’d be very unhappy in a lab. And I’m like, who me? So looked at medical school, looked at PA school, and my best friend was going to Nursing school at University of Iowa, where I went to undergrad. 

And I just thought, you know, I think this might be the calling for me. And so I started my journey many years ago. I tell people I’ve been a Nurse for 150 years, and Nursing has been the best career ever. And I tell people this all the time, there’s always something or a direction in Nursing that will fit with your professional and your personal and your family goals. 

And that has been true for me for many, many years. So I stepped on the Nursing track and completed my BSN, and then I went back to school for a couple years where I received my master’s degree. And then I was working clinical at the bedside. Became a clinical Nurse specialist. 

And my background has always been med surg, surgery oncology. I dabbled in the ICU. I don’t like patients on ventilators. I like to talk to patients. I like to teach them. I don’t like to spew them. And so med surg has always kind of been my home. And became a clinical Nurse specialist, and then did a little bit of work when we went to the east coast, in administration. 

I was a Nurse manager for a while, learned so much, and I have such a healthy respect for everyone in that role, and realized it was not the role for me. And went back to my clinical Nurse specialist role. We moved out to— I currently live in Arizona— moved out here and thought I was going to be a stay at home mom, and decided that I was… I’d been a Nurse much longer than I had been a mother, and I needed that piece of me back. 

So I worked part time for many years and as a clinical Nurse specialist, once again, my passion, working with direct care Nurse at the bedside. I’m at a University Medical Center. I’m attending physicians and residents and patients, and just absolutely loved that. Went back and got my doctoral degree, once again, as a clinical Nurse specialist, and was looking for something a little bit different. 

And I think, as many of you know, the pandemic hit all of us, whether you were working at the bedside, whether you were working in administration, whether you were retired and you wanted to go back and help. I mean, it just impacted us in so many different ways. 

And during that time, I was doing my job, I was given a couple of roles and responsibilities I didn’t particularly want to do, and I was getting very, very burned out. And that was around the time that a Nurse who used to report to me had left the organization, and she had gotten her Nurse Coaching certification, and I thought, let me talk to her. 

And so I talked to her, what she was doing and how she was working with people, still working with Nurses and connecting with them. I thought, this is probably what I might want to do. So I ended up taking the INCA course, part one and part two. And thought, this will be great. 

So I was really… I could really feel that burnout creeping up as time went on, I was doing some tasks and projects I wasn’t really passionate about. And also, at the same time, got my yoga certifications, to teach yoga, be a Nurse Coach. But the question is, as some of you may know, you try to make these decisions about when to change, when to… you’re so embedded in your day to day structure. 

And you think, I’m a Nurse, I’m tough. I can just do this. And that other stuff over there is a little bit scary. Starting my own business is a little scary. But I had all the content. I had all the Nurse Coaching skills that I had learned and needed to work on. I had the yoga experience. 

But it was just that fear of what am I going to do next? And it got to the point where the work that I was doing was really affecting my mental and my physical health. When you come home from work as a seasoned Nurse, I call myself seasoned, and you’re standing in your kitchen and screaming at the top of your lungs that I just can’t do this anymore. 

I just can’t. I knew it was time for a change. So I was making the preparations to start my Coaching business, and this other opportunity came up at a different organization as a System Director for Evidence Based Practice and Implementation Science, and that is something I’ve been passionate about for many, many years. So I thought, well, let me just see. So I applied and ended up getting the position. 

And I’ve been at this new organization for a little over a year, so I thought, okay, I have all my Coaching skills, I’m going to do that on the back burner, along with yoga. I’m going to dive into this new role as EBP and Implementation Science, and see how I can incorporate all these tools I learned from Nurse Coaching into my current job, and I think I really have been able to do that.

Nicole Vienneau  06:27

What a past you have. And I think that advice long ago from your medical technology teacher, saying you won’t be happy in a lab, was right.

Jill Arzouman  06:42

Very much so. Yeah, me and a microscope would not have been a good fit after a few years, I’ve definitely realized that.

Nicole Vienneau  06:50

Well, we’re so happy that you decided to become a Nurse, and then had this most incredible path of all these different experiences alongside your family life too, and recognizing when it was time to pull back and go to part time. 

And then, you know, coming into these roles, and I really appreciate how you were speaking about, you know, the times in our Nursing careers, or any career, where we are voluntold that we’ll do extra jobs, and sometimes those roles and jobs are things that we don’t like, don’t necessarily want to do, I think were the words that you used. 

And how that can take a toll on us in our spirituality and our wellbeing, health, mental and physical, as you expressed, you know. And I’m interested to know a little bit more about that in your journey, not necessarily the roles that you took, but really how that transpired, and some of the signs and symptoms that you noticed in yourself related to all of that, and how you recognize that was going on for you.

Jill Arzouman  08:02

Well, as Nurses, we put our heads down, we grin and bear it. And, you know, and I think that throughout my career in healthcare, so much has changed. There’s always that, well, the Nurses can do it, the Nurses can do it, and at a certain point in time, the Nurses just can’t do it anymore. 

And it was the dread— I don’t know how new the term is, I just heard it recently from one of my sons; the Sunday scaries. It’s like, I have to go back to work tomorrow, and I don’t want to do this. Or the week I was working, Monday through Friday, so I didn’t have shift work, but Friday would come, I’d be so exhausted. 

I couldn’t do anything. Monday morning, driving into work going, oh my gosh. Or if I was on a Zoom meeting, thinking, why am I here? What am I doing? What is my purpose? And I’ve always found such a great purpose in Nursing. To feel like I was losing that was very… it was scary. 

And I’m a big… have always been a big health and wellness proponent as far as exercise, weightlifting, running, walking, trying to eat healthy, those types of things. And you just feel like you’re run down. You have no energy. I had friends and family members saying you don’t… you’re not smiling anymore. You’ve got this constant frown on your face. 

And I was like, no I don’t. Like, well, actually you do. And noticing I didn’t have time for family and friends, mostly friends, I mean, family, they’re there, but I didn’t want to connect with people. All I wanted to do was get the work done and just go home and crash. And it was feelings of anxiety, chest palpitations. 

I think the biggest thing was just the incredible fatigue. And it’s like, this is not healthy. It’s not okay. And also, I saw it myself, but I also, as I was doing the Coaching course at the same time, I was noticing it in other Nurses I was seeing in the hospital, you could just see it written on their faces. 

You’d walk into the emergency room and they were just flat. And since I was in a position where I wasn’t… I didn’t have any direct reports, people would tell me all kinds of things. Come in my office, eat chocolate and tell me what’s going on. And I could just see that everyone was so stressed out. 

Then all of a sudden, you see it in yourself, you’re like, oh my gosh, I really, I really do have to make a change. This is really not okay. It’s kind of like, I don’t know if I necessarily hit rock bottom, maybe I did, but all of a sudden, you realize this just can’t happen. Light goes off. It’s like, I gotta do something. 

It’s up to me to change. And you think about that as a Nurse, we have all these skills, we help others, but how do we help ourselves? And that’s one of the things in the Nursing code of ethics. Is it provision five or seven? I used to know it, but it’s we have to take care of ourselves— five, it’s five— in order to take care of others. I mean, if we don’t do that, then we’re not living up to our code of ethics as Nurses.

Nicole Vienneau  10:59

Yeah, yeah. And still, we can fall into those patterns of, you know, just doing the the day to day, like just barely making it through the day. Because, one, it was a job that maybe we once truly loved. And then things change and adjust over time. 

And we’re seeing, we see that today, we see that in the past, the systems are adjusting and changing, and more responsibilities are being put onto Nurses. And you know, the ease of Nursing has shifted to require a lot more effort. Yeah, and so you decided to make the change. Now it took you a little bit of time to do that, sounds like.

Jill Arzouman  11:41

Well, yes, their interview process was quite slow. It was a nine month interview process. And then I was actually… actually it was six months. But then the stick-to-it person, I was still finishing this project. So they wanted me to start, like in January. I said, it’s gotta be March, because I have to finish this project. 

And my husband said, seriously, go. No, I do, but I do. And in retrospect, I saw there was an end in sight, so it was okay to stick it out and do that, but it did take a little bit of time. But in the meantime, I was still doing some Nurse Coaching, just like one client at a time. 

And I think that was around the time that we had started our community Nurse Coaching event, the Tranquil Tuesdays for Nurses, and so I had that piece to hang on to. So there were some other pieces I was doing that were helpful. And at the same time I was also started… I didn’t want to be tied down to one place to teach yoga in a studio, so I started doing virtual yoga online on Zoom. 

That’s one of the enduring things we’ve done now for I think it’s been almost three years. We have family zoom yoga. So we have my family from the West Coast to the East Coast. We all get together at five o’clock Arizona time on Wednesdays, and we do yoga. I lead them in yoga. So there’s some things I was doing in the interim while this was all getting put into place.

Nicole Vienneau  13:05

Yeah, so you were finding some peace and some, I guess, more avenues that were really speaking to your heart and bringing you joy in order to get to the finish line, so to speak, of that project that you were working on.

Jill Arzouman  13:19

Correct. And I knew that… once I knew there was an end in sight, then it was like, okay, now I can do this, and I’ll owe it to my current colleagues to finish this off and not hand them off something unfinished. And I felt better in my heart about that in the long run. We had a successful adventure, and then it was off my to do list.

Nicole Vienneau  13:38

Yeah, yeah, off your to do list. Yes, off the to do list, and then moving on to new adventures. Okay, so now you’re in your new role, and you have been in the new role for nine months I think you said. 

Jill Arzouman  13:55

A little over a year, over a year. 

Nicole Vienneau  13:56

Sorry, a little over a year. System Director of Evidence-Based Practice and Implementation Science. Okay, so tell us a little bit about this role.

Jill Arzouman  14:06

Well, I don’t know… you know, depending when you graduated from Nursing school, everyone has a different understanding of what evidence-based practice is. My undergraduate program— it wasn’t a topic. My master’s program— it wasn’t a topic. 

It wasn’t till I did my DMP that I really learned a lot about it. And evidence based practice is where we close that no-do gap. So it typically takes anywhere from 17 to 15 years to get research translated into practice, which is just really unacceptable in this day and age. 

And so evidence-based practice uses very set frameworks, and there’s a number of different frameworks, they’re all very similar, to take that research and translate into practice at the bedside. And I had been doing this for a long time through my work, through my national organization, and some volunteer work I’ve done with the Helene Fuld Center for Evidence-Based Practice. 

And it’s something that I really enjoy, because as a Nurse, when I was working clinically, and when I was working with Nurses at bedside as a clinical Nurse specialist, if there’s something that isn’t going right, like you’re not getting the patient outcomes you want, or you’re seeing things that just don’t make sense, rather than complain about it and say, oh, woe is me, we’re doing these things we shouldn’t be doing, or this isn’t working. 

How can we empower Nurses from… and not just Nurses, but the bedside all the way to the C suite, on how to have the tools to change, practice and make it better for our patients. And that we’re doing… that we’re living up to our standard as Nurses to provide the best possible care for our patients. 

So in this role, I am putting structures and processes in place to embed evidence based practice throughout the organization. We have— it’s big— 144 hospitals in 24 states, and we keep growing. So doing it in bits and pieces. But as I see that as it relates to wellness and Nurse Coaching, I am helping Nurses at the bedside and providing them with tools and expertise to change their practice. 

Make a difference in the things they do every single day. So let’s just… I’m going to keep it really simple. Let’s just say you had high catheter associated urinary tract infections on your unit. Well, there are very definite evidence based practice protocols that can be put into place, if you’re not already doing them, that will reduce that catheter associated track urinary infection, and that’s how we should be practicing. 

Same thing if your central line bloodstream infections are high. There’s evidence based practices that be put into place. And those are some of the basic ones. But there’s other things too that are out there. It’s all not patient care, some of it’s the practice environment. And maybe there’s best practices for how to create a better work environment. 

You know, the American Association of Critical Care Nurses has their healthy standards, healthy practice environment standards. Those are things that can be put into place. And so it’s teaching Nurses to go out, search the literature, find the evidence, appraise it— because not everything that’s published is good— but pick up the stuff that’s good, synthesize it and make recommendations to an organization. 

So for example, we just put together an initiative on danger to self and others from a patient standpoint, and so we went out and looked for the evidence about what type of practices should be put into place to help protect. Yes, you want the patients protected, but what about our Nursing staff? 

What about our other clinical staff? So there are best practices that are out there that are research based, that we could compile, put together and add that into the policy to make a safer work environment for our Nurses. So I was part of that work. 

So I think that’s really, really important. And so giving Nurses the opportunity to change practice at the bedside. And then there’s the other piece of that, which the author, let’s say, is Ashton, wrote an article in 2018 and they entitled it the acronym of GROSS: Getting Rid of Stupid Stuff. 

Nicole Vienneau  18:07

Perfect!

Jill Arzouman  18:07

There are things that we are doing in our practice environment that are not evidence based. We should not be doing them. We don’t have the time, we don’t have the energy, we don’t have the bandwidth to do it. And there’s some really simple examples of that. So back in the day, yes, I was a Nurse before there were cell phones. 

And when cell phones first came out, there was a complete ban on cell phones in the ICU. You could not bring a cell phone into the ICU, because you’re going to do something with those monitors. That’s been shown not to be effective. You, Nicole, were an ICU Nurse. We used to restrict visiting hours. 

We could not let those patients’ families in there. They’d stand outside and call once an hour. Can I come in for two minutes? Well, maybe, maybe not. That has been… that myth has been debunked by science. We need families at the bedside. I mean, there’s times when they shouldn’t be there, but more often than not they can be very helpful. 

Something as simple as auscultation for feeding tube placement. You know, we put that syringe on the end, we inject the air. Oh, I hear a bubble, it’s probably a place. No, evidence has shown the gold standard is a radiographic verification of the correct placement of that tube. So all these things have put into place by science. 

And then getting rid of things that we don’t need to do, because we have plenty to do as Nurses. So that’s one thing. And then, I think, because I touch so many different people and so many organizations, it’s always talking that one-on-one about modeling, you know, great healthcare practices, and self-care, and self-care too. 

I happen… I’m fortunate to partner with a PhD prepared Nurse whose whole body of research is wellness. It was in Nursing, and she’s done a lot of work on burnout and wellness. She’s done some of the system work for the initiatives we’re doing around that, and so she’s just been a great partner to work with. So we’ll bring all that information when we talk to Nurse residents. 

If I’m coming to present a topic on EBP, I’ll take the first 10 minutes and say, hey, how’s it going? You know, how are you doing? What’s going well? What’s not going well? I don’t control your schedule. I don’t control your evaluation. How’s it really going? 

Because those first six months, year, are just so critical to helping our new Nurses stay engaged and not feeling overwhelmed. If we, as seasoned Nurses, are feeling overwhelmed, imagine what our newer Nurses are feeling coming into this complete, everyday, constant change.

Nicole Vienneau  20:35

Yes, I’m witness to those new Nurses, our amazing, cherished, new Nurses coming into the Nursing world and how much support and love and mentorship we can bring as seasoned Nurses to that space. Yeah, yeah, to support and love them. Okay, so it sounds like you are having many roles in this position.

Jill Arzouman  20:59

Oh, it’s all every day. So, well, I have certain projects that I’m working on, things that I do, but it’s a lot of different things, and I get pulled into a lot of different things, you know, policies, looking for evidence, de-implementation. 

One of my big projects I’m working on, I think people will find this interesting, is that the evidence is out there and has shown since 2012, 2013, that using incentive spirometer post op, for most patients, for most patients, not all, but for most, is no more effective than coughing, deep breathing and ambulating. 

So I’ve been working on… and you think, as Nurses, how much time do we spend going into a room, teaching a patient, if you work in the med surg, or ICU, or post op unit, teaching them how to use an incentive spirometer, and then it sits in the nightstand, and like I just spent how much time, they’re not using it. So that’s one of my GROSS, getting rid of stupid stuff projects. 

But it changes from day to day, and I just get pulled in different ways, whether it’s talking to new grads or even our rising leaders. I’ve talked to rising leaders about health and wellness and importance of that. So it’s a little bit of everything.

Nicole Vienneau  20:59

And what do you feel yourself being drawn to the most?

Jill Arzouman  22:13

Connecting with Nurses on their level, and then working with them to determine what’s going to make… what’s going to make them tick, what’s going to keep them in Nursing for the long haul? Maybe that’s a little bit selfish, because someday I might need a hospital bed, and I want really great Nurses taking care of me or my family member. 

But Nursing has been such a rewarding career, and the landscape has changed so much, so how can I… I think that’s my duty, to share my expertise and ask them, what do they need to keep them in Nursing for the long haul? How can we keep them engaged at the bedside? 

Everyone may not want to be involved in evidence based practice. Everyone doesn’t want to grow up to be a Nurse manager, but what can we do with them, one-on-one and just listening? I think it’s just that, the simple task of listening. We certainly learn so, so well, that… the right term, I don’t know… how to do that in our Nurse Coaching courses, to listen to people and let them speak from their heart. 

And then obviously you can summarize and reflect back and things like that. But oftentimes, I think the Nurses just feel either right or wrong, they aren’t listened to. So I provide that that forum for listening to people, whether it’s in a meeting or after a meeting, or we chat via email, things like that, and talk not about their day to day practice, but what are your dreams for the future? 

Do you want to go back to school? Great. You know, do you not? That’s okay too. It’s got to be what fits for you and your personal life. Not everyone has to go back and get an advanced degree.

Nicole Vienneau  23:44

So when you look at yourself and the way you practice today, and not that I like to say compare, but I want to say compare, comparing yourself to the time when you were practicing before you learned the Nurse Coaching tools and were immersed in Nurse Coaching, what would you say the biggest difference is? Or the differences are related to both of those separate times?

Jill Arzouman  24:13

I think a lot of it is setting boundaries and not being afraid to speak up and say, I need help, even if it’s like I need help getting this patient out of bed, or I need… can you just pass my meds for the next… these two patients while I go just take a break. Knowing you have to take breaks, knowing that, especially when it comes to clinicals. 

So for clinical care, there’s two, or back in my day, there were three shifts, but there’s a next shift that you can hand the care off to. So we shouldn’t… There are times when you have to stay over time, but there’s an end and there has to be a time where you say, you know, I’ve handed this off. I’ve done the best that I can in the 8 to 12 hours given to me. 

And I’m handing it off to the next shift. Same way, now, I went in an administrative role, I would come home from work, I have dinner, and I turn on my computer and work a few more hours. I don’t do that anymore. There are times where that might be warranted, if there’s something… I don’t know, there’s not too many evidence based practice crises. Let’s put it that way. 

But there are times when I may have to do that, but it’s rare, or on the weekends, because it was getting to the point where people were emailing me and texting me on the weekends to do things. Like, no, this is my time. So setting boundaries. If there’s something that needed to be covered, there’s someone covering for me. 

And then making sure that the self care that I do, which is yoga, lifting, running, walking, that type of thing, or just being mindful and taking some quiet time, meditating, that that’s part of my routine and not something extra that I do. It’s not like, oh, that’s just the… that has to be part of the day, because I think Nursing is so demanding. 

I tell people… I have usually three or four Nursing students that I kind of mentor. Undergrad. Nursing is not for the faint of heart, and so you need to make sure you’re taking care of yourself for the long haul. 

So I’ve really… well I probably gave lip service to that in the past, or maybe I had some unhealthy practices where, you know, back in the days of eight hour shifts, you went down the street to the local bar with the whole crew and hung out, and that maybe was not, you know, sure, every once in a while, but if you find yourself doing it five nights a week, yeah, maybe not so healthy. 

So just really, instead of giving lip service to that,  really internalizing it, and making sure that it’s exactly what I am doing, and I’m, you know, fairly religious about that. And so that’s one of the things I really try to share with people. Set some boundaries, make sure there’s me time built in. And that’s not being selfish. That’s being really, really smart.

Nicole Vienneau  26:56

Yeah. So it sounds like you really became very aware of things that weren’t working for you before, and then implemented some… maybe some even evidence-based things into your life. 

Jill Arzouman  27:08

And you know, and sometimes I think that it really takes others, our family and our friends and people who  know us and love us to… them to point it out and say, wow, you know, are you doing okay? And that’s what we can do as Nurses and as healthcare professionals or as humans, ask other people, are you doing okay? 

Maybe they don’t want to share, but we can least offer that opportunity to listen. And I think that we all learn about listening skills in our Nursing programs, wherever we do it, but I think Nurse Coaching and that curriculum really gave us some very solid tools to listen thoughtfully and help people make decisions. 

We’re not directing them. They’re making their own decisions as we Coach them. But it’s just so fun to see people make those changes, and maybe their Nursing journey takes a different path, or they get back on the path they were on with just a little bit of things they’re doing for themselves, as far as self-care.

Nicole Vienneau  28:09

So good. Yeah, it’s so, so important. And yeah, learning different ways to listen and show up authentically for the people that we’re with.

Jill Arzouman  28:23

And also, I think, also as professionals, sometimes we need to take a step back and look and reflect ourselves. What are we doing? What’s working? What’s not working? I just got a message from a Nurse who works in AD and said, you know, I’m feeling burnt out. I’m really burnt out. 

I saw you have this group Nurse Coaching event on Tuesdays, and I really need to talk to Nurses. And it was canceled last month, and we’re doing it next month. This will be good. And she goes, but Nurses get Nurses. And I know that in my previous organization, we had talked about some Nurse Coaching things, and their philosophy was to put social workers and other people in place to do some of this work with our entire healthcare team. 

And I am a firm believer that— not to diminish social workers, they do such great work, and I know plenty— but when it comes to Nursing, what we do, unless you’ve been there, unless you’ve, you know, been in the trenches, we understand each other. And I think I know I’m more comfortable talking to a fellow Nurse, because they know what I’m talking about.

Nicole Vienneau  29:31

Yeah, yeah, absolutely. We understand each other. We get right to the meat of the subject. And don’t have to waste any time and energy, kind of explaining, oh yeah, this is a heparin drip, and this is what it does, yeah. Instead, I could just say those words and yes, a fellow Nurse understands, and yes, and not discrediting other healthcare professionals, because they also do fabulous work, yeah, yeah. So where do you see your future?

Jill Arzouman  29:59

Well, we just put together a five year strategic plan for evidence-based practice that will really— so at the national level, we provide support, but, you know, I’m not working in a facility anymore, which has its pros and cons. But for the proposal, we’re going to be getting more in the weeds, more education at the local facility level, partnering at different hospitals and different regions to get some of this work done. 

So I’ll have more one-on-one contact with Nurses. So once again, more opportunity to meet with Nurses. We don’t do a lot of traveling these days, post pandemic, like a lot… many organizations have realized we do some of the same work and save cost and stress too, but not having to do all this traveling. 

But so working in front of more Nurses, in front of more direct care Nurses, and meeting with them at their level and hearing what’s going on in their universe. So I’ve got that proposal. We’ll find out how much that gets funded, and how we’re going to roll it out, or how we have to tweak it if we don’t get all the funding. 

Because we all know hospitals have such tough budgets that that everything we want to do is going to get funded. But we think this… we have put very much into our proposal, how this is something that will give Nurses tools to help improve the care we give to patients and help them be engaged and hopefully more excited about the work they do, instead of just… 

I tell everyone that there’s so much more to Nursing besides punching in, passing meds, punching out, and passing out. There’s so much more to that. We have so much expertise and experience. So that’s the one thing. We’re going to be revamping some of the evidence-based practice pieces for the Nurse Residency Program, so I’m going to have more interface with them. 

And my colleague, my PhD colleague, and I will put in some more wellness pieces early on in the whole program, instead of six months in, because six months, they could be long gone by then. I’m looking at also spending this wellness and EBP through all levels, so not just direct care Nurses, but our middle management, our senior leaders, our executive leadership team. 

And then I also have been doing some things, kind of bringing in the yoga piece, where a couple years ago we, for Nurses Week, we had one of the events was a 30 minute online yoga session. It was office yoga, but we had sequences all standing, because you certainly don’t want to get on the floor in your hospital, right? So we had it live. We also recorded it so you could do it later. 

So we did some yoga across the entire enterprise. I’ve led yoga for a couple of National Nursing conferences, which is really fun, because once again, you know, as Nurses, we go to a conference, and you get there and you have your first meeting at 7am you go all the way through to eight o’clock at night, and you learned a lot, but you’re absolutely exhausted. 

So we were able to— with the Academy of Medical Surgical Nursing past president, we were able to incorporate some yoga into those sessions. Get them to shorten the days, first of all, start the morning with morning yoga and a brisk walk, and then get into the conference, so we’re all refreshed, and once again, embedding those health and wellness practices into things we do. 

Even when we’re learning at a conference, we still need to take care of ourselves. Yes, it’s fun, but you know, 12 hours of educational sessions is a little bit much. So I can see me continuing to do that. And then I’d like to get more involved. Now that I’ve been in my role for a little over a year, I’d like to get to do some more things volunteering… or working… I’ll say volunteering. 

More Nurse Coaching in our local community, because there’s such a need. We have a… I say it’s a big small town, but there’s so many Nurses, and we all, one way, shape or form, are connected, or someone knows someone or someone. There’s such a great need here locally. That’s another opportunity to reach out with some Nurse Coaching skills. 

And I don’t have a lot of time to do a big Coaching practice. I have a full time job, even though I keep it within my 40-50, hours a week. But you know, Coaching, you know, one client at time, really keeps me connected with what’s happening in the daily Nursing world, and most of my… the majority of my clients are, or have been Nurses. 

Nicole Vienneau  34:15

So lots coming up in your future. Exciting. I love how you are remembering to incorporate all your movement practices into things that are maybe not normally used to having movement practices in. For example, conferences. 

Yes, yes. So in our last few moments here, I love to ask the question, and you can take a few moments to think about it and take a few breaths, but what is on your heart that you would like to share with our listeners? 

Jill Arzouman  34:57

Oh, this is the million dollar question. I’ve heard you ask this in other podcasts, and I should have been prepared.

Nicole Vienneau  35:04

Your heart’s gonna tell you. Your heart will tell you.

Jill Arzouman  35:06

It will. I just think that Nursing is such a noble profession. We are so honored to be able to be with people in time of need, and so I’m very honored to have had the privilege to become a Nurse, and feel very blessed the path that’s taken me to so many different things, from a staff Nurse to a clinical specialist educator. 

I’ve done so many different things. And I just think that it’s taking me this long, 150 years I like to tell people, to realize that taking care of me allows me to take care of my patients much better. And so if we can instill that knowledge in our newer Nurses and our seasoned Nurses, because it’s never too old to learn. 

We’re never too old to learn. I wasn’t too old to learn that too. And to all of our Nursing, you know, across the spectrum, whether you’re working from home or in quality, or in leadership or a clinic, it’s all Nursing care, and we have to take care of ourselves, and that’s just… 

and however you find a way to do that, and if you’re not doing it currently, dip your toes into maybe taking… maybe you take… you wash your hands for three minutes instead of one minute at the sink, and you just do some just mindfulness. I think that’s what our profession really needs, is take care of ourselves, and then just being kind to one another. 

You know, human kindness is so, so important. Reach out, ask people if they’re okay. Sometimes we just need to be asked. And that’s why I went into Nursing in the first place, is to take care of other people. But take care of ourselves, take care of others. There’s so much work, great work, to be done, and we need a solid Nursing force to do that. 

And I think we’re doing a better job of it. We’ve got a long ways to go, but there’s definitely great, great opportunities in the future. And the three Nurses I worked with last year who are just graduated in the past six months, future is very bright for Nursing. 

We have some amazing Nurses coming out there into the world. And we have some superior, intelligent, amazing, seasoned Nurses who have so much expertise to impart this new group, that, you know, there’s no place to go but up, it’s going to be great. Great partnership.

Nicole Vienneau  37:36

Yes, no place to go but up, yes. And we’re already doing such amazing work. I would love for us to be able to share the article that you were talking about, about GROSS: Getting Rid of Stupid Stuff. 

Jill Arzouman  37:50

Oh, I’ll send it to you. You can post. I’ll send you the PDF, and you can post it. Yeah, there’s plenty of things we do that are not based in evidence, and we shouldn’t be doing them. And de-implement— there’s a whole science behind de-implementation science, just like implementation science, it’s a new and evolving field. So it’s been kind of… it’s been really fun.

Nicole Vienneau  38:08

De-implementation. I heard you say that earlier, and I was like, oh gosh, that sounds like something we all need to learn a little bit more about too. Yeah. If you have any articles on that, we’d love to have a link to those too. 

Awesome. Well, thank you so much, Jill, for coming with us here and sharing your wisdom and talking about things related to evidence based practice and how Nurse Coaching aligns with that, and just sharing your passion for what you’re doing. 

Jill Arzouman  38:36

You’re very welcome. I think that my Nurse Coaching coursework has just added such a breadth and depth to the work that I do, that it was the right step at the right time. Plus, I’ve met so many amazing Nurse Coaches, which has made it even more fun.