Functional Nursing: Tools, Presence, and Hope for Modern Nurses- Thomas Sult MD, IFMCP and Elizabeth Sult BSN, RN, NC-BC

Functional Nursing: Tools, Presence, and Hope for Modern Nurses- Thomas Sult MD, IFMCP and Elizabeth Sult BSN, RN, NC-BC Transcript

Nicole Vienneau  00:00

Welcome, everyone, to the Integrative Nurse Coaches in ACTION! podcast. My name is Nicole Vienneau. I am your host, and I’m also a board-certified Integrative Nurse Coach. And today is an exciting day because we have two amazing guests that we get to learn from and be with on our podcast today. 

First, we have Elizabeth Sult, who is a recent alumni of the Integrative Nurse Coach Academy’s Integrative Nurse Coach Program, and just recently became board-certified as a Nurse coach, and she’s also a functional Nurse.

And we also have her husband and also co creator Tom Sult, who is a functional medicine practitioner and medical doctor and has been practicing functional medicine for over 30 years, far before it was even called functional medicine. 

And together, the two of them are the creators of our newest specialty course called Functional Nursing: A Functional Medicine Framework for Nurses. And this is a super exciting day, because we get to hear from them, the creators of this new course firsthand so we can get gain a real clear understanding of their process, their goals, their intention, their heart for this course. So we welcome Elizabeth and Tom.

So okay, we’d love to take a trip down history lane, and we know that sometimes history lane is a long lane, so we’ll ask you first, Elizabeth, can you share a little bit about why you even decided to become a Nurse?

Elizabeth Sult   01:45

Why I decided to become a Nurse was because my grandma was a Nurse. She was a dialysis Nurse, and on Sundays, they didn’t have any patients, so I would sometimes go in with her on Sundays while she set up for the week. 

And I, of course, adored my grandmother, loved her, and watching her be in that space, and just knowing how she was such a loving and caring person, I wanted to be like her. And so that’s really where it began for me, and it grew through my grandma as well. She was she started as an LPN.

It was an LPN for most of her Nursing career, and then when she was in her 50s, she went back to school to get her RN. And I would sit with her at the kitchen table. She was doing her postcards and studying for those hard tests, and in her mid to late 50s. And so I really would have to say it was because of my grandmother is planted that seed within me.

Nicole Vienneau   02:52

I love that I have such a strong connection with my grandmother too, and she was really influential in many of my decisions. So I love that our connection with that as well. And then, how did you discover functional Nursing?

Elizabeth Sult   03:07

So I discovered functional Nursing from my own journey through chronic illness. I was sick for about 10 years with these symptoms that I just didn’t know what they were. And I had all the tests, you know, I had echocardiograms. EKGs, you know, MRIs from my pain, and no one could really figure out what was wrong with me. I was healthy.

Everything was great, so I was sent on my way and but I wasn’t great. I wasn’t healthy. I was struggling day to day in normal tasks. And I guess that’s when I started to look at, why am I having these symptoms? So I didn’t even realize.

I didn’t know the word functional I didn’t know about functional medicine. I hadn’t heard of it. I hadn’t heard of Tom or that he was in functional medicine. So that’s kind of where it began for me. And then once, I started to figure out my why and really uncover those we talk about, you know, antecedents, mediators, triggers.

When I started to uncover those, I started to heal. And that’s where I fell in love with functional medicine. It really is a, you know, a yes, and it doesn’t replace conventional medicine. Conventional medicine is great, but it is definitely a needed complementary medicine. It really helped me to elevate my wellness to a point that what I was struggling with no longer flourished, and I could be me again.

So that’s really where I found out about functional medicine, and then started working with Tom in functional medicine, and then just seeing our patients come in. Sometimes they’ll come in, you know, using a cane or a wheelchair. 

And I’m not saying, you know, I’m not saying any words out there, but after months of going through, you know, their why? In the functional medicine approach, I see people heal from things that I would have never thought they could heal from.

Nicole Vienneau   05:07

Yeah, beautiful. And so as you were in your journey coming back to who you are, and healing and learning about functional medicine, and then along came Nurse coaching. So tell us how those two connected and how you decided to become a Nurse coach.

Elizabeth Sult   05:29

So when I found out about Nurse coaching, I was I was actually just ready to start a Nurse practitioner program, and I wasn’t quite feeling like that’s I wasn’t quite feeling in alignment with that choice right at that moment. 

And I was on social media one night, and that up came Inca, and I really just, I listened to I dived in, I started listening to the videos, and I really knew in my heart, like, Yes, this is where I want to go next. And so I signed up for the next cohort that started, like, within a few days. So it was really like perfect, divine timing. And then when I started diving into the program.

And the reason why it caught my eye is because instinctively, I already do a lot of those things, day to day, in the functional Nursing aspect, I sit, you know, with patients, and I listen to their stories, and I reflect back and it really I’m there to assist them in discovering their own healing path. 

And, you know, Nurse coaching just beautifully aligned with that so and I remember our first it was our first meeting, and Pat Melson was my instructor, and she said, Welcome home. And like, I just felt my heart explode, and like tears came down my face, because I knew, like I felt like, Yes, something about this, I know I’m home, and, yeah, so that’s kind of my journey and how it was really divine, you know, sequence of events, it’s just kind of unfolded perfectly.

Nicole Vienneau   07:14

Love that when that happens. Okay, now we’ll shift over to Tom. Tell us a little bit about your journey of becoming a physician.

Thomas Sult   07:30

I have dyslexia, and I can’t, on most days, spell my own name, so you might imagine that made school less than optimal. So I actually struggled a lot in school. Got the opportunity to do third grade twice. 

That was really fun, and when it came time, I did okay in college, you know, I had my GPAs were good enough, but didn’t get a US medical school interview at all. So went to I’d been working as a paramedic because I kind of saw that writing on the wall.

So I stayed as a paramedic. Then I went to acupuncture school, and then I was working in an emergency room, and one night, I just had an epiphany. And it’s like, you know, the trauma’s rolling in, and I’m calling the lab, I’m ordering the typo, I’m doing all the things, and then it’s like, these guys aren’t that smart. I can do this job. And I decided to go back to school and finish up.

And then again, didn’t get any interviews for the second time. So went to a school in Grenada, and was there during the US intervention. They call it there. And when the US invaded because of the Cuban influences there. That’s a whole different story of our whole entire broadcast.

But then I was there for two years, and I transferred to UCLA and Norman Cousins was there. He was, at that time, the Director of the Office of psychoneuroimmunology, which, of course, is the fancy way to say holistic medicine. 

And I just fell in love with him. He had written a book entitled Anatomy of an Illness, which is a book about him curing his own ankylosing spondylitis with laughter. He was just watching Laurel and Hardy movies.

And so anyway, I just fell in love with the guy, and he became a really important mentor to me, and I was the guy who ran around so, you know, medical schools are compartmentalized, and he had a budget of $0 so I had to sneak into the surgery office at night and do all the copying and stuff, because he couldn’t even afford to do copying. 

So I was that guy, and hung around with him for the two years I was at UCLA every second I had spare, which, of course, wasn’t a lot. And then I was working in an urgent care in Lake Tahoe, where we lived before we lived here in Minnesota or where I live, and a woman came in and said, I’m seeing a nutritionally oriented doctor. Her down in Sacramento. And I said, Oh, okay, well, stop, what’s a nutritionally oriented doctor?

And then it just came flooding back to me, you know, all the things I learned, I skipped apart. I lived with a Grenadian family who was very interested in maintaining indigenous culture, and they were very interested in shamanic kind of stuff, so they called them bush doctors there. 

And I thought that was like Australia and the Bush the Outback, but really it means, it means herb bushes, herbs. So anyway, I learned a lot about that by living with them and having these very strange people come over to the house and do all these very strange things. And then, you know, Norman Cousins and his work and acupuncture school and that work.

So all of that came flooding back to me, and I called this guy up named Kirk Hamilton, and he reminded me about people like Jonathan Wright up in Seattle and others, and plug me into the Institute for Functional or what was actually not the Institute at functional message at that point. 

It was called Health Comm, which is Jeff Bland’s original company. And I started getting these little cassette tapes. Remember those cassette tapes? I started getting the cassette tapes and listening to the cassette tapes and sort of translating the highfalutin Jeff Bland education by fire hose approach into clinical practice.

And then several years went by, and somehow I found myself being asked to take over Jeff Bland’s lectures at IFM, which, like, you know, was a non sequitum to my little brain thinking that I’m, you know, growing up dumb, right? I got dyslexia, can’t even get a good grade. 

So anyway, that’s sort of my journey, and I’ve been teaching for the Institute of functional medicine ever since, and now this opportunity to teach this course, which I am really excited about, and I guess that’s my story, and I’m sticking to it.

Nicole Vienneau   12:00

So you’ve had a long journey within holistic style medicine, and you know, just a lot of different pathways to consider as you’ve grown up…

Thomas Sult   12:15

Yeah, well, and in addition to a full, a full family medicine practice, including OB and C sections, and I used to run a 16 bed ICU, and, you know, all that kind of stuff. Used to float swans and all the sort of high tech stuff that doctors do, but not really my call. I mean, so I was a paramedic, right?

So I went to medical school thinking I was going to be an ER doc and, you know, intubate and do all that stuff that people do. But it turns out, once you’ve intubated a couple 100 people, it’s just not that exciting anymore. But sitting knee to knee with somebody who’s really suffering and realizing that there’s a new path for them is extremely exciting.

Nicole Vienneau   12:59

And so when do you feel that shift happened for you? Or do you have something in mind that was really like this? This is the pathway I want to go.

Thomas Sult   13:10

Yeah, well, at some point it’s well, it just No, it’s more gradual. But, you know, I think, frankly, it was that one of those very first patients who had sort of been failed by the system, right, people with any name, the chronic complex disease. 

I mean, if you’re in a car wreck, boy, you want to be in a level one trauma center, right? And they’re going to do a bang up job. Or if you’ve got some nameable diagnosis function, standard medicine can do a great job.

But if you have, if you fit between those cracks, or if you have one of the diseases where it’s just sort of so sad, too bad you know an autoimmune disease or something where you know, here’s what we’re going to do for you. 

We’re going to give you this shot, and it’s going to kill a portion of your immune system to make you feel better. Well, okay, that doesn’t sound like an optimal choice, but it, you know, it is a choice, and it does help people feel better. 

But there are ways to treat that don’t include killing a portion of your immune and once, I started to see those kinds of successes, like people were coming in with inflammatory bowel disease, and not only they were coming in on, you know, the typical drugs, plus the biologics, and we were weaning them off of everything to the point where they were just not on any drugs at all.

And I started thinking, Well, gosh, maybe this is really the path. I’m a slow learner. So it took a whole bunch of those cases to get me that.

Nicole Vienneau   14:39

I’m a pretty slow learner too, because it took me over almost over 20 years to figure out that I was more of a suited for holistic Nursing instead of intensive care Nursing. And yet we still need to go through all of these things as we all learn what’s best for us.

Thomas Sult   14:56

For me, I had to get past my own ego too, right? Because, I mean, I was running. ICU, I was a big, important guy, and, you know, I was saving lives and in a way that the community understood, in a way that my colleagues understood. 

And then I started doing functional medicine, and I kind of became the pariah, right, the guy who skipped the catechism and didn’t follow the right rules and all that kind of stuff. Took me a while to get my head around that was okay,

Nicole Vienneau   15:23

Yeah. So I have a burning question, and that is like, Okay, you each have your different pathways, and then somehow you have connected. And so I’d love to know how that worked, what happened?

Thomas Sult   15:42

Only good things for me.

Elizabeth Sult   15:43

So our paths have kind of crossed throughout the years. When I was a brand new Nurse, I worked in a small hospital near our community and he was one of the medical providers there, so I would do IV therapies in the hospital, we had a room designated for IV therapies that he would do, and it was called chelation therapy. 

And at that point, I had no idea what he was doing. I knew it was kind of different, and I never heard of it before.

Thomas Sult   16:13

Probably one of the only places in the country where we were doing chelation inside a hospital kind of, kind of kind of exciting, yeah, and other nutritional IVs as well.

Elizabeth Sult   16:25

So that was, I suppose, the first time our paths crossed, probably 25 years ago. And then I had my own journey through chronic illness. And I was, I did you know, 10 years of hospital Nursing, and then some years as a surgical Nurse, and then once I had my fourth child, I stayed home after that, and that’s when I those symptoms really started to plague me. 

They have been I had weird symptoms for over a decade, but that’s really when they started to get to me, and I stayed home for a few years, kind of bringing myself, you know, raising my youngest, the other three children. I had four children.

I had a husband that traveled a lot, so he was gone all the time, so I was really home alone with, you know, my four small children, not feeling well, trying to navigate all that. And that’s where I kind of found the functional medicine and my own healing began. 

And then I was like, I want to work in a functional medicine clinic. Like, when I go back to work, that’s what I want to do. So I googled functional medicine clinics near me, and then that’s how I found his clinic.

So I was like, I’m going to watch for a job opening. And I watched him, like, the next week he had an opening for I was called a hyperbaric technician, and I sent in an email, and I was like, Well, would you consider a registered Nurse, as you know, for that position? 

And his manager at the time was like, Yes, come on in. So I did an interview, and I actually, he had a position open up for his medical scribe. And I was like, Oh, this sounds really interesting, because then I can be in the room.

I can, you know, take the notes during the visit. It’s a great learning experience. So I ended up coming to the clinic as a medical scribe, so I took a huge pay cut, but I had been a stay at home mom, so for me, it wasn’t about going back to work for just for money. 

I wanted to go back and be a part of something that I believed in. And that’s and that’s kind of where our paths crossed again, yeah, and that was probably 10 years ago that I started working in a functional medicine clinic, so I’ve been there for it transitioned from third opinion to then, when Tom’s wife passed away, he took off some time, And then we came back together as just be well in 2020 It was perfect time to come back.

It’s like May of 2020 so at that time I had, I had my own, I was a business in town called simply beautiful, where I did, you know, kind of a little bit of just meeting with clients. I did some different therapies and a little bit of coaching. 

I didn’t, you know, realize that it really was coaching, but that’s kind of what I was doing. And then, yeah, we just kind of merged those two together and created Just Be Well, based off of his book: Just Be Well. When we were trying to decide what to name it, I was like, why not just name it Just Be Well? You have a book named Just Be Well. It’s a great name.

Thomas Sult   19:51

I wasn’t convinced, but she won. 

Elizabeth Sult   19:54

Yeah, I won. 

Nicole Vienneau   19:55

She wins!

Elizabeth Sult   20:00

I liked it because you can do it…. can be, just be like, be present, be here, and then also be well. So I think that was kind of a… that’s pretty much how we… I mean, that’s the very short version. There’s a lot of other stuff in there, but…

Nicole Vienneau   20:21

I’m sure there is, and all relationships, there’s a lot of other twists and turns in there. So you’ve been in practice at just be well for since 2020, and so tell us the kind of patience that you see, or maybe just give us a day in the life of or something like that, so we can understand that.

Thomas Sult   20:44

So we our average patient has probably been sick for a couple of decades. They’ve been seen by their local doctor, the local specialist, a regional place like the University of Minnesota or Mayo, and they’re either undiagnosed or don’t like the diagnosis they have, and somehow, you know, they’ve been seen by their favorite chiropractor and naturopath and all these other ancillary people. 

And because I’ve been teaching at the Institute for Functional Medicine for a long time, a lot of people know me, and they tend to refer to me their cases that aren’t going so well. So we have a very high acuity kind of, you know, for functional medicine, right? I call it tertiary care functional medicine.

We have a very sick people who have failed many different kinds of therapies. They haven’t failed them at the therapies have failed them, right? And we just start that where they are. That’s, that’s sort of my view. What’s your view of what we do?

Elizabeth Sult   21:48

Yeah, we start where they’re at. I would say, you know, and a lot of times along the way, one of the things that I get when they come out of the room with him is, you know, like tears in their eyes, like I’ve never had anybody listen to my whole story before. 

And you know, again, that’s where Nurse coaching and functional medicine, they meet beautifully, because it’s all about the patient’s story. It’s about their journey. It’s about them being in a space where they can actually share all those things, and then in their own, you know, in their own awareness, kind of have those aha moments.

And I think that we have a lot of those aha moments with patients where they’re like, Oh, I never thought of it this way. Or sometimes they come out of the room and Okay, he’s well, he’s recommended 10 supplements, three tests and a whole bunch of diet is, yeah, and then our job is, we have other coaches on staff too. Our job is to Okay, so how does this fit into your lifestyle?

What realistically we always go at it with? What realistically do you see yourself, you know being successful at is it the diet? Is it, you know what type of diet

Thomas Sult   23:09

I am, the icebreaker, and I leave this wake of destruction behind me, and then they clean it up. I like to say I know what to do, but they know how to do it.

Elizabeth Sult   23:19

We help the patients find ways to be successful with their plans, because they are very extensive. And he always explains it as you know, we’re not running a race here. It’s a marathon, and we’re doing things that a lot of people say can’t be done, so you’re going to have to do hard things. 

And you know, when they come at it with that awareness, but also with that hope. Like a lot of what we do is just give patients hope. And give patients hope and listen to them. And that, in itself, is so healing. I think it’s so healing and transformative, even if we can’t… even if they don’t get to where they were before, they become the best version of themselves that they can be.

Thomas Sult   24:07

Yeah, give them maybe a therapeutic diet to use for a finite amount of time. Teach them some reset stress management skills. Fortify their physiology with a few supplements, trying to nudge it in the right direction, and give them hope, and that hope opens the possibility, right? So, yeah, I like to think that. So she just said, you know, they come out of the room.

They got this diet, they got all these lifestyle things, they got all these supplements. Oh, my God, but in medicine, so often we’re taught what’s the minimum we can do here, and my idea is, what’s the maximum we can do here? Right? What’s the maximum we can do here? And then we’re going to fit.

We know what the maximum is, but now we’re going to do what you can do. And so like as an example, we see a lot of people who’ve been sick for so long. That they can’t tolerate anything. I mean, these are people who are sensitive to, you know, fluorescent lights when they get turned on. I mean, very sensitive people.

And so, you know, they can’t take any of the supplements. Maybe we have to start with just breathing exercises, or we have to start with just, you know, and they can’t meditate because they’re locked in fight or flight, and who’s going to cross their legs and close their eyes when there’s a saber tooth tiger chasing them. 

So they can’t even meditate as a therapeutic intervention, so they have to get extremely creative. And you know, we work together on getting creative, but nonetheless, they’re there. You guys are where the rubber meets the road, as they say,

Elizabeth Sult   25:36

Yeah, we spend a lot of time on the phone follow up calls and yeah, times just calls. They just call in and yeah.

Thomas Sult   25:45

I think sometimes we’re because the journey of being having chronic illness is isolating, right? Lose your job, you lose your friends, you sometimes even lose your spouse. You know you may still be married, but it’s deeply for some couples, it’s very much like, I think you’re just you need a psychiatrist, and they go to the psychiatrist and it doesn’t help you.

So it’s extremely isolating. So I think sometimes our office is their only friend, and we take that obligation of friendship very seriously.

Nicole Vienneau   26:22

Well,  thank you for what you do, because bringing hope to fellow humans is no… that’s irreplaceable. When you know a human is at their worst, and then you can bring just a glimmer of hope.

Thomas Sult   26:39

As they say, the light at the end of the tunnel, and we’re hoping it’s not an oncoming freight train.

Nicole Vienneau   26:49

So 2020, that’s a lot of years now in practice as Just Be Well. And then, of course, Dr. Sult, all of your years in history of practicing. And then Elizabeth, all of your years of wisdom and learning and growing as well. 

And then now you have met the Integrative Nurse Coach Academy, and you’re developing our brand new specialty course. So tell us a little bit about maybe that relationship, like, how did that even come up? 

Thomas Sult   27:27

It’s all her fault. 

Nicole Vienneau   27:28

It’s got to be someone’s fault.

Elizabeth Sult   27:29

Yes, so I had just finished cohort 50, and I had Karen reach out to me about a functional Nursing opportunity, she had said. And right away, when I read the email, I could feel that excitement inside of me, like, oh, I need to look into this, because it sounds exciting, or it feels exciting. 

I can always I’ve had somebody tell me I have spidey senses. I can always tell when something is in alignment or there, you know? So I hopped on the phone, had conversation, and that’s kind of where it all began.

I guess. I don’t know where it began with Inca, or how far prior to that it began. I know they’ve had a journey with, you know, they’ve done functional Nursing programs before. I wasn’t aware of their program before. 

I had never taken it and so when I was introduced the opportunity, I really just came at it from a Nurse coaching and functional medicine lens blended together because I have been working very close to a functional medicine practitioner, like I said, I was his scribe for many years, and been working close with him for a decade.

I just knew how well that they just blended together. They go together, and so does Nursing. I mean the heart of Nursing. A lot of us, I think, become Nurses because we care and we want to be that presence, and so they just all fit beautifully together.

I could probably talk a little more about that too, but so that’s just kind of how it began. I mean, I’m not, I can’t really say much to you know, how it came to be on INCA, all I knew is that I was in the perfect spot at the perfect time to fill a void. 

So I’m very excited to, you know, to have had the opportunity to bring forth this course, because I think it’s definitely going to be different than any other, you know, functional Nursing courses out there, because it is aligned with integrative Nurse coaching, and that’s really the heart of it, is the heart of a Nurse coach.

Thomas Sult   29:55

Yeah, I’d say it’s unique in another way. We’re really designing this course. To be, first of all, it’s it’s going to embody everything that we do every day in terms of the therapeutics that we use, but it’s going to be framed in the kind of language that RNs use. So instead of jumping into the medical sort of model, it’s going to stay within the Nursing model of health and wellness, rather than disease management.

Elizabeth Sult   30:25

So which isn’t an alignment with functional medicine, it’s totally in alignment. Yeah, functional medicine is not, you know, diagnosis, disease focused, yeah.

Thomas Sult   30:34

In fact, I like to say, you know, okay, the diagnosis is important, but it’s only the starting point. You know, in conventional medicine, the question is, what’s the diagnosis? And once you know the diagnosis, then there’s sort of these algorithms that, you know, you try to see if they help. But in functional medicine, once you understand what’s the diagnosis, the question is, really, why? Why do you have the diagnosis?

And that’s where these antecedents, triggers, mediators, all these kinds of ideas come from— to get to the why. But I like to say that the antecedents, triggers and mediators are kind of like Einstein’s theory of relativity, right? Because an antecedents from one frame might be a trigger from another frame.

And so, you know, getting to the real root cause. You might think, Oh, I got to the molecular medicine cause. But actually, it was a spiritual mal-alignment that caused the biochemical issue, because it caused all this stress and strain and all that trickles down to the molecular medicine, right?

Elizabeth Sult   31:37

So there’s still one more why, there’s always one more why. Yeah, but why? It’s like a three year old. But why? But why? Got to keep peeling it back.

Nicole Vienneau   31:52

Oh, that’s a wonderful place to be. Is to have the opportunity as a human or patient, is to actually have someone ask you, well, why? Why do you think this is where we don’t really see that in conventional medicine? It’s more like here, get out what I need to say in the in the brief, short appointment I have, and I hope that I might get an answer or something to help me. And then off I go into the world I am.

Thomas Sult   32:18

I just decided I’m going to see one patient an hour period. So people come in with that rushed sort of, I got to get my story out. And I say, okay, just take a breath. We’re here for an hour. It’s okay. And you can just see the relaxation come and the like, the sort of, I got to get this done, kind of angst come out of them so quickly.

Elizabeth Sult   32:40

I can just settle into this? Yeah.

Thomas Sult   32:43

And it’s a powerful thing, just giving them space to breathe and time to tell their story. And you know, what happens to people is they have experiences, and they interpret the experience from their own worldview, right? And it’s not maybe a biomedical interpretation that they’ve given it. And so doctors say things like, Well, that can’t happen. And their experience is, well, what the hell are you talking about?

I just told you what happened, you know. But what I do is I listen, and then I think, Okay, well, I don’t understand. I think to myself, I don’t understand that from a biomedical point of view, but it’s their experience. And so how? What’s the interpretation here?

What does it mean from a biochemical experience, rather than telling them it can’t happen, right? So, I mean, there’s a there’s they call it the art of the night. There’s an art here of listening and trying to understand. And so they say something that’s like a complete what? Well, you got to just roll with that and ask them a few questions about it and try to understand it from my perspective, you know, from my functional lens.

And it turns out that there’s a magic that happens when people can’t do what you ask them to do. So I used to, you know, I’m a big, important doctor, and I’d say, Well, you know, if you’re going to do what I say, you might as well just go somewhere else, just some arrogant non noise like that, right? But what happens is, if somebody doesn’t do what you want, that’s the opportunity. That’s the moment where they are up against a rail that we don’t understand.

And that’s just to me now. I frankly, I love it when people aren’t able to follow the plan, because it’s like, oh, now we’re getting somewhere, right? Rather than it being, oh, well, you’re non-compliant, right?

Nicole Vienneau   34:43

Say something like that. Oh no, it’s a revelation.

Elizabeth Sult   34:47

Yeah, right, yeah.

Nicole Vienneau   34:50

And what’s below the surface of that? Yes. Okay, so now we’re getting into what our listeners of Nurse coaches really like to talk about.

Thomas Sult   34:59

Can I tell a story? So I just love this story, because I had this woman, she’s about a little under 30, I think she’s like 28 or something, and she had some bad gut issues. It was more of an IBS kind of situation than an IBD situation, so more irritable bowel, but I asked her to go on an elimination diet. She didn’t do it. 

And, you know, she’s a young professional starting her life, and she I sit down times like, okay, that’s fine, so let’s do it like, she’s okay, yeah. And she’s like, 1,000% compliant on everything else, right? She’s just, like, on it, which, you know, should have been a hint that maybe there’s an issue, because when people are that on stuff, maybe they’re in fight or flight, but anyway, so she didn’t do it a second time.

And I said, Okay, well, what’s going on here? So it takes two or three more visits to find out that her mom, I knew her mom passed away, but her mom passed away when she was a young kid, and when she was sick, when the patient was sick, her mom would feed her milk toast. Why anybody would do that to another human being? I don’t know. But this was warm and cozy for her, right?

And I was trying to put her on an elimination diet, which eliminated wheat and dairy. And so, you know, that was taking mom away, right? That was taking mom away. And so we talked about this for a while, and she realized her mom didn’t care about milk toast. Her mom cared, and she was totally sub subliminal about it.

She didn’t think, well, I can’t take away my toast because that’s my mom. It was just subconscious, but she became conscious when we had these conversations, and she said, My mom doesn’t care about milk toast. She wants me to be well.

And all of a sudden, bang, she can do this diet, and all of her gut issues go away. She heals, and then she’s able to return to kind of a normal, healthy, whole foods kind of healthy diet. But just those little barriers that come up for people that are so subliminal that we don’t even know they’re there.

Nicole Vienneau   36:59

And we’d never know they’re there until we take the time to truly listen and be with and yeah and support and heal and bring hope and all of the things. Yeah. Love this story. Thanks for sharing it.

So I’m reading on your website, justbewell.info, and there is a statement here. And so I know some of our listeners don’t know much about functional medicine, so we’d love to have a little definition. So it says here, functional medicine is a systems biology based approach that focuses on identifying and addressing the root causes of physiological dysfunction that contribute to disease

Thomas Sult   37:45

That makes you sit up straight, doesn’t it? You know that all of that’s true, but it’s… I tend to live in my head pretty deeply. So I wrote that. And it might be better to say that functional medicine is systems medicine, meaning that there’s sort of this interesting idea that there’s this line, and over here is reductionism, right, where you learn more and more about less and less until you know everything there is to know about nothing at all.

And on this other side of the line, there’s holism, and you learn less and less about more and more until you know nothing at all about every possible thing. So taking both ideas to the extreme illogical conclusion. But there’s another axis here, and it’s systems, right? It takes the best of both worlds and uses them. And so it’s systems medicine, systems biology.

It grew out of this discipline called systems biology, which was the effort to try to understand whole systems at a very detailed level. So both sides of this sort of arbitrary, linear thing that somebody created. So that’s true, but it’s also true that it is trying to understand the root cause and understand and treat is a bad word in this context. That’s a medical word.

But let’s say support. The idea is to support wellness to the point that disease can’t flourish. And that’s really, I think, a better working definition.

Elizabeth Sult   39:32

Yep, I always get a good visual with that. So raising wellness. Disease is down here, and you raise your level of wellness up to the point where disease is no longer there.

Thomas Sult   39:46

Just can’t. You can’t flourish, you can’t get a foothold. Yeah, right.

Nicole Vienneau   39:51

And this connects very well with Nursing, because that was a definition of functional medicine, yeah. And now we have this new term, functional Nursing. So how would our Nurses benefit from taking this course, Functional Nursing: A Functional Medicine Framework for Nurses?

Elizabeth Sult   40:15

I think because when we know the framework, when the framework becomes second nature to us, we start to see these patterns emerge. And it’s really about seeing those patterns and connecting those dots, that it’s like, all of a sudden you have an image. And that’s the best way for me to put it into terms, and also to give kind of a little bit of a visual to it. 

Functional Nursing is about bringing up those patterns, making those patterns not just visible to us—because really they’re visible to us—but it’s about helping patients have that awareness to see the patterns themselves. Because once they see those patterns themselves, aha, then they have those moments where they’re like, oh, like the milk toast story.

They had that aha moment. And those are those breaking moments that shift. It shifts their awareness, and then it shifts their physiology, and it really gives them that little fire. Almost, I feel like it’s a little bit of a flame that kind of lights their fire, that gives them the motivation to make changes, yeah, which works beautifully with integrative Nursing.

Thomas Sult   41:42

So, like, one of the tools we use is called our functional timeline. And so it’s a timeline, and this happened, and then this happened, and this happened, and this happened. But the way I think of it is as a staircase. Your health is going along, and then somehow it breaks. Two things: did it heal, or did it break down, right?

And then the next thing that happens, it breaks. Did it heal, or did it break down? And so right here, at this inflection point, right there, we’re looking for, what are the antecedents, what are the triggers, what are the mediators that caused this? And then what are the ones that caused this, and what are the ones that caused this? And so you’ve got the staircase of health, right?

And sometimes it’s a single event, but most of the time, if you really dig in, it’s like, oh yeah, you know, when I really think about it. Like I ask the question, when’s the last time you were truly well? They go, Oh, last Thursday, I felt pretty good for three or four hours. No—truly well. Oh, well, yeah, maybe two years ago.

Oh, so two years ago you were great. Well, you know, actually, I’ve had IBS for like 10 years before that. Oh, okay. So 10 years before that, you were really well. Well, you know, I had chronic headaches.

Oh, okay, so how long were those? Five years. Oh, so five years before that, you were truly well. Well, you know, not really. And so it’s all of these things, right?

And so finally you get way back there. And not only that—we all have a genome, but what we live in is a phenotype, right? We have a genotype and a phenotype, and our phenotype can be influenced for generations before us. Phenotype—elements of phenotype, things that cause the phenotype—can be inherited, even though they’re not genetic. So the story really begins with your family history.

Elizabeth Sult   43:37

So as a functional Nurse, I have a toolbox of questions, those open-ended questions that really get to those different breaks. And then once you get to that break as well, there’s other questions to help bring forth, okay, but why? 

Okay, that was the break, but what was happening—not just happening in the external environment, but what was happening in your internal environment at that time? Because a lot of times things happen to us and it changes that internal environment.

And that could have been when we were five, but it changes that internal environment and all of a sudden we’re living life on hypervigilance, or maybe we’re in fight or flight. And when you’re in fight or flight, that takes you out of healing. So if you’ve been stuck in fight or flight for 20 years, well, what has that done to your immune system, or what has that done to your hormones?

Thomas Sult   44:41

And just a lack of sort of repair mechanisms. And so even—

Elizabeth Sult   44:46

Even though digestion, yeah—digestion. You can’t digest well in fight or flight. So if you haven’t been digesting food well for 20 years, well, you’re probably depleted in some nutrients. You maybe have some gut issues. But again, going back to that why, and if we can help them find that why, and maybe have that aha moment, that revelation that changes their perspective.

Thomas Sult   45:11

And I would like to say that we are the proverbial frog in the pot. We don’t realize that we live in this all yang, all the time society, right? Because we just live in it, and so most of us spend a significant fraction of our day in fight or flight. And so we’re shunting blood away from our gut to go to our muscles so we can fight or run. Digestion suffers, obviously.

Absorption suffers, so you have this functional maldigestion, malabsorption, even though you’re eating a great diet. Seventy percent of your immune system lives in your gut, so you’re functionally immune-compromised. Your detoxification pathways are in that same circulation.

Your adrenal glands are in that same circulation. So really, it’s a profound thing to be in fight or flight all the time. So yeah, that’s a big piece of our work.

Elizabeth Sult   46:01

A big focus to the functional Nursing is that center of the functional medicine matrix, which is the mental, emotional, spiritual aspect of it. That’s in the center of the matrix, and that’s really where the foundation of the course is built, yeah.

Thomas Sult   46:16

Which I think is—I don’t want to say ignored—but underrepresented in other functional courses. And part of that is because it’s a hard thing to talk about, right? Because your religion is always going to be better than my religion. That’s just by definition. So you can’t really come at it from a religion point of view.

But instead, you can come at it from an autonomic point of view, right? If you’re in fight or flight, what is that doing? Well, it’s dealing with your mental, emotional, and spiritual life on some level. And how can we use your spiritual life to calm down your autonomic nervous system and bring all of those systems back online?

Elizabeth Sult   47:00

Yeah, that’s also another powerful question that we ask: What things bring you joy? What do you do for fun? It’s not just about the negatives. It’s also about what makes you feel like you.

Thomas Sult   47:16

I ask that very question in every new consult: What do you do for fun? And it’s a really hard question for a lot of people, and that’s sad. It’s like, what do you do for fun? And they go, fun…

Elizabeth Sult   47:31

They really have to think. Yeah, I know sometimes I have to think. It’s taken me a long time and a lot of discipline. What do I do for fun in my daily life? And it’s because it’s little things.

It’s going for a walk, or perhaps it’s reading a devotion. It’s all those little things that add up. And I guess that’s probably a revelation I’ve had on my own: I don’t have to do big things for fun. It’s the little things that count that I can integrate into my moments in the day, no matter how busy and crazy they are, yeah.

Thomas Sult   48:06

The other question is, what brings you joy? Fun and joy are slightly different.

Elizabeth Sult   48:11

Yeah, or how do you cultivate—

Thomas Sult   48:14

Which I also ask. I often will ask, what’s your passion project? What are you doing that really spins your beanie? They hear “passion project” and they’re like, what does that even mean?

What are you talking about? What spins your beanie? And I’m old, so I know what that means, but a lot of young people have no idea what that means.

Elizabeth Sult   48:31

I would say that functional Nursing right now is our passion project. Yeah, absolutely.

Nicole Vienneau   48:37

I love that. So what do you envision as Nurses are graduating from this program? They’ve completed it. What is your hope for Nurses as they complete the course?

Elizabeth Sult   48:52

I guess my hope for Nurses is kind of where I’m at. I have completed the Integrative Nurse Coach Academy Nurse coaching program. I am board-certified in Nurse coaching right now, and with my board certification in Nurse coaching and functional Nursing, I can have my own coaching practice, and I can make a difference in those lives that come to me. 

I can sit next to people, sit with them, listen to their stories, and help them have their own aha moments and revelations that really help them to heal themselves. In the course, I quote Florence Nightingale a lot because to me, she is Nursing—the heart of Nursing—creating the environment around the patient so that nature can do its work and they can heal.

And functional Nursing and Nurse coaching—my hope is that there are Nurse coaches as well, or they will become Nurse coaches, because I see that being a beautiful way for Nurses to, if they want to step out on their own and have their own practice, they can do that. Or it doesn’t matter where they’re working. If they’re working in a hospital, how beautiful is this framework within that as well to help them see those patterns.

We spend so much time with patients. So while I say about Nurse coaching and having your own practice, I think that’s beautiful, but I do think this is needed in any area of Nursing that you are in, because it’s doing things from that different perspective, and really from what I believe is the heart of Nursing. That’s my hope, I guess.

Thomas Sult   50:56

When I was a medical student on rounds one morning, we all come schlepping out of the call room, and we all got our scrubs on, disheveled. And this one guy, he’s all put together. He’s got his clothes on, he’s got his tie on, and he looks like— I mean, I know he was up all night because I was on his team. 

The senior resident is explaining an admission, and the chief says, “Is he a dirt ball?” And this guy, who’s all put together, says, “Well, that’s not a term I use, but he is socially, economically challenged, and he’s got a number of problems around that issue.” 

And that just hit me in the face, because we’re all a bunch of young doofuses as residents. And to have somebody with that level of dignity, displaying that kind of dignity to his challenged patient, changed me in that instant forever.

So from that day forward, I got up before I had to get up. If I could, I showered, I definitely put my clothes back on, and I walked out ready to be respectful to my patients. And I think that’s what this course is going to help Nurses do: learn a whole new toolkit to relate to their patients in a way that shows that patient that they are a human being worthy of dignity, and that there’s somebody in their presence who deeply cares. Because I think they do care. They just have been brainwashed.

We all have, right? We’ve been socialized in this medical model where we got to deal with the gallbladder in 384, rather than Mildred, who’s having a cholecystectomy in the morning, right? But at least me—I was certainly guilty of that for many years. 

And I think bringing that level of dignity back, no matter what, no matter where working, is magical for the patient, and it’s magical for your own professional well-being, because there’s now a lot of evidence that acts of service are actually the most powerful thing you can do for your own health, right? So taking that act of service to a new intentional level, I think, is just magical and beautiful.

Elizabeth Sult   53:38

Yeah, it’s what comes out of you that matters most.

Nicole Vienneau   53:45

So in our last few moments, I love to ask the question—and I’ll leave it up to you who would like to go first—but we’d love to hear from both of you: what is on your heart that you would like to share with our listeners?

Elizabeth Sult   54:02

When you asked me the question, what is on my heart, what comes to me is presence. And I think that we forget our presence is our most powerful tool when we walk into a room. Not just our presence, like how we look on the external, but where our presence is at internally. It co-regulates with whoever is in our environment. Our hearts, they sync, and they have their own language, and they talk to each other.

So when we walk into a patient’s room, our presence affects them, whether we’re aware of it or not. Functional Nursing is about the art of our presence. It’s about how we show up day to day, not just for our patients, but how we show up for ourselves and for anybody that comes in our path. 

So what’s on my heart is that idea of heart coherence, of presence, of being that change that you want to see in the world, because it does come down to each and every one of us. Each and every one of us has a responsibility, and that is to be the best version of ourselves that we can be.

A lot of that, from what I have found, starts internally, and then it is externally. And this functional Nursing course starts at that center. It starts at our core, at our presence. That’s the first module. It’s about presence and about that mental, emotional, spiritual framework. So yeah, that was a long, little roundabout version of what’s on my heart.

Nicole Vienneau   56:02

Thank you for sharing that. Yes.

Thomas Sult   56:06

I’ve been saying for decades, easily and by far the hardest job in medicine is the role of the RN, and they’re underappreciated from every angle, right? The doctors are upset with them because their little thing didn’t get done exactly the way they wanted it to. 

The administration is upset with them because they didn’t answer the call light fast enough, so the patient is upset with them. And we’ve come to this place where we have acuity, right? And I don’t know who made that stuff up, because it seems to me like the acuity is always about three people too short.

And so these dedicated professionals are running themselves ragged and trying to please everybody—actually just trying to deliver good care—and not pleasing anybody because they can’t, because of the system they live in. 

We talk about burnout—it’s not burnout. It’s an abusive system, right? You’re smart enough to get through Nursing school, you’re smart enough to get through med school, you’re smart enough to get through whatever school you are. And yet we’re so fragile that we’re burnt out?

No, we aren’t. We’re not burnt out. We’re abused. And I think that’s something we need to understand. So if we’re abused, and if we’re locked into this abusive system because we have few choices, then how do we arm ourselves?

How do we create better internal systems so that we can cope better, not by blaming ourselves? “Oh, you’re burned out. You must be a fragile little flower.” That’s nonsense. If you were a fragile little flower, you would have never made it through Nursing school, right? So instead, how can we build these resiliencies into ourselves so that we can manage this abusive system that we’re kind of forced to work in?

And that, frankly, is a big piece of our course. Functional Nursing is arming ourselves—not intentionally arming ourselves, but just because of the things we’re learning. It arms us. So I guess that’s what’s on my heart. It’s been on my heart for a long time, this idea that we’re all fragile and we’re all burnt out because the system is fine and you guys are just wimps.

That is so far from anything rational. It’s ridiculous. It is an abusive system that we’re forced to work in. And so how do we cope? And something you said earlier that’s really on my mind a lot is functional medicine shouldn’t be apart from conventional medicine, and it’s not on top of them.

People say we stand on the shoulders of giants in functional medicine. Well, on some level, that’s true, but it’s just the way medicine should be practiced. That’s the way Nursing should be practiced, and that’s what we’re trying to teach and model: a more inclusive, holistic way of thinking.

Elizabeth Sult   59:16

Yeah, you know, just developing this course, I’ve learned so much just from developing it, about myself. And I always think that’s magical. When you’re doing something, you’re not just doing it for your patients, or those that you interact with. You’re also doing it for your own self-growth, and your own— I lost the word, but it was a good word. I don’t know—your own education, but yeah.

Nicole Vienneau   59:53

I love it. Well, thank you so much for sharing what’s on your heart. I’m sure there are other things that are on your heart, and I know that people taking the course will get to witness that as well. 

So if I’m a Nurse, and I’m thinking about signing up for Functional Nursing: A Functional Medicine Framework for Nurses, what can I expect in the class, in the course? 

Thomas Sult   1:00:22 

You can expect—so there is a tool we use in functional medicine called the functional medicine matrix. What we normally think of as a matrix, there are seven nodes around the outside that are things like assimilation and detoxification and immune, and all those kinds of physiological nodes. 

In the center, which is what we’re really using as the heart of this course, is the mental, emotional, and spiritual domains of wellness. Along the left side are those ideas of antecedents, triggers, and mediators. 

Along the bottom are the modifiable lifestyle factors. The modifiable lifestyle factors are kind of where the rubber meets the road when it comes to how do we actually implement the plan of functional medicine.

In this course, we’re going to basically go through that entire tool in a deep way so that when we’re done, you’re going to, I think, be expert at understanding how to implement functional medicine from a Nursing scope perspective. And again, we’re building this not for advanced practice Nurses, although, you know, this is the way I practice. 

Elizabeth Sult   1:01:36 

It fits beautifully with advanced practice Nursing. I mentioned it in the modules, that it just gives you a deeper skill set in the different lens. 

Thomas Sult   1:01:47 

This is the way I practice, but we’re framing it without having to use my little slips of the tongue, you know, the diagnostic stuff, which, frankly, I don’t care that much about. I care more about that root cause idea. 

So this is going to be a deep course that really helps people understand these tools at a deep level, and hopefully helps them bring these tools to whatever setting they’re working in to deepen their sort of professional engagement and professional enrichment—job enrichment, yeah. 

Elizabeth Sult   1:02:21 

Through a Nursing lens. 

Nicole Vienneau   1:02:24 

So any Nurse could sign up for the class, don’t have to be a Nurse coach. 

Elizabeth Sult   1:02:30 

Nope, you don’t have to be a Nurse coach.

Nicole Vienneau   1:02:34 

Wonderful. So RNs, it could be Nurse practitioners if you choose. Don’t need to be a Nurse coach. So Nurses, I think you should get on this website and check things out.

And when does the course start? February 2. Whoo. So, oh, to be in the inaugural course, I mean signing up before February 2. And if our Nurses, our listeners are saying, oh gosh, I have some questions, how can they reach you?

Elizabeth Sult   1:03:08 

They’re more than welcome to reach out to us by email. So fn@justbewell.info. That would be a great email to send a message to, whether it’s a question, feedback, anything. 

Nicole Vienneau   1:03:25 

Yeah, perfect. And I will put the link into the show notes so people can just click on there or get your questions answered. If you’re on the fence, you need to jump over the fence, right? Just a quick email to say, okay. 

Thomas Sult   1:03:43 

Yeah, the grass is long and soft on our side of the fence. Go ahead.

Nicole Vienneau   1:03:50 

Oh, that sounds wonderful. Well, Elizabeth and Tom, thank you so much for sharing this time with us and bringing to light what functional Nursing can be for our community, and we’re so grateful. Yeah, thank you. 

Elizabeth Sult   1:04:05 

Thanks for having us. 

Thomas Sult   1:04:07 

Yeah, I’m very excited. 

Elizabeth Sult   1:04:09 

Yeah, we are. 

Thomas Sult   1:04:10

This is, like we said earlier, this is our passion project. We’re very excited about it. Yeah.