83: Recognize and Stop Nurse Specific Trauma- Dr. Lorre Laws PhD, RN

83: Recognize and STOP Nurse Specific Trauma- Dr. Lorre Laws PhD, RN 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 you know, one of the best things about doing this podcast is I get to be one on one with some of the most amazing people in the planet or on the planet, and today is no exception. We go way back. 

We go back four years now, and I’ve been watching and watching and listening and reading and absorbing all of the work of our next guest, and it’s been very helpful. It’s been very inspiring, and I know that all of you listeners are going to feel the same way about this podcast. 

So I would love to welcome Dr. Lorre. Dr. Lorre Laws. And I can’t tell you where she’s at right now, because she’s all over the world right now, doing some exciting things. So we’re not going to say exactly where she’s at, but yes, let’s welcome Dr. Lorre.

Lorre Laws  01:03

Oh, thank you, Nicole, so much, for having me. And right now I’m in Boise, Idaho, but I am touring the nation and speaking to Nurses about burnout and Nurse specific traumatization. So coming soon to an Airbnb near you is, is my address, I think, for this year.

Nicole Vienneau  01:25

So exciting, so exciting. Yes. And when you’re coming back to Tucson, of course, we’re going to be getting together for lunch so I could hear more stories. Yes. Okay, so we love to go down history lane. We love to just have a little snippet of why you recall even deciding to become a Nurse.

Lorre Laws  01:44

Oh, well, gosh, that’s I’m going to give you the Cliff Notes of that very long story. My first job as a teenager, at the age of 14, was cleaning restrooms in a skilled Nursing facility, and I fell in love with the residents, and so at the age of 15, I was eligible to get my CNA. And so before I was old enough to drive or vote, I was facilitating end of life transitions. And I think that is where, what I call my healers heart, my why for Nursing, my why for doing many of the things I do, for what matters most. 

I think the seeds were sown there. So I worked as a CNA for six years. That’s how I provided for myself during high school and college. And at the age of 21 due to lack of equipment in the teaching hospital med surg unit where I was working, we didn’t have enough Hoyer lifts, one for four floors, and I had a large patient go down, and my back herniated severely in four discs. 

And so the medical team, my school counselors, I was an undergraduate student at the time, everybody was like, you cannot go into Nursing. Like, this injury is so significant that, you know, we really need to advise you to do something else. And 21 year old me, heeded that council. 

And so I went off and had a career in business, and then I had a career as an art teacher, and then, but it was still with me. You know, it was. It was still with me. And at the age of 48 I survived a life threatening illness, which turned out to be toxic mold growing in our home for over 20 years. 

We didn’t know, and my life sort of got turned upside down. My marriage fell apart. I wasn’t employable because I had been sick for so long, and I was really leaning into nature. I took a year and lived out of my truck in nature, looking for holistic, integrative ways to heal, because we still didn’t have a diagnosis. At this point, the state of the science wasn’t where it is now. I recently had a diagnosis. 

I have made a full recovery since 2017, but at this time, we didn’t have the evidence base where it is now. And so I was mysteriously sick for a very, very long time. And as I was out in nature, doing what a lot of us integrative Nurses do, I didn’t know I was integrative Nursing and self caring myself, but that’s, in fact, in fact, what was happening I started getting these intuition vibes of like, heal the healers, heal the healers. 

Now I’ve been a healing arts practitioner since I was a very young woman. So, this was very much part of my vocabulary, very much part of my way of living. And so it’s like, well, I have to go back to school and do something. So I think I’m going to go back to school. At the age of 48 I started my pre reqs, and at 50, at the age of 50, I went to Nursing school while in menopause, and that’s important to say.

Nicole Vienneau  02:57

Absolutely important to say.

Lorre Laws  04:10

Because I was like Nursing school, you know, oh my goodness. And so I went through the University of Arizona’s Method program, the Master’s entry to the profession, and I was really disheartened that not much had changed in the treatment of Nurses as sort of marginalized and oppressed and occupationally restricted due to a lot of healthcare system inadequacies that had not changed since the late 19… the mid, late 1970s and early 80s. 

That’s how far back I go. And so to have this 40 years, 45 year span of going, wow. I mean, back in the day, we had to wear all white. We had to, if we were charting at the Nurses station and a physician or a provider came up, we had to immediately avail our seat to them. You know, it was a very kind of paternalistic culture then. And while there have been gains made, I still was observing. 

You know, when you’re entering your practice at 50, 51, 52, you have a lot more wisdom than you do at 21, 22. And to really see that Nurses were still being, for lack of a better term, treated as pawns on the corporate chess board, you know, being stretched so thin, being overworked and under resourced. And, you know, the same things that we were talking about in the 70s and in the 80s and in the 90s, you know. 

And so I opted not to go into practice and into direct patient care, but I continued on to earn my PhD, and it was a real… it was a real crisis of conscience for me, because I felt as though I was somehow less of a Nurse because I didn’t do that first year in med surg, right? I had been conditioned, as many of us had, that you earn your stripes and you earn your value, because you have to get out of Nursing school and you have to do a year at least in med surgery or you’re not really a Nurse. 

And my colleague was different. And so it was really… it was, you know, I knew that if I entered practice in a traditional manner, that I would not be able to affect change on behalf of the Nurses that I was seeing, and that I myself as a student Nurse and new graduate, was experiencing at the age of 50… 51, I think. 

And so I pursued and completed my PhD, also at the University of Arizona. And kind of my specialty, if you will, kind of my geek flag specialty is that I’m a synthesizer of evidence. I’m a framer and an applicator of evidence. And so I have developed conceptual frameworks that guide clinical practice. 

So I’m one of those kind of people that likes to get lost in the evidence base and find solutions in those ways. And so I  finished the PhD in 2018, and in 2019 I kept getting this, heal the healers message, heal the healers message. Okay, well, all right, I’m a Nurse now, what am I supposed to be doing with… like it was, it was just such a calling. 

And I don’t know, for those of you out there who have had a calling, it just, it’s like somebody’s gripping you by the hand and isn’t letting go, like you really… it’s just like it really touched my heart so deeply. And so I started doing the research and trying to understand. 

Because the question that I had, and this is what led me to Nurse coaching, the question that I had is that the same burnout narrative that we were talking about in the 1970s when that term was first brought forth, burnout syndrome, was first published in the 1970s it’s been the same narrative for decades. 

And yet, the people that I was working with as I was going through my Nurse coaching, training and in my community and with my colleagues who were refractory, they were not responding to the traditional self-caring practices in a way that was helping them to recover from what was quote, unquote burnout. 

And so that got me asking some really big research questions, because I’m a Nurse scientist for my day job. I am a professor at the University of Arizona’s College of Nursing, where I teach in the nation’s very first BSN program with an integrative health focus, which is super exciting for me. Yeah. 

And so I started asking these big research questions, and then the pandemic unfolded, and I knew, I knew that this was a once in a lifetime opportunity, because people were posting very openly and very candidly their experiences about what they were experiencing. And while it was a, of course, just an incredibly difficult time for humanity. 

Each and every one of us were challenged in ways that we could have not foreseen, and challenged in many, many ways. And so I really started working with the Nurses who were on the front line, and started, I started to see that it wasn’t burnout that we were talking about. It wasn’t just burnout. Yes, burnout, perhaps is an aspect, right? 

But I came across, you know, I went to four… I also have background in social and behavioral sciences, where I taught in that college for eight years prior to joining the College of Nursing. And so I have this really wide, inter-disciplinary, inter-professional lens through which I can conduct research. 

And so I started looking outside of the Nursing evidence base for solutions and to try and figure out what was really going on. Why are millions of Nurses not responding to traditional self-caring practices to address burnout, like what is going on here? And so I went into the disciplines, not only Nursing and integrative Nursing course, that’s where I started. 

Then I went over to neurophysiology and transpersonal neurobiology, and then relational neuroscience. And that’s when I started to see that what we were talking about was a physiological response to trauma exposure. And then, and then, as I, you know, as I’m like, stepping into all of this research and now it’s like, now, I can’t not see it. 

Now, it’s like, now what we have are traumatized Nurses here. All the pieces started fitting together. I started studying everything. Dr. Stephen Porges had written about polyvagal theory, and was just the most best fortune to work very, very closely with Dr. Bonnie Baden, who is a relational neuroscience expert on the world, and she has also endorsed my book. 

And so we started, really started unpacking what was happening right down to the level of the mitochondria, like, let’s get down to the autonomic nervous system. Let’s look at this through the lens of polyvagal theory. Let’s look at this through the lens of Dr. Naviaux’s cell danger response theory, which really talks about how the body— what happens to the mitochondria as a result of prolonged stress or trauma exposure. 

And so at the same… so I had some choices to make at about this time. So I’m finishing, I have completed my coaching program with INCA, which was five star, excellent, if anybody out there… a shameless plug, it has changed my life in the best senses of the word, has directed my practice to be very aligned with who I am and what I’m called to do in the world. 

So I’m just so, so grateful for that. So as I’m finishing, like, finishing my INCA program, and I had been publishing my findings in peer reviewed journals, like an academic is supposed to do. And I grew frustrated because I realized that I was not reaching the Nurses in their living rooms who needed this information, this help, this opportunity for healing the most. 

A good majority of Nurses can’t access through their employers or through their budget, you know, to spend $50, $60 for one article, right? And so I sat with that for a long time, and though I have published in peer reviewed journals, and that’s important, it’s important for Nurse scholars and scientists like myself to contribute to the evidence base. I’m also, first and foremost, a healer. 

You know, I’ve been in the healing arts forever, my whole life, and so my healer’s heart was like, how can I get this… how can I get this research and the conceptual framework and the four step process and the 100 practices that I had developed while I was coaching other Nurses who were experiencing burnout, which almost always turned out to be in Nurse specific traumatization. 

How can I get this into the living rooms of Nurses worldwide? That was the question. Well, that’s a big question, that took a minute to process. Wait, wait a minute, did I just say I wanted to get in the living room of every Nurse who needs this information? Yes, I did. And so how do I do that? 

So that led me, while I’m a scientific writer, I had to learn how to write a book that is not a textbook, but really a Nurse coaching book, if you will, educational resource where I wrote, learned how to write like a traditional, mainstream author, where I could bring this work into the living rooms, as though you and I are doing right now, sipping a cup of tea and talking about it in a very approachable, accessible manner. 

And so I had to go to how to be an author school after I finished my Nurse coaching, right? My Nurse coaching, and I have a practice where I work with Nurses and other health professionals and coach them through the occupational or Nurse specific traumatization healing process. 

So, while I was doing that, I went to author school and learned how to write a book proposal, do market research, and all the things that an author has to do that I had no idea. And you know you’re on the right path, you know that you’re answering that calling when, as a debut author, without an agent— I did not procure a literary agent to represent my work. 

I just felt like I wanted as few layers on this work as possible, because I wanted this book, this work, to be priced affordably for any Nurse on the planet, that they could get this if they wanted it, right? And so I went and I submitted three proposals, three, and I sold the book to a traditional publisher on just those three. 

Now, usually as a debut author, nobody will even look at your work, let alone, you know, acquire it for worldwide distribution. So that was a huge, huge blessing. So that at the same time, at the same time all of this is happening, it’s as though the sky parted and Dr. Foley, Dr. Karen Foley from Purdue University, I want to give her so much attribution and gratitude, because I knew, because my job as a Nurse scholar, is to know how to do to work with theory, right? 

That’s a big part of what I do for a living in my day job. And I knew we didn’t have a middle range theory for Nurses that address psychological trauma, you know, and I was in the process, I was starting the process, you know, to cobble together, because my work, although written for any Nurse in their living room, I’m also, you know, I’m also a professor, I’m also a scholar. 

And that needed to be grounded in the evidence base. It needed to have strong philosophical and theoretical foundations, even though I don’t talk about those overtly, they’re present. You know, that we all know that this is high quality, and there’s Nurse literature. 

And one day, I was just a little bit, to be honest with you, I was a little bit overwhelmed at the thought of having to write a middle range theory while I’m writing a book that that felt like a lot on my nervous system. I’m not gonna lie. But you know, but when you say yes, when you say yes to your calling, and how I said yes to this calling to heal the healers, to help to do my part. 

You know, when I say heal the healers, I mean, facilitate healing. But that’s just a mouthful to say. So it’s like, heal the healers. You know, I’m willing to do whatever is required with ease and grace. You know, I surrendered to this work with every fiber of my being, as I am willing to do whatever is required. 

Does that mean I’m going to self fund five years of research so I can get it into Nurses’ living rooms? Yes, I will do that. Does that mean that I will go to author school to learn how to write a book in this manner? Yes, I will do that. Does this mean I need to write a middle range theory? 

I mean, yes, squeaky voice, I’ll do that. But then, a huge blessing fell out of the sky, and in my inbox landed Dr. Karen Foley’s middle range theory for Nurse psychological trauma. And I still get goose bumps when I think about the synchronicity and the timing of her work and my work intersecting in such a harmonious manner. And so my book is grounded in that middle range theory that I did not have to write. Thank you, Dr. Foley.

Nicole Vienneau  21:23

I’ll be sure to drop the link in for Dr. Foley in the show notes about this Nurse psychological trauma.

Lorre Laws  21:31

Yes.

Nicole Vienneau  21:32

Tell us what the theory, again, is? Nurse psychological…

Lorre Laws  21:34

Well, it’s a middle range theory for Nurse psychological trauma, and it is what we can use. And this is the last chapter in my book, which, by the way, is titled Nursing Our Healers Heart. And it’s a recovery guide for Nurse trauma and burnout, where I, you know, I facilitate and I use excerpts from sessions that I have had with real, real world Nurses doing the real world healing work and present, you know, the 100 practices in the and the innate care plan framework that’s in there. 

We can talk about all that, you know, coming up. But, yeah, that was such a gift. And so this middle range theory is what we as Nurses, whether we’re clinicians, whether we’re leaders, whether we’re educators, scientists, wherever we find ourselves in our vast scope of professional roles, that we can now stand on this middle range theory and advocate for system and organizational change, because it’s not just burnout. 

In the vast majority of cases, it’s not just burnout. It’s Nurse specific traumatization, and much of that trauma exposure is avoidable. And so this is, you know, her middle range theory and the work that I’m doing through the book and through my nonprofit, were sort of the gates that have opened so that we can really, as scholars and scientists and clinicians, that we can stand on the evidence base and say enough of this burnout narrative. 

It’s, you know, a whole different approach is needed for our workforce wellness, for Nurse safety and Nurse professional well being. So it’s, you know, all  juicied up. And then after I got the book sold and a written, and then it became clear that, well, you know, only so much healing can be accomplished. 

You know, we’re not intended, we’re not evolutionarily designed to heal in silos, in caves, by ourselves, right? We are, as mammals, as humans, we are hardwired to co-heal and co-regulate with one another. And so that heal the healers thing came back again. I’m like, come on now, I wrote a book, I went to author school. I did all the things. I didn’t have to write the middle range theory. Thank you. Thank you. 

But I did all the things, I was willing to do it. And then it became clear, in working with a good number of my clients, that they really wanted a 12… they wanted a program where there was a beginning, a middle and an end, and where the healing could be facilitated. 

Because if you look, as I have, and I’m sure you have to, if you look out there and see what is available for Nurses who are struggling right now with burnout, which is really in the vast majority of cases, Nurse specific traumatization that is unintegrated. Most websites, including the ANA, are pushing out resources. 

Yes, there’s a lot of resources. No doubt there’s a lot of resources. They’re not trauma informed, the vast majority of them, and there’s no facilitation of healing, right? Healing needs to be fully realized. That’s why Nurses, that’s why we exist professionally, is we are the ones that facilitate the healing for those in our care, right? 

And so to push out a bunch of resources at Nurses who are traumatized, who are burned out, who are unwell in any dimension of body, mind, spirit. In my work, I call that body mind essence to capture the legacies of unintegrated trauma that are generate racially transmitted and all sorts of other oppressions and abuses that get proclamated down the lines, right? 

So, body, mind, essence, and my work, and so it’s like, wow. Well, it sounds like we need a healing program. And every Nurse I talk to: yes, please, yes, please, yes, please. And so that meant you had to learn to do something, because I said I was willing to do whatever is required. 

So for those of you out there, just know that sometimes a lot will be asked of you when you surrender to this degree of utter surrender, of being willing to do whatever is needed to affect the change that you have been called to lead. And so I learned how to form a nonprofit organization. It’s called the Haelan Academy. 

And haelan is the old English word for healing. So that was… which is a core concept in the book and in this work. And then I had to go to entrepreneurial school, because I had to learn how to build a business, a digital. Wait, you want me to do an online business that serves an international Nursing community? 

That seems like a lot for just a little Nurse over here. And so for the last 12 months, I have been in entrepreneurial school learning, learning how to develop and run a business. The container really that Nurses can come to from any part of the planet. 

And I’m working with Nurses in Canada and in England and in Australia, and, of course, here in the US and in various parts of I think almost every state, I am working with one or more Nurses. So it’s really provided a rich, you know… I’m a qualitative researcher, that’s my research specialty. 

So I am getting such rich data and information that is really informing from Nurses, through a Nurse, a Nurse scholar and scientist, and back to the Nurses. This is us leading and being the change we need to see so that we can be safe and professionally well. So that has been, in a nutshell. So you asked about my Nursing career…

Nicole Vienneau  28:18

Wow, I know we’re all listening with bated breath, like, oh my gosh, girl, so much has happened for you over your lifetime. And this is just the little bit that you want to share with us right now, right? There’s so much more that, of course, that is Dr. Lorre, right? 

You know, a few things really stuck out for me with all of that and so many things are sticking out, but you spoke earlier about conditioning. Before I even go there, I just want to celebrate first. Can we celebrate? Like, can we celebrate all of this work that you’re doing? 

Lorre Laws  28:58

Aw, thank you!

Nicole Vienneau  28:59

Can we celebrate that? Because, oh my goodness. And you were just asking the question of the universe, how am I going to help? How am I going to help? And you just gave in. And then all of these downloads, all of these messages coming to you, and, okay, what now? 

What do I need to do? And then just taking another step, learning something new, exposing yourself to all the vulnerabilities of that, and just saying, you know what, I’m just going to do it. I just feel so called that I will do anything that is necessary. 

Lorre Laws  29:38

Yeah, you know, when you say it, it feels big in my body. As I’m doing it, it’s just like, you know, I’ve been working 12, 14, hour days, you know? I have a day job, and then I have dinner, and then I do this work in the evenings, every weekend, every holiday. 

Every vacation has gone, you know, into this lightwork project, heartwork project, right? And so thank you. I mean, really, like I’m getting a little over clamped because to have it mirrored back to me. You know, it has been a labor of love. It is hard work, and it comes from a place of such deep caring for those of us who have chosen, whether by calling or by other choices, you know, Nursing doesn’t have to be a calling. 

It is for many, but it doesn’t have to be. We are all showing up in service and facilitating healing, and we bring our whole heart with us, and we bring, you know, our whole lived experience with us and in service to those in their most vulnerable times. 

And you know, what a great privilege and honor, although it has added many gray hair and many line on the face, but that’s expected for where I am in my lifespan, so I’m not mad at it. But yeah, it has been, it has been a lot. And thank you. Thank you for just giving me a moment to even just kind of process that with you. Yeah, it’s been big for me. It’s been a lot in a lot of ways, it’s been a lot, yeah.

Nicole Vienneau  31:34

Well, thank you for the work that you’re doing. Yes, yes, because somebody’s got to do it, girl. And I was listening to your story like, yeah, 1970s here you are a CNA and being exposed to the realities of healthcare, and then coming back later. You know, what was that, almost 50 years later, maybe 40 years later, and it’s the same, some of the same things we’re seeing. 

Yes, technology and everything is advanced, all of the things that we do, the tasking, all of that is advanced. We’re advanced, and yet we’re still faced with the challenges of being able to function to our full capacity of being a human, in the systems that may not be truly supporting us, or that are not truly supporting us in the ways that we need as fellow humans, caring for fellow humans. Yeah.

Lorre Laws  32:37

Now, one of the challenges, and this is part of why I’m spending a lot of time, hopefully, doing interviews and podcast conversations, is because it’s the conditioning, you know, going back to that conditioning. We’ve all been conditioned to think and to believe to be true— and I’m going to invite each and every one of us to challenge these old assumptions from the 1970s— 

that even when we look at the World Health Organization’s definition for burnout, it is occupational stress that is not effectively managed. Now we’re not talking about occupational stress anymore. We are talking about extreme trauma exposure, right? 

And I find, and I recently… I have a baby podcast on YouTube. I’m just, you know, I’m just learning how to do that right now. That was the next thing I had to learn how to do is, like, you know, a podcast. Are you kidding? So I’m learning how to do that right now. I’ll be honest.

Nicole Vienneau  32:38

It is a wonderful podcast, by the way, listeners, we’re putting that link to the podcast in our show notes. Yes.

Lorre Laws  33:52

Thank you. And we’re moving over to, you know, to Spotify and Apple at the first of the year. But when you start scraping the evidence bucket as I have, what you find is there’s these systemic biases that are gaslighting towards Nurses. Well, it’s kind of this blame the victim culture, like, you know, well, Nurses, if you’re burned out, well, you should just do better self care, you know, you should work on your resilience. 

Let’s you know… and even the ANA recently, and I say this with such humility and respect, because I have such tremendous regard for the good work that the American Nurses Association is doing, but things like having a positivity squad. Now we are talking about trauma, and what is happening is when you start shifting the blame onto the Nurses, you know, like when… and I have been physically assaulted. 

As many of us have. I just spoke recently for… yeah, you too, raising your hand. I just spoke at the National League of Nurses last month, and I had over 200 Nurses in my audience, which I was so grateful for each and every one of them there, and I asked them questions as I’m going through my slides of you know, raise your hand if you have ever been. 

And I had kicked, hit, punched, had your hair pulled, spat upon, clawed, bruised, battered, and all but three hands out of 200— imagine me up there at the podium, looking out at my colleagues who I love with my whole healer’s heart, and I see that 197 out of 200 have experienced physical assault while in practice. 

Well, it’s just not okay. And so then you start looking, because that’s my job as a scientist, right? I start looking, and I’m like, these outdated narratives around burnout are really a blame the victim culture, just like when we get assaulted at work and we go in and we report it following procedure, and the first question is what, Nicole? What’s the first question that if a Nurse gets hit, as you and I have, that leadership would ask? 

Nicole Vienneau  36:17

What did you do? 

Lorre Laws  36:19

What could you have… yeah, what could you have done differently? You know, and so everywhere I started seeing it, in the evidence space, in the policies, I start seeing it even in… I’m an educator, you know, the American Association Colleges of Nursing, we have the essentials. I went through those essentials with a fine tooth comb, a fine tooth comb in those in those competencies that pertain to self-care and resilience. 

They are not, and I say again with tremendous respect and humility, they are not trauma informed. And it’s this systemic, what Dr. Karen Foley would call this historical trauma that we as Nurses are unknowingly transmitting from generation to generation. And you can see evidence of it in the World Health Organization definition of burnout. 

And it’s not classified as something that’s reimbursable even in the ICD 11, right? And you go to the website, the AACN, you go to the ANA, these are some of the most prestigious, well regarded Nursing organizations on the planet, right? And we’re finding the same sort of systemic structures in this blame the victim sort of gaslighting thing, that it’s the Nurses’ responsibility, it’s the Nurses’ responsibility, it’s the Nurses’ responsibility. 

So when the ANA, or, I’m sorry, the AACN, the American Association of Colleges of Nursing had their public comments on the essentials, please know everyone that I spent hours, I spent hours advocating for us, because these are not trauma informed. Where is the organizational responsibility? 

Where is the system’s responsibility? If Nurses need to strike because it’s unsafe for them to practice and they are working within their scope of practice and within the laws of this land, it’s the Nurses responsibility to find someone to cover their shift? Are you kidding me? Are you kidding me? 

And everybody is sort of, you know… I guess somebody, you know, I guess I was the one that drew the short straw that said, you know what, you’re going to challenge the system on your way out, close enough to retirement that it kind of doesn’t matter for me right now. I’m just here because I care, you know, and it’s like, you know what? 

I’m going to say, and I’m going to stand on the evidence base, and I’m going to stand on our middle range theories, and I am going to stand— I had, Dr. Jean Watson endorse my book, Dr. Bonnie Badenoch, Dr. Terrence Hill, who is a medical sociologist, Dr. Janet Quinn, who is one of the nation’s leading Nurse scholars, and Dr. Mary Beth Ackerley, who is a renowned trauma healer and board certified psychiatrist. 

And so everyone that has looked at this work has assured me, because let me tell you, in the beginning, I’m working across discipline. That’s a big limb to be out on for a Nurse scholar to be out really like doing deep, deep diving. 

So, I went and got peer reviews of this work from each of the disciplines that is represented in this work to make sure that I was bringing the very best that I could to our Nurses worldwide, and really start challenging these assumptions, these embedded structures that aren’t really in our awareness. Because, like for me, since 1970 for Pete’s sake, it was 1974. 1974! It’s 2024. That’s 50 years, right?

Nicole Vienneau  40:35

Yeah, 50 years.

Lorre Laws  40:36

It sure feels like it my body. It sure feels like a half of a century over here. And so, you know, really looking at it, I think that was, you know, the divine guidance of why, why my back was injured so substantially as a very, very young woman, so that I would come back into the profession, you know, an experienced professional who had done well in other sectors, with humility, I had done well. 

And came back in, you know, because I had a calling, like many of us do, but I didn’t know that this was calling, but then, but you see it, but you see it differently when you enter the profession in your 50s, as I had done, then I would have, would have not, I mean, you know, when you look at divine perfection, which is something I’m always tuned into, the divine for perfection, the divine right order. 

And so I see the divine right order, and why had to endure such a horrific back injury that still is problematic to this day. It’s, you know, back injuries like this are never… 

Nicole Vienneau  41:57

What could you have done differently back then, Dr. Lorre, right? 

Lorre Laws  42:03

There’s one hoyer lift. You know, this was at a major academic teaching hospital, and the med surg floor had four wings. This is how big this particular hospital was, and there was only one hoyer lift for the whole… for four wings, you know, in a building. So, yeah, what could I have done differently, but I do see the divine perfection as to why, you know, I needed to go through that. 

And, you know, my life path and it has led me to this point where, you know this, like you said, somebody had to do it, and I was the one that it was my ear into the calling was whispered and yelled and, you know, so all I have done, really, is just answered that calling. 

But boy, what a ride it has been and continues to be. I mean, the book is coming out. It’s coming out abroad in the middle of December, and here in the US, it’ll be out January 1st. And so really, the work is just beginning. You know, in many ways, the next phase of the work where Nurses will actually be able to work with this. 

They’ll be able to come to the offerings in our nonprofit, where they can be facilitated in their healing, rather than somebody just shoving. It’s like giving a cancer patient a bucket of chemo and, you know, a bunch of…and say, well, here go heal yourself. We see that you’re unwell. We see that you’re sick. 

And not to say that Nurse specific traumatization is the same as cancer, but can we really, you know, can we really… the autonomic nervous system, the organs and cells in our body, they don’t care about the narrative of the how, how we became unwell, right? 

The organism at the cellular and in organ systems level doesn’t care about that, unwellness is unwellness and sickness is sickness and illness is illness, and all of it needs to be facilitated. The healing needs to be facilitated, even when curing isn’t possible, you know, and that’s what is so sorely, so sorely lacking in our health systems. 

Because the Nurse’s role as healer, as facilitator of healing, as the one who is supposed to be heart centered, fully present and open and curious and engaged in every aspect of the people body mind essence in their care, and it is simply not possible, given today’s staffing ratios and lack of shortages and resources and violence in the workplace, it is not possible, and this is no deficit. 

If you are a Nurse out there, please know this is not your fault. You do not have a character flaw. You do not have a personality deficiency. There is no deficit. We are experiencing unprecedented trauma exposures, and some of those traumas, in Dr. Foley’s work, you know she talks about, in our middle range theory, she talks about avoidable and unavoidable trauma, and I really went down the rabbit holes with that in my work. 

And Nicole, you’ve heard me rant about that. But you know, we are trained because there is a certain degree of the unavoidable trauma exposures that Nurses, like many other first responders, we are trained in that, we are trained in second victim or vicarious trauma. 

Maybe not as well as we could be, but yes, but we are prepared for that in our training, in our education, and just as another form of unavoidable trauma exposure that’s inherent with our profession comes with the job is trauma from disasters, and we’ve all been trained on how to respond to disasters when they occur. 

So, that’s not the problem, the problem and what is driving Nurses from the profession in droves like never seen before— please don’t talk to me about attrition, well, yes, that’s a factor— people are, the world, the world is hemorrhaging Nurses. And that’s a quote from Dr. Terrance Hill, medical sociologist, the world is hemorrhaging Nurses and the root cause for that, it’s not about burnout. 

And please stop gaslighting Nurses about burnout resilience. Please just stop. The reason, the root cause, according to my research, five years, four disciplines, is avoidable, Nurse specific traumatization. And this would be this historical trauma, where we are unknowingly transmitting. 

An example of this historical trauma is Nurses eat their own, you know. And I have permission to share this, Nicole, but my daughter, my middle child, my daughter, Katie, she went through the same map and program that I did, and here is her mama. Her mama is a Nursing professor, and she is doing research for this work, and I’m an integrative Nursing professor, like every possible tool and support that this young woman who happens to be my daughter, could possibly have entering her practice. 

She graduated from Nursing school with honors and awards, and arguably, is a very, very good Nurse, and that’s not me just being her mom. Others have bestowed awards upon her, and I knew, I knew, as she was getting ready to enter practice, I said, I want you to call Nicole, and I want you to get a series of sessions of Nurse coach sessions to coach you through, to help you, because you’re going to be pushed off a cliff. 

You know, as a Nurse educator, I mean, it keeps me up at night, because we do everything we can. And I know you’ve spent a lot of time working and coaching our new graduates in your role too, Nicole, and we are all, we are all doing such a good job by our students and by our early career Nurses in these ways. 

And the system, it’s like that takes their healer’s heart, and my clients have reported it to me. It’s like it just runs us through a paper shredder, or we get run over by a steam roller. Those are the two most frequently remarks that I get when I ask what their experience is like. 

And so even, even despite, despite having me for a mama and despite having you for a coach, within six months, my daughter experienced the same degree of burnout and Nurse specific traumatization. Within six months. She was working, and she was a home health hospice Nurse, and they were having a new graduate Nurse. And I’m not singling out any one agency. 

This is… I’m working with Nurses in every state in this nation and countries worldwide. So I’m not singling out any one particular organization. This is a systemic problem. And you know they were supposed to be working Monday through Friday, eight to five. It was Monday through Saturday, 6:30 till midnight, one o’clock, two o’clock by the time they could get their charting done. Well, none of us, it’s physiologically impossible. 

You know, this is where we start looking at polyvagal theory, and we start looking at that cell danger response theory, and we start seeing what is really happening physiologically. I don’t care what the World Health Organization is calling it, quite frankly, and neither does your body, right? I’m interested in your health. 

I’m interested in your professional well being. I’m interested in your safety, and so I’m looking at it through that lens and seeing what’s going on right down to the organelles. Right? Let’s talk about the mitochondria and the trauma exposure for most Nurses is so great. 

It’s so great that— and I don’t know if you want me to go unpack polythegal theory, I can, but I’ll skip to the finish line, and then you can tell me if your audience would be interested in that. But what happens is that the trauma exposure that we are evolutionarily designed to be able to withstand just about anything on the short term, right? That’s the sympathetic nervous system. 

This real autonomic nervous system does a brilliant job with you know, we think about Selye’s, oh, it is that general adaptation to stress response syndrome, right? And so we have plenty of evidence that shows us very clearly that we are equipped to deal with short term stressors, short term trauma exposures. 

But I’ve been around 50 years, this is not short and a half of a century is not short term. I think we can all agree. We can all agree on that. And so what is happening is that the mitochondria literally cannot produce the energy that is needed to withstand this amount of trauma exposure for this long of a period of time. 

And so the dorsal aspect of the vagus nerve— in part, and it’s more complex than that, but I’m just going to break it, you know, super simple— then starts putting the Nurse into a protective mode called freeze or outright collapse. So if you’re a Nurse out there and you are dragging yourself into work, you want to do the best you can, but you don’t have any oomph, any gas in your tank, and you’re beating yourself up over, please don’t. 

Because this is a physiological situation where we have endured too much for too long. And you know, another narrative we need to be challenging is this resilience narrative, as though there is an unlimited reservoir within each of us of resilience, and you just need to go get you some more, you know, go to the resilience station and fill yourself up, Nurses, right? 

And so, but it doesn’t work that way. And so this is why Nurses are leaving the profession. And again, if you are a Nurse out there and on your day off… it’s called presenteeism. Presenteeism is when we’re at work, but we aren’t all the way at work because, you know, because we’re tired, because we’re a little brain foggy, because we’re lethargic, because we have extreme fatigue. 

This is not you. This is not a deficit. This is not a character defect. This is your body has you in a shutdown, kind of a freezy state to conserve energy, because your mitochondria literally cannot produce the energy that is required in this severe of trauma exposure context. 

So let’s start changing the narrative around burnout and around resilience, and let’s take a trauma informed approach to how we practice. And it’s a big part of what I do in my book and in my nonprofit work is so if you’re a Nurse out there, and maybe you’re not yet burned out or feeling, you know, and here’s the other thing, when I was scraping the evidence bucket, as I love to do, the very bottom where all the sludge, that’s where you’ll find me. 

I did a symptom cluster analysis, because I was curious about, you know, why Nurses aren’t responding to traditional burnout methods for healing, and well, what are the symptoms of new specific traumatization, and what are the symptoms of burnout? And when I started, I mean, I deep dove. 

I needed a scuba tank. That’s how deep I went. And into the evidence base, there is so much overlap between the symptoms and how the body is affected that we really need to update the burnout narrative. And so many of our policies, how we’re teaching our students is not trauma informed when it comes to self care and resilience, how we are onboarding our new graduates, and we should be supporting them with everything we have in those those first years. 

There is no training for how to insulate yourself, how to insulate your nervous system, how to learn the language of your autonomic nervous system, learn the language of your vagus nerve so that you can insulate yourself from the impact of the avoidable Nurse specific trauma exposure that you’re going to endure. 

So learning how to use an innate care plan that is curated to your life experience, your personal trauma history, because we all have one, the American Association of College of Nurses, the AACN says that we as Nurses should assume that every patient in our care has experienced trauma. 

We don’t need to know what that is, but we need to be sensitive to it. Well, guess what everybody, Nurses are a subset of everyone. We are a subset of the general population, and so we too should be taking trauma informed approaches to our professional well being, workplace wellness, workforce wellness. And so this is what I’m doing. 

So I’m hoping that I can get these programs. I have a 12 week curriculum. Anybody out there, I have a 12 week curriculum for your healthcare organization, for your educational organization, I am here. I will partner with you because we have the science, we have the conceptual framework, we have the middle range theory, we have the four step process. 

We have over now 100 practices. This is what I’ve been doing for the last, well, six years, and six figures of my own money. That’s what I’ve got invested to date. And so all of this has emerged, and it’s available. And for Nurses out there, if you think you might, you know, when I was in front of the 200 Nurses at the National League of Nurses, I surveyed them at the end, asked them for two questions, because I’m really kind that way, just two questions. 

And one of which is, do you want me to stay in touch with you? You know, do you want to be on my list? And I’ll keep you updated as the science evolves. And then the other question was, you know, how do you feel in your practice? Now, this was startling, but not surprising to me. It made me very sad, but not surprised that 18% out of 200 said that they were thriving in their practice, that they were doing okay. 

20% said, I’m definitely… I’m beyond burned out. I’m not just burned out. I am beyond burned out. And just over 50% said, I’m pretty sure I’m experiencing Nurse specific traumatization. I didn’t know that that was a thing before I came in here, but I know it’s a thing now, and I see it, and now I can’t unsee it, which is beautiful, because we have all of these resources that are ready for the Nurses, ready to help healthcare organizations. 

I’m not here to bash on any healthcare organization. I’m here to partner. I am a healer. However you, you know, feel called to let me serve you and your community, individual Nurses, you know, I’m here for you in those ways also, and we are going to also… 

what I’ve learned from Nurses in this last year is that, in addition, like many of them now, have finished going through the academy, you know, our 12 week program, and they want continuing support beyond that, like a membership, like a monthly where we can continue to do this healing work and continue so that we can maintain the healing gains and translate those into practice. 

So that when we go into the workplace, we aren’t getting our nervous systems hijacked by the extreme trauma exposure, that we can stay regulated in our nervous systems. We can stay safe and healthy and well in our professional roles. But we to do this, you know, each individual Nurse, there’s an individual component where we each, you know, we each are responsible for our own healing work, whether it’s this type of healing work or other ruptures. 

You know, as Dr. Bonnie Badenoch describes, and her science suggests that 30% of the encounters that we have with one another are harmonious, and they land well with one another. 60% result in micro ruptures or big ruptures. 60% the time we’re in a process of rupture and repair. And that’s, of course, in service to our, you know, building resilience and tolerance, right? 

And so here we are. Her research isn’t specific to Nurses. So I would argue that for Nurses that that would be, that would even be higher. So as individual Nurses, we all have our individual ruptures that we’ve experienced over a lifetime and that are in various degrees of repair. And then we have the Nurse specific traumatization. 

We have the individual traumas that we have all endured in our own very, very unique manners that are in varying degrees of healed-ness, which isn’t really a word, but I love it. And so, yeah, and so here we are. And so we, as individuals, we have to do that work. This is, you know, this is Nurses, I know this is what Nicole is doing in her work. 

This is what so many of the Nurse coaches out there. I know I am, I am talking with you all out there, and I know you’re doing good work, helping Nurses, Nurses helping Nurses. There’s such a beautiful community out there. So if what I’m bringing to the table isn’t, you know, resonating with you. 

It doesn’t stop with me. You know, the LinkedIn all over the place, you can find Nurses helping Nurses, and us coming together and doing our healing work individually and as in  communities. And then when we start working from our healing scars, instead of our gaping wounds, because right now, we’re hemorrhaging out as a profession. 

I’m telling you, I’ve looked at the data from every developed country on this planet, and Nurses are hemorrhaging out in terms of professional safety and professional wellness and well being. We are not healthy in our professional roles, and a lot of that is due to healthcare system inadequacies and organizational shortcomings, the avoidable trauma exposures, the short staffing, the too high of acuity, the being floated to a unit that you don’t have any experience in that particular specialty, the workplace violence visited upon us from from families and patients, not to mention the lateral violence, the bullying, the incivilities, the hazing. 

Then there’s the second, you know, that we have the second victim trauma. So if you’re a Nurse out there, and this is another avoidable Nurse specific trauma exposure, and you have been involved in a near miss, an adverse event, or a sentinel event, there’s a whole nother layer of trauma that comes with that, the dark night of the soul type of trauma. 

And then it’s really, really unfortunate, because when you start looking at the root cause in well over 90% of the cases, it’s a system failure and no shortcoming of the Nurse. But yet the Nurse is carrying the burden of the shame and the guilt that was never theirs to carry in the first place, you know. And so this is another one of those avoidable Nurse specific trauma exposures. 

And so it’s really changing the whole language around everything, around burnout. It’s not just burnout. We’re so passionate. Maybe it was burnout in the 70s. I don’t know. I was a teenager, I couldn’t tell you. But the good news is there’s hope available, and there’s, you know, that’s the good news, is that we’ve got our thumb on the pulse and that healing is possible. Help is available. 

You’re not alone, and there is a pathway out, and you can thrive in practice. But we need to learn how to insulate our nervous system, learn how to navigate our nervous system. Language of our vagus nerve, and then reframe how we go about self care. Because if you… all the self care in the world, if you’re on a dysregulated nervous system, you’re not going to… and this is why Nurses, this is what I discovered. 

This is why self caring, traditional self caring approaches, aren’t working for burnout. And it’s because we’re putting those on a faulty foundation. The foundation is a regulated nervous system. But if the nervous system isn’t regulated, if we aren’t practicing and living from our window of tolerance where we are healthy, thriving, and well, but if we’re in sympathetic overdrive when we’re overwhelmed, or we’re going into that dorsal vagal kind of freeze response, right? 

Or we’re being kind of shut down, you can’t self care yourself out of that. You know, specific approaches to trauma healing are needed, and it needs to be, in the vast majority of cases, it needs to be facilitated. You need someone with you and and holding space for you and guiding you and availing their regulated nervous system for yours to sync up with and co-regulate, because this is how we have survived as a species over the millennia. 

So partnering with the wisdom of our most ancient and primal systems. I’m not interested in what the prefrontal cortex has to say about is it burnout, or is it not burnout? I’m interested in what’s happening in your body, mind essence, and how we can get you out of survival mode as a Nurse or a health professional. 

I mean, my work isn’t Nurse specific. I happen to be a Nurse scholar, but, you know, I work with all disciplines, but getting out of survival mode is done. And then, once we’re regulated in our nervous system, all of the usual self care things that we as Nurses all know how to do. So please stop telling us that we don’t know how to do this. We know how to self care. We have licenses that say we know how to do this, and then those self caring practices will be optimally effective.

Nicole Vienneau  1:07:18

Ah, so I know that you have also written an article. What If It Isn’t Just Burnout? Moving Beyond Self-Care and Resiliency? So I’m hoping that we can pop that into the show notes for our listeners. I’d also love to share a podcast. 

It’s episode number 79: Together We Can Stop Shame and Blame in Nursing with Kristy Meyer which is also going to be just a great listen to the story behind Kristy’s story, and supporting Nurses in her way. And Lorre, I know your book is coming out, Nursing Our Healer’s Heart, and so it’s coming in January, and so we can pre order this book, I guess. So tell us how we pre-order.

Lorre Laws  1:08:06

Well, let me tell you what I learned in how to be an author school, which is really, it’s the preorders that drive the algorithm to get this book shown to the Nurses who need the help. They’re searching for Nurse burnout. They’re searching for Nurse trauma. 

And if this book, Nursing Our Healer’s Heart appeals to you in any manner, wherever books are sold, Amazon, Barnes and Noble, all the usual places, if you would consider pre-ordering or ordering in January, that would help the algorithm show this book in the search results when Nurses are searching. So I would be so grateful. 

It’s affordably priced at $23.95. I priced it to make it as accessible to as many Nurses as possible. And I’m just so grateful for however you may choose to support this work and to support our profession. I’m just thrilled to be here and thank you. Oh, there it is!

Nicole Vienneau  1:09:05

I went on to Amazon, and you just go search Nursing Our Healer’s Heart. You’ll find the book and it says it’s not yet been released, but you can pre-order now. So clicking that button, yes, ma’am.

Lorre Laws  1:09:18

Thank you. Thank you, Nicole, I appreciate that. 

Nicole Vienneau  1:09:21

Yes, yes. So Lori, thank you so much for being with us, for sharing your passion, for helping and healing our healer’s heart as Nurses and Nursing our healing heart, our healer’s heart. We’re going to put all your links in our show notes. So yes, there’s so many beautiful resources that you’ve created, and so we’ll pop those all in our show notes for our listeners to click on. And I know that you’re available, so we can find you. How do we find you? 

Lorre Laws  1:09:56

Well, my website has literally everything on it, and that’s drlorrelaws.com. My mom spelled my name kind of funky, so I’m going to spell it out for you here. It’s drlorrelaws.com, or you can just google me and it’ll pop right up for you.

Nicole Vienneau  1:10:19

Yes, yes. So so amazing. Thank you once again for just being you and for answering the call, answering the call.

Lorre Laws  1:10:29

Thank you, Nicole. I’m so, so grateful to be able to serve your community. And thank you to the Nurses out there and the Nurse coaches out there. And again, if you’re considering at all Nurse coaching, I could give it 500 stars, yes. So it’s a beautiful, beautiful way to practice. So yeah, if you’re considering, you know, take the tumble, you’ll be glad you did. 

Nicole Vienneau  1:10:55

That’s right, the Integrative Nurse Coach Academy, yes, all right. So, thank you.