Mary Lagaard Interview 7-7-2023

00:03 Hi, this is Jocelyn Bassett Garland, and this is really one of our first interviews for the St. Kate's Storycorps nursing interviews. And my name is Jocelyn Bassett Gorlin, and I'm 64 years old. Today's date is 7720 23. And I am speaking with Mary Lagaard who is my colleague. And I am recording in St. Paul, Minnesota.

00:31 And I am Mary Watzka Lagaard I am 70 years old. Today's date is 7720 23. And I am speaking with Jocelyn and with Sarah. I am recording this interview in St. Paul, Minnesota. Great.

00:49 So, Mary, thanks so much for coming to be with us, and we just are so thrilled that we're going to have this conversation with you. So first, let's just begin with, can you tell us a little bit about your decision to become a nurse? And did your community, your family, your faith, or any of your health beliefs impact your decision?

01:12 It's almost happenstance that I became a nurse. Okay. My mother was a nurse, and she was a pediatric nurse, and she loved very much her job, and she worked very hard. And I had for years, in my teenage years, said, I'm never going to be a nurse. I don't want to be like my mother. And I was originally interested in being a journalist, and I really liked people's stories. And it was through a variety of circumstances that I found myself having to make a decision for survival. And because the nurses get employed, I became a nurse.

01:55 Wow. So it was kind. And did your mother influence you? Did that? Kind of.

01:59 No, no. Actually, what happened was I got a degree in psychology from St. Ben's, and I fell in love with a man named Frank. And Frank's mother died after we graduated, and he asked me to move to the University of Iowa in Iowa City, where he was in medical school. So I moved in. Three weeks after I moved, we broke up. And so here I was in Iowa City and did not know what to do, and I certainly did not want to work at Howard Johnson's nor Perkins. And so I interviewed for the nursing program. I was accepted, and I got myself a job in the operating room on a PM shift. And so it seemed to fit in a kind of odd way. So once I started the program too, I liked it. So I thought, darn, my mom was right.

03:01 Oh, that's wonderful. Sorry, do you want to tell us a story? I know there's a little bit more to that about how you kind of became working in the or and.

03:10 Yeah. Do you want to hear the story about the.

03:15 Yeah, I want to hear that story.

03:16 Okay, so the story that really actually from working in the operating room that echoed forward in my life is the following. I was working with a couple of guys. You know, one was, I think he was an environmental major, and the other one was another pre med kind of guy. And we were in charge of the PM shift. We cleaned the rooms. We took samples to the. We ordered supplies. So we really had a good time working together. But what happened one day was at 04:00 in a busy 32 room operating room at the University of Iowa. I was called to an abdominal case. When you go into an operating room, there are all these machines that are operating. And one thing you don't often think about is what's on the floor. You look at the table and you look at the machines and you look at the recordings. So I came in and skipped over all these wires on the floor and was handed a large, about five pound container that had a sample in it. I wasn't told what was in it. I said. They just said to me, get it to the OR.

04:33 Now, was it covered or.

04:34 It was covered.

04:35 Okay.

04:35 It looked like. It looked like takeout. Okay, look like takeout. And so I. They want to hurry you out of the room very quickly because they don't want any source of contamination. So they opened wide the doors and were almost physically shooshing me out when I tripped on one of those cables. Went face down and in front of me. The container came open, and the contents escaped, and it happened to be a five pound blob of fat. So in the busy ore at 04:00 there's a lot of people leaving and coming and going. And everybody had the same similar response, which was, oh, my God, what is that floating tumble? And it kind of. It kind of wove like a river. You know, it didn't kind of straight slide. It kind of wove like a river. So people were actually trying to dodge it as it weaved from side to side. And how were you? I was, like, just trying to get up, just trying to stand up, because I couldn't really see what was happening because all these people were there, and there was all this laughter and appalledness. And then the head nurse of the oR, you need to know her. Her name was Nancy, and she was a military nurse. And she took no grief, none at all. She was the commander of the operating room. No three ways about it. So she came out. She looked. She was appalled. And so she wanted this gone quickly. So she went and she grabbed it, but she missed it. And it slipped past her. And it made this oily substance over the front of her operating or her scrub suit. So what happened then was I thought, oh, no, I gotta get a hold of this situation. I went back to the operating room. I knocked on the door. They let me right in. I said, I need a barbecue fork. Anything like a barbecue fork. And they said, amazingly, we do. And so they gave me this thing that looked like a barbecue fork. I took the empty container, I went down the hallway, stabbed it, put it in the container, put the COVID on, and went down to the. To the lab with it. But when I came back up, I probably. She must have been waiting for me right off the elevator, because she said, come with me. And I went, yes, ma'am. And she assembled me with the other two eights, because I think she wanted to make a point to us, all of us lowly people on bottom of the social ladder. She said, I am appalled at what happened. And I said, well, I just tripped. And she's like, sorry. You don't trip in this ore. And I. You're fired. At that moment, what happened for me was here. I had moved to the University of Iowa. I felt so lucky to have a job that wasn't at Howard Johnson's counting lettuce leaves. Okay. And I had just gotten into the University of Iowa. What was I going to do? I really felt like, well, so much for being a nurse. And then one of my coworkers spoke up, and his name was Tom. And even now, 50 years later, I'm very grateful to this man. He spoke up and he said, well, he said, nancy, you can fire her. You can't fire her, but I want you to think about how long you're going to spend looking for somebody else who works as hard. And then the thing that I relished the most, he said, it is as much fun. And he said, it's going to take you a while. And she's a hard worker, and we enjoy working with her, and I think we make a good team, and we can provide good service for you. And, Nancy, I. You know, you live in terror of these people who operate like that. I thought, she's not going to renege. Thank you. But she's not. But she said, okay, think about it. She said, you come back tomorrow. And they must have talked somewhere after I left, but I was just beside myself, and I went home, went to bed, came back the next afternoon, and they said, we'll take you back. And I was just so relieved. It was like, you know, there was grace there, too. You know, in being let back in. And just as a joke, you know, I think I didn't tell you guys this part of the story. The guys brought me some chicken fat, you know, they just wanted to make me laugh when I got back. They were very kind.

09:44 So, Mary, I'm thinking too, did you guys have gloves at that time?

09:47 Oh, we didn't wear them all the time.

09:50 That's what I was thinking. And then the other thing is that you tripped on wires in the oar. In the oark, which is a total, it's a hazard, right?

09:57 I mean, so it was a total hazard. In fact, later I thought, well, maybe they should put like a little bridge over.

10:04 I think they probably have changed it. Let's hope they change it. I love that story.

10:09 Oh, I'm glad you love it, because I've told it many times, and the context that I've told it is I've spoken to some nursing organizations and I've said, you know, if you really want to pursue something, don't give up. And then the other thing is, it's not all about you. Other things happen that you have no control over. So just innovate and be flexible and you can gain what you're looking for.

10:39 Did it make you feel, like, more resolved to be a nurse? Yeah, it did, you know, because you're kind of like, I'm going to do this now.

10:47 It's like you're not getting in my way.

10:51 So you talked a little bit about your education, but tell us, like your, what kind of a path, like, did you tell us about your education to becoming a nurse?

10:58 Well, actually I started out at the University of Minnesota in psychology, and I liked that a lot and was privileged to be part of an honors class there, which was really, you know, if you go to the U, you're usually in the beginning psych class. You're one of 7000 students. So I was one of 40. So I felt very lucky. And that, I think, kind of cemented and gave me a good foundation to be a nurse, actually a background in psychology. And then I felt I had gone to a private girls school in Little Falls, Minnesota that was run by the San Franciscans. And then I ended up going to the u because I wanted to be a nobody. I didn't want to be a somebody when you're in a, you know, there were like 56 people in my high school class. I wanted to be a nobody and so I was. And, but then I thought it wasn't challenging in the same sort of way. So then I transferred to St. Bands. And one of the most, one of the most impactful things that happened at St. Ben's is I was in another honors course, but this was so much fun. I was in a course with Father Kim, who was a sociologist from the University of Chicago, and he yelled at us in class. He said, you think you're so smart, you know? And he made us good. A library of, at the time, it was $250 worth of books, which was a lot. But that library still, I seek answers in. I mean, we got a lot of basic greek thinkers, and then he was heavy on the philosophy, and he tend to like russian writers a lot. It's kind of what I ended up with, but he shaped us in saying, what you have going on now is this library in your thoughts now will be reshaped when you're older. And I want you to have these resources for you as you age. And so that gave me an idea about education. Do you know what I mean? That education, we think about, we're training people to take a job, but the truth is we're really training them to look at the world a different way and to see possibilities and to see opportunities, but, and also to challenge what we see, because the writers he gave us did a lot of that. So that's.

13:42 Is that why you're interested in ethics? Did it came from that?

13:45 Because I know it came from that. It came from that. And, and actually, no, I want to say this. I'm reading a book now called the Fragility of Goodness by Martha Nussbaum, who was a philosopher at the University of Chicago. And a lot of her work on the fragility of goodness has to do with the great tragedies. And what I like about what she says is goodness is fragile, and it needs people to speak up. It needs people to shore it up. But especially in this time now. Yeah, but you could see that the same thing happened in Athens that people have to do. So it's kind of part of the human struggle is to do that. And so that goes back to, again, what do we educate students to do is to change the world. And if you go back to the ANa code of ethics, what does it say nurses do? Nurses heal the world. That's your mission. And you don't heal it by just following rules and putting in computer things all the time. You do it by holding certain values.

15:12 So you see it as much bigger than just an educational paradigm, which is bigger. Yeah.

15:18 Well, why would we just fit you into a role for a slice of life? I mean, why wouldn't we open you to all the possibilities? I mean, wow.

15:31 And then from there, you were at St. Ben's, and then you went to.

15:35 The University of Iowa. Then I followed that guy to Iowa.

15:39 Okay.

15:39 And then I got my bSN in Iowa. And one of the things that was important there was that I was a speaker at graduation for my class. Yeah. And what was really kind of intersected there is my mom came, and she. She really was like. She was very bemused. Okay. Let me just say that it was so fun to have her there because I could just see her shaking her head in the audience while I was talking. Like you said you'd never do this.

16:15 Why do you think they chose you to speak?

16:17 Oh, I know why they did, because it was I. And my best friend. My best friend was like my polar opposite. She, in my view, she was a beautiful blonde, but she had a higher kind of squeaky voice. But we were both kind of. There were a lot of questions about the ethics of the director of nursing at that time. And so what we advocated for was her to come and talk to the class, and. Because, you know, you don't know what's the truth, you know, until you hear it from the horse's mouth. And so. And she did. She came. But the fact that we had stood up and asked for confirmation.

17:00 And was she the head of your school or the head of the.

17:03 She was just head of the nursing school.

17:05 Oh, the head of the nursing school. Interesting.

17:06 Yeah, well, she got caught. She got caught doing. I mean, she's human.

17:11 Yeah.

17:12 Okay. So she was. I think she kind of created a different image of a nurse and going around with her sports car and getting a number of tickets. She was fun, too.

17:25 See? So you think your kind of advocacy kind of brought you to be the speaker because they.

17:32 Yeah, my advocacy around these issues. And it wasn't so much advocacy as asking questions.

17:37 Yeah.

17:38 Because I didn't know the answer. You know, I didn't know the answer. So it was more. I think the whole class was asking those questions, you know? And rather than sit and stew and make up rumors, the thing to do seemed to be to ask the question of the person involved.

17:57 You seem to me as someone that feels comfortable asking questions, and I've always really admired that about you, and I think that kind of speaks to what you're saying. It almost. What are your thoughts about that? I just think you do ask questions, and I think, oh, well, it's a.

18:13 Blessing and a curse. That's my thinking about it. And it puts me in conflict a lot with some people that don't clarify where I'm coming from, and I'm uncomfortable with that. And.

18:32 But it's like questioning sometimes brings you clarity. Right. And that's. That takes a lot of strength. Yeah.

18:42 Yeah.

18:43 So you were. You were then at the University of Iowa, and then what was next?

18:48 Oh, what was education? Oh, well, it was. It was on the floor. It was on the floor. It was on the floor. Being a neuroscience nurse, and if you learn advocacy, and if you learn how to stand up for nurse, for patients, the place to do it is being a neuroscience nurse, because neurosurgeons think they have all the answers and they never make mistakes. And so that's where advocacy starts. I can tell a real quick story. So I was a night supervisor, and I observed a patient having seizures. And the surgeons would come around at 06:00 in the morning and make rounds. And so I had to have all the data organized, all the head nurses or the night charged, organized to kind of give reporters and saw these patients. Well, they came to this one patient, and I witnessed the seizure, and I said, this man had seizures during the night. And the surgeon looked at me and he goes, he could not have seizures. The surgery was perfect. And I looked him right in the eye, and I said, because the patients are so vulnerable, I looked him right in the eye and I said, this man had a seizure. You can deal with it, or I can take it to the chair of the department, because that's the right advocacy for the patient, you know? But I was scared to do that. I was really scared to do that because I'm a young new nurse. But that's where you learn that is, you learn that it's really important to stand up for people that are vulnerable. Another quick story. So it becomes a mix of egos. Okay? So this one, another world famous surgeon who was famous for clipping aneurysms, had a patient with the surgery did not go well. And he asked us, the nurses, to give this patient a solution iv that would literally cause intracranial pressure a high and kill the patient. And we all knew this, and we refused. You know, he just didn't want this on his record. So it became a really messy.

21:00 He didn't want what on his record?

21:02 That this patient failed. I mean, it's not about the patient.

21:07 Right, right.

21:08 It's about his record, you know?

21:11 So what did you do? You said no.

21:12 We said no. It wasn't just me. It was. Everybody said no. I mean, we took it up the ladder. At the University of Iowa, we said, we're not doing this. This isn't right. And this is before there was hospice or palliative care. And now I've learned, too, how much hospice and palliative care really help not only the patients make that transition, but the caregivers make that transition.

21:39 That's a good point.

21:40 Yeah. Because, you know, I get having ego in a job. I get that part. But when you see how much stuff, I mean, ethically, I just can't do that, you know. But that's where the ethics comes in, just having these fine kind of little detail things, you know? And I have one more story because it's really dramatic, and then I'll be quiet about it. No. So again, during the night, we had this patient that was, in the old days, used to put a patient who was a quadriplegic on an elevated bed and they would have traction to keep their cervical spine in line. This young man, he had been injured in a motor vehicle accident. He must have been 21, handsome young man, and he had blood out of his tree. And so then the charge nurse calls me, she says, mary, you gotta evaluate this. So I called the guy on call, and what he told me to do is to stick a Foley catheter, if he did it again, down his trach, inflate the balloon to tamponade off the area that was bleeding. And I thought, this is a little out of my reach. But I said a prayer, you know, oh, please, God, don't let this guy blood out of his drink. And thank God. God let it happen when they were making rounds and thank. And then what happened was, it wasn't a little. He gushed blood all the way up to the ceiling. He. What had happened is there was an anastomosis or an opening between the end of his trachea and one of his subclavian arteries. And so he was bleeding out of. Through that erosion that had happened. And so I called the surgeons down and of course, the guy died. But the hardest part for me was there was this little itty bitty nurse who was doing CPR on him and crying. She was crying because, first of all, she had to get a stool to get up there to do CPR. And every time she pushed, it squirted again. So it's like, you can't do this. You can't do this. You're not solving the problem. But that's what I mean. It's that kind of tense environment kind of percolates those questions and makes them every day. Okay.

24:13 It's not routine, and you have to decide what.

24:16 And you have to decide right. Right at the moment. Okay. So those are just three. But it happened probably at least once a week. But that set me up for that kind of. Kind of having that kind of take on things. And that's both good and bad, because sometimes I see ethical dilemmas when there really aren't. Okay. So, you know. But I just want to improve my average.

24:42 That sounds good to me. And then sue, you were. So then what happened next? So you were doing. You were on the neurosurgical floor, and did you go back to college?

24:52 I went back. I went back to. I went and got my master's at the University of Minnesota, and I worked for some neurosurgeons at St. Paul Ramsey at the time.

25:01 Did you become a nurse practitioner?

25:03 No, I didn't. I became their clinical nurse specialist, and I developed a clinic for minor head injury patients, and I did my master's thesis on alcohol abuse and minor head injury.

25:13 Wow. Interesting.

25:15 It was very interesting. And then after that, I worked then as a clinical neuros specialist at Abbott in neuroscience. And the reason they hired me, I can tell you just the reason they hired me because I worked with one of the neurosurgeons that came to work at Abbott, and he was hard for everybody to handle, so they got. And I didn't really handle him. I just worked with him, you know? But we had developed a relationship, you know?

25:46 Sure.

25:47 You know, where you. You have to be strong to talk to a neurosurgeon. You have to say, don't call me a horse's ass. Cause I'm not. Okay. I mean, quite frankly, that's what you have to do. I'm not. And so we got along. So that was when we did that. Then I got married, and then I couldn't. My husband's an orthopedic surgeon. He wanted to. He did not want to work in the city. So then we moved to the country. So that's when I went back and became a nurse practitioner when I was having kids.

26:19 Who did that? Where did she get married?

26:21 At the University of Minnesota.

26:22 University of Minnesota. An adult. Tell me what you got your nurse practitioner.

26:25 I got it as a geriatric nurse practitioner. But here's the irony of it. The person who was the head at the time, because they were just developing the nurse practitioner program, she did not like old people. So again, we went to the dean of. To talk about it because, you know, I did. Again, I didn't. She ended up in a position. It wasn't her fault. She just ended up in a position where she didn't belong, you know, and she wasn't comfortable with it herself. So they did change that whole thing. But there was a whole group of us that were like, oh, my God. In fact, Linda Hayden was in that group.

27:01 Oh, really?

27:02 Interesting.

27:03 Another one of our colleagues. That is so cute. And then what happened after that?

27:08 Then Richard, then I worked as. And then I was kind of a frontier nurse practitioner, working in rural Minnesota and worked in the 169 corridor. So I worked in Princeton. I worked in Malacca and Elk river.

27:25 What did you do there?

27:26 I was a geriatric nurse practitioner. I was the first in that corridor. And then we.

27:32 Did you go to homes? Did you go into homes?

27:34 Nope, we went into nursing homes.

27:36 Nursing home.

27:37 Nursing homes. Yeah. But that also was a challenge because it was a new role at the time as a nurse practice.

27:44 What year was that when you got your.

27:48 Later nineties?

27:49 Okay. Yeah.

27:50 So it was over the 2000.

27:52 So that was kind of the nurse practitioner role was kind of developing.

27:54 Developing. And so I did that. But then it was an adjustment for people in the nursing homes, too, and especially it was the head nurses that had the biggest challenge with that because they lost. I mean, they weren't. They didn't have the same relationship with the physicians that they had historically had.

28:15 I see. Yeah.

28:16 So that was a big. That was a negotiation. Again, how did you study?

28:22 So what brought you to St. Kate's? What?

28:24 Well, then after that, honestly, my children left, and I went back to my DNP then. Oh.

28:34 Where?

28:35 At the University of Minnesota. Again, I went back from my DNP. I met a lot of lovely people, and Linda was there again, so got to talk with Linda again. In fact, Linda and I worked on a number of teams together, and we also shared. She has a background in neuroscience, too.

28:52 Do you know that?

28:54 Yeah, yeah. She worked for the neurosurgeon, a different group. And so, yeah, that's when I got my DNP. And then the way I ended up at kates is I wanted to teach. And so I interviewed in a number of places to teach at Mankato, at St. Cloud state, and at St. Kate's. And I won't say the name, but somebody at St. Kate's asked me not good questions during the interview, things she shouldn't have asked. Okay. But that's part of the process, you know? And so then my. I had an offer from St. Cloud state, and I was very torn because they were offering me, sorry, more money than Kate's was. And so then I. I decided to work at Kate's for a number of reasons. Because of the outreach, you know, the, you know, love the dear neighbor without distinction, because of that, because of the social justice focus, and because my son was going to law school down here, and I could get to see him sometimes. That was the truth. And so I started teaching at St. Kitts.

30:11 When was that? What time?

30:13 About 2011.

30:15 Okay. Wow.

30:16 2011. So, wow. Yeah. And. Yeah. To be quite honest, it was a tough transition. Yeah. To teach here.

30:28 Yeah.

30:28 Yeah.

30:29 To go from clinical to teaching.

30:31 Well, that wasn't the transition. The transition, let me be real honest, was the culture of what was going on here at that time. It was really. It was a difficult culture to work in. What I didn't appreciate was it seemed like some of the professors would undermine people, and they would, you know, they weren't kind. They weren't forthcoming either. They didn't confront. They didn't say, hey, they just did it all underhanded. And so I had a lot of trouble with that, given my past history.

31:10 Of course, because you're very honest. Do you think that's changed over time?

31:14 Yes, I do think it's changed now, but then it.

31:17 At the time, it wasn't.

31:18 It wasn't. And so I branched out and buddied up with people not in the department. Yeah. And I buddied up with William McDonough.

31:30 Yeah.

31:30 Bill McDonough.

31:31 Bill McDonough was here?

31:32 Yeah. Yeah.

31:34 Okay.

31:34 Yeah, yeah. He. He was the chair of the master's of theology program, and we worked together on a number of spiritualities and palliative care things. When. If you think about it, that makes sense.

31:46 Yeah, that does make sense.

31:47 Yeah, it makes sense. And so it was wonderful. Is it 45 minutes? No. Okay.

31:52 You don't even worry about it.

31:53 Okay. So, yeah, so we buddied up on doing resilience and spirituality and being a care provider, and that was really fun. It was really fun to work with Bill. And I got to the point where I would bring to him, you know, he's an ethics. He's christian ethics. So I would bring to him a lot of my case studies because I was working in rural Minnesota still while I was teaching, and so I could bring to him some of my case studies and get more insight.

32:26 Wonderful.

32:27 Oh, yeah. Because I needed that.

32:30 Yeah.

32:31 And so that was.

32:36 Wonderful.

32:37 Well, and it also increased my understanding, you know, of what you're doing. And, you know, the do no harm thing. That's really hard because it's so easy when you don't understand the full context of what you're doing to make a misstep. So he was great. He still is. He's still.

32:57 I think he's at the U.

32:58 No, he's here.

32:59 He's still here.

33:00 But he's teaching part time.

33:02 Oh, that's right. Yeah.

33:03 Yeah, he's teaching.

33:05 So tell me about, you talked a little bit about this, but challenges that you've had along the way that have made you who you are. You know, you've said some, but tell us a little bit more about challenges as a nurse, you know, like in your career.

33:18 Oh, probably. Well, one of the big challenges was being one of the first nurse practitioners out on the 116 in rural, rural Minnesota. Another challenge would be learning how to work in an academic environment, and I didn't realize what a different world it was.

33:42 Okay. Yeah.

33:43 Okay. And then. But I was also thrilled because Bill McDonough really likes the Ana code of ethics.

33:57 Oh, interesting.

33:58 And so he kind of reinforced my love of it, too.

34:01 Mm hmm.

34:01 And kind of opened it up a little more about the possibilities that it could provide. So that was really good. And, yeah, that's all that comes to mind right now.

34:15 What have been some of your best experience or moments of being a nurse.

34:19 Or just being with patients?

34:21 Well, yes. And you haven't even touched on what you're doing now.

34:24 Right.

34:25 Tell us about that. And.

34:26 Oh, what I'm doing now. So when I was working before I retired, I was working in rural Minnesota, and I had a number of amish patients. And so when I retired from that job, one of my amish patients came to me and said, well, would you be willing to work with us in terms of accessing care and health education? I said, well, sure, but I don't know what I'm doing.

34:52 You're so honest.

34:54 And they said, well, we'll work with you. And that's kind of what's really evolved is we've really learned to work together. And so right now we have a nonprofit. Last year, we found a nonprofit, the Minnesota Amish healthcare program. We started off by doing monthly education sessions, and then during COVID we had to pull that back. And then I've had a number of doctorate and nursing practice students that have tried to translate some care into amish culture, and that has really been a phenomenal learning experience. And what I've really learned to appreciate is the middle space. And by that, I mean the middle space.

35:42 Is that what you said?

35:43 The middle space?

35:43 The middle space.

35:44 The middle space is, it seems american medicine has a big ego. Okay. And we think we're always right, and we're all powerful and we're all technological. You know, we're full of technology. We can do. I think we've kind of gotten ahead of ourselves. Okay. In terms of what's allowable and what's human. I think that's the other thing we've gotten ahead of. And that's where the Amishev showed me. You know, it's interesting to me when I talk with students that a lot of their work is computerized when they're working as nurses, and it just seems like they're hungry for, as well as the patients are hungry for a more human connection, and that they don't see that as much anymore, so they tend to get more discouraged.

36:41 The students.

36:41 The students, yeah. As well as the caregivers.

36:44 Yeah.

36:45 And so the Amish remind me of that. They look you in the eye when they talk to you.

36:52 Something we don't get.

36:54 Something we don't get. And so that's really wonderful. And then the other thing is, they have a deep humility about what happens to them, and I think that that's also really hard for our culture to understand, which is they will never sue. Okay. If something goes wrong or someone makes an error, they forgive them. Okay. They forgive them. They don't hold them accountable for this, because they know that we all make yours, and they trust that God has the final word. And so that's what I've learned from them. And so what we try to do together is really find where we can, where that middle space is in between, because I don't want to change them, and they want to access just some resources. They don't want to buy into the wholehearted system. And so that's what we're trying to negotiate. And I won't. I won't kid you. We've made. I've made a ton of errors, a ton of errors, but we've learned, and I hope to share some of that. And writing a few articles before I die, that would be one of my.

38:07 How has nursing changed since you first started?

38:11 Well, I think technology has really changed it a lot, and I don't even. You spend more time with the computer than you do with the patient, and I think that that's a loss. I think we have to find more. Maybe AI can help us dictate more. And the other thing I would like us to be able to do is just to understand and know the patient's stories and to attend and to treat not as a number, but as a person, what's going on in their lives, and to give them viable choices rather than us tell them what to do. I'm not very comfortable with that.

38:55 You like kind of getting their story.

38:56 And working with them? Well, and co creating. That would be the term I would use. We co create a plan of care. I don't tell them what to do, and they don't tell me what they're going to do. We co create it, because then we both moved. We both moved, and it's not. I try to diffuse the power dynamic in that relationship. Wouldn't you agree? Yeah. And so that's been really rewarding.

39:26 Mary, if you could have three wishes for the nursing profession, what would it be?

39:30 I would say pay attention to the narrative. I would live the Ana code and find a better way to buddy up.

39:47 What do you mean by that?

39:52 You know, I went to a girls school.

39:54 Okay.

39:55 For high school.

39:56 Yeah.

39:56 And I find that. And then I went to St. Ben's.

40:00 That's a girls school.

40:01 Yeah, girls school. And then I've taught here. Another girls school is, I think, women, and this is gonna sound really biased, need to pay more attention to supporting each other and less to undermining each other.

40:24 So you wish that for the nursing profession as well?

40:27 Yes.

40:28 Yeah.

40:29 Yeah. And that. Yeah. And I see that happening on a state level with the. With the negotiations that they've made with the recent legislature. I've seen that. But then I also see how we're divided by Mayo pulling off, and, you know, if you want to work for Mayo, then it's a different story.

40:50 So you see some political things kind of going. That are splitting us.

40:55 Yes. And that's. That's. So I forgive us all because it's a product of the time.

41:00 Yeah.

41:01 But that we need to be more conscious in our effort to be together, to work, to support each other.

41:09 Mary, if you could have free wishes personally, would those be different, or do you have some wishes that you would have?

41:16 Oh, just personal wishes.

41:18 Yeah. Just pursuing yourself as an individual.

41:20 Yeah, as an individual. Finish those articles on the Amish. Be more connected to my kids. You know, that's the other thing I really feel. You know, the Amish have a deep family connection, despite the distance that some of them have. And it seems like the current cohort of young people would rather choose their family than work with their family, because. I get it. Because it's easier. It's easier. But my whole thing is, you can run, but you can't hide. Those problems are going to come up again. I mean, if you think, you know. But that would be the second thing I would do. And then the, the third thing is I would just spend more time outside.

42:10 You like to be outside?

42:11 I love to be outside.

42:13 I know that about you.

42:14 I don't want to be outside.

42:17 Mary, what do you know now about nursing that you wish someone had told you before you started your career?

42:34 I'm just so grateful for it. I'm just so grateful for the opportunity to serve people in such an intimate way. And I'm very, I feel very lucky to have been a nurse, despite my original abhorrence of it. And my mom was right.

42:57 That's what you wish.

43:00 Oh, yeah. Well, she knows. I told her before she died, but, you know, it took me a long time.

43:06 So you feel really lucky to have.

43:08 I really feel very blessed to have been a nurse.

43:11 What do you, what do you cherish the most about?

43:14 Well, just the, just the ability to be with people in that intimate setting and just the privilege. The privilege of hearing their stories.

43:30 They trust you, don't they?

43:32 Yeah. Yeah. Well, and I trust them, and that's just, in this world, that's phenomenal. That's just phenomenal. I feel very, very lucky.

43:49 How would you describe the practice of nursing? What makes nursing different?

43:55 Oh, because we have a big mission. What makes nursing different is we have a big mission to heal the world. That's what it says in the code of ethics. And it's not to make money, it's not to be prestigious. It's to be with people in pain and suffering. And that's a privilege. And I'm very, very lucky to be part of that.

44:26 It's so different from so many other professions, isn't it?

44:29 Yes, it is. You know, the only other thing that would still appeal to me would be, I still think I would love to write up some of these patient stories I have because they are. So.

44:42 Can you tell us about one that you would love to share, that you'd like to share?

44:46 Oh, I can tell you without, of.

44:48 Course, saying their names.

44:49 No, no, no. I can tell you one that still kind of twerks me a little bit, is this is working up north in rural Minnesota, and this is a woman who had had breast cancer, and she was, she was quite ill and she was getting chemo and radiation, and she went back to her ex husband, and her, and her primary care doctor cut her off from her hospice services when she did that. Why? Because he didn't think it was healthy for her to be with her ex husband. And I thought, who are you? I said, well, she came to see me, and I said, well, here's what we're going to do. We're going to find another hospice, and I can make that referral. But that story just stuck with me. It was like. And I think that's part of being a nurse, too, is you're with people. Even if they make a mistake. I mean, even if it was a mistake, I mean, who am I to say that for somebody else? And I think that's part of the tension of being a nurse, too, is, you know, I've been with addicts, too. I mean, it's like they have to make the decision. You can't make them do it. All you can do is be beside them, and you have to have a boundary. You know, you have to have a boundary, but you can still be beside them, and they have to let them make the decisions. And that's what's hard, and that's what I've learned. You just gotta let them make the decision.

46:42 Does that come to your. Does that influence your life as well? I mean, do they go back and forth?

46:47 Oh, yeah, they go back and forth. Yeah. Yeah. So. So I have to let my kids make their decision to leave.

47:00 I'm going to ask you some things that are questions that we thought would be really nice to please, you know, share with us what you'd like. Who has been a mentor to you in the nursing profession?

47:11 Well, my mother, for starters. My mother, for starters. And Kira has. Kira has. Because I'll just say it, she has a real gift of being vulnerable and yet strong, and she also has a gift of clarifying those ethical choices that I wish I had had. So that's.

47:51 What are lessons that nursing has taught you?

48:06 That it's work. Let us work. That the real work of nursing is emotional work. And standing by somebody is not something that you learn in a classroom. It's something you learn by doing. And I wish we had a way where we could help, maybe with AI or something, where you give students the experience of really, it's not a job, it's a profession. I profess these beliefs and I try to live them, and that's all I can do.

48:58 How has being a nurse changed your life?

49:03 Oh, I can't even imagine. Cannot even imagine.

49:12 Right. It's so interesting that from that fat in the little box, your pat, your journey has come here.

49:22 From fat. Probably. We could probably do from fat. Back to fat. Yeah. No, I can't even imagine it. I cannot imagine being anything else other than a nurse. And my mom, again, I can just feel her turning over in her grave because she used to give me such a hard time about that.

49:47 What challenges do you think the profession of nursing is facing at this time?

49:52 Well, I think, first of all, the challenge of technology. Okay. It's a challenge. The second challenge would be the challenge of AI, and the third one would be a challenge of the time we live in, which is more divisive than it is cohesive. And those would be the. Probably the three things.

50:15 If you could change one aspect about nursing, the nursing profession, what would it be? Kind of touched on that a little bit.

50:26 Yeah. I would probably have us work better together.

50:30 If you could give a message to others about what nursing has meant to you.

50:37 What would it be?

50:41 You were saying to like maybe some younger students who are studying to be a nurse?

50:47 Well, I told them the fat story. You know what else I said to them is find a mentor. Find a mentor because you need somebody, you need that relationship to process the emotional work that goes into being under. You need somebody who's been there, done that. That's what I would say. Get a mentor.

51:13 What values have you chosen to live by as an individual and as a nurse?

51:22 Wow.

51:26 And were there any experiences that clarified that for you?

51:35 Well, one that I'm still working on is I value presence and I'm just trying to work on that one a little more. Just being present to people at the time and being present to myself too, paying attention to what is going on inside at the same time that something's happened. And for nurses. Yeah. You can't save the world, but you can be part of it. Yeah. Yeah. And you do it one person at a time.

52:15 What is the most fun that you've had being a nurse?

52:18 The most fun? That's a good question. The most fun I had is there was this group of night supervisors on the neurosurgery floor. Okay. Is we would get together after a night shift and we would cook and we would make these elaborate breakfasts and we would just sit and scream and holler at and tell all the funny stories of the night. And that was so much fun. And I still am friends with one of those people and we've been friends for 45, 50 years.

53:00 Wow. And so you do that at night?

53:03 We do it in the morning after night shift.

53:06 Night shift, yeah.

53:07 So we probably wouldn't get to sleep till eleven or twelve. Then we'd wake up and we'd have to go to work. You know, that worked. It was so much fun, and maybe that's why I hunger for that kind of connection.

53:21 Yeah.

53:21 Is because I had that experience, and it was just fun.

53:26 Do you think that was unique to being a nurse? I.

53:29 No, it probably wasn't, but. It probably wasn't, but it was unique to the group of, you know, the group of people that came together.

53:40 Did you find that in your life? Sometimes when you work with people, it's like you just. You just click, right?

53:45 Click.

53:46 Yeah.

53:46 And that's what I value, is that clicking and being together and sharing ideas and, like, we'd share recipes and, you know, I learned how to cook, and my dear friend taught me how to have an apartment. She gave me very specific advice on don't buy a big bede, you know, and the type of couch to get. And all of her suggestions were quite right on. Yeah.

54:19 So, sweet Mary, is there anything that you'd want to say to, you know, this is a recording that's a legacy that you're giving. Is there something that we haven't talked about or something you'd like to emphasize, to tell other people about, about being a nurse, being a teacher?

54:41 Well, the struggle is long, but the rewards are great. And you don't know the effect you have, so you don't have to measure it. Unlike a DMP project, quality improvement project, you don't have to measure it.

55:04 Words are not measurable.

55:07 Yeah, well, that's like a life. How can you take a life and, you know, measure it? You know, you can say, well, I don't know. Well, I do want to say this, okay, because this is. This is something I argue with my aunt about when I die. Don't only say the good things, say the bad things, because that's who people are. We're both. We're both. And it's the mixture that really makes you who you are. It's like nobody's all that good.

55:43 Yeah. So it's like, what makes you human, right.

55:45 What makes you human? And so. So that's what I would say is just remember that about your. Your nursing care, too, is you will make mistakes. Yeah.

55:56 That's something we don't talk about, is it?

55:58 No.

55:58 It's almost like they always say, well, you know, there's. We don't. If you make a mistake, tell us. But. But you won't get in trouble. But it. But then it's. You don't feel that way because you're. You know, we have high expectations, and it's about perfection. And that's. That's hard, isn't it? Yeah, it is, because that is, we're like, we come as this person, but we become something very different, don't we? And as a nurse, you're probably not the same nurse you were when you started. Not at all when you were carrying that little bucket.

56:30 But, but, but it is. But that would also bring us together more if people. If people just said, I share that with you.

56:41 That's a really good point, Mary. Like, just being kind of being vulnerable and saying what? And that would let our students maybe be able to be less stressed and.

56:54 But also more open to changing.

56:57 That's a good point.

56:58 Yeah.

56:59 Also more open to changing because they realize it's part of the process. Right.

57:04 And that's why I admire Kara so much, because she has that vulnerability and is open to the process. She stopped me along.

57:15 That's really nice. I'm so happy that we'll be sharing them, you know, with her. Well, thank you so much. Is there anything else you'd like to say?

57:22 No. Thank you for the opportunity to do this.

57:25 We're so thrilled that you shared with us. Thank you. Maryland.