Rebeca Barroso

00:02 Okay.

00:02 Hi. Thank you, Rebecca, for coming to speak with us. We're really pleased that especially you, that you're coming to talk with us. So thank you. So this interview is part of St. Kate Story Corps Nursing Interviews. My name is Jocelyn Berlin. I am 65 years old. Today's date is September 29th, and I am speaking with Rebecca Barroso, who is my colleague at St. Catherine University. And I'm recording this interview in St. Paul, Minnesota.

00:36 Hello, my name is Rebecca barroso. I am 74 years old. Today is September 29, 2023, and I am speaking with Jocelyn Bessette- Gorlin, who is my colleague. I am recording this interview in St. Paul, Minnesota.

00:56 Great. Thanks again. Thanks for joining us. Dear Rebecca, so let's begin again. We talked about that. These are kind of questions, but you can kind of bring us to wherever you, you would like to, what you would like to share with us. So tell me about your decision to become a nurse. What influenced you to become a nurse? Was it like your family, your beliefs, financial, what could all the things that it could be?

01:24 It's complicated. It's not straightforward. I didn't decide to become a nurse. I sort of found myself there. My father and my grandfather and my great grandfather were all Freemasons, and they led lives of service in my lifetime. My father's service was being essentially a hospice worker when the term didn't exist. So he took care of people who were dying and mom helped him. And my mom was essentially a lay nurse. She came from a fairly impoverished background and health care had to be accessed sparingly because there was no money to do so. And early on in her life, she learned basic nursing skills so that she could take care of people in her neighborhood and her family. And she had a first aid kit when she was in her teens. Her sister in the 1920s had tuberculosis, and my mom was the person who took care of her through her death. At the same time, her father had what I believe to be congestive heart failure, and she took care of him through his death. And when I grew up, my mother had this first aid kit that of course I couldn't get into. And everybody in, around where we live, when they were sick or whatever they were, mom would go and say, yeah, you have to go to the doctor. No, you have to go to the hospital right now. And she would make these decisions that I thought were kind of matter of fact, but she didn't have any training to do, so she just knew how to do it. And then when I was in grade School. My parents had a friend who had Ms. And there was this progression until she died. And my parents helped that family a great deal. And I was exposed to it. I was exposed to it on a kind of a daily basis because my mother would go and give her a bath every morning at 11 o'clock and she would take home the dirty laundry and bring it back clean and she would bring baked goods. And then as the disease progressed, my father started explaining what was happening to me. You know, he explained to me when she started hallucinating. He explained to me what I was seeing and he let me see it. And he told me that death was coming. And so I, I had this exposure up to real, I mean, I didn't get to witness her death. My parents were there. I got left with my aunt and uncle. I was 11 years old. And I would say that, that that illness and that death were very impactful to me. And they planted the seeds of a life of service. A life of service. So then I, you know, I grew up, I, we migrated. I grew up, I went to college. I was not involved. I mean, I have a undergraduate degree, linguistics. I didn't really, I didn't really want to be anything. I just was being. And then I got involved. I mean, it was the late 60s, early 70s. I got involved in the women's health movement.

05:33 Like how old were you when you came from Cuba?

05:35 I was 13. To the U.S. okay, 13. And so then I got involved in the women's health movement and it was like one thing led to another.

05:46 What encouraged you to be involved in the women's health movement?

05:50 Politics. Feminism. Feminism. Feminism. The, you know, women's body parts, women's functions were all named after men. It just seemed like a, you know, we were under third class citizens. I didn't want any part of that. So I got involved in the start of the Elizabeth Blackwell Blackwell Women's Health center on the west bank, which is where now the People's center is. And it was just self help. It was just self help. It was, you know, women learning about their bodies and how their bodies worked and, you know, our bodies, ourselves came out around that time. It was just a whole swell of events that were happening across the country. And so my first segue was that I got involved in birth, but I was a layperson, I was not trained. And we started the nurse middlewives that existed at the time. The medical establishment was not going to do anything on behalf of helping people who wanted to have babies at home. So we did it ourselves. It was C1. Do one. And so I, I got involved in that whole thing and, and I would, I would go to Deal Hall Library and I, I had enough education that I could pull the books out of the shelves and read and learn. And so that's what I did. I, I would, I would go to the stacks and I would look things up.

07:43 Which library is at the U.

07:45 The Deal hall library. The medical library. The biomedical library. Yeah, I would just, I would do that. And so I did that for a lot of years. I didn't go to nursing school until I was in my 30s. And I had been an outlaw, basically an outlaw for years. And I would be in places or some situation in which I would have a name tag and there would be some medical person from some local institution who would also look at my name tag and I would say, yes, I am her, because I was kind of infamous because I was just out there doing my own thing. And so I, I went to nursing school in my 30s, and so I became a nurse. And then Case Western Reserve University, in conjunction with Frontier, had a program whereby if you had, you had a. An rn. I was an ADN at that point because I. There wasn't anything else. I mean, I wasn't going to go back and do a whole bsn. If you had an ADN and a BA and your GPA was high enough and you did well enough in the GRE and the Miller analogies, and you had to write a portfolio. You had to write a portfolio, a fancy portfolio. And if you turn all this in and they accepted you, you were in a joint program, msn midwifery program, where you would get the MSN from Guest Western Reserve and you would get a certificate of midwifery from Frontier.

09:43 How did you find that program?

09:45 Word of mouth. Word of mouth. I mean, there was no Internet word of mouth. Somebody would just tell you and you would tell somebody else. Right. And so anyway, so that's, that's how I became legit. That's how I became legit. And how many years was it to do that? Well, from the time I became an outlaw.

10:11 Yeah.

10:12 Until the time I became legit, it was over 20 years. Oh, wow. A lot of years. Okay. A lot of years. I have a lot of miles on me.

10:22 So how long was it that you practiced, as you say, like, as an ella? How long did you do that in the community?

10:27 20.

10:28 And then you went back to school.

10:31 To school. And I became a legit person.

10:33 And so you graduated from Case Western.

10:37 And the Frontier at the same time?

10:39 How old were you then?

10:40 I was in my early 40s, so, so I was an outlaw for a lot of years and then, then I was a legit person. And yes, I mean I, I remember, I remember being at a conference that was, being the, the keynote speaker was Dr. Gaziano who was one of the early perinatologist in the Twin Cities. And he's giving his lecture and you know, he's just like, I'm sitting in the front and he's just like looking at my name tag. So in the reg, I came up to him and I said, hello Dr. Gaziano, I'm her.

11:26 Because you were infamous. So and when you say that, what do you mean? Like you would go to.

11:37 I, I did home birth, I did home birth. I didn't have a license to do so, I didn't have any formal education to do so and I just up and did it. But I had very good results. I had a very low transfer rate. I didn't bring anybody in dire straits. I, I had standards that I had set for myself. I had tried to educate the other outlaws, I had tried to consolidate the other outlaws. But the other outlaws were an anarchistic group. They were not into having standards of care. They were not. And everybody just wanted to do their own thing. And as I acquired experience, I realized that doing your own thing was dangerous, that they had to be standards, that they had to be parameters, that they had to be. When I went to nurse midwifery school, people were really scared of me because like, what was I going to do? Well, I was very law abiding, I didn't get myself into any trouble. But you know, before I went to nurse midwifery school, I was in two committees set up by the board of medicine and the health department to figure out what to do about the lay midwife problem in Minnesota. Lay midwife problem in Minnesota. And, and I would sit there in this committee and I, that's how I finally became aware that I had to go to school. I sit in this committee and I would, I would feel in terrible conflict. I would be asked questions and I would have to think quickly about what to say because I would have to sanitize what I was saying so that it wouldn't look so bad. And the conflict being in these committees just kind of brought to my consciousness things that I had not really thought about. And finally at one point the representative from the health department said, well, I understand what you're saying. I mean, could you put together like a 50 state thing of what the Legal status of non nurse midwives are in all 50 states. And if there are any legal cases or any precedent and sort of what's going on? And I sat there and I thought, ooh, for our next meeting in six weeks. And I said, sure. And I had no idea how I was going to do it. No idea. I mean, there was no Internet, there was nothing. So I, I went home and I took a yellow pad and I put the name of, started with the A's all the way down the name of each state. And I thought, okay, I need to know if there's a law that governs a practice, if there's legal precedent, like I have had any cases. And so what's going on? How are, how are people governing themselves? And so the way I did this is I called somebody I knew in California, give me the California. And then could you, do you know anybody in Oregon, Washington or Colorado? Can you give me the name of somebody else? And so I got somebody in each state who would give me two or three other states. And through that kind of cascade effect, I hit all 50 states. But it was a lot of phone calls. Expensive. I had to do a fundraiser in the community to pay my phone bill because it was a regular phone bill. It was not this. And so I put, I, I got the 50 states and it was much worse than I thought. It was much worse than I thought. And so I called whoever, I think, whoever was in charge of the meeting and I said, I cannot give you anything in writing, but I can do a flip chart. I can't commit anything to writing because I got this information through sources that, whose I, I promise anonymity. And so, so I, I, I, I gave my presentation on a flip chart. Flip chart. And I sanitized what I had to say. I said that I found medical practices that were unsuitable to the home. Happening. Meaning I found two people that had vacuum extractors. I found people who were using Pitocin, putting it in a syringe and sticking in a vein and then just pushing it. I found outrageous things, outrageous things. All, you know, telling everybody that I would never say who they were. And it was harrowing. It was harrowing. I sanitized it. I didn't say anything. You know, the most I said was that there were practices that were medical practices that were unsuitable for the home environment.

17:21 And Rebecca, were these individuals nurses?

17:24 No, most of those people were not.

17:25 Okay.

17:26 Most of these people were not. Some of them were. Some of them were. And there was, there was a sprinkling of nurses. There Was there was a significant sprinkling of nurses, but they weren't certified, they were not nurse midwives. There were people who were educators, nurses and were doing it. So anyway, so at the end of this thing, the commissioner of health said to me, you know, this is publishable. I said, well, I would have to reveal too much. I would have to say things that I don't want to say. I mean, I actually found, I. I actually found a few dead babies that had been buried in hills without ever know their certificates. I mean, I found, I found awful stuff. So when the commissioner Harrell said to me, so what are you going to do next? I. I had not really thought it through and I said, well, I want to become a nurse midwife. And the person who was the head of the nurse midwife program at the University of Minnesota, who was in attendance, tripped over the chairs, tripped over the chairs on her way to me. She said, you're going to do what? I said, Case Western and Frontier have this program. And she said, you could go to our program. I said, oh no, I need to be anonymous. I need to go someplace where nobody knows what my. Nobody knows my background, nobody knows my history, where I can just. So that's. So that's how I went. It was a very circuitous route to becoming a nurse. It was a circuitous route to becoming a midwife. But my life has been circuitous. My life has not been a straight line progression. I have not, I have not had the blessings that a lot of people have had of a continuous life, an unbroken continuum. You know, having the community that you grew up in, that you can go back to having a family that's all together in one place, that wasn't the path that life gave me. So I have had to make it up as I go along. And so that's how it is. But you know, I would say, like my mother, I was always a nurse. I mean, back in my undergraduate years when we did the anti war marches, I took the first aid class, I carried the first aid kit, I took care of anybody who got banged up during that event. Did I ever think I was going to be a nurse? No, it didn't occur to me. When people, when I was an undergraduate, people started taking hallucinogens. I didn't take hallucinogens. But word got out that I could talk people out of a bad trip and I knew how to do it. And how did I know how to do it? I had no idea. But I knew how to take somebody who was flipped out and Calm them down. I knew to take them outside. I knew to talk slowly. I knew to keep silent. I knew to touch people if they wanted to be touched, read people if they wanted to be touched, read people if they didn't want to be touched. I knew how to do that. How did I know that? Perhaps my family background, perhaps the fact that as a child, I grew up around all of this. I mean, my mother would say, tonight we're eating dinner early because Mr. So and so is dying and dad has to go over there, right? And it was. This was normal, or dad has awake, or dad, you know, this was. Death was totally normal process in my house of origin. Then there was the revolution, civil war. It was all kind of patched together, so I think it'll fit. When it all finally came together, my mother said, I can see it now. I can see it now. The picture was unclear for a very long time, but I can see it now. I can see now that even though it looked like you were going all over the place, you were really going in that trajectory. It was just not a straightforward trajectory.

22:28 Rebecca, how did your, your role as, like, you were a care provider, so beautifully described, and then you were, you were like a lay nurse practitioner and then a nurse practitioner. How did your roles change? Like, how did you. How did it change when you became.

22:46 Certified as a nurse practitioner? It was cumulative. It was cumulative. I still did strange things. Like, I didn't use my hands the standard way. There was a standard way that you were taught to put your hands on the perineum to do a birth. Well, I didn't do that at all. I just did it my own way. And people would say, that's not the standard way. I'd say, well, watch it, it works. And so, so I did. And when I became a nurse midwife, because I had gone, I had been an outlaw. I had thought long and hard about how I was going to get along with the obstetricians, and I got along with them beautifully. I never had any problems with them. I mean, a lot of the other nurse midwives have problems with the obstetricians, but they hadn't had 20 years to think about it. I had had 20 years to think about it. I had 20 years of figuring out how I could do this better and how I was going to do this better. Not for me, but for the people that I served and how, what I had to do to give the families, the women and the babies the best care that I possibly could give. So I, you know, I was never I was never in a bad situation with an obstetrician. I never had an obstetrician yelling at me. I never had an obstetrician telling me I should be doing something else. I had. It just. It never happened. I mean, they all liked working with me because I was very respectful. I knew my scope of practice. I did not. I did not put one toe out of my scope of practice. Not one toe. How did.

24:45 Having. Working as like a lay nurse midwife, how did that influence the way you practiced as a. Like a licensed nurse practitioner?

24:55 How did it influence. It's. I knew all the things I didn't want to do.

24:59 That's what I was.

25:00 I knew all the things that were dangerous. I knew all the things that. I mean, when I left that world behind, I was totally ready to leave it behind. I was like, when they accepted me at Frontier, they were scared of who this person was going to be. And then I ended up being the model pupil because I didn't want anything to do with what I was leaving behind. I realized that I had to leave that behind and why. So I. I was. I was. On the contrary, I was more law and order than anybody. I would say, no, that's dangerous. And the professor would say, rebecca, explain why that is dangerous. And it's because I had had experience with whatever the dangerous thing was, or I had seen it up close. So. So, you know, they would come up with these case studies for us to do in class in which there was a patient who wanted some cockamamie thing to be done. And so my classmates would start entertaining it, and I would say, oh, no. The answer to that is no. And they would. The professor would say, why not Rebecca? And then I would say, well, because this leads to this and this and this and this. So anyway, I. So the transition was not. The transition was not difficult for me because I was so ready to make the transition and I had thought so long and hard about the issues, and I knew what was safe and I knew what was not safe. I knew it before I went to nurse midwifery school. I knew. I knew safety from unsafety. So my first. My first birth when I was a nurse midwife student was at St. Mary. What was St. Mary's then? And the nurse said to the nurse midwife, this cannot possibly be the first birth this student has attended. And the nurse midwife says, what makes you think. She said. She was totally relaxed. She. She wasn't nervous. She sat on the bed. She was just. I said, well, yeah, you know, I. I Had at that point been to hundreds and hundreds and hundreds of birth.

27:31 How many babies did you deliver as a lay midwife? And then tell me a little bit about when you.

27:37 I did about, I did about 600 as a layperson and then I became a nurse midwife. So my lifetime tally is about 3, 500. Whole city.

27:56 It's a lot of babies.

27:57 Yeah, yeah.

27:58 So you went from when you graduated from Case Western and Frontier, you came back to the Twin Cities?

28:06 Well, it was, it was, it was a remote program. I went there for periods of time and then I came back.

28:12 Okay.

28:13 Like I went to Case Western for several weeks in the summer and then I came back. Out of the people who started that program, I think 60% graduated. Attrition was high. It was hard. It was very hard. And my mother had worries so long about me. So I said to my mom when I entered nurse midwifery school in Case Western, I said, mom, I'm going to graduate first in my class. And she said, is that going to be kind of hard? I said, oh, it's going to be horrendously hard, but I'm going to do it for you. And I did.

29:05 And what did she say?

29:06 I graduated first in my class. I mean, only, I mean, out of a class that had had huge attrition.

29:12 And the attrition was because it was so hard.

29:14 The attrition was because it was so hard and it was long distance at a time in which long distance was hard. I mean, I would write a paper, finish the paper, and I would take it to the airport post office which was open 24 hours a day by the, by the airport. And I'd be mailing my paper at 2:30 in the morning because that's how I got relief. My relief was, okay, I got this done. It's in the mail. Now I can sleep. So I would write a paper, I'd send it to my professor, and to make it easier, I would include a self addressed stamped envelope. My colleagues, my student colleagues didn't do that because they thought that was an unnecessary expense. I thought that was a necessary expense.

30:10 Did you work while you were in your graduate program? Were you working?

30:14 I was working. As a nurse.

30:16 As a nurse. So where did you do that?

30:19 I worked for an agency and I did mostly hospice work or I did. I. Yeah, that's mostly what I did. Or I, or I did dementia work. I would be sensed some kind of dementia unit.

30:37 And then when you graduated, you came back to.

30:40 I was here, I was here, I.

30:41 Was here, you were Here. And then where did you work?

30:44 I work for healtheast.

30:45 For healtheast.

30:46 Okay. And it was. It was not easy for me to get a job because people were scared of what. What was I going to do? Was I going to be a difficult person? Was I going to abide by the guidelines? Was I. They didn't know. So my first job was I worked for Healthies. I got hired to work at a little clinic that's on Randolph, just a block or two east of Snelling. It was a family practice clinic. The family practice physicians were overwrought. They were overrun with work, and they were ready not to do births anymore. So I got a job there, and I worked there for a year. And then it got to the point that I was exhausted because I had to be in clinic four days a week. And then I had to do the birth. And some. There were nights in which I did the birth, all night, took a shower, went to the clinic, and I did that. And so it got. And so then after a year, I had had a track. I had a track record. I had a track record. And the big nurse midwife practice at HealthEast had an opening, and so I just kind of slid in there. And that's sort of where I worked for the rest of my years. But so it was all very. It's not a straightforward kind of thing. It kind of. My. My nursing work on. My nursing career has had kind of loops. And then I only in. I was about 60 when I decided that I would work toward a DMP because pretty soon I wasn't going to be able to do clinical practice anymore because it's brutal, brutally hard, the hours, and especially the way I did it. I didn't. I didn't leave. I didn't leave. So I was. I was gonna not be able to do that forever and that I owed it. I owed it to generations to come to pass. What I knew that had been acquired in such a circuitous way.

33:31 Did you think that you wanted to teach at that point?

33:34 Yeah, I feel I. I didn't want to. I owed it. See, I. I had. I knew fairly early in my life that I would have a life of service. I didn't know what service to what, but I knew that I. I knew that I would serve. And so I felt that I had served clinically and then I would serve educationally, and that I had had such a wealth of experience that I could pass it on to the next generation. And even though I don't teach, I mean, I taught nurse Midwives for a while.

34:18 Where did you do that?

34:18 At Frontier. But I. I feel even though I don't teach nurse midwives, I teach nurse practitioners or I teach nurses. And the first thing I teach him is safety, and the second thing I teach him is selflessness. If. If you are in this for what you're going to get for yourself, you won't last. You have to have you had to find that fire within you that helps you be of service to others without you being part of the mix. It's not about you.

35:13 Do you think it's something that you're born with, or do you think it's something that develops over time?

35:19 Well, obviously I grew in that household. My parents, that's. You know, my mother was in her 80s and she was still making and delivering food for people who were dying at home or she was still doing stuff, you know, she. She was still at it. And my father. My father did it till. Till he died. So I. I think it would have been strange if I hadn't done it, given. Given how much that was part of the house that I grew in. Yeah, I think it would have been strange if I had gone a whole different route because that just sort of seemed normal. But of course, given my migratory status and given the turbulent times that I grew up in, in the 60s and the 70s, it's really not at all weird that I ended up doing what I did and that I kind of went around in several loops before I became a nurse and before I became a nurse midwife. It's not. It would have been unusual for me to have a more straightforward thing. It would have been unusual. It was just the way it was. And.

37:04 What would you say has been your best experiences of being a nurse or a nurse midwife?

37:13 Taking care of people that nobody else wants to take care of. Working at Satan Catholic Charities, where I worked for. I worked at Decedent Catholic Charities for 20 some years. I worked there until Seton Catholic charities closed in 2016. That was. That was, for me, the richest thing was taking care of women and families that had nowhere else to turn. Recent migrants, people who were illiterate. I remember one woman that when she came pregnant with second or third baby, I said, well, what can I do? How can I help you? Because I would say that. And she would say, I really want to learn to sign my name. She was illiterate and I taught her to sign her name. It's nursing. That is nurse. I still remember her face. She had a very kind face. And by the end of her Pregnancy. She could sign her name. I mean, I, I couldn't. I could. That's as much as I could do, you know, But I did teach her to sign her name. And, and I advocated for them and I took care of them. And if they had to interface with the medicals, with the physicians, I was there to advocate. And because, because the patients grew to trust me and they were afraid of the physicians. There was too much of a distance between them and the physician. You know, they call me Rebecca. They call the physician doctor. So and so. And that's a huge difference. And so I, I really. Working at Satan Catholic Charities, there were women there from all over the world. There were impoverished women. There were young women who, who said, I want to become a nurse because I want to be eventually a nurse midwife like you are.

39:50 Wow.

39:50 I don't know if they did. I never, you know, I never had. That's one of the things that we, we didn't have very good. It was kind of a crisis situation. We didn't have long term continuity with a lot of these families that we served. But I really liked working there because these women would give birth at St. Joe's and they would get the same care at St. Joe's as women who had insurance and women who were not poor. And, you know, it was just like, I have a room to myself and a nurse to myself and a clean bed and all these things. And it was, it was just a. It was just a really good thing to do. I was, it was really. It was really good. It was really. It was just really fabulous. I would say that was just. And then, then when it closed, it closed because the church needed the money for other things. And it was considered that this was 2016, and it was considered that with Obamacare, everybody was going to have access to health care. And it would. This was just unneeded. And I would say that a lot of those people that we serve there probably are the ones who show up at hospitals right now with no pre. Having had no prenatal care. I mean, we took care of people who have been trafficked. We took care of prostitutes. We took care of anything that walked in the door pregnant and needed help.

42:02 How did you know about that program, Rebecca?

42:05 How do you know about Seaton? Healthies got probably a tax write off by providing an obstetrician. I see. And the obstetrician worked there pro bono. And the midwives, we got our wages. We got our wages, but the young midwives didn't want to work there because it Was. It's kind of. Kind of gut wrenching scene. I mean, I, I remember the first time that I saw something that I couldn't make any sense of. And I went up to the obstetrician who was, at that point, I was in my 40s, was somebody in his 60s. And I said, I, I have this clinical picture that I cannot decipher. I told the obstetrician what I was seeing, and the obstetrician said to me, what if I were to tell you that there's a market for pregnant prostitutes? I went, whoa, yeah, get it now. I get enough. So there was a market for pregnant prostitutes, a market for pregnant strippers. And we took care of those people, and you had to take care of them without any judgment. And that was a spiritual exercise.

43:40 How did you, how did you do that?

43:42 You. You had to figure out how to transcend your own. Your own ethics, your own prejudices and say, this is a human being needing care. But it was hard. It was hard to transcend your own moral parameters and ethical standards. It was very hard. But I was able to do it. I was able to do it because.

44:11 What helped you do that?

44:12 Huh?

44:12 What helped you to do that?

44:15 I'm a survivor. I'm a survivor. Yeah. I mean, when people say, how come you're not sweet? I said, you cannot be a sweet survivor. You become a survivor by developing grit and you develop some pretty coarse sandpaper so that people don't bully you. I mean, so they can see far away that they can't mess with you.

44:46 So that gave you strength and all that.

44:49 Yeah, yeah, yeah, yeah. And it. I. You know, once Seton Catholic charities closed, once St. Joe's Maternity center was about to close, there was really. That was the end of my clinical practice. That was. There was really. I had done my work, I had contributed clinically. I had educated several generations of nurse midwives. I had precepted 20 or 30 nurse midwives. I had taught at Frontier. It was. It was sort of. It just. I wasn't going to provide care to make money for Medical Corporation. I. That was just really not. No, that was not that. That was not what I was going to do. That was not going to do. My last straw was a woman who came in wanting an ultrasound for viability at five weeks. There's no viability by ultrasound in five weeks. So I said, we can do a quant ACG and repeat it in 72 hours. 48. 48. To see if it's doubled. And that would let her, you know, that the pregnancy is progressing well. No, no, I want the ultrasound. And I said the ultrasound won't give you the information. It's a waste of money. So then I was told that by my superiors that I should order the ultrasound because even though I was going to give an information, we could still, we would still get the revenue. I wrote my resignation letter that day, two weeks notice. I just thought, I can't, this is not, this is not being of service to people. You know, this is, you know, I do this ultrasound and it adds to the healthcare bill for everybody and it helps the premiums continue to go up. This is not, this is not, I, I, I cannot function this way. So anyway, which kind of makes me.

47:32 Think about, like how has, how have you seen nursing change over the years? Or, or midwifery?

47:43 It has changed a lot. I seldom hear my students talk about wanting to be of service or putting the patient first. I don't know if I am becoming the past. I think I am becoming the past. And it is, it's sad. I mean, my son is a nurse and he does it like I do. He doesn't like it. He has it, he has it. The compassion, compassion, care. He, he, he, he saw a lot of death through the pandemic, including children. And he got through the pandemic, he says, by talking with me. He would, he would leave the hospital after, you know, the 12 hour shift that became 14 or 16 hours, they'd have 8 hour shift that became 10 or 12 and he had a 45 minute drive home and he would put me on speakerphone and we would process what happened. Every single shift he would call me at 2:30 in the morning, 3 anytime, anytime. And I would wake up, put on my glasses because I think better with my glasses on. And, and we would, we would go through the cases and what happened and what, and could he have done something better? And occasionally we did find something. Most of the time he was stellar. But of course you always, occasionally find something that could have been approved on. And we did that, we did that for months and months and months and months and we both got through the pandemic together, together. And I wasn't working clinically, but I was working clinically with him. I was trying to, I would try to extract everything that I could possibly give up so that he could go on, so that he wouldn't burn out, that he didn't burn out.

51:07 Do you think you burnt out from. No, no. You left, you feel like you left.

51:12 Before I, I left, I left because if I had stayed I would have burned out if I had started doing procedures that didn't need to be done just so that we could make money. That I would. That, that. That would have killed me. No, that would have burned me right out. No, I left. I left when I realized that I. If this was the way things had to be done.

51:42 Do you think that the students have that passion, that compassion, or. What are your thoughts about that?

51:49 I don't know. I don't know. I don't know. I think a few of the students do. I'm not sure about the majority. I mean, I think. I think nursing and being an advanced practice nurse has become a pretty good way to make a living. And I don't know that that makes you good at what you do. And I don't know that that sustains you when the going gets rough. I don't know, because I never had that. I mean, I always said I have to make a living, but I don't do what I do for money. No, no, no. I was always willing to come in early, leave late. I was willing to go in the middle of the night to St. Joe's because there had been a death and help support the young midwife or help the midwife with the paperwork. I was always willing to go in and help somebody prepare for quality assurance. I was. And then when I left, I. I asked a couple of years later who was doing what I did. No one. And how come it's not being done? You never got paid to do it. We're not going to do anything that we don't get paid to do. The corporation is. The corporation. It's no longer. It's the wrong of that tight little group. So I'm concerned. I'm concerned about what lies ahead. It's not that I thought that I did any big deal. I actually thought that I did what everybody else could or should be doing. I didn't think I did anything remarkable. I just. I just. I just, I was just of service. I mean, I was. My mom was okay with what I was doing.

54:17 What did she say when you told her that you graduated number one from your class? Oh, forgot to ask you that.

54:24 She. She said, well, of course you did it. Oh, of course you did it because. Well, it was, it was. It was fairly straightforward. There was no one else with the 40 except me. And it was just something I did for myself. She was so proud of me. I, I mean, it was just something I, I did for myself. I, you know, I, you know, I, I had fantastic people at Frontier I would say, okay, so I, I've been doing, I've been, I've been, I've been out on the field for 20 years. I know what you're covering. I know this much. What, what can I do to prove that I know this much so that I can do something on my own, so I can do my own research, I can do my own thing. And they would tell me what I had to do to prove basic mastery of the course of the. And then I would get to do, I would get to go to the, I would go to deal hall and I would get to go up the stacks and dig and write about, I don't know, the patriarchy and women's healthcare or. Yeah. Or for pharmacology. I wrote a paper called, it was called Acyclovir on the politics, Cesarean prevention. And my professors love this. And they would say to me, oh, it would be so great to publish this, but it's politically too sensitive. It would get us in trouble with the obstetricians. We have to keep this under the qt. But. And then I found, I found out later when I became a professor at Saint at Frontier that they used to pass my papers around to all of them, the people who were teaching, they would pass my papers and they would all read my papers because they thought my papers were so much fun. And I was writing about things they had never thought about, but they had never been outlaws. See, the fact that I had been an outlaw. The fact that I had been an outlaw gave me a real unique perspective. And actually as an. Because I had been an outlaw, I became more law abiding than anybody because I realized, I realized the follies. When you color outside the lines, you could get yourself into big trouble. So you know, so anyway, so they, they, they liked my papers and they, they liked what I did. And you know, Kitty Air is my mentor. She said, she said to me, you are the best student I ever had. I mean, that meant a lot to me. She said, you know that last paper you wrote, it was 103 pages. Rebecca. I had given and I, she said I gave. She said, I gave three or four or five A's in my whole life. I got a B for me, but you got an A plus. I said, I killed myself doing that paper. She said, it was obvious that you killed yourself doing that paper. But so, you know, I, I did that, you know, and then, you know, toward the end of, of my mentor's life, she had to write a letter or she had to Write something. She had to nominate somebody for some. And she was now too old. I mean, she was in her 90s. She calls me up, rebecca, I need you to put something together for me. I said, sure. And so she told me basically what it. Need. What. What the elements were. And. And I said, okay, I'll. I'll. I'll write you the first draft and send it to you. She was in her 90s, so I sent it to her and said, kitty, what else do I need to do? She said, I submitted it. She said it was perfect. He submitted it. I just said, oh, oh. And it was. It was great.

59:13 Was this an article or.

59:16 It was. It was some kind of lifetime achievement award for somebody. For somebody who had been somewhat. Yeah, I mean, it was. It was still somebody older than me, but it was somewhat younger colleague, and it was some kind of fancy thing.

59:37 And you wrote it, and I.

59:39 And she submitted as hers. And I thought that that was the biggest honor I could ever have, that my mentor would ask me late in her life to write something that she was going to submit, though she had written it and she did.

59:58 That's beautiful.

59:58 And. And, you know, it was like nobody would know about her. And. And she trusted me. I mean, I haven't told that story to anybody. I just thought of it now and that she trusted me enough that she knew that I would not blab it. And she didn't tell me anything. She didn't tell me not to. I mean, she didn't give me anything, but I knew.

01:00:18 And she knew you would do a good job.

01:00:22 And so it was just really neat. That's so neat.

01:00:25 Rebecca, what if you could have three wishes for the profession? What would it be? What would they be?

01:00:36 Avocation, avocation Avocation. People finding within themselves Avocation, avocation, which is the thing that feeds your fire and keeps you going. That's. That's what keeps you from burning out that application. It's that. That. That. That feeling of that sensation that you are fulfilling your purpose. You're fulfilling your purpose. You are. It's a. It's a spiritual component. You know, it's.

01:01:21 Do you think you can teach that to somebody or.

01:01:24 I don't know. I try to model it. I try to model for the students that I have a vocation. I think they can see it. Not all, perhaps. Not all. I mean, I think some of them think I'm just weird, and that's okay. But I think. I think that if we can model that.

01:01:56 So model kind of.

01:01:58 And they can see what that looks like the compassion. The compassion, the caring, the being of self. Less service. If they can see that, maybe it will awaken that in them or it will feed that in them.

01:02:18 That's a good point.

01:02:21 That is sort of. That's how come I get up in front of the classroom and I entertain them and I make them laugh. And, you know, this last week in the pharm class, I had given them a medication error case study that came straight out of my son's ed. My. My daughter thought he was sick because, you know, the patient went into respiratory distress from overdose, two. Two doses of narcotics. And my son and I are sitting together across the table putting this thing together, and we're laughing, right? And my daughter saying, you know, I think nursing humor is sick. And M and I are just laughing and M says, aisha, we have to laugh because the alternative is, you know. And so I gave him this case study and I told them that the thing that really struck me, me about the case study, that it was that maybe they felt compassion toward the nurses who found themselves in this horrible predicament. But nobody had written about it. Nobody had actually stated it in the case study.

01:03:45 So you were trying to bring that up. But yeah, that's. That's an interesting thing because we don't talk about that a lot.

01:03:50 No, the. The. The compassion toward the nurses. The compassion toward the nurses. I said a couple of teams wrote that they were really kind of perturbed by the charge nurse who, an hour ahead of the change of shift came in and said, we need extra nurses. I cannot get anybody for X number of time. Change of shift is delayed by an hour. They were really ticked off. And I said that charge nurse had probably been on the phone for two or three hours trying to figure out the staffing, and that's the best that could be done on that night under those circumstances. Do you see the case study? It was late at night and it was raining in the middle of nowhere, Wisconsin. I said it was probably a week. It was a weekend night. It was a weekend night. So that's the best. That's the best that could be done.

01:04:55 Yeah.

01:04:56 I said. I said to the class, compassion. Class compassion. That's the best that could be done.

01:05:04 Wow.

01:05:05 I said, if that nurse was a slacker, let me tell you, that nurse would not be the charge nurse at a critical access hospital in the middle of nowhere, Wisconsin.

01:05:14 That's interesting.

01:05:15 Not be.

01:05:16 Yeah, that.

01:05:16 That could not happen. That could not happen. That could not happen. So. And, you know, it's interesting.

01:05:24 So you're teaching people kind of that compassion or modeling it. What, what other wishes. Do you have any other wishes for the profession that you can think of?

01:05:30 Like, well, compassion keep its heart. I mean, it's, it's all, it's all about heart. It's all about caring. Yeah, it's all, no matter how much you know how to program the pump, if you can't convey care, if you can't, if you don't think that giving somebody a bed bath is an important ritual of caring. If you don't think that, it's, it's all about caring. It's all about having your heart come through your hands. You know, it's all about this. You know, I, I found, I found a, a picture of my hands that was made at the American College of Nurse Midwives convention. And I think I'm about 60 and it's just my hands like this and my, I was going through my stuff with my son. The picture came out. He said, what's this picture? I said, just think of the life and death that had gone through these hands so much. So much. It's about that, it's about that, it's about that, it's about, it's about caring enough that you want to learn more and you still want to learn more. You know, like I was putting together this thing on, on for pharmacology. I was given. Brad said, oh, you do the female and male health. I don't want anything to do with that. I said, okay. So I look at the objectives. The objectives are strictly plumbing. Plumbing. There's more to being a female and male than differences in genitalia and. Right. There's more to it. So I started looking for other things and I thought, okay, old drugs. Old drugs. What happened with old drugs and how were they developed and tested? And well, I came up, I, I, I, I came on aspirin and this was a few weeks ago. I now have 250 downloaded articles in aspirin and three books. And I am just on a path on aspirin because aspirin is the oldest synthetic drug. It has been used medicinally as a bark for thousands of years. Aristotle writes about it.

01:08:17 Is it Spireans?

01:08:18 Yeah. And, and then it was developed in a lab there, 1899. It was tested on men and tested on men and tested on men. Most of the findings were on men. The physicians that I'll study was all men. And then it was just extrapolated that all these things that are known about men, except for reproductive things, are equal in women. And so now we know that the adverse effects of most drugs that are on the market are. Women have 200% the incidence of adverse effects of men because they have not been tested on women. And so I got on this whole thing. I start with aspirin. I'm only going to give, like, six slides in my lecture about aspirin, right? Because it's just, it's over the top, but it's, it's. This is nursing. This is nursing. It's, it's, it's, it's trying to dig the knowledge base, trying to figure out what is wrong, how do births serve, how to collaborate with medicine. You know, how to collaborate with medicine, but also how to tell medicine. You guys, there's something here that's haywire. So it's all of that. So I, I have now. I, I am now, like, my kids call me and they go, how are you doing, Mom? Aspirin. I go, yeah, aspirin. And, and, and it's just, it's just, it's, it's just, it's a wealth of information, and it's just, it's, it's a little snippet of what the profession is, how the profession has traveled, what the problems are, what the glitches are and what we need to do to go forward and do better. I mean, the thing about aspirin is not judging the people who flubbed up the research and who flubbed up the knowledge base. They didn't do it out of malice. It's just that we have to continue to change and grow and evolve and figure out how to provide better care in a compassionate way, you know?

01:10:48 Sounds like you're saying in a creative, passionate way.

01:10:50 Yeah, yeah, yeah, yeah. How. How to give of yourself. I would say that my best thing that I've ever done in terms of. Of nursing is that I know how to give of myself. I, and, and I, I, I would say I do that with the students, too. I give of myself. I give of myself. I. They see in me the possibilities, and maybe they see in me possibilities of things that they don't want to do, but they see possibilities.

01:11:25 Is there anything in nursing that you wish that someone had told you before you started?

01:11:34 No, because. Because. Because of what? Because of growing up how I did. No, I, you know, my, My mother. My mother came from a poor family, and so she, she. They had two houses kind of diagonal from each other.

01:12:01 Yeah.

01:12:02 In one house was her family house, and the other house was where her sister was dying of tb. And my mother was the Person in residence there. And my mother managed not to get tv, right? My mother managed not to get tv and she. Her father died and she would go back and forth because the two were very sick. So her father dies and then she goes back to taking care of her sister, who dies three days later, the middle of the night. My mother says she dies looking at me. She's just gasping. Looks at my mother, dies. And then my mother, two days later, turns 21. My mother was 20 years old. She took care of her sister and her. And her father. She was 20 years old. She turns 21. It was like. So I. I come from. I don't.

01:13:16 Kind of knew. It sounds like you almost kind of knew what to expect.

01:13:19 I. I knew what to expect, yeah. I knew what to expect, yeah.

01:13:22 That's interesting.

01:13:22 I knew what to expect. Yeah. Yeah. And my. And my mother. My mother always asked me about. Tell me about some interesting cases. Tell me around. What did you do, Mom? What do you think? And she would. And she would. She. She would say, did you consider? And sometimes I would go, no, I didn't consider. Well, next time you run to something like that. Yeah, yeah, yeah, yeah. And then I. Then I took care. You know, I took a leave of absence and I spent the last five months of my mother's life with her. And I did all her nurs. Nursing, all of it. No one did any nursing for her other than me. And she said she would say, if my daughter cannot do it, I don't need it.

01:14:13 How did that make you feel?

01:14:14 Were you honored? Yeah. Yeah. She said she wanted to die at home. I want you to close my eyes. She was exceptional. Thank you. She was an exceptional mother. She was an exceptional woman. And she was taking care of others until she couldn't do it anymore. She was. She was. She was finding out who was. Who was dying at home, who need. And bringing food, thinking, taking laundry home, getting it back clean. She was doing all that till she couldn't do it anymore. Until she couldn't do it anymore. So it was. I plan to do the same. So, I mean, I take care of, you know, in my community of people, you know, I take care of everybody who's needs anything. You know, I mean, people call me, I. I show up and I know.

01:15:33 You do that for the students too.

01:15:34 Yeah, yeah. So anything. Anyway, I'm. It's a little different story then. Well, but everybody's story is different. Yeah, but my, My story is not linear progression.

01:15:53 Is there a time that you can think of, you've had so Many experiences, but one where you had an experience with a family or patient that had like an ethical challenge or something that happened that you always remember, that you'll always remember a case that you always remember.

01:16:14 I have several. The ethical cases are many. I remember taking care of a young woman who presented to the clinic pregnant and she. I had never seen anybody that was that physically dirty, dirty, dirty she was. I had not bathed in a very, very long time. And at Zen we did a intake pap smear on everybody, an STD check on everybody because we needed to know if we could not take care of them there. And when I went to do the basic pelvic, her crotch was. The whole, the whole mon pubis area was perfectly shaved. It was perfectly clean. And I realized that this very, very otherwise unkempt young woman was selling this part of her body. That's how she was alive. And it was a huge ethical dilemma for me because I had to really fight not judging. I had to fight not judging. So I, I would say a lot of the ethical dilemmas have been that kind of a thing is a situation that is really awful and finding a way of being of service without judging, without judging, just. Just giving that human being a little something that perhaps they've never had, you know, or the. And becoming good at it. I, I. The late in my, in my life as a midwife, I. I had a. A woman, a social worker from a nearby place who showed up as I was trying to leave Seon late in the afternoon with a young woman on toe very pregnant. And a woman had shown up at the social worker place and, and had not care and was like. And sat her down and I did a basic intake. I knew I couldn't take care of her because we had certain parameters. Care had to be established by X number of weeks for the midwife for the person to be a midwife patient. If we couldn't take a blade pregnant, that became obstetrician safety again. Safety, I mean. And so in like five minutes, I was able to get from her what substances she was using, when was the last time she used. And I said, I'm going to send you to see Dr. So and so who's at the hospital and the docs are going to take very good care of you. So we had this vouchers for a taxi and I put her in one of these and sent her out to St. Joe's and the social workers said to me, how did you get all that out of her so quickly? I said, I now embody no judgment. I said, I don't, I, it's not something I can, it's not something I consciously do. It's just that I've done it for so long that it just. She said, yeah, the way you said to her, to her. The way you got that history out of her. I said, no, it's just, I said, I could say it's divine intervention, but it's probably just experience. So that I'm hoping the next generation will continue to continue.

01:21:33 Just what brought you to St. Kate? Does it have anything to do with.

01:21:39 It has to do with Satan. This is Grandelette. Yeah, this is Grandelette. Started seating in the, in the very early part of the 20th century. And, and, and St. Joe's is Sister Grandelet and that. And then they're saying Kate's. Yeah, that's. It's all, it's all part of a piece.

01:22:02 Yeah.

01:22:03 And it's a, this is a place that has a, a mission of being of service. It's, it's the same thing, you know, I, I am.

01:22:11 Did it fit for you?

01:22:12 Yeah, it all fits together.

01:22:13 Yeah.

01:22:13 You know, I'm not, I'm not Catholic, but it all has heart. So, you know, it's, you know, St. Joe's Seton, Frontier, St. Kate. It's all part of the same piece. It's, it's. Yeah.

01:22:42 And I want to ask you, you talked a little about how you got along well with the physicians, the, did you ever have any, any pushback from nurses when you were a nurse practitioner.

01:22:52 When you were a midwife?

01:22:54 Yeah.

01:22:54 How did you know?

01:22:55 How did.

01:22:56 No, because I, I treated the nurses as they were my colleagues.

01:22:59 Okay.

01:23:00 And I never lorded over them.

01:23:03 Okay.

01:23:04 And I always asked their opinion when something was going on that was, I would take the nurse out of the room and I would say, this is what I'm thinking. What do you think?

01:23:15 So you, you treat him like a colleague?

01:23:19 I, I got along and I, I taught all my students that the mock up of the room after the birth, that was the midwives work. So I never let the nurses wipe anything from the floor. Never. No, I would say the floor is mine. So if anybody had to get on the hands and knees on the floor, that was me. And I, I, and I, I cleaned up the room and everything that had to be gone, everything that had to go to the dirty utility room, I took it. So I always, I always packed up the room, I always cleaned up the room and. Wow. Treated the nurses as colleagues.

01:23:59 That's a real servant leader.

01:24:01 Yeah. And, and Got along, got along really well with the nurses. The nurses liked working with me. You know, the placenta, all of it. I, I took care of it.

01:24:13 What, what are some lessons that nursing has taught you.

01:24:20 So much? The infinite reserves of the human spirit. I would say infinite, that you never know when the next amazing thing that another human being is going to manifest is going to be. And, and you see it under extreme duress. You know, you see it when people are being born, where they're dying, when they're terribly sick, and you see that immense capacity of the human spirit. Intangibles. The intangibles. That's, that's where nursing is. The intangibles.

01:25:18 What sustains you in being a nurse? Like, how do you, like as a, an educator and as a, as a, as a midwife? Like, what sustained you that helped you to just kind of go through.

01:25:30 Your life has to go on. Yeah, life has to go on. You have to do what you have to do so that we can keep going and we can do it better. And we can do it better. I mean, that whole thing of trying to figure out ways of doing it better and being the change that you want to see. Being the change that you want to see. So all of that, all of that is crucial.

01:26:05 If you could give a message to other others about what nursing has meant to you in your life, what would you say?

01:26:14 Everything. It has meant everything. Yeah. You know, it links me to my, my, my roots, my parents and, and it links me to the future, my son and, and it gives me hope that life will go on. Yeah. The dignity of people. The dignity of people. That's of a health through nursing. And, you know, and I am really glad that I didn't become a physician. Why is that? Because I like, I like giving people direct care. I don't find it particularly helpful to just come in and tell people what to do and not do it myself. I like doing it myself. I like, I like that. I mean, I liked it. I always liked it that I was Rebecca to the patients, you know, and I was accessible. I like that. I like that a lot. I, I, you know, I would know if doctoring was not for me.

01:27:46 You know, I sounded like you had a real connection with all the, your, your patients and your students.

01:27:54 And I, and I really like working with the physicians, but they were too removed for my taste. You know, they were not in the, and the physicians would say to me, how do you get these things out of the patients? They would also, I mean, the physician that I worked to at Seton, he would say, okay, I know this is a high risk patient, that it's not a midwife patient, but I'll take over the patient. As soon as you take the history, you take the history. Rebecca, you, you, you have, you get, you, you. I, I cannot get the history that you can. Okay, I would get the history.

01:28:35 Rebecca, what's been like a real highlight in your career? What, what have you done that just was either fun or just like a highlight? You'd say, like, wow, I, that was really, that was really great.

01:28:47 I love that. I don't have a particular thing. I, I, I think it's the totality of it. The totality of it has been very satisfying. We had a woman with help syndrome that was from sedon that was sent to Joe's. She was getting sicker by the hour and she was African. And she told the obstetrician, oh, I was told that I could go home because she was, had become a physician patient. But I lingered and she had, she refused to sign the surgical permit. And the physician comes out of the room looking ashen and said, she's going to be dead in 24 hours. And I said, okay, you sit at the nurses station. Give me the clipboard. I'm going in the room. I'm going to close the door. No one is to go in there until I come out. No one. I came out, I think was 50, 55 minutes later with a surgical pro permit signed. I told the woman I would be with her through the C section and that I would spend the night, that I would be at her side all night long. And I was, the physician said, you probably saved a life or two.

01:30:37 But it said similar to when you helped that family that had the children with congenital issues and you spent so much time with them. I've just always felt that was so, so wonderful.

01:30:47 And yeah, I did. So I would say that's, I have a few things like that that are just really like, it's not that I did anything, it's just that I was able to help people help themselves. You know, Like, I, I was able to tell that woman, I know that you come from a place where having a C section is nearly a death sentence, because one in like the death, maternal death rate secondary to C section. Some of those places, it's 33, 50%. I said, but, you know, it's going to be different and this is what it's going to be and this is what I can do. And this is da, da, da, da. What questions do you have? She signed that surgical permit based on the relationship she had with me and her ability to believe in me because she really didn't have the knowledge base to make an informed consent decision.

01:31:50 Then you helped her with that.

01:31:52 I helped her say, you're more likely to live and have a baby if you do this and if you don't.

01:31:59 Yeah. Connecting.

01:31:59 And I was able to answer her questions.

01:32:02 Yeah. That's very special. Rebecca, this. This interview is something that will go on forever. It will be in the Library of Congress.

01:32:16 What.

01:32:16 Is there anything that you would like to say, either to your children or that you would like to say before we. We conclude.

01:32:36 You give us better than to receive? It really is, because it isn't. It isn't giving that we receive. If you can give, you can't give. You have a very empty life. Very empty life. So I know my children know how to. How to give. I trust my grandchildren will know how to give, too, and we'll keep it going. Yeah.

01:33:10 Well, thank you so much. Is there anything else you'd like to add?

01:33:13 No.

01:33:13 Thank you so much. And I just want to say, for the record, that you are one of the most wonderful people I've ever met, and I'm so thankful for everything you've done for our students and for. For this community.

01:33:25 I mean. Yeah. For nursing. Thank you.