Podcast by Dr. Bjorn Mercer, DMA, Department Chair, Communication and World Languages and
Dr. Jameelah Powell, Nursing Faculty, School of Health Sciences

COVID-19 caused significant changes to the U.S. healthcare system and took an incredible toll on healthcare professionals. Learn how responsibilities and opportunities shifted for different levels of nurses, including CNAs, LPNs or LVNs, RNs and NPs, and what aspiring healthcare professionals can do to prepare themselves to work in this very difficult field. In this episode, Dr. Bjorn Mercer talks to Dr. Jameelah Powell, about her extensive experience working in healthcare, including her work as a nurse and public health professional. Learn tips on managing stress and addressing the emotional toll of working in healthcare, including having a debriefing partner, being mindful, having gratitude, and prioritizing your own health by eating well and exercising.

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Dr. Bjorn Mercer: Hello, my name is Dr. Bjorn Mercer. And today we’re talking to Dr. Jameelah Powell, nursing faculty in the School of Health Sciences. Today we’re talking about health issues. Welcome Jameelah.

Dr. Jameelah Powell: Thank you. Thank you for having me.

Dr. Bjorn Mercer: Excellent. This is a great topic because of COVID of course, so much has happened in the last two years, and health issues and health sector in general is so important. That leads into the first question is, what are the differences between a CNA, LVN, RN, and NP?

Dr. Jameelah Powell: Well, there’s quite a few differences, and it’s kind of an interesting question, because a lot of times people just say nurse and it’s supposed to cover the entire gamut of nurses. What I will say is there are levels. A CNA is usually sort of like the base level, sort of the starting ground level. They usually are not considered “nurses” because they are, as the name entails, certified nursing assistants, the nurse aid. A lot of them work in hospitals and in SNFs, as we call them, senior nursing facilities, and they aren’t really allowed to provide medications or anything like that. It’s usually direct patient care, helping people to get out of the bed, helping to switch positions.

They may take vital signs, your blood pressure and your heart rate, and your respiratory rate, but that’s sort of the limit for them. Usually, the programs, I mean, you can finish a program, sometimes times within three weeks, depending on how intense the education is. But anywhere from three weeks, I say to about eight weeks, you can be a CNA within that timeframe, and you do have to pass like a test to get your certification, but you don’t have a license. That’s sort of like the base level.

I think the next level after that would be what we in California call LVNs. I think in other places, they’re known as LPNs, licensed practical nurses. Here, we call them licensed vocational nurses. They’re the same thing, so if you see them, they’re interchangeable. That one is a little bit different because there is a test that you have to take to get licensed. Those programs are a little bit longer. I’ve seen them as little as 12 months, you’ll be an LVN.

And you work in hospitals, actually can work in a lot of places as an LVN. I want to say there’s not as many LVN programs, but you can pass medications, and in some states, you can even do IVs. In California, you cannot, unless you have an IV certification in addition to your LVN license, but you can do vital signs, you pass medications, you can assess. You’re a little bit more limited in what you can assess in a patient.

Then you go up to an RN, which is what I think most people sort of refer to when they say, are you my nurse? Your RN is your registered nurse. Those programs can range as well, depending on if they are doing like a two-year associate’s degree program, like at a community college, or if they’re doing a four-year bachelor program. Those nurses can pretty much do everything from procedures to medications, to IVs. Some RNs run clinics and things like that.

Then you get into what we call advanced practice nurses, and that can vary in a lot of different ways, because your advanced practice nurses may even have doctorate degrees. They could have doctorates of nursing practice. They can have Ph.D.s, like myself. They can be nurse anesthetists, where they may be in the hospital giving you your anesthesia. They may be the nurse practitioner delivering your baby actually. Some are nurse midwives. They may be the person doing your, sometimes they do stitches.

They can do a lot of procedures. I think the main difference is there are probably not nurse practitioners or advanced practice nurses doing surgeries. So, that’s sort of like a very quick and dirty overview of the differences there.

Dr. Bjorn Mercer: That’s a wonderful overview of the different levels of nursing. I think for many people, just like you said, when somebody says nurse, it’s just a blanket, oh, this is a nurse. But just like you said, there’s many different levels of nurses. My own mother was an RN for years. So, she had a three year, was in between an associate’s and a bachelor’s. So, she was able to be a nurse for well, her entire career. I always think of nurses as the backbone of all healthcare. It starts with nurses, it ends with nurses.

Not to discount doctors, but they often come in, they look and they leave, and who is still there to care for the patient? Nurses, of course. Now, a follow-up question, so for the CNA or the LVN or LPN, those are really great options for people who want to get into healthcare, but don’t want to go for, say the full three or four years, correct?

Dr. Jameelah Powell: Sure. You also have to look at how much money you want to make. With the CNA, I think what I saw was somewhere like median was about $30,000 a year. Typically, as a CNA, you probably are going to be working 12-hour shifts if you’re working in a hospital. It is a lot of physical work, as with, I think, any level of nursing, to be honest. If you work in a hospital, you’re probably going to have a lot of physical work. I think as the years go by, that can put a lot of strain on your back because you’re standing most of the day.

But I think if you are interested in a CNA, just sort of being aware of what that work looks like, it’s a lot of, as they call it, the grunt work. I was a CNA when I was in nursing school. I can tell you, I actually really appreciate it because I felt like the connection that I got to my patients was a little bit different because they saw me come in, giving them a bed bath, or helping them to the bathroom. It’s just, that appreciation was so profound.

It’s like, you are here to help me do things that I should be able to do for myself, but I can’t right now. I think that level of gratitude for me was just, I appreciate that. I appreciate that you appreciate me. I think for an LVN, it’s probably a little less of the grunt work, but you are limited in what you can do, but your money goes up substantially. I think it was, I’ll say about $48,000 median a year for an LV, and a lot less time than an RN, a 12-month program in a year, you’re done, and you can be used in a lot of different places.

LVNs are not only in hospitals. You can start working in home health, sometimes they use LVNs in home health facilities. I’ve been seeing a lot of LVNs during COVID making a great deal of money, just doing testing and helping with those COVID sort of protocols during these, like the lines, that whole operational process of getting people through.

I think that LVNs have actually been in demand these last few months as a result of COVID, and really expanding on what they can do. I think there’s a lot of great opportunities in LVNs, even though I don’t believe that there are as many programs for LVN education. So, that’s sort of the big difference there.

Dr. Bjorn Mercer: One of the things that I don’t think people realize, who aren’t in healthcare, is how emotional being a nurse can be and how intimate ones interactions with patients can be. Because, as you said, when patients are there, they’re in a state in which they probably can’t do things for themselves. And that can be very difficult for people, because most people love being independent. They love doing their own things, but when they’re in the hospital, or a SNF especially, there’s something going on, that they are unable to do it.

So, the nurses, the CAN, therapist, my wife is a therapist, and so she talks all the time about what it’s like to be with these people and helping them out and how oftentimes they will apologize and kind of the emotional, and I’m not going to say toll, but just how emotional it can be and how that’s something that people have to, I guess, understand before they become nurses, but it could be extremely satisfying.

Dr. Jameelah Powell: I think you hit the nail on the head to be honest. It’s something that, as a nurse, I don’t even think about that, that often, but when you said it, I thought, “Oh my gosh, yes.” That’s absolutely one of the big things that I tell my nurses when I’m teaching, literally before we start introductions, I say, “Hey, if you want to be a nurse, one of the things I need to tell you is money is not going to comfort you at night when you’ve lost that patient, or money is not going to comfort you when you’ve been on your feet for 12 hours, having to deal with a patient that was very, very sick or the emotional.” And I am going to say toll because I do think it does take a toll depending on the area of nursing that you’re in, especially if you’re in like oncology or the burn unit.

I think it is very emotional, even if you’re working with kids. I think majority of my career, I’ve worked with the entire lifespan, but I’ve worked with kids a great deal, and because they’re so vulnerable and just small, there are so many things that, when they happen to them, it feels much worse than it would if it were an adult.

I tell my students quite often, be for those things, because that’s not something I can teach you. I can teach you procedures. I can teach you skills. I can teach you terminology, but I can’t teach you how to deal with a death. You’ve been working with the patient for years and they die. How do you manage that?

Or, how do you manage just seeing so somebody who is sick day-in and day-out, and then you come home and you have your children to deal with, or you have your, maybe sick family member to deal with? How do you rotate between those two? That can be very difficult.

I would even venture to say that nurses see a lot of things, and I’m going to say healthcare professionals, because it’s not just nurses, but healthcare professionals see a lot of things that I think the average person doesn’t see in their lifetime. I’ve seen neglect. I’ve seen abuse. I’ve seen death, probably more often than I would like to. I’ve seen sickness and disease way more often than I think the typical person does. You see what that does to your body. I think, just in general, one thing that I’ve always told my nurses is, make sure you have a debriefing partner.

Make sure you have somebody that you can go and just sort of, I say, just let it all out. Somebody hopefully who gets it and understands, whether that be a therapist or whether that be another nursing friend, or even if it’s your husband or your spouse, that sort of gets it. You just need to have somebody like a sounding board, or just something to get that out, because once those stories are in you, they’re just sort of in there, and I think they can do a lot of damage.

I think they can actually be kind of traumatizing in a way that nurses don’t know. I actually have told, and I don’t remember if I was talking to you about this, about how sometimes people can become numb because there’s so much emotion and so much feeling that they just sort of stop because it’s overwhelming.

Dr. Bjorn Mercer: I think we were talking about that. It reminds me of when I talk to police officers where they oftentimes deal with a specific group of people in the country. So, they get jaded, and they think everybody is going to break the law. Just like with healthcare professionals, they see the sick, they see the neglect, like you said. They see the people that are suffering, and so you can become numb to that. Like everything, health care workers, especially emotionally, and they have to process that if they want to have a long career, of course.

So, this brings me to the next question is, when do you go to an urgent care versus an ER, or say a regular doctor visit? Health care in this country is, for lack of a better word, very expensive, even when you have insurance. Most people think, how much is this going to cost even with my insurance? These choices are actually very important to make.

Dr. Jameelah Powell: Yeah. I think you were just talking about burnout, and I was thinking to myself, COVID-19 has obviously exacerbated that type of burnout. I think it’s made the situation for nurses even worse. I think that there’s been a lot of people leaving the field, to be honest. I’m on a lot of nurse blogs and groups, and I just see questions like, “What else can I do? What else can I do?”

I think one of the things that actually would help, maybe sort of balance healthcare a little bit is if people knew where to go to get healthcare, because hospitals are getting sort of overwhelmed with people. This is not just as a result of COVID. I just mean people going to hospitals when they don’t need to go to hospitals.

One of the best things to do is have a primary care provider, whether that be your nurse practitioner or whether that be your primary care doctor, I think it’s important for people to have that, but I know that people just don’t go to the doctor. You mentioned healthcare, and I’ve worked in public health. One of the things that is really scary is that people put their health on the back burner. There are so many things that take priority over your health, and people take it for granted until they’re very sick or very ill.

I think your primary care provider is your first, like that’s where you need to be going, because they keep your records. So, they have a history, they have a detail of like, “This happened to you two years ago, I’m seeing a pattern here.” So, that’s important. And because they know you and they see you, they interact with you, they know what you need, and I think they can sort of have expectations of what labs you might need.

Because you’ve had high blood pressure for so long, I think I want to run this test, or I think you should have this procedure. I think they can anticipate your needs a little bit better. I think that’s sort of like your first line of defense, is your primary care doctor.

But obviously, especially in communities that are poorer, working lots of jobs, working long hours, they probably don’t have the ability to see a primary care doctor that often. So, then you have what’s left over is urgent cares, ERs, and walk-in clinics.

I think the ER is just the most accessible, because everybody knows, whether you speak the language or not, ER is where I go for care and you can’t be turned away. So, people use the ER a lot as their sort of primary care. But, as you said, that can be very expensive. I mean, even for people who have insurance like I do, it’s still, I think I want to say an ER visit can cost you upwards of $100 each visit, and really, I want to say upwards of $300. If you had to have an ambulance ride on the way there, that’s another $800 to $2,000 just for the ambulance ride.

When we’re talking about urgent cares, I think for me, because I know how expensive it is, that’s one of the first places I will go. If I can’t get to my primary care doctor, I’m probably going to go to an urgent care, but this is for things that are not emergencies, and that’s sort of a very subjective word to people.

Well, this is an emergency. I had a friend recently, and they had surgery, and it was surgery to take out their gallbladder and they weren’t feeling very good. And they were like, “I think I need to go to the doctor. I just don’t feel well. I need to go to the ER.” I thought, well, what are your symptoms? Just please tell me your symptoms, because let me save you some money if you don’t need to go. “I just, I feel a little nauseous and I just feel like something isn’t right.” I said, “Have you been eating” “Well, no, I haven’t.” “Have you been taking pain medication? Well, those are two things that don’t work together. You can’t take a very strong pain medication on an empty stomach if you haven’t been eating.”

It turned out they needed to eat and they just had a lot of gas. That was pretty much, and after those things were addressed, they were like, “Oh my gosh, I feel so much better.” This was literally the same day. I think it’s important to take a look at your symptoms.

Is it an emergency? Emergency is like a stroke, paralysis somewhere. Any head injury is always an emergency because you never know what the repercussions of that can be. I think chest pain. That’s a big one because you don’t know where that could be. A serious burn or, obviously, if you’ve been in a motor vehicle accident or any type of accident where you could have internal injuries and not know the extent of the damage.

But I think small things like I have a sore throat, or I have a fever, and a fever maybe without a rash, because that’s a totally different thing. But my eye is discharging, discolored maybe. Things like that, I would say, please go to an urgent care because it’s going to be less time-consuming for you. It’s going to be less expensive for you. I think that you will probably get the care that you need because most urgent cares have the equipment necessary to diagnose a lot of things, sometimes even broken bones, they can set and fix there, I mean, depending on the urgent care.

I think if healthcare was a little bit more balanced in that way, like people are utilizing the services where they should be utilized, you wouldn’t have such an imbalance in what’s happening, especially in ERs and hospitals.

Dr. Bjorn Mercer: Exactly. It’s one of those things where it’s hard to know how to get the message out because everybody knows healthcare. Everybody knows that there’s doctors and nurses, but again, just like we were talking about with the different types of nurses, they don’t know the different types of facilities to go to. So, urgent cares are great. Because oftentimes, and my wife and I have talked about this, going to urgent care is the same, or cheaper, than going to the primary and then getting a script to go to someone else to then have something else, and it’s quicker, honestly.

For some reason, urgent cares have popped up more frequently in localities, which is good, and without getting into a larger discussion about the problems with healthcare in the U.S., which could go on for or ever.

One of the things I always say is that people don’t always need a “doctor” to fix you. What people need is a nurse, a nurse practitioner. Those people will usually take care of the vast majority of problems and help you out. But like I said, if a bone’s broken or if they need some lab work or something like that, then, yes, obviously there has to be a doctor maybe, or something like that to have the process be facilitated.

But it’s one of those things where I think, as people, we’re alive and we think, I’ll be fine. Most people don’t, I would say, think about the mortality in the prime of your life, so then you just think, I’m fine forever, and then when something happens, they do put it off. I’ll gendersize a bit here, especially men. Men will especially put things off until literally something’s falling off.

Dr. Jameelah Powell: I will say research shows that. I’ve actually read articles about that. Unless you are bleeding uncontrollably or not functioning down there, you’re probably not going to the doctor very often. And it’s usually pain, blood or dysfunction that I have found that’s usually when men go. Obviously there are exceptions to that.

But what I think helps with that is a primary care doctor. I really do, and that’s sort of why I say the problem lies, because if you have somebody that is connected you, and that you see often enough for them to say, “Hey, it’s time for you to get this thing done.” And you build a relationship and a rapport with that person, I feel like that doctor or nurse practitioner, or whomever your primary care health professional is, is more likely to get you in before something happens.

I think that so important, because we talk about healthcare, and I think it’s important to mention preventive care, because preventive care is so much more important, but I come from a public health background, and that’s sort of the first thing we talk about is primary care, and primary is preventive care. That’s like getting your immunizations, that’s getting your screenings done. That’s eating healthy and exercising. That’s preventive care. I just feel like, unfortunately, there is a mindset, and I don’t know which population or culture, but I do believe there is a mindset that, when I feel sick, I’ll just go to the doctor. I’ll just go to ER.

I feel like, yeah, but you could save that money and save yourself, because maybe by the time you get sick, that problem is already too far gone. So, don’t wait. I had a friend who hadn’t gone to the doctor in 40 years. He was about 60, yeah, 60-something years old, and he hadn’t gone to the doctor in 40 years. Part of that was circumstances and part of that was he was a guy and just, everything, I feel fine, so I’m good.

He started having symptoms of double vision. He was losing weight, and not trying to. He was having some stomach trouble, some pain in his back. By the time he was able to go to the doctor, we had to take him to the ER, he had cancer. And it was stage three or four. Unfortunately, he passed away, and I use his story to tell people, it is important, your health is important. It’s hard to impress upon people like the prioritizing your health when they have bills, or when they have kids, or when they have food insecurity.

I understand that, I truly, truly do. And I think it’s so unfortunate that people have to choose between paying a bill or going to the doctor, or health, or getting food for my family. That’s sort of what you talk about, is the conversation about healthcare in America is very vast and it almost feels bottomless.

Dr. Bjorn Mercer: It does feel bottomless, because as a non-healthcare person, now I rely on my wife to diagnose everything. As a therapist, she’s seen a lot, and she especially has a good temperature on how severe something is. So, when you’re talking about, should people go or just kind of wait? But one of the things that the healthcare seems to fix things. Modern medicine is great. It can fix so many things, and obviously people live much longer than they did 100 years ago, so much more.

But at the same time, with preventative care, one of the things you said, which is food and nutrition, which is talked about a lot, but I think should be stressed even more, because a good, well-balanced diet can help so much. My own plug here is we’re about 95% vegetarian. You don’t have to go all vegetarian. You can still eat a burger. We still have a burger every once in a while. But having that really good, fresh fruit and vegetables forward as the foundation of your diet is healthy. Of course, it is.

Again, it’s not to say that you have to completely throw it out and become a vegan and only organic, all those things, not at all. But if you do that and if you exercise consistently, and exercise consistently, it just means that you’re active. You don’t have to become like a body builder.

If you do those two things, including having a balanced work-life and not stressing out, because you can still have a great diet, exercise, and then kill yourself because you’re a stress ball at work. That is where it’s like, healthcare is great, healthcare fixes so many things, but healthcare cannot fix people in their individual lives at home. It’s hard to know how to get that as part of one’s holistic health conversation.

Dr. Jameelah Powell: So interesting because I was just talking about this. I’ve had these discussions with my husband because I think this is where we talk about social determinants of health. This is where we talk about how society, how where you live actually impacts those choices. Because it’s very easy for me to say yes, eat right, eat healthy, and exercise. But I have worked and actually lived in communities where that just isn’t as possible as you think it is. The grocery stores are limited. What I mean by limited, there aren’t a lot.

There’s one grocery store in the neighborhood, and that grocery store has limited, quality, fresh fruits and vegetables, which I think is completely important. When I was in public health, we used to do these walkability assessments, where we’d go through the community just to see how safe it was. We’d walk into the grocery stores and do like an assessment of the expiration dates of the foods, and what types of fresh fruits and vegetables are available. Are they quality? Are they organic? Because I can tell you, the organic is going to be very limited.

Then, in addition to that, we talk about working out and exercising. I myself am intrinsically, I know how to work out. I have that within me. I don’t know what that is if that’s a fear of being unhealthy, but I will, it’s nine o’clock, I’m like, wait a minute, I have an exercised today. I’m probably going to bust out a hundred jumping jacks and some sit-ups, and something like, I’m the person to do that. Other people need that external factor, that external, I’m going to call it pressure, but help, assistance. That’s why some people go to the gym because they need that environment. Other people are working out around them and so they need that.

But the problem is, when you live in a community where there isn’t a park that safe, there isn’t a park available at all. There isn’t a lot of green space for you to go out and move around, and move about, and maybe there’s poor lighting, and that’s sort of where that whole safety issue comes in. Because if you are in a poor community, and you work long hours, and you get home at six o’clock, and you’ve got to make dinner, and then it’s now seven o’clock, and now, where are you going to go to exercise? It’s late, it’s dark, what are you going to do?

I think that’s why that message sometimes is very difficult to get out, because again, people, it’s hard to empower somebody to value themselves the same way you value yourself with the knowledge that you have. I understand the importance of my health and I understand the importance of eating healthy. So, if you see me eating, I want to say some fries, I’m aware, but I also know it’s okay to do once in a while.

I think other people may not understand that balance. As you said, you’re 95% vegetarian, but I don’t think everybody understands the importance of incorporating like vegetables in every meal you have, like that’s a thing. How do you get that out? I think that is, to me, a national campaign. I really do.

Dr. Bjorn Mercer: Oh, I completely agree. Changing one’s eating habits is so difficult because it’s where you’re raised, what your parents fed you. If you have emotional attachment to food, and that’s something that is, it can be changed of course, but it’s very, very difficult.

So, just like you were saying, “Oh just have a better diet, exercise a little.” I, of course, always recognize that, in my own family, we have a room that is our gym. We have an extra room. We’re very lucky. We have three grocery stores within two minutes, and one is an organic grocery store. We’re very lucky that we live in a community where it’s right there and there’s plenty of fresh everything.

Even living in the Southwest, the weather, well, unless it’s 120, is very good for walking. During COVID, it made me think a lot about people in highly urban cities, like New York, where if they’re in a small apartment, and then COVID happens and their gym is closed, they’re stuck, and their gym is closed. Then, if they’re not intrinsically motivated to exercise, because like you said, some people do need that external motivation, I think, and I apologize if I get these stats wrong, but the average person gained about 28 pounds I think during COVID.

Dr. Jameelah Powell: Yeah, I think that’s probably, but I heard somewhere between 20 and 30 pounds.

Dr. Bjorn Mercer: Which is a lot. That’s a lot of weight. So, it’s very easy to see how, because of COVID, certain things took the back burner.

Dr. Jameelah Powell: Absolutely. You mentioned something about stress, which I think was very important to mention. Because I want to say, I don’t think people realize the amount of stress or trauma that they’ve experienced from COVID. Who’s lived through an epidemic? There’s not a lot of people living that can say that. I think just the fear of it, the anxiety of it, the uncertainty of it, especially with people who’ve lost their jobs. People in healthcare who have been dealing with a lot more than they’ve dealt with, probably most of their working careers, we have to allow ourselves to process that, and I don’t think people are really processing it. I don’t think they understand the full impact of it.

I used to see, memes or, I want to say inspirational thoughts on Facebook, people saying, we’re in a pandemic, so if you’ve gained a few pounds or if you just don’t know what to do and you’re just sort of sitting, that’s okay. Unfortunately, what that meant was a lot of people, that took a toll on their health is well, being sedentary for a lot of people. I think some people got blood clots, and not because they had COVID, but just because they were sitting in chairs for long periods of time and not getting up and moving around, not going for their actual lunch break. They’re having lunch at their desk instead of getting up and getting outside and going to get something to eat.

Socializing even, like your friend down the hall, I’m going to go stop and say hey to them. So, because you were able to get up and move and walk around, but now that you’re just at a desk, I think it just sort of kept people there. It’s almost like you were held hostage by your chair. I think that is something to be considered as well, what you mentioned, just that trauma and just that anxiety and that uncertainty during these times.

Dr. Bjorn Mercer: The last question is, as fall’s approaching, what are some health issues to be on the lookout for?

Dr. Jameelah Powell: Ooh, so every season has its issues. In the fall, the temperatures drop, and I think one of the things you have to think about is infectious diseases. Infectious diseases are always, always, always worse during colder seasons because people are congregating together, people are staying inside, people are going indoors instead of going outdoors, to the beach where open air and fresh air and things like that. I think allergies is a big thing for people.

It’s like allergy season. I feel like it’s allergy season most of the time, except for in the summer, but like fall, winter, spring, it’s just allergy season. So, that’s something to be on the lookout for. Some of that had to do with heaters because people are starting to turn their heaters back on. So, one thing that I recommend for people is making sure that, when you first turn your heater on, that maybe you air out your house first. Turn on the heater, open all the doors and get all of that out.

Maybe even clean your filters and things like that, because your allergies are going to be so much worse if you turn on your heater that hasn’t been turned on in months. Also, ragweed is a big thing, dust mites is a big thing. One of the things with the heaters is that, when you turn your heater on, it can actually aggravate the dust mites, and now there’s dust mites in the air. Just be mindful of that.

Cold and flu, obviously we’re in cold and flu season. So, you’re going to get things like sore throats, ear infections. I want to say things like nasal drip can be caused by allergies, as well as cold and flu.

Another thing that people don’t think about unless you have it is arthritis. If you have arthritis, it can be much more excruciating during these colder months because you can just feel it in your bones. I think that’s important for people who have arthritis, or even cold-induced asthma. This is where you really start need to like bundle up. You need to start wearing warmer clothes so that you can keep your body temperature a little warmer so those things don’t affect you as much.

Another thing that I was thinking about is, this is also the time mental health issues, things like depression with the holidays coming up. There’s also something called SED, seasonal effective disorder, where that’s the time where suicides increase, the time where depression increases. I think this is the time you need to really check in on people, especially because we’re still going through COVID. That to me, in itself, is a big conversation in and of itself, like mental health in COVID, and mental health in the start of the fall. Because it sort of begins our holiday season.

People are missing family members. As people are joining together and not out and about, like you can be on a beach and be alone, but you’re out with a bunch of different people, and I think it makes you feel a little bit different than during the holidays when people are indoors celebrating, and you’re indoors, but you’re indoors by yourself. It’s very different. I think those are things that we really need to pay attention to right now.

I was just looking at some stats on suicides increasing in certain populations. Of course, suicides have always been higher in elderly and teenagers. Unfortunately, males are more affected by that. Usually, what they say is males go through with it, like it’s more lethal. They are more likely to have it be done the first time and it’s done. Whereas, I think women, or girls, have more attempts.

Those are things, as a public health nurse, and just sort of as a person who’s very aware of like mental health and its effects, especially right now during COVID, I would say just be mindful of that for people. Check in on your friends, check in on your family members, have really real conversations. Say not, “Hey, how’s it going?” But “Hey, how are you doing right now? I know it’s been really tough in your field.”

As we’ve been talking about nurses and healthcare professionals, I really feel like, if you have a healthcare professional in your life, please, please talk to them and see how they’re doing because they are really suffering right now, especially those working in hospitals, they really are.

And on these blogs, I’ve just been, like I said, I harken back to what I was talking about earlier is, they are talking about other careers right now because the work is so hard and it’s hurting them. It’s a little painful and it’s depressing, and they’re getting burned out. Mental health is a really big thing right now for fall issues. I feel like I took a bit of a tangent.

Dr. Bjorn Mercer: No, it was an important tangent. It really makes me think of kind of what we’ve talked about throughout this entire podcast is healthcare and health issues isn’t just nurses, doctors, it’s everything. It’s nutrition, it’s a work-life balance. It’s, I would say, having a hobby, it’s having some sort of faith structure, whatever that is for you, whatever works for you and your family that allows you to live. Because for a lot of people, getting that education is such a struggle, and then they get the job, and then you get the job and then you work so many hours that you’re stressed out. That’s great, but you’re still stressed out even though you have enough money now.

So, health is more than just the education, get the job, and then you’re stressed out still. It’s about having that balance. Even just in our conversation, one of the things that I always tell people is, as my wife and I transition to a more vegetarian diet, any inflammation that I had, had in the past is gone. I’m not going to say that’s for everyone that will happen, but it’s one of the simple observations I’ve had of my own life.

There’s just so many different things. I always tell people, find a hobby. What do you do when you’re done with your shift? With kids, of course, you focus on your kids, but besides the kids, you have to do something for yourself. It can be as simple as reading. I do music and writing, different things that can help you enjoy life.

That’s one of the things, and it’s hard to know, because then when we’re diagnosing culture here. How does culture teach us to enjoy life or how to live? That’s such an individual family issue, and it’s hard to know how many families do it correctly, and that’s, I’m just saying correctly, not as a judgment, but just, what do you do when you are presented with life as an adult, and how do you do it in a healthy manner?

Dr. Jameelah Powell: I think what you bring up is a pretty interesting point because you’re talking about culture, and I know just in general, when we look at like different countries, American culture is work, work, work, pull yourself up by your bootstraps. I think that’s changing a bit, but I think there has not always been this idea of work-life balance. There has not always been this idea of self-care. There has not always been this idea of, when I’m off work, I’m off work. I think, people feel like, when they’re working, they’re productive.

If I work 10 hours, I’m being productive, and sometimes that’s not always true. You putting in 10 hours a day doesn’t necessarily mean you’re more productive, it means you might be there more, but it doesn’t mean you’re more productive.

That conversation has been sort of discussed in this idea of the four-day work week as opposed to the five-day work week, and what it’s really productive, and what’s really important. Because giving people time off and giving people vacation time actually encourages them in their health to be more productive at work.

Because if I’m sluggish, if I’m tired, if I’m nauseous, if I’m just, in general, in my body, I’m just not healthy, and I’m probably not the most productive person at work. When you talk about culture, the first thing that came to my mind is, like in America, we are about work. Working to get that American dream and working to be successful, whatever that means. In America, being successful is having money and having a good job, and not necessarily being healthy. Because I feel like that’s successful, being able to just sit and be mindful.

That’s why I said, I think that’s changing a bit as we talk about self-care. This idea of taking time out for yourself, whatever that is. You mentioned music or writing or having a hobby. I think sometimes it’s just, did you have five minutes to just breathe? Did you just sit and be with yourself?

Because I think we’re moving, moving, moving, moving so much that you don’t even know what you feel right now. If I say, “How are you doing?” People just automatically say, “Oh, I’m good.” But literally, if you took a breath, close your eyes, and just went inside yourself for a minute, it’s weird to say because you are in yourself, but like, really be mindful of, am I in pain right now? How does my body feel? Is my back hurting? This interaction that I just had with somebody, how did that make me feel? Instead of just moving past it.

Dr. Bjorn Mercer: Those are all such wonderful observations, and it makes me think that, in general American culture, and again, I love American culture, and American etc., but the desire to be on top, the richest, that doesn’t make you happy, and especially it doesn’t bring you joy.

One of the things that people should really always try to do is be reflective. Reflect on who you are, where you are, where you’re going. What’s your life purposes? There’s a great commentator/preacher Skye Jethani who said that oftentimes, in American evangelical circles, there’s not a good reflective structure, even in that faith structure.

We can say like, even when people are part of, say faith structure, which is supposed to give them community, which it does, they could still be lacking the ability to reflect, and without the ability to reflect, we can’t change, and that’s so integral to your health. At this point, it’s been a great conversation. Any final words?

Dr. Jameelah Powell: Well, since we’re talking about health and nursing, one thing that I will say is, because of my own journey with mental health and just learning what’s good as a nurse because you see so many things, I say reflect, as you said, reflect on life. But also, when you wake up in the morning, think of something that you’re grateful for. Because I think that is something that you can change from the inside out. We talk about eating healthy and things like that, but just emotionally, I think it’s so important to just recognize the goodness.

What’s good? What are you grateful for? What are you glad for? What are you happy about? Because being happy is a state, and you’re not always going to have it. But being able to just have joy, that’s a different thing, just to be able to feel the goodness in your own life.

I think mindfulness, I would say, please just be mindful of yourself. It’s important to know what you feel, know how you feel, and it’s important to feel the goodness because there’s so many negative things going on right now. It’s like, can you see the one plant growing in the middle of the weeds? If you can do that, I think it’ll be so much more healthy for you mentally.

I think that would be sort of my words of wisdom, is just recognize the goodness, really recognize the goodness, and what are you grateful for? And finding time for you to be able to sit with yourself in a comfortable place. A lot of people I think are uncomfortable sitting with themselves. So, I think it’s important to sit with you and know that you are good and you are okay.

Dr. Bjorn Mercer: Exactly. If people can do all that and have that mindfulness before they fall apart, and then the doctor says, “Go to a beach and relax, that’s your prescription.” Do it before you get to that point, and everybody will be healthier.

Absolutely wonderful. Thank you, Jameelah, for a great conversation. And today we’re speaking with Dr. Jameelah Powell about health issues. Of course, my name is Dr. Bjorn Mercer, and thanks for listening.



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