Episode Transcript
[00:00:03] Speaker A: And she said to me, I don't care what people know until I know that they care. And I said, oh, okay, you can be the top in your class, but if people don't know that you really care about them, they don't care what you know. Community people, I think they look at your heart first before they look at your head. And so you've got to come in and be sincere about what you want to do. And it goes a long way to, to build trust in those communities.
[00:00:31] Speaker B: Welcome to another episode of Advocates in Action, a podcast created by the Patient Advocate Foundation, a nonprofit that helps promote equitable access to affordable, quality health care through providing case management services, financial assistance, and patient education and advocacy tools to people living with chronic, life threatening and debilitating illnesses.
I'm your host, Ashley Freeman, manager of Stakeholder Outreach and Engagement.
[00:01:00] Speaker C: I would love for us to start with your story. Can you walk us through your journey into becoming a nurse and what led you to focus on community based care?
[00:01:12] Speaker A: Thank you. And thank you for the invite. I've been a nurse for 44 years and that's so hard to believe. And my first two years I worked in a hospital in a clinic setting. But I knew in nursing school that it was something about the community that just kind of drew me to people that were in the community.
So I left the hospital setting and began doing home health and hospice. So actually I was doing home health care, providing infusion services. So that was my first time dealing with patients that had a six months or less cancer diagnosis or a deaf diagnosis. But honestly, I would leave those homes feeling encouraged. It was never a moment where I was depressed. It's something about being where people are, what we call people's safe place that made me feel safe and made me feel at home.
And it really, really was a place where I could have evidence of the work that I did. And it was not just patient centered, it was family centered, it was community centered. And that's what I liked a lot about that.
[00:02:24] Speaker C: When you said something about being in someone else's safe place also made you feel safe. And when you stepped into people's homes, what did you notice about the gaps, maybe in health care when having those conversations with family, family members? Because now you get the opportunity to not just interact with the patient, but the whole family. So through those interactions and building those relationships, what were some things that you noticed about the people that you were serving?
[00:02:55] Speaker A: That's a wonderful question. And I learned so much. And sometimes I would say, as I left the homes, who taught who, because I learned so much from them, they just had a deep well and I just kept trying to drink the water. Because in learning about people's health and their health care, you also have to learn about how they live, how they look at health, what's important and what's not. Now, one of the things that I did find out that was kind of surprising to me was primary care for a lot of my patients was unheard of. I don't feel bad, you know, I don't look bad. So why do I need to go to the primary doctor? Why do I need a routine checkup?
So oftentimes family members, if they had toothache or toe ache, guess where they would go? They would go to the emergency department because they didn't have a primary care doctor.
So the emergency room was used more for primary care than it was for emergency care. And I saw a lot of that. And so trying to get people that were underinsured in places that would provide care. And then sometimes it's people that would have, would be able to be on Medicaid but just didn't know that. And getting them connected to those resources as well.
Because you want to have a happy family. Yeah, I mean, you know, a healthy family. And I was treating the patient, but it sometimes I felt like I was treating the entire family.
[00:04:36] Speaker C: So what did that relationship and educating the whole family look like? Because I can imagine, especially caregivers, right. They're always so focused on the person who is visibly sick in this situation. Especially in a hospice situation.
[00:04:51] Speaker A: Yes. Sometimes you have to remind people that you need to be healthy and feel good to take care of someone else. And if you're not, then you're going to be that person that either needs the help or you're going to be in the hospital.
So if you make reference to they need to be strong for the person they're caring for, then I think that adds more to them, more validity to why they need to get treated. But the thing about connecting people to resources, because there's a ton in the community, but not all of them may meet the need. And so I learned early on to call these places to make sure that they provided those services because people get frustrated if they make a call, oh, we don't have that, but this place has it, then they call that place that don't have it. So they're not calling the third place. So I wanted to be like a one stop shop.
So I vetted every resource that I gave someone. Yeah.
[00:05:57] Speaker C: Wow. Sounds like to me you were more than just a nurse. You were a patient navigator, advocate. All of the things balled into to
[00:06:07] Speaker A: one in doing that, it is community health or population health.
And sometimes some communities, I was the person that people felt comfortable asking questions. You know, they. It didn't matter how they asked it.
I understood. And if I didn't, I'd ask them explain a little bit more.
So they were sharing things that they probably should have shared with their. If they had a primary. Their primary doctor. But they didn't. So I was that safe person for them to ask questions. Yeah, yeah.
[00:06:45] Speaker C: And I know in that same vein of population health and community health, your work eventually branched out past the four walls of someone's home. But you also started an initiative where you started bridging the healthcare work that you were doing with your local church. So tell us about the inception of that initiative.
[00:07:08] Speaker A: Absolutely.
So I've been diagnosed with breast cancer. And so that was a biggie for me. And what I did notice when I was diagnosed and just talking about it, because I didn't have anybody that came to me and said, oh, I was diagnosed with cancer.
So after I stood up in church to talk about was an older lady that whispered in my ear I had that she couldn't even say I had cancer, as if the word was contagious. And so I said, I've got to figure out a way that I can bring people together so that they can understand health information in a plain language and then they can act on that information.
This is the thing I had to be the living proof that you can go through all of this and still survive. And so that's when I began to think of ways to bring information to the community, but also bring my oncologist to the church and other people that I work with in the institution to the church. So now the doctor that seemingly is intimidating to people, now he's in their safe place, and now he becomes a person that's approachable and those kinds of things. And so it kind of works, but you have to be a bit creative. The first event that I had, I had a African. Well, it was 100 men in black. And they sang to open up the conference. And I figured if I could get them there, people knew about music, gospel music, so they would think, oh, well, this is not too bad, I'm going to cancer conference. But they open up with the Christian music, so you see them relaxing a bit. And one of the speakers was a prostate cancer doctor. So I had 100 men in black. Right.
So I had to figure out A way, how am I going to keep these men here so they'll stay throughout the conference?
So I had them to sing midway in the conference so they couldn't go anywhere. So then we had a ready made group of people for that oncologist to talk to. You kind of try to do what you can to keep people engaged, keep them interested in their safe place. And the church was that safe place. We could give good information, but also have survivors like me to provide evidence that when a cancer is caught early, you can survive it. And I think we managed to do that.
[00:09:51] Speaker C: This theme of safety, safe places, being a safe person that keeps coming up in this conversation. I love this theme. But for those who are listening to this and they don't know the history or the value of churches, specifically in the black community, and how they have been a safe haven for since the beginnings of time, please share some background and context around black churches being the backbone of our communities.
[00:10:21] Speaker A: Yeah, so I can share from my experience when I was growing up. So I'm from a small town in eastern North Carolina. It's called a Hoskie. It's very small, but our church was our foundation piece. And so in our particular church, we had a lot of educators and people who made foundations for something that they probably never would see, but they knew that a generation would come that could appreciate that. So within our church, not only was the word of God important, but education was very, very important, important.
And.
And the beauty of that was that your teachers were in church, you know, church, or you saw your teachers at the grocery store. So it really was this village. And not only with Christian information exchanged and disseminated, but also educational, political materials, all of this. It was really the hub of the African American community. And it was just important. Like people had a need before social services and all that was really big.
It was the church, we were the foundation. And I think we've lost some of that now. I know I'm on this safe haven place, but the church has always been the safe haven. And so if that's where people are, then let's find resources that will, that we are able to share with people so that they really believe that the church is the place to go for a lot of needs.
[00:12:17] Speaker C: I loved what you said of before social services were available and also thinking about segregation. Even when social services were available, they weren't accessible to us. So we were very resourceful on our own.
[00:12:32] Speaker A: I'll be 67 in August, but I lived where there was segregation until I was 11 years old. So I know exactly what you're saying. And that's. We. We were our own social services. People had farms and vegetable gardens and.
And our teachers taught and everybody was everybody's mother.
And I mean, that's just. It was the village, it was family, it was safe.
Yeah.
[00:13:10] Speaker B: Yeah.
[00:13:12] Speaker C: And what are some examples of how you've been able to use your partnership between your health background and work and within the church? I know you mentioned one example with 100 black men there for the prostate education, but what are some other examples of your programming and partnerships over the years?
[00:13:36] Speaker A: I've been in a church all of my life. I was in nurse and I'm a cancer survivor. And I thought I could look at that being the glass half empty or half full, you decide how your life is going to be. And I decided to choose that the glass was half full, meaning there was work for me to do.
So I looked around at where I was, my circle of influence, and how I could bring two entities together that probably would have never, ever crossed paths on a level that people felt comfortable to exchange information, fears, apprehensions. So the doctors that I knew in our local centers, and not always were the doctors African American, but every single doctor that I asked, can you come to my church and talk about whatever. They were so willing to do that. And then from the church perspective, talking to my pastor. And honestly, when you get approval from the pastor, everything else just, it flows. And the pastor saw the need for cancer awareness. And so to have other survivors that have survived things and being able to have them again be the evidence that cancer does not have to kill you, that really did help in us getting people to come and just to talk and have these conversations and to ask people ask really good questions. I love that.
And they were able to talk to doctors that they normally wouldn't talk to face to face and have these questions. They ask the questions and have them answered. So it was a really good opportunity for people to feel comfortable talking and sharing things.
[00:15:37] Speaker C: And like you mentioned, it's in a safe space because there are questions that you probably feel more comfortable asking in the recreation center downstairs of your church than you do in a doctor's office. Right. Because there's this sterilization to a doctor's office. We all have heard about the power dynamics and hierarchy, and sometimes if you get a diagnosis or you get information, your brain can go blank. So all the questions that you once had, you can't even think straight. So to be able to have these types of events within the community where it is more Relaxed, your shoulders are down, your guard is down, and you can think straight to be able to ask clarifying questions. And that environment matters.
[00:16:29] Speaker A: It does matter. And what I noticed was that in my church after the event, more people would come to me with questions about scannings or screenings that they were going to have. And some would share their results.
And that didn't happen before. And people that were interested in getting screenings that increased. It really was a good collaboration partnership. But I think it prepared each of the two groups now to have earnest and comfortable conversations with each other.
[00:17:07] Speaker C: And you mentioned this concept of edutainment.
So can you explain what that term is and why you have found that's the best way to deliver healthcare information?
[00:17:20] Speaker A: Yes. Especially when it comes to cancer. One person said the big C, people don't want to hear about it. In African American community, when you think about cancer, most people think about death. Even when I was diagnosed and I was done with treatment and I think I shared that I was a cancer survivor, someone said to me, you don't look like you had cancer. What does that look like?
Because people have in their imagination what it is. So when I had events with a group that I was a part of, we had, say, breast awareness, because people didn't want to come to a breast cancer event. And so it was really all about breast cancer. So we had a fashion show and it was survivors.
And so as the survivors would walk the Runway, the announcer would give out information. Did you know one in eight women are diagnosed with breast cancer as she's twirling. Oh, and Hope Valley has on a pink outfit and da da da da. And did you know that, you know, and that's what Edu. Edutainment. We would entertain him, but we were educating them while we were entertaining them. Yeah. And that, that made our difference in the world. So people didn't feel as if. Oh, these statistics, these numbers.
No, we edutain them. And I think people receive that so much better than standing in front of them reciting numbers and outcomes. So it makes. I think it makes it difficult. You have to get creative sometimes.
[00:18:56] Speaker C: Yes. That you explaining that example reminds me of a time when I was in grad school for my master's in public health on a college campus where kids don't want to talk about sexual health. They just want to do it and not have any information about anything else. And so I worked on campus and our office around health awareness. And we had an HIV and AIDS bingo night where like all the bingo cards had different facts. So when you were explaining that. I was like, oh, yeah, I've done that in my own work. Like, how do we make this digestible for college students want to come? Because like you said, there's that intimidation factor or even that fear factor of if I don't know this information, then I won't be impacted by it. It's something that I don't have to worry about. Actually, you might feel more empowered to be able to handle it when it comes your way, or if it comes your way, or if it comes a loved one's way because of the knowledge that you now have.
[00:19:56] Speaker A: That is so true.
[00:19:57] Speaker C: We're talking about all the great benefits from it, but it can come with challenges as well. So I would love to hear your experience over the past couple of years about both the challenges as well as
[00:20:09] Speaker A: the wins, knowing both of your communities and building relationship.
So if you don't have a relationship with those healthcare providers, then you can't invite people that you don't know to your safety place, honestly.
So that requires you building relationships with people. And it doesn't always have to be a doctor, nurse practitioner, physician's assistant, but some medical person that you can start out bringing them in.
I tell you, another challenge for me, and I still don't know that I've overcome this. But how do I bring the smaller churches, the ones we call the store front church? How do I get all of those people together and so they can get this health information as well? There's a church on every corner, but how do we bring people together to do this? And sometimes you have to write grants to kind of COVID some of this, because if you have an event that's at 5 o' clock on a Friday, nobody's going home, you want to have some food, and if you have literature that you want to share the printing costs, looking at the cost, see if there's a community grant that you can apply for, or if you're partnering with the healthcare facility, just trying to discover if they have funds that they could assist you with. Because community outreach is important to our healthcare providers as well.
I don't know how people respond to people that they really don't know. And they just see them in white coats. People have the white coat phobia.
And how do I prepare my church for these professional people? Because you don't know how people will respond.
But when it all comes together during an event and you see these exchanges and smiles and people are getting office numbers and getting information about accessing xyz, that's the Evidence that this has really been successful and that people really want to take care of themselves and their communities.
So it really does work. It takes work to do this, but it does work.
[00:22:36] Speaker C: If you work it, there's an intentionality behind it. Because building relationships, that takes time to be able to build trust and vet someone before you invite them into this safe space. Because you being the middle person, you're putting yourself at risk, right, of inviting someone in who doesn't honor or respect, respect the community or is willing to
[00:23:01] Speaker A: learn from the community, has no cultural sensitivity that's so important. I remember going to a patient and talking to them about health care. And, you know, these arts are really great. You know, they've gone to XY school.
And she said to me, I don't care what people know until I know that they care. And I said, oh, okay, you can be the top in your class, but if people don't know that you really care about them, they don't care what you know.
So that that exchange and the community people, I think they look at your heart first before they look at your head. You've got to come in and be sincere about what you want to do.
And it goes a long way to build trust in those communities, being sincere
[00:23:52] Speaker C: and looking at your heart first.
So how do you, as the connector and bridge, how do you vet these healthcare providers that you are bringing in to make sure that they do have that heart and that they are sincere and that they won't approach the situation thinking that their knowledge is allowing them access to this environment. But no, it's your character. So go with that first.
How do you even have conversations or scope people out to figure out, is this someone that you can first trust before inviting them in?
[00:24:32] Speaker A: Well, believe it or not, it is the people that you would least expect that you would ask the question.
It could be the receptionist at the desk, the people that make sure that your environment is clean.
It is the people that you wouldn't expect that could give you insight to other people. If that doctor is someone that walks into his office, walks by the receptionist desk, and never speaks, I don't think you can come to my community. You can go somewhere else, but you can't come in my community. Because if you can't smile and be kind to the people that you work with, you won't be able to come in my church. You just won't. So would I hear not another professional like the person that I would want to come speak. Well, that's great. That's great. I expect you to do that, you figure they know what they're talking about. But where's your heart? And when I hear other people and uneven patience. That's how I love that doctor. He gives me time to express myself. What are he said since he never misses coming by my desk and speaking and that kind of thing. Yeah, he's a good guy. He's a community guy. It's just the little things. It's the little things that make the difference.
So you have to kind of do your homework.
[00:26:00] Speaker C: Yes, yes. Lots of homework.
[00:26:03] Speaker A: Yeah.
[00:26:03] Speaker C: Because you don't want to jeopardize your trust and your relationships that you have within your church and your community. I would assume that when people come in, people know. Oh, Valerie said that they're good. You know, Ms. Worthy said that they're good. So I'll trust you just off the stack, right? Just off the strength of you.
[00:26:25] Speaker A: Yeah. It's almost like you put your thumb of approval there. I'll say this.
Every person has a job to do on this planet, and so everybody can't be community people.
And that's not good or bad.
But know who you are and what your purpose is, and you won't get frustrated. If some person is a health professional, they're out in community and always they're just frustrated. It just is not working.
You're not the person that needs to be here. Because this shouldn't be frustrating to you.
It should be something that is rewarding.
And you just see the value of helping someone in their safe place. And so if you don't feel comfortable doing it, that's okay. That's not a bad thing. Just recognize it.
Leave that community and go to a place that is more comfortable for you. Yeah.
[00:27:30] Speaker C: Knowing thyself.
Because you're right. Your heart needs to be in the.
In the way, you know, because this
[00:27:40] Speaker A: is the thing about community. Either is or it isn't. Like, either you feel comfortable or you don't. And. And it's not a bad thing if you don't.
But I've seen people try to make it their thing when it wasn't. It just didn't flow.
And so now that person is taking up space where some other person could be and they're leaving an empty space in a place that they could do best.
[00:28:09] Speaker C: Yeah.
[00:28:10] Speaker A: Yeah.
[00:28:11] Speaker C: Operating in your. Your area of expertise, your environment of expertise.
[00:28:16] Speaker A: Yeah, for sure. Gifting. And. And it's okay if it's not this place.
I think people always want to do best wherever they are, but sometimes you're doing best is taking a Step back, looking at where you are and then making that pivot.
[00:28:33] Speaker C: What keeps you committed to this work, especially in this current state of our healthcare climate with people becoming more uninsured, access barriers increasing, with all of the heaviness that could be surrounded in this time, what keeps you committed to coming back to this work and saying, no matter how difficult or bleak are the challenges that may come, this is where I belong.
[00:29:01] Speaker A: Yeah.
Your question. So many emotions come just thinking about that. Like, what keeps me committed to the work?
I am committed because I believe this is my calling. So I think somewhere in it, there's a scripture in the Bible that says, make your calling it an election. Sure.
And I know.
Whoa.
I know that my calling is being a nurse.
I know that my calling is going out to the community and talking to people that otherwise would not have a conversation with people.
I know that God has given me the tongue of the learned so that in due season, when I'm there and someone's weary and they're exhausted and they don't know what to do.
[00:30:02] Speaker C: Oh,
[00:30:05] Speaker A: that I can speak that word, you know, and that, and the fact that God allows me. I'll be 27 years survivor in December, that he trusts me with his people, that keeps me committed, that keeps me going, that gives me energy.
I. I could have fainted, but I thought about the goodness of God and that's why I do this. Yep.
[00:30:35] Speaker C: Now you make me cry when you said I could have fainted. You know, that's another scripture. Do not grow weary and well doing, you know.
[00:30:46] Speaker B: Yeah.
[00:30:46] Speaker C: And they're like you said, there's so many opportunities for you to grow weary.
[00:30:50] Speaker A: Yeah, but you. But you keep on. Yeah, you keep on doing it. You know, I always say to my friends, when, When Jesus comes, he taps me on his shoulder. I'm saying, oh, but it's one more. It's one more person. I need to give a resource. He said, but I'm here. Oh, no, it's just one more Jesus.
One more person.
[00:31:09] Speaker C: I'm not finished yet, Valerie.
[00:31:12] Speaker A: I'm here. You don't have to worry about it.
[00:31:15] Speaker C: I got them.
[00:31:16] Speaker A: Actually, they.
[00:31:16] Speaker C: They were mine before they were yours.
[00:31:19] Speaker A: Okay, Lord, if you say so.
[00:31:23] Speaker C: I guess you're right.
Oh, me.
Well, thank you so much for sharing. Any other parting words that you want to add?
[00:31:37] Speaker A: Only debt. All of us, no matter what. So I'm a nurse, but that's not the only profession, and that's not the only opportunity that we have to bring people together.
If you are working anywhere, you have an opportunity to bring the anywhere people to the safe place. And the safe place is not always a church. It could be the barbershop, it could be the hairdresser. It could be be breath is going to be your sorority fraternity.
But if you have a place where you you work or you you have people that man it would strengthen these two groups to be together then you conduct that because you have a unique position and you can bring people together and that's what God trusts you to do. That's what the universe tells you do. That's what each community trusts us to do is to bring them together and we all can do that.
[00:32:39] Speaker B: I'm Ashley Freeman and thanks for listening to this episode of Advocates in Action. If you haven't yet, please subscribe, review and share this podcast. Your support is greatly appreciated. We enjoy connecting with our listeners so please visit our website for show notes, resources and ways to engage with us on social media. Thanks for listening.
