Nicole Vienneau  00:00

Welcome, everyone, to the Integrative Nurse Coaches in ACTION! podcast. My name is Nicole Vienneau. I am your host, and I'm also a Board Certified Integrative Nurse Coach. I'm coming to you all the way from Tucson, Arizona, and it is my absolute pleasure to invite our next guest. 

We have been in contact for many years, and just watching each other from afar and celebrating and elevating each other as we've gone along on our journeys together. And this guest is really increasing the vibration of Nurse Coaching, of Nurses, of being present, of blooming where she's planted, and doing all these amazing things. 

And I am really excited to share this time with her, and to share her with you our amazing listeners. We welcome Dena Alberti. She's from Long Island, and she is doing some very amazing things as a professor, and she's going to tell you all about it, so I don't want to spill the beans on anything. So let's just welcome Dena.

Dena Alberti  01:09

Thank you so much, Nicole. It's an absolute delight to be here with you and to share my story of Nursing and Nurse Coaching with the listeners. 

Nicole Vienneau  01:18

Yay! Okay, so we, of course, love to go back in history and ask, how did you decide to become a Nurse?

Dena Alberti  01:26

I actually graduated high school a year earlier than expected. School that I was in was closing, and I found out, like the end of junior year, suddenly. So it was quite shocking, and I was asked the question, I was able to graduate, what do you want to be when you grow up? 

And I was 17, and I said, I want to be a Nurse. And I've had some influences, both from the patient perspective, and also my godmother was a registered Nurse, and she inspired me with her stories of taking care of people throughout my childhood. 

So I went to a... started out in an associate's degree program. I was an RN at 19. Worked full time. I grew up pretty quick. My experience with it was it was an intense program, I never forget that experiences I had with some of amazing professors that had my formation as a Nurse. 

Yeah, that's how it happened. I knew... You know, being faced with what do you want to do, registering for college and 17— I want to be a Nurse. It was something that I've always felt was right for me.

Nicole Vienneau  02:36

I love that. So you knew. You knew. Some of us don't know, and then all of a sudden we're faced with making a choice. It seems like you knew in your heart this is a direction that you wanted to go, maybe because of the influence of your godmom, or having some experiences with patients, you said, as well.

Dena Alberti  02:56

It was actually being a patient. Yeah, I was young, and I had to have surgery when I was a teenager. And there was some things going on at home, and my parents couldn't always be there, because my mom had just come out of the hospital from having surgery. 

So we had all this stuff happening, and it was the incredible care that I received that I said, I want to make people feel the way these Nurses made me feel, and so that really had such a impact on me. Yeah, and, you know, finding out that you're graduating a year early suddenly, and having the school close, and having... it was like you thought, oh my gosh, this is like the end of the world. 

But when I got through Nursing school, and I look back, the journey was... it was amazing. It turned out to be, this is what it was meant to be, you know? And so that was always like a pinnacle when things got hard. Well, remember when you were told that school was going to close, and you thought, oh my gosh, but then there was the opportunity, right? 

So I always fall back on that story. You know, maybe if I went through a full high school experience, maybe things would have taken me a different path. So I found that experience to really help me when you're in a fork in the road, to remember, to go back to what you know, and to take that path that's feels right, not necessarily in here, but to drop down into your heart and what feels right.

Nicole Vienneau  04:36

Yeah, and listen, listen to your heart instead of what's going on in your mind and maybe some external influences that you may be having as well. 

Dena Alberti  04:44

Exactly.

Nicole Vienneau  04:46

Yeah. So, you graduated from Nursing school...

Dena Alberti  04:51

An associate's program. I remember sitting in the back of the class and the professor saying, you know, you go on for your bachelors. Because at that time, the associate's degree program was much more common. You know, this is how... this was an entryway into Nursing. And I said to myself, I am never going back to school. Never. 

I remember sitting in the back of the classroom saying, this is it. This is the hardest thing... this is it. And here I am, PhD prepared. So that's like the biggest joke. Little did I know at the time, like, that's the biggest joke. I've pretty much been in school and learning my entire career. 

I wouldn't have changed it, you know, it's just, you know. So I worked full time for a couple of years, and I found out that I needed more theory. I wanted more theory for my work. And so I felt that going on for my bachelor's degree would give me that theoretical foundation that I was looking for, a compass more for my practice. 

Because I got only a very small amount of introduction in my associate's program, you know, it's a very technical, clinical, foundational. So I went on for my Bachelor's as a part time student, RN to BSN program. And full circle, that's where I now teach. I'm an alumni of the program that I graduated from RN to BSN, so it's very meaningful to be back there. So I worked full-time, went to school part-time. 

That degree took me about four years, part-time to do. Raised my family. Decided that I needed to go on for my master's because I was interested and passionate about Nursing education, and I knew to reach my potential in that arena, in the clinical setting, was to have that graduate degree. 

Then I completed a research study at the clinical setting. I was in a research cohort I was accepted into because I was interested in studying Nurses and the effect of mindfulness. And that was an amazing experience. And then when that ended, I needed more. I felt like my work... I had to do more research. I had to learn more. It couldn't end here. So that's what brought me to pursuing my PhD degree. 

I felt passionate about being able to find language to express holistic Nursing. And so that's what I was... that's what I strived for, is I've been a certified holistic Nurse probably over 25 years, so way before it was popular, yeah. So that's really kind of what got me through education, was always that link back to there's something here about Nursing that we're not recognizing. 

We're focusing on the technical aspect, the tasks of Nursing, but we're missing the esthetics. What I've learned... now I've learned through all my exploration and finding language is the esthetics of Nursing, how to be that feeling that you have when you're with patients that we sometimes don't know how to explicate or explain it. We don't know how to explain it. So that's what I really became... the reasons why I extended my... continued my education.

Nicole Vienneau  08:22

We all have reasons why we're extending our education. Nurses are notorious for keeping learning and learning and learning, which is so great because it expands our horizons and things we didn't ever think about. 

And for you, in your case, I mean extending research about something like esthetics in Nursing, where we do have trouble explaining some of the things that happen when you're a Nurse, like some of the ways in which you act, I guess. See, even I'm having trouble explaining it. 

Or the perception of what the patient receives from you because of the way that you are and your behaviors, and the things that you internally have, your gifts that you're giving, and you don't even know sometimes, and how we explain that.

Dena Alberti  09:18

Right, yeah, yeah. And I think finding... and I've learned that finding the language, so we can explain it, so others acknowledge the importance of it. You know, I was an ICU Nurse in my early career, and I loved the work I did, and I loved being in that unit. I had great peer support. We had a great team. 

But I felt that I wasn't... there was such a rush to make sure, you know, that all the technical aspect, and I felt like at some points I was losing my connections, or being having that presence with the patients, with the families, and it was affecting me. I was becoming physically ill, you know, like stomach issues and just not in a good place, because I was missing that connection. 

But I loved the work I was doing, but you know. So I remember talking to one of my peers to say, you know, we have to do all these things as an ICU Nurse, the tasks, but how do you bring in that piece of the, I guess, the care of being with. And they're like, oh, you just have to keep going. 

You just, you know, you don't really... we all feel that way. We all have those feelings. You just keep going. You keep going. And that didn't... and I would say I was a Nurse for about five years. And it didn't sit right with me. You know, I was taught early that when you have a question, you keep looking for the answer. 

It was something that, you know, my love of reading growing up and you look to books to find the answer. So I said, no, this isn't right. So that's how I found the American Holistic Nursing Association. That's where I was able to say, oh, this is what I'm talking about. This is it this. Ah, yeah, they're speaking my language. 

These are my people. So that's how I started my holistic Nursing journey, because I needed to find this angst I was feeling, you know, about treating the whole person, and not just the medications and the treatments.

Nicole Vienneau  11:44

Yes, I have had a similar experience related to intensive care Nursing, and always wanting to learn the latest and greatest treatments and machinery. And the more drips, the more machines, the better Nurse you are, blah blah blah. Which is important. Those things are important. I shouldn't say blah blah blah, because that's not really what I mean. 

And there came a time for me that I didn't know why I was doing it anymore, even though I was really good and I loved it all, but I lost that, the heart space or an understanding of how I was showing up as myself. I really wasn't myself anymore, and I lost that, and didn't even know that that was happening. 

Or couldn't recognize it, because I was caught up in the fast and the rush and the go and the fix and the, you know, all of the things that we tend to do. And those things are important, and I didn't... I now know, because I lost me, how important me is, and the things that I bring and the things I can't even describe sometimes, like what you're talking about, the Nurse esthetics.

Dena Alberti  13:07

Yeah, and I really didn't have anyone to have that conversation with. So that is where I was like, yeah, you feel isolated. You feel like, what's wrong with me? You know? Like, what? Oh, so maybe, you know, it took me a little while to figure out, and then, you know, it was the whole... it was the AHNA that... and then I started sharing what I was learning, and I had the support. 

I would, you know, I started talking to people, Nurses started listening, and this is, like, in the 90s, and they're like, well, can you tell us more? So I started setting up Saturday mornings for us to meet. I would get a classroom at the hospital on my day off, and I started, like, with three Nurses. 

We would meet once a month, and I would just talk about the holistic... it was their model. And, you know, we talked, and I then I broke it down, and then we said, can we meet more often? I'm like... then I started having 10 Nurses come. You know, we started like, this, just organically happening. 

People started listening. They wanted to know more. And so really, that's where I found that to listen to my truth, because look at everyone that wants to hear more, right? So it was very validating, because I had support of the CNO at the time. And so that ended up coming to fruition, a holistic Nursing council, that's still very vibrant today. 

You know, this little group started in a small classroom of like three people, and now it is throughout the organization. We have a respite room in that organization that I worked for for over three decades, and you know, now I've moved to academia, but is a very vibrant, holistic Nurse community there.

Nicole Vienneau  15:01

Thank you for learning to speak your truth and for showing up for others, not even knowing what this future would bring. And now look at all of the influence and the positive ripple that you created just for wanting to share what you're learning to fellow Nurses.

Dena Alberti  15:22

I wanted to scream it from the rooftops, like, you know, and I just was so passionate about it, because it was so... it changed me. It helped me find joy in my work.

Nicole Vienneau  15:35

Joy in your work.

Dena Alberti  15:37

Yeah. Joy, yeah, yeah. It was, you know, once you find that I was taking care of myself, I was able to start bringing that back and finding joy in my work. And I did leave ICU and I went to another role. It was actually an endoscopy suite. Was quite different. But, you know, sometimes it's that little shift just to get, you know, a little change, to just get grounded again and figure things out and that's okay, you know, it's okay. 

It's okay to find balance, and to go to different areas and explore, you know, to make... so we can continue to have peace within ourselves, so you can have that joy. I feel like, if you're feeling angst or you're feeling physically ill and you know, your mind isn't at rest, we can't find joy.

Nicole Vienneau  16:33

Yeah, just not at ease in some of the roles. And you don't realize it sometimes. And there's always a path that you can choose, like you had mentioned. You know, which direction should you go, continuing on, on the same even though you're not feeling like yourself or you're feeling physically ill, and yet you're continuing feeling like you're trapped into something. 

And I know in my journey, I have done that. I have done that. And this returning to joy, and rediscovering joy sometimes, and losing it, and then recognizing, oh, I'm noticing these patterns coming again. And, you know, I didn't know all of this. 

And I love your journey about discovering the American Holistic Nurses Association and then sharing your learnings with all of your people, and then screaming it from the rooftops, and then this expansion of a holistic Nursing within your organization. And so now, then you took a new job in endoscopy, and then tell us more, a little bit more.

Dena Alberti  17:43

Oh, gosh. And then I think somehow I ended up in an opportunity— I was approached to say, we need some coverage in— I also was a Nurse manager in between all this for a couple years, and I realized that that was definitely not my path. It was not my path. 

I was more of an educator, and I had experienced a workshop I had taken about finding joy in your life many years ago, and one of the questions was, when you were a child, what did you do during your play time that allowed you to forget about time? What kind of play did you do? And for me, it was teaching. I played teacher in the neighborhood. I was the teacher. 

I had the board, you know, the easel, where you had the magnets and the alphabet, and I would have my neighborhood friends, and we would have dittos, and I would make dinner, right? I know I'm dating myself. Some of our listeners might not even know what that is.

Nicole Vienneau  18:48

We'll put a link into what dittos are in the show notes, just for fun.

Dena Alberti  18:53

Right? And those would be handouts. We don't even have paper handouts anymore. Everything's on the computer. Right, so I'll tell you, so you really know it's my childhood, right? We used to do that in the summer. We had... and I had such joy of me standing there. 

And so that's when I realized that teaching others, and you could see that, right, with my passion for wanting to share with others about what holistic Nursing was like. I could see this thread of how I'm always... I found some of my greatest moments with my patients was sitting with them and teaching them their discharge. 

And I always took... that was such an important part of what I did, you know, it wasn't just giving somebody something and saying, read this. You know, I always wanted to sit with them and make sure. It came natural to me. It was just something that was part of who I was, who I am. 

So I remember when I finished my bachelor's degree, I said, okay, I can now think about getting into the education department. And I remember going for an interview and not getting the job initially. And that was quite devastating. But then six months later, they had a need. Someone was out sick, and I was asked, I think I was... when I was an endoscopy, to say, you know, we have this opening to for an educator. 

Would you be willing to fill in? Yes, yes, yes. And that was the end of... like that was... And then I just main stayed in the department, as a clinical educator, and that's really where... and then I went on for my Masters in Nursing Education. And again, I was at... when I went on for graduate school, I was at that fork, right? 

So at the time, there wasn't many programs for Nurse education, it was all the NP and the CNS rules, and the Nurse education roles were starting to dwindle. And people were trying to talk me out of being that masters in education. This is the way the future— NP, NP. But I'm like, I don't want to prescribe. 

I don't want to diagnose as a primary practitioner. There's a great need for that. But that wasn't me. You know, and so I went with what I felt was right for me, and that wasn't... you know, a lot of people who were mentors to me tried to talk me out of that, Nicole. And I just like, you know, I appreciated so much their insight, but I went that path, and I continued being a clinical Nurse educator. 

And it was in that role, and we had a new CNO, and my work as being a holistic Nurse at the organization, that I was able to become a Nurse Coach. Yeah, that's how, you know, like, when I look in the summary and I reflect back, you know that thread of, I just gave you, like, a summary of over 30 years, right? But that's how I got to be a Nurse Coach.

Nicole Vienneau  22:00

How did you discover it? Nurse Coaching.

Dena Alberti  22:04

We received... we applied for a grant, our CNO did. Dr Sue Penque was our CNO at the time, and she applied for a grant for this program because she had a vision that Nurse Coaching could be a way to offer education in a holistic way. And one of her areas, her research expertise, was presence as well. 

So she felt that Nursing, Nurse Coaching would give Nurses the ability to be present. And so we received this grant. So she really was the pioneer to bring this to the organization about the integrative Nurse Coaching program. We received the grant, and we had a total of 10 Nurses go to the cohort. 

We were in cohort 20, and we were able to be at Cormaria in the beautiful Sag Harbor, which is on the east end of Long Island. And yeah, was 10 of us that went through the program. And then we received this... we had a second ten go a year or two later, you know, to the program. So I was blessed to be directly taught by Barbara Dossey and Susan Luck. 

I mean, I shared space with them at Cormaria, and it was so life transforming. It was so profound because my decades of being a holistic Nurse and taking all of these programs, all of this aromatherapy, I went to a two year program, and I studied traditional Chinese medicine, and I became an Amma therapist, and that's this type of Oriental massage. 

And I'm talking like, this is early 90s, Nicole, before any of this was really mainstream. Like people were like, what are you doing? What are you... ? You know, I remember saying I'm going to this program one weekend a month that was really intense, and this was right after I finished my bachelor's. I did that before my graduate degree. I'm like, no, I gotta explore this holistic Nursing path. 

And so I had all of these skills as a holistic Nurse. And then I found Nurse Coaching, and I remember being there, and I remember listening to Barbie— Dr Dossey, and saying, yes, I can now take all of this in one well, in one place, and be it. This is it. This is where I can just bring all of this knowledge as a holistic Nurse into one place. 

And all of that experience I had, what I learned as a Nurse Coach, I didn't have that exposure. It didn't matter. Like, I had all this experience, but the communication skills I learned, of the appreciative inquiry, the motivational interviews, the theoretical framework, right? Like we have... like, I followed Jean Watson's theory all my years. 

That was my... that is my compass. But now I had this other beautiful theory of, you know, the integrative Nurse Coaching, and Barbara Dossey's theory of the healing in the center, right? And all those ways of knowing. That was my language, that's what I was looking for all these years. 

Really, that's like the pinnacle of my whole experience. And that allowed me to really know that all of my experiences was meant to put me there, you know, to put me there in Sag Harbor with these beautiful people. And really allowed me the confidence and the language and the support, you know, the support of peers to keep going, to keep doing what I was so passionate about doing. 

Nicole Vienneau  25:56

So your cohort was in person. 

Dena Alberti  26:00

Yes.

Nicole Vienneau  26:01

Mm, yeah. So now we've moved more towards online education, and we just recently had our very first conference, the Integrative Nurse Coach Symposium in Miami, Florida. Which if... listeners, if you haven't listened to episode 72 and 73, I went around and interviewed people, so you get to hear from so many Nurse Coaches and Nurses who were exploring Nurse Coaching and even supportive family members who came to the conference. It was just such a wonderful experience. 

Dena Alberti  26:34

It was, it was wonderful. Yeah, that was a wonderful experience and great energy. And it was great to see some that I haven't seen, like, I haven't seen Dr Karen Avino since cohort 20. And it was just so wonderful to be back in that space and to meet new people and to see what cohort they're up to. 

That was the most amazing, you know, the work that INCA is doing now. Oh, I'm just... it's just so needed, and I'm so thrilled, you know, to see how it's expanded. 

Nicole Vienneau  27:09

Yes, it is amazing, and it keeps on expanding. And we love our Nurse Coaches and how they're positively influencing the healthcare system and the spaces in which they're working, whatever direction they are choosing, bringing in their authentic self into their work. 

And, you know, creating this framework in which to— I like how you just said that, like I have all these little skills, and now I can, you know, plop them into a framework which is Nurse Coaching for me, and theory to support that. So, you know, I'm thinking about you and your history too, because you mentioned this grant. You got this amazing grant. 

10, 20 Nurses in the end from your hospital were exposed to Nurse Coaching and received their education. And then you spoke to this case management position, and your CNO's vision for implementing Nurse Coaching. So would you mind speaking a little bit to that in your role as a case manager? 

Dena Alberti  28:12

Sure, sure. So after cohort, after I completed cohort 20, I had... the director of case management was also in that cohort. So we were brainstorming, and we said, okay, now we have these skills, and where's the biggest impact? You know? Where can we make? And there were Nurses from all different units, so they were going back and bringing this to their practice. 

And everyone had their ideas. I knew I was covering... as a clinical educator, I was covering the unit where we had a lot of heart failure patients and, you know, chronic illness, and we were having, you know, the readmission rates, you know, patients are readmitted, it has a big financial impact on the hospital organizations for reimbursements. 

And so we said, well, what would it look like if we had a Nurse Coach see these patients that have chronic illness and have a risk of being re-admitted? So we put a proposal in for per diem position, to say, what would this look like, and we got it passed. So I then became from my Nurse educator role, I became part of the case management department as a Nurse Coach, as a Nurse Coach. 

And so I started, you know, coming in on my assigned two, three days a week, with a list of patients that were re-admitted. Right? So these were patients with heart failure, COPD, you know, those high volume readmissions, and then I would meet with them, and I said, you know, we're kind of missing something. They're already readmitted. 

So I've kind of missed it. Like, yes, we're trying to identify the reasons why they were readmitted, which was helpful, and I'm listening to their stories, but we want to prevent the readmission. So I got to get them through that first hospitalization, you know. So then when you look at that, all the patients that were at risk for readmission, that was enormous and overwhelming for this per diem position of one person. 

So I said, well, how can we zone in on one or two diagnoses and see if we can impact that? And then we started with a... I put together, like this brief little questionnaire the case managers can do if they were at risk, if they felt, you know, patients who had these certain diagnoses, like their support at home and their accessibility to medications, proper diet. 

So then we started using this assessment as okay, this would put the patient at risk on this admission. Let's get Dena to go talk to them. And what was happening, Nicole, is as I sat with these patients and asking these patients, I would start off every interaction for the most part, saying, tell me what's most important for me to know about you. 

Simple question, what is most important for me to know about you? They look at you and they're like, no one's ever asked me that. And so now I knew I was onto something about the listening piece and hearing some patient stories and really finding out what the meaning of their illness was to them as a person, and not as the patient with COPD. 

And you know, staff would be like, what are you doing? Like, what did you do in there? Like, what's going on? And you know, I would hear and, and then you started getting, you know, when the word got around, then I started getting calls. Well, call Dena the Nurse Coach, because we have a non-compliant patient. 

Call, you know. And so that started happening. And that word, non-compliant, does not exist in my language. It never did, you know, from early on in my career, I hated the word. Now I know why, because I didn't... I couldn't label what I was feeling about patients. I didn't want to believe that patients didn't want to do what they had to do to be healthy. 

I believe that every patient wants to feel well, every person, let's not say patients. Every person wants to feel well and wants to feel their best. So there's where the curiosity and the awe comes in. But why? Why are they not able? So that's what Nurse Coaching gave me, was the ability to ask the questions, to find the why. 

And I'll tell you a story that I never forgot, one patient story, if that's okay, to give the example of this. We had this gentleman who kept coming in with uncontrolled hypertension, and that was the initial call— he's non-compliant. He's non-compliant. He's not taking his medications. He keeps coming back. 

This is the third visit, and I said, okay. I said, thank you, and let me go talk to him. So I meet with him. I needed an interpreter because English was not his primary language. So that was the first thing. And I sat with him, and you could see how excited he was that I sat down next to his bed, right? 

And through the interpreter, I first in asking these questions, what's most important for me to know about you? On your mind, in your heart today? You could see he got very emotional. He actually started to cry. So then, throughout my interaction with him, I held his hand, and what he shared with me was he lived above a storefront. 

Okay? He lived in an apartment, a room, studio room above a storefront, and that storefront was a deli, Spanish deli. And he used to clean and do work around the deli, and in turn for that, they would give him his food, and that was his source of diet. So when you have a patient who has hypertension and he's eating this prepared food from the deli, as you can imagine, is very... has high content of salt, but this was his source of food. 

And then we talked about access of medications. That was, you know, that was a whole other concern, right? Getting him access to the medications. And so this was his story. And as a Nurse Coach, I was able to now say, after his third admission, and after being able to hear the story and have the time, and to know how to ask the questions to find out this is why. 

So then it was the education of this is some of the things that's important for you to eat. Do you think that the place that you work... So then I called. That was another part of my role. So then I called the person of the deli. And I said, you know, with his permission, of course, I asked the the patient I was working with, you know, would it be okay? 

And this is all through an interpreter. Would it be okay if I call and maybe there's something like before they add the salt that could take out for you, because you're such an important part of their business of cleaning. And so this is what we did. So I partnered and you know, that's just an example of the impact that Nurse Coaches have. 

But then I like to believe when Nurses can just ask the question, or know how to ask the question, and also being supported in having the time. The system right now doesn't... the system as I see it sometimes, and it's no fault of anyone, it's just the financial constraints and the, you know, I'm not blaming fault, but just the way Nurses are able to give care, they are not allowed, they don't have the time for this— interactions. 

And this is what I felt in my practice. You know, it's real. So that's just an example of, you know, some of the work that I did. You know, I had another patient, again, non-compliant, lived on a houseboat, lived on a houseboat, on a canal. Nobody knew that until I sat and they were like, what? How did you...? 

And then they're like, what are you doing in there? And so then people would start coming in, you know, and like, just listening and like, what is she doing, you know? And it was like, this big mystery. I'm like, it's really not. Anyone... you know. 

Then I started sharing the skill of motivational interviewing, appreciative inquiry, and not using those terms, but just breaking it down very simply. And the pause, right? It's the pause and first recognizing the other person as a human in the life experience, and not as the patient.

Nicole Vienneau  37:45

And in this new way of... not that it was new. I mean, I'm sure that you innately felt and knew these skills, and yet we needed to also learn them and be exposed to them and practice them and explore and yeah. And how did this shift the way that you practiced and felt about your practice?

Dena Alberti  38:10

It gave me the confidence to those powers that be, that the importance of it, because we were seeing results. We were seeing— I was able to now prove that this is an important part of Nursing. We were seeing, as a follow up, when these patients would discharge, any patient that I met when they were discharged, I followed up with them once a week for four weeks. 

So that was another part of it. So you could see how this position now is rolling into a lot more than a per diem position, although that's what I maintained. But you know, when you're passionate and love what you do, it's just, you just get it done. But it gave me the confidence. 

Not only was I having these beautiful connections with the patients that I was working with, that brought me tremendous joy in my work and meaning and purpose, but it allowed me to sit in meetings with confidence to say, this is why this work is important. This is what the results are. 

Let me share this story with you. So it gave me the language and the experience and the examples to share it with others that maybe weren't really sure, you know, what this was about, what Nurse Coaching was about.

Nicole Vienneau  39:35

Yeah, and I'm linking this back to our conversation about Nurse esthetics and when we can have these real life stories of the impact for another human, then we can start to really display the importance of things that you can't describe, of what you actually are doing. 

And yet you see the impact in a fellow human, such as the man in the deli, and how his behavior potentially, or his just his attitude and his... the way he's now showing up in his own care. You know, just shifting the way that we are communicating, even for a second, in the way that we practice. 

Because at the bedside, it's true, it's very difficult to have an hour conversation with a patient. I mean, I don't know any Nurse who could possibly do that. And yet, we can show up in a different way. Maybe it's not a different way, show up in a way that is meaningful to us as Nurses, and show up how we want to show up for our patients, how we would want to be treated too, even if we don't have time. 

So I'm really appreciating the reconnection to joy, or the connection to joy. It's not like we've lost joy. We can connect with joy when we're ready to connect with joy. I love this. I love this so much. And so you saw these results at your organization through likely a decrease in readmissions.

Dena Alberti  41:18

Yes, yeah, we did. Yeah, we did. We certainly did. And I think you are touching upon the awareness that the Nurse can pause, having the... setting the intention of, okay, I have to go in and take care of this person. And so I just left this room, and now I have to go into this room. 

So the ANA quite some time ago, put out that stop method, right? Stop, take a breath, observe how we're feeling and proceed. And that gives us the intention and the mindfulness to pause and be intentional. You're talking about the intention of bringing that back to our patients, and I think that's how we weave this in. 

It's the presence that you're speaking of, the esthetics. That's how I see it, as presence, that way of knowing, of being with somebody, that awareness, that awareness, that being with. 

Nicole Vienneau  42:23

Yes, and so now in your role, because you are doing something completely different. So tell us a little bit more about that.

Dena Alberti  42:34

So I'm in a full time faculty role now, back where I received my BSN. I teach in the undergraduate curriculum. I teach adult health and pharmacology, and I also have the joy of teaching the first semester, Intro to Professional Practice, which is such an exciting course for me, because I feel it's such an honor to be able to introduce students into the profession, right? 

That I just absolutely and just so passionate and it just brings tremendous joy. I think Nursing is the most sacred work that someone can choose to do. I think it is an honor to be in someone else's presence at their most vulnerable time, right? So the impact of that, I don't know is always at the forefront. 

I know individuals choose to become a Nurse, and so to understand the impact that that has and what you're choosing to do. And so I like to set that pretty early on in the formation of their education to honor this choice, to realize that you are making a choice to really have such an impact on other individuals. 

So I embed, you know, being a Nurse, being a holistic Nurse, being a Nurse Coach, it's really, at this point, I don't... it's something that I... who I am. It's not something that I have to do separate. It's something that just it's impacted the way I am as a person. So I really bring in that ability to pause, to listen, to honor another person's journey. 

What are their goals? What do they aspire to be? So I am very interested in contemplative pedagogy, which allows time for reflection. So I like to bring in quotes and maybe a piece of art or journaling, just to have the students get in touch with other ways of knowing. And you know, regardless of what the curriculum is, you could do that. And I also say that some of the best Nurses I work with, that I worked with in the past, especially in ICU, they were not "A" students. 

They were not "A" students. And so I think we put a lot of pressure on the perfectionism and the performance overall, even in society, separate from Nursing students, you know, but it's the way you be with somebody. Yes, you have to meet the criteria of the curriculum. But also just as important is the development of self during this journey. 

So I try and role model that. I try to interweave activities in the classroom that allows that dialog. I do some group... you know, we break off into group work in the classroom, because I think it's so important to communicate with others. Sometimes the students, when I will see them in their second clinical course, so it's after their fundamentals, and one of the things that will be brought up is that they're nervous to talk to patients. 

You know, what am I going to say to them? What am I... what happens if they ask me a question and I don't know what to say? And I said, well, I said, look we're having this conversation. I said, I see your beautiful smile. You have a beautiful smile. I said, you go into a room and just sit down with a patient and just smile and say, how are you today? 

Tell me about yourself. What kind of work did you do, or do you do? Just have a conversation. And they're like, oh, oh, that's all I need to do? Yeah, that's all you need to do. You know, like breaking it down to the human connection, right? And I said, when you're in clinical, notice how many staff members are able to sit with the patients. 

I said, you're going to be assigned to one or two patients. That's a gift in itself, just being with another patient. So this is how I bring the tools and the methods of holistic Nursing, Nurse Coaching. It's particularly helpful during advisement. You know, having conversations, not say, okay, what are you taking next semester? Let's look at the list. 

First, I ask them, tell me what's happening in your life. Tell me more about you. Tell me what's working well for you. Tell me what are you struggling with. And then we'll talk about what do they envision for the next semester. I think it's important to honor another person's story, because we all have stories, right? And don't people just want to feel listened to, Nicole?

Nicole Vienneau  47:47

Yes, yes, we do. When you are communicating with our future Nurses and asking them in the ways that you just ask them, what are you noticing in their behavior?

Dena Alberti  48:06

Relief. They take a deep breath. They take a deep breath. They're like, oh, you know, they take a deep breath. They are excited that they already have the ability. They don't have to know about meds. They have a basic foundation, you know, to go into clinical.

So I say, draw on what you know, and you are enough. It's validating. You are enough to go in. And they just feel so, oh, like excited. They're excited. And I love when they come back as the weeks progress during clinical, and I could see their growth. That's one of the most rewarding things, is as the weeks progress, and they're sharing their stories of clinical. 

Oh, I did this, and I did this, and I spoke with this patient, I was able to speak to the Nurse and tell her what I did. And they're building their own confidence of their communication. Because I think the technology of texting and how we communicate with others these days makes it very difficult to have conversations, and so it's building that confidence that we need to talk to each other, we need to talk to each other, and that's why I appreciate doing assigning group projects and doing group work in the classroom. 

And I'll say only one person should have their laptop open to take notes, everyone else, we're talking. So I really encourage that person to person dialog. It is my sense that the students... although sometimes they could be like, oh, you know, we're doing group, I gotta talk, you know, I gotta get into the... can you just, you know, lecture, and just, I'll just take notes? 

You know, sometimes... But I think overall, it's a sense of, they get excited. They get excited to know that their smile and the energy that they bring into a room, and to be aware of that energy, right? I talk about that too, the awareness of, if you're sitting in a hospital bed, who do you want to come in the room? 

And I'll do like, you know, I'll like, act out someone with my back to them on the computer. Okay, today we're doing this... this. This morning you're going down for your test, you're going to do this. Or do I simply just face them and lean in and say, good morning, Mr. Smith, and hold their hand. 

This morning we're going to have... I said, did either one take more time? No, right? So it's that approach that we have, to that awareness, and so I ask a lot of questions, what type of energy do you want to bring to the classroom? What type of energy do you want to bring to the clinical? Now, we're all human and I'm very transparent. 

Like, sometimes if I get stuck in traffic, or there's something going on in my own life, I'll get to class, I'll be like, just take a deep breath. I said, who else needs to take a deep breath with me? You know? I said, this is what I'm feeling right now. This is what's happening. 

My dog wouldn't come in, and I couldn't get out of the house, or this, or whatever. Anyone else feeling that way, you know? And just, we're all having the human experience. And I think acknowledging that allows everyone just to settle in and relax. 

Nicole Vienneau  51:24

Yes, and as you're in this role as a professor and sharing what you have learned through your amazing career, and how are you imagining your impact? 

Dena Alberti  51:40

My hope is that the students recognize the need to preserve their self as they go throughout their career. The importance of self-care. That has to come first, because I didn't have that. And so that's why in ICU, when I was not aware of the importance of taking care of myself and was feeling physically ill, I didn't want anybody else to have to find the answer. 

Like, I had to find the answer. You know, so I want them to have a sense of the importance of caring for yourself first. That has to take priority. You cannot deliver this type of care in this type of healthcare environment from an empty well, you cannot. So to me, that's first and foremost. That's the most important thing, because you can't build on that. I can't. 

And so that's really how I even build the classroom. If I have students that have something else going on, they can't learn the information if there's, you know... you think of Maslow's hierarchy, right? Basic needs, security, all of that— they can't possibly learn everything in this curriculum if they're not having here. So that's first and foremost, and it's most rewarding. 

I love going to commencement, and you know, we do a beautiful thing at the end of commencement, all the faculty line up, and the students come walking down. And to see their... when they see their certain faculty members that they've had, and they come to you, and they have that glow and that excitement, and they hug you, and they thank you. 

I know I've left to such a... we, not just me, we as a Nursing faculty, have left such a important... we've given them their foundation. I say we're building a house, right? We want to build this house on strong concrete. So, as in, like in the Intro to Professional Practice, there's the foundation, right? 

This is the stone concrete. Then when you get to fundamentals, we'll build in the frame, right? Then when you get to adult health, we're putting... starting to put this house together, the shingles and the windows. And then as you get to OB and all your specialties, oh, now you're decorating the inside. 

And when you graduate, you're going to have this amazing structure of being a Nurse, and I want them to visualize, but it has to start at the base. If we, you know, we talk about Little Red Riding Hood, you huff and you puff and you blow the house down, if it's made of sticks and weak foundation, you're not going to be able to sustain the work. 

So that's how I know when they... and on that day that they're so excited to begin their work as a Nurse, I want them to remember that. I want them to hold that, whatever they feel as they're working, because it's going to be hard days. We know that, right? We know that as Nurses, it's such hard days, but to remember the why and to have a compass of a Nursing theory, that was what was most helpful for me. 

But to know your compass, why you're doing this, that keeps that spark ignited, otherwise you get tired and you forget. And I think that's the most important message, is to always realize why you chose to do this sacred work of taking care of another person.

Nicole Vienneau  55:12

So in our last few moments, I love to ask the question, and you shared so much of this already, and I know there's more— what is on your heart that you would like to share with our listeners?

Dena Alberti  55:27

So to summarize it, Nicole, I think what's most important is to realize that we all have a choice of the presence, the presence that we hold when we're with another person. And in that presence to find joy in our own lives, so then we can bring that joy to others. But it has to start here, in our own heart. 

And so, you know, I think realizing what does presence mean for us, and that being with and when we talk about that ways of knowing, of the esthetics of being a person who you know, knowing our purpose, of why we chose Nursing and holding on to that, reminding ourselves that. We need touchstones. We need things to remind us. I have quotes all around me. 

I have people that I surround myself with to keep reminding me, because it's hard work. This doesn't come... you know. We have to constantly fill and keep our bucket full, not half because we're already then half empty, right? You have to keep it full. So how do we live a joyful life intentionally? So then we can bring that to others. And for me, it's being present in the moment, honoring this time. Yeah.

Nicole Vienneau  56:51

Thank you.

Dena Alberti  56:53

Thank you. Happy to share this time with you. Thank you for giving me this opportunity.

Nicole Vienneau  56:59

So many yummy nuggets of wisdom coming out of you this morning and today, your life full of wisdom and your passion for Nursing, continuing on and sharing with future Nurses to come. And thank you so much for being here. 

Dena Alberti  57:21

Thank you, Nicole, thank you.