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, and today's super exciting for me, because this is a milestone, one, for the Integrative Nurse Coaches in ACTION! podcast. 

One is that we've never had five of us on a call before or on a recording before, so it's super exciting for me. The second thing is that we have distinguished guests in our podcast today. So I'm going to just keep it short. 

They have been on our podcast in the most recent episodes, and we wanted to bring together these amazing guests, because what they're doing for Nursing, for healthcare in general, is truly expanding the way that we as Nurses show up, show up as energetic beings, as professional beings, as personal beings, and it is changing the way that we can feel and show up in our work. 

So I'd love to welcome first off, Karen Avino, who is the Director of Education for the Integrative Nurse Coach Academy. We also have Karen Laing, who is the creator of the Lifestyle Nursing: A Lifestyle Medicine Framework for Nurses. And we also have Elizabeth Sult and Tom Sult, who are the co-creators of Functional Nursing: A Functional Framework for Nurses. So I'll just have you each just come on and say hi. Starting with Karen Avino.

Karen Avino  01:53

Welcome, everyone. We are really excited, as Nicole said, to be here together. It's wonderful to be with like minded individuals and helping to pave way for Nursing.

Nicole Vienneau  02:07

Okay, and Karen Laing.

Karen Laing  02:09

So as Karen said, it is wonderful to be here with like minded folks, and what a great opportunity to pair lifestyle Nursing and Nurse coaching, because they really are such a fantastic fit. So I'm just thrilled to be here, and then to be able to add on to that, the functional Nursing piece of it? Bonus.

Nicole Vienneau  02:33

Elizabeth?

Elizabeth Sult  02:35

Yes, thank you, and welcome. Very excited to be here with these beautiful, brilliant individuals, and to dive in and to discuss the functional Nursing program, the lifestyle Nursing, and then also Nurse coaching and how they all integrate well together.

Nicole Vienneau  02:55

Awesome. And, Tom.

Thomas Sult  02:58

Yeah. Also, thank you for being here. Welcome, and it's fun to be on the podcast with everybody. So let's dive in and see what's going on. 

Nicole Vienneau  03:07

Awesome. We are excited. Alright, listeners, get your pen and paper ready. Take notes, and of course, we're going to share all the links that you need to know throughout this podcast in our show notes, so we'll have that at the ready as well. 

So I would like to start with Karen, Karen Avino, and maybe, Karen, could you give us a high level view of how the Integrative Nurse Coach Academy even thought of functional Nursing and lifestyle Nursing. How does that all fit together from the from the program's perspective?

Karen Avino  03:42

Well, Nurse coaching, as we know, is not only about coaching others, but it's also about self development of the Nurse and helping the Nurse to transform and into greater health and well being for themselves. And how did we think of it? 

Well, we certainly have been in the space together in certain conferences and listening to certain programs, and we realize that Nurses have an awful lot of education, experience that they can bring to clients, and use a lot of functional medicine principles as well as lifestyle Nursing principles. 

We always said we really wanted to be able to give core coaching concepts to the Nurses, to be able to work with clients in a new way. Nurses needed to know about the guidelines of all of the things, like exercise, for instance, you know, which is not, perhaps, something that they would have talked with a client about if they were a staff Nurse in a hospital. 

Or perhaps even nutrition, because there's other people to do that. Yet we have a lot of experience and education surrounding that, and we are able to talk about healthy lifestyle and exercise and all the different dimensions that are included in the Integrative Health and Wellness assessment. 

And Nurses are really very excited about that possibility for themselves, because I think that that's like possible, you know, it's really the core of who they are, is to be able to bring more about health promotion, lifestyle, how to really, in a way, stop this, the continued development of chronic diseases, which is a lot of what we do when we care for people. 

We're caring for them in their chronic illness episodes, and if they only knew very early on, how that could change, how they could avoid that and change their lives, that Nurses have a distinct place in that space because of all of the quality and the information and experience that we can bring to people. Plus, we're just relationship based to begin with, with our clients, and coaching and all of this is definitely, you know, it's where it's related to.

Nicole Vienneau  06:30

Wonderful I know that in my own personal experience, being an intensive care Nurse, and seeing so many patients at their worst, and I would wonder, caring for these patients, like, Why? Why haven't we done something before? Like, how come we didn't help them? Like, what is wrong with our system where we're almost allowing patients to get as sick as they are, and not stepping in before? 

So I personally feel that lifestyle and functional Nursing together combined really give Nurses a stronger framework for them to be able to show up with more confidence and more education to support what it is they're doing. 

So I'm excited about both of these courses, and then the idea that they can both come together, and you can have both of these certifications and get a ton of CEUs, 150 of them, in fact, combined, and get a discount, all just for taking both of them, which they've just both aligned so perfectly together. 

So thank you for giving us a high level view of what we can expect, why we even decided to do these amazing programs. So I'd love to take a little step in down the history lane for just a few minutes, because all of us here on this call have been traditionally educated in the medical and Nursing models and the approach. 

And so something along our lives opened our eyes to see that there are other possibilities and other pathways that we can take. So I would love to maybe start with Karen Laing first, what was this moment in time, or possibly a couple moments in time that allowed you to see this willingness to shift your thought process.

Karen Laing  08:28

Well, thanks for asking Nicole, and it's interesting that you mentioned working in the ICU environment, and how that shaped the way you looked at things. Because my first Nursing job, I worked in surgical intensive care, and I ended up working with the cardiac surgery patients, and I loved them, and I loved that environment. And I would come home and I would talk to my dad, and I would tell him about it, and he would say, why don't you take care of these people before they get sick, so they don't have to have surgery? 

Well, my father lived into his early 90s, independently at home until the end. So, you know, he knew something. He never listened to what I said, of course, but you know, he really was on to something there. So that little bug in my ear was important. 

And then I moved into cardiac rehab, cardiac and pulmonary rehab, and there was one gentleman who he will never know how important he was to the path that I have taken, because we had worked together for a year, he had had a heart attack, and he said to me, I feel better now than I did before my heart attack, because now I've made all those changes I meant to make some day. 

And I thought, how awful is it that you have to have a heart attack in order to feel better? People shouldn't have to do that. And so that's what led me into coaching, and I was really, at the time, this was quite a while ago, I was looking for something in Nursing that I could be involved in and do that. 

And there wasn't anything. Nurse coaching was becoming a thing. And so that was when I became a coach. Then I became a Nurse coach, and then I found out about the American College of Lifestyle Medicine. And that was when I said, Okay, these people are looking at helping us get paid to keep people well, because right now, we're getting paid for procedures. 

We're getting paid for, you know, all those types of things which, you know, our healthcare system developed into a sick care system for a good reason. You know, we needed that acute care focus. When it came to be, the problem was we ended up only focusing on that, and we let go of those foundational things that used to be part of our health care system. 

And so lifestyle medicine, lifestyle Nursing, I always say it's like we're returning back to our roots. The things that we know are important. Lifestyle medicine is the prevention. When I talk to people, they think it's all about prevention, and that is important, but we can also use it as treatment. We can use it as reversal, but its focus is on chronic diseases. 

Now, not that that doesn't help with some acute things, because, of course, we're going to be able to, you know, stave off some viruses if we've gotten enough sleep, and we're physically active and all those kinds of things. But in lifestyle medicine, lifestyle Nursing, we're really focusing on those chronic diseases. So that's kind of how I ended up where I am now.

Nicole Vienneau  11:49

It is incredible to me that that gentleman had to have his heart attack before he realized he could feel better, right? Yeah, wow, wow. That is definitely right in my face. Okay, Elizabeth, how about your thoughts on this question?

Elizabeth Sult  12:06

Thank you. Thank you, Karen, as well. That was wonderful. So for me, you know, I started in the traditional model that was kind of my goal when I entered Nursing, was to work in the hospital and to be one on one with patients. And while I was there, again, like I started to see patterns, I started to see the same patients, not necessarily the same patient, but the same type of patients with, you know, the same type of issues. 

And you know, they repeatedly would come in as well. And I started to think, well, there has to be a better way. Like, how do we reach these people before they get here and again, kind of that thought back to our system. So, how is our system right now, you know, kind of funneling people into these more end stage things, or waiting till there is an emergency or they do have a heart attack. 

And that was kind of what started me thinking and kind of moving where I was in the Nursing field. And then came my own kind of bout with chronic illness. I was,, you know, I had my own garden. I was eating healthy, making meals at home for my family, my children. I was exercising daily. 

I was doing all the right things, yet I was feeling very unwell and unwell enough that I couldn't practice my normal day to day activities that I had, you know, flourished and thrived in before. So that really got me to thinking, Okay, I'm doing all the right things, so why do I still feel this way? And I would go to doctors and they would do the test and on paper, I was healthy. 

I was the perfect sign of health, but at the same time, I didn't feel healthy, so I looked like this young, vibrant, healthy person, but I couldn't function on a day to day normal activities that I previously had done with ease. So that's kind of how I started thinking about functional medicine before I even knew there was such thing as my functional medicine, I was more so looking at the why and why I didn't feel well. 

And that really opened my eyes to kind of the center of that functional medicine matrix, that mental, emotional, spiritual center. And when I started to really listen to my body and address those things, some of my symptoms started to melt away, and really, that's what kind of opened me to be, Wow, there is another way, and we can offer hope to those patients like me who thought, well, this is the way I am. 

Like I thought, well, those symptoms, I'm just going to have to learn to deal with them because that's just, you know who I am at this point in my life, but it really offered me hope. And then when working with patients, I can offer them hope as well. 

And that led me to a lot of different beautiful paths. It led me to functional medicine. It led me to then Nurse coaching, and now I'm so excited that I'm, you know, helping bring them together. And then also, you know, lifestyle Nursing. Honestly, I don't know a whole lot about lifestyle Nursing. 

I know about lifestyle, you know, that's on the bottom of the functional medicine matrix, those lifestyle patterns. But I'm also really excited to learn more about lifestyle Nursing as well, and how we complement one another.

Nicole Vienneau  15:50

Thank you. I know our listeners are super excited to know a little bit more about each of these programs too, so we're all on the same page together. Excellent. And Tom, how about you? What's your perspective on this?

Thomas Sult  16:02

Well, it sounds like we should start an ICU. No? Okay, probably good idea. So I'm a classically trained family doctor. Went to a small program with a, you know, rural bend to it. And they were trying to create Marcus Welbys, if you remember that show, where he was everything from the brain surgeon to the pediatrician. 

And my practice started out with high risk OB and C sections, and I ran a 16 bed ICU and blah, blah, blah. So very high acuity. And like everybody else has talked about, seeing these patients and wondering, well, gee whiz, this is bad luck, right? And then it turns out, maybe it's not all luck. 

Maybe your genes are not your destiny. Just because you have this family history replete with nasty things, doesn't mean you have to go down that same path. And that led me to... actually, so I have dyslexia. It means I can't really spell my own name. And I didn't do all that well in college because of that, although, you know, I did well enough, but not in my day. 

If you didn't have, you know, super high MCAT score, you probably weren't getting to med school. So I didn't get into med school, and I went to acupuncture school, and I learned about, you know, all this holism. Then I did get into med school, and I went through that, and I did all the things I already talked about, but one of my, one of my first experiences in med school was meeting a guy by the name of Norman Cousins, and he was the Director of the Office of Psychoneuroimmunology at UCLA. 

And I thought, well, what the heck is that? Turns out it's a fancy word for holistic medicine, right? So I became his disciple, and I was the guy who had to sneak into the surgery office to make copies because we didn't have enough budget to make our own copies, you know, and all of that kind of stuff. 

So I became very interested in his work and what he was doing and all, you know, all that stuff. And then as I got out of residency, one of my very first patients had chronic fatigue syndrome, and she said, I'm seeing a nutritionally oriented doctor down in Sacramento. I was in Lake Tahoe, California, and I said, Well, stop, what's a nutritionally oriented doctor? 

What are you talking about? And so I called the guy up. Really great guy, Kirk Hamilton, was his name, and he sort of replugged me into Jonathan Wright and Alan Gaby, and then Jeff Bland, and the whole movement towards nutritional medicine, individual biochemical blah, blah, blah, all the big words. 

So in a couple of years, I ended up, you know, in those days, we got the little cassette tapes. Remember those fun things? Got the little cassette tapes, and listen to the cassette tapes. And sort of, you know, Jeff Bland is been described as somebody who, you know, it's like trying to drink from a fire hose. It's just information download. 

But I would work hard to translate that into clinical practice. And then, after a few years of doing that, they asked me to teach for him. So I've been teaching for him for a long time. But like Elizabeth said, you know, the foundation of functional medicine, the absolute critical aspect of foundationally critical information, is lifestyle. 

And then we have this matrix, we call it, and at the center of the matrix, as Elizabeth said, is mental, emotional and spiritual, or I like to say psychosocial, spiritual. And so this course that we've created, and this is Elizabeth's genius, she wanted to teach this course from the center of the matrix. 

So the beauty of that is you won't find that anywhere else. If you go even to, you know, the mental, emotional, spiritual courses at IFM, they don't teach it this way. I guarantee it. This is, this is really unique, a new, unique perspective to bring, Okay, well, your gut's messed up, what does that mean from an autonomic point of view? 

What does that mean from a psychosocial, spiritual point of view. And how can we, of course, do things for your gut, right? We need to think about diet and blah, blah, blah, but also it just is this much larger portal to look through to think about health. And then, just one thing I wanted to add for Elizabeth, how many times did you quit working for me before you figured out your journey or whatever? I mean, it feels like it was like 20, but it was probably only two or three, I guess.

Elizabeth Sult  20:52

Yeah, I did. It was like three or four times. I was really struggling with my chronic illness at that time, and I was always pushing myself to the ceiling, like the top of the top, and that's, you know, so I would push myself, and then I collapse. I'm like, Oh, I can't work anymore. 

And then, oh, guess what, I would go home, I would take care of myself and nurture myself, and then I'd feel better. So then I go back, and I would push myself 100% again, and I'd end up where I was. So it took a couple cycles till I really... I was a slow learner. We'll just say that.

Nicole Vienneau  21:25

Always live and learn, right? Live and learn. So I'd love for all of us here on the call, and, of course, our listeners, my goodness, we'd love, or I would love, and we would love, maybe Karen Laing can start, is what is lifestyle Nursing, the basics?

Karen Laing  21:46

Yeah, great question. And one thing I do want to throw in here is we did meet as a group before we developed our courses, because we didn't want to be redundant. And as they have both pointed out, lifestyle is a very important aspect of functional medicine as well. So just know that when you take these two courses together, it's not going to be just repetition. So I'll just throw that in there.

Nicole Vienneau  22:16

Thank you for throwing that in there, because our listeners are probably thinking that right? Like, why would I take both courses? But they are distinctly different.

Karen Laing  22:24

And they definitely have something to offer that I don't have to offer, and vice versa. So you definitely will get something out of both courses. So lifestyle Nursing, really, when I talk about lifestyle medicine, is a specialty in medicine, and I always say they actually took it from us as Nurses, because Florence Nightingale did this. 

She made sure that the soldiers got clean water and that they had rest, and that they, you know, had good food and all those things, and she kept statistics on it, because lifestyle medicine is evidence based. So you can't be making recommendations. I can't be making recommendations that work for me and my dad, but you know, it's got to be something that's evidence based, that's going to work for the majority of the population. 

This is what we're looking at here. So lifestyle medicine and as I have translated into Nursing, because, as I said, we are taking back what is really ours, is we want to have daily stress management, quality sleep, regular physical activity, quality food, a lot of which is going to be plants, strong social connections and avoidance of risky substances. 

And when we talk about avoidance of risky substances, of course, we're talking about things like too much alcohol, tobacco, cannabis, but it could be things in the environment. For some of my clients, it's Oreos, you know. So it depends. We all have different risky substances, and we use it to prevent, treat and potentially reverse chronic diseases. 

So as we created this course, we've got a module on each of the pillars, but also, which is what we call each of those things, but we also have modules on specific disease, chronic disease states. So we're talking about how all those pillars can be used in the treatment of diabetes. 

I spent a year working with a lifestyle medicine focused endocrinologist. So, you know, it's powerful stuff, and we've got one on cardiovascular disease, obesity. Oh, my goodness, that one's a big one, you know, just buckle, buckle your seat belt. Because that one will take a little while, because there's so much good information there, and then hypertension as well. 

So it's not just looking at what these pillars are, but how we can actually use them as treatment modalities, intensive lifestyle interventions. I just had a Nurse practitioner recently say to me, have you ever seen this work? 

Like, yes, but there are a lot of traditional healthcare folks who don't know that it works because they've never been around somebody who actually uses intensive lifestyle interventions. They're thinking of, eat more fruits and vegetables, move more, as lifestyle interventions, which is not what we're talking about. We're being very specific. So I hope that that answers your question, Nicole. 

Nicole Vienneau  25:53

Oh my gosh, yes.

Thomas Sult  25:55

Can I join in on that? 

Nicole Vienneau  25:57

Well, sure, because you're up next. 

Thomas Sult  25:59

Because what she said...oh, well, that's okay... but you know, that's so critical— people talk about, get your five a day, and that comes from, get your three to five vegetables and two to three fruits. And they take the two and the three, and they say, get your five a day. 

Nobody talks about get your eight a day. But if you're not, well, eight a day is the minimum, right? And then nobody gives the tools. So handing somebody a diet sheet, as Karen well knows, this is nothing she doesn't know, but handing somebody a diet sheet is not lifestyle medicine. Lifestyle medicine is creating pathways to success, and that's what she has done in her class that's so beautiful and powerful.

Karen Avino  26:43

And that's why Nurse coaching fits in so beautifully with that, because that's what Nurse coaches can do with clients, are use those tools and those specific guidelines. And the other piece of it is not just about patient outcomes, but this is about Nursing too. It's Nurses really practicing Nursing. 

And, you know, unfortunately, I was a professor at a university, and we taught medicine. We taught them how to live in the medical world. And even though we use terminology like caring and you know, things like that. It doesn't really help the Nurse know how to implement those, you know, things in their own practice. And this is truly giving Nursing, number one, job enjoyment, which is what Nurses need right now.

Karen Laing  27:40

So to tag on to what Karen just said, I want to say that the course was created recognizing that a lot of the participants are going to be specifically Nurse coaches, but the course was created for Nurses, so if you are not a Nurse coach, per se, they're still going... it's a coach approach, but it's not something that you already have to be a Nurse coach in order to participate in.

Karen Avino  28:12

You'll want to be a Nurse coach after it.

Karen Laing  28:14

You will, you will, but you don't have to be coming in the door.

Nicole Vienneau  28:18

I love that, because there's so many of our listeners are Nurses who are looking for something that is going to refill their hearts and souls for the passion that they have for caring for other people. So it's really important that we understand that we can take steps today and find a pathway that will help us reconnect to the joy that we may have lost, or we want to reinvigorate, right? 

So love this, okay, so now we have a better understanding of lifestyle Nursing. So I'm going to turn it over to either Tom or Elizabeth to give a high level view of what functional Nursing is or could be.

Thomas Sult  29:03

Go ahead, Elizabeth.

Elizabeth Sult  29:04

I will start. We each bring our own perspective and our own expertise. So I think it's important that Tom speaks as well next, but I will definitely start. So with a functional Nursing, like Tom previously mentioned, I really wanted to bring it from the lens of that center of the functional medicine matrix, and not only the lens of the center of the functional medicine matrix, but also the Nurse coaching lens. 

And again, in this course, I think I have, it's split, you know, part of them are Nurse coaches, but we also have a lot that are not Nurse coaches yet. So I'm not saying this that you need to have that perspective, but I wanted to bring that perspective. 

Because with the center of the functional medicine matrix, it starts with our presence, just how we even before we enter the room, how we prepare ourselves, how we first ground ourselves and regulate so we're more in that parasympathetic state. So when we walk into the room, our presence really signals safety to the patient. 

Because whether you're in, you know, maybe it's an inpatient that you are a Nurse in, or perhaps it's you're coaching someone, or you're in a clinical setting, really anywhere, our hearts, our bodies are always, they can always sense the person in the room with us, and when we come in in a stressed, hurried state, that automatically shifts that energy in the room a little bit, or perhaps it sustains the energy in the room, if you already have an anxious patient. 

So really, the center of this course is with every module we're really showing how being in that regulated state helps to co regulate the patient and really create the conditions in that environment. So then everything else we do just takes better effect. So whatever we're implementing, the body is better to receive it when it's in that safe space, like Tom discussed earlier. 

You know, when you're talking about the gut and you're having all these... maybe a patient is having all these GI symptoms, and you know, they're down to eating three foods, because everything triggers their allergies, we really then look at the autonomic tone, like, are you in fight or flight consistently throughout your day? 

Because that's shunting blood away from your gut, and no matter what you eat, it's going to leak into places that it shouldn't be and exacerbate those symptoms. So we go into each module, each center, whether it's, you know, immune, hormone transformation, GI, each module, we kind of bring it back to that center of the matrix. And then also, we do talk about lifestyle. 

Tom will go more into this as well, but he reviews common functional labs too, that perhaps he would look at with these patients. And then there's also a module on supplementation, so kind of the top supplements that help to support the system. So I think kind of a misconception with functional medicine is it's just green pharmacy, and that's not what functional medicine is. 

We're really looking at those underlying contributing factors, and often it's more than one. It's a system that has tried to remain balanced over a long period of time, and it's really compensating. It's trying to compensate for those imbalances. So, yeah, that's my little take, but Tom, I'm sure, has more to offer.

Thomas Sult  33:06

Well, I just wanted to tell a little story about way back in the 1980s there was a guy by the name of Dean Ornish. He was a professor of medicine at UC San Francisco, and he was the first person to show that diet and lifestyle could reverse coronary artery disease. And over the years, you know, he had this vegan ish, vegetarian leaning vegan ish diet and yoga and stress management. 

And over the years, he grew to believe more and more strongly that it was the stress management, more than anything else, that really changed things. And then if you start looking at the blue zones around the world, blue zones are these places on Earth where people live longer, healthier lives. 

So you know, kind of like Karen's dad and my dad, my previous wife, who's unfortunately passed away, but my previous wife, her big complaint about my dad was that when he was 90 years old, he walked too fast, you know. So that's possible to walk too fast when you're 90 years old. 

And these blue zones are places where people do that. But what are they doing? Are they going to the gym and working out, or they, you know, no, they're not doing any of that stuff. They're tending to their garden. They're walking down the rocky trail to the pub, having a couple of bumps with their buddies. 

They might even smoke, which, you know, isn't, I'm not recommending that, but they might. And then they're going to climb back up the hill and go tend to their garden and maybe go out with a couple of friends for dinner and they're going to have these built in social structure that creates stress management and exercise and healthy diet all automatically. Right? 

And so what we try to do, and what we're hoping that people come away with from our course is, how do you build a blue zone, a personal blue zone, around yourself? And that's really, I think, what we're trying to do, and how these things mesh so beautifully. Because that's really, that's lifestyle medicine. 

And then the little bit that's different in functional medicine is trying to hyper personalize it, because maybe we notice that somebody doesn't methylate well, so we're going to push harder on methylation foods and push harder on some methylation supplements, or maybe they don't detoxify as efficiently as they should, and we do a test and we see that they're really toxic. 

So we're going to optimize their detoxification pathways. Or we notice that a woman is having tons and tons of perimenopausal symptoms, and we figure out that the way she's detoxifying her estrogen is the inflammatory way, and so we're going to give her things like dim or, you know, something else to help move that detoxification pathway in the less inflammatory way, or, you know, other little patient specific things. 

So I would say, like, when people are starting out in functional medicine, oh, I don't know enough, well, you know enough to apply the lifestyle. And you know, that's 80%, maybe even 90% of the battle. And so, you know, I think that the problem is, most of our education today, especially our postgraduate education, comes from drug reps. 

And drug reps are not going to come in and lay a head of broccoli on the table and say, Man, this stuff, it's amazing. You know, they're gonna lay the newest gorilla cylinder nucleosome on the table and tell us how wonderful it is. And so we're not getting the education that we should be getting about these topics.

Karen Avino  36:55

Nicole, if I could just interject, so, you know, I think what Tom was alluding to is such an important piece is that registered Nurses can do this. You don't have to have an advanced degree, except in the instance where you could probably take functional medicine a bit deeper. Am I correct, Tom? 

In perhaps testing and diagnostics and things, although you certainly can collaborate with somebody who's in that area. And so Nursing is well equipped to begin using all of these lifestyle, you know, changes and behaviors and things with clients. So, you know, don't think you have to be a physician or a Nurse practitioner to get started.

Thomas Sult  37:53

In fact, we talk about the tyranny of the diagnosis, right? We were all brought up in the medical model, right? And it's the diagnosis. And so we get attached to this thing, but the diagnosis, you know, if you have heart disease or diabetes or arthritis or even mood disorders, they could all have the underlying cause of inflammation, all of them. 

And so why are we worrying about the diagnosis when we know there's inflammation and all we're trying to do is use structure function stuff. So you've all seen the FDA warning that says none of these, you know, you buy a thing of vitamin C, and it says, you know, the FDA has not approved any of these topics, right? 

Well, we specifically designed the functional medicine modules to use that kind of structure function language, so a registered Nurse who's not an advanced practice Nurse can talk about these things using Nursing diagnosis and Nursing language and lifestyle language without prescribing to a diagnosis, because it's not important.

Nicole Vienneau  39:08

Conversations getting juicy now. So our listeners would love to know like, how does this even apply? I know you've been saying, okay, yeah, Nurses can do this. So we'd like to know like some specifics. So how have you seen, and Elizabeth and Tom, let's start with you first, like, how have you seen functional Nursing be used, and a story that might surround how Nurses are using functional medicine to affect themselves and or affect a patient that they've worked with.

Elizabeth Sult  39:47

So how does functional Nursing affect me as a Nurse or my patients? And when I think of that, both of them come to mind, because, as I was developing this course, I also learned so much about myself as I was developing it. You know, while I was aware of the concepts, really seeing it, how it, you know, kind of took on, kind of, it became its own entity. And I just learned so much about becoming more aware of my own presence. 

And even as these Nurses in the course, they're already reflecting back to me like, oh, you know, I didn't even realize but you know, when I did this, like if I came into a room in a more regulated state, or notice that the patient was, you know, very short, or they were angry about something, or they had been ignored, or things weren't communicated right— 

When I came in with the mindset or the, you know, just being present in the moment and really listening to them, like, not trying to defend the system or defend yourself, but really, really listening, like we do with Nurse coaching, just really being present with the patient and listening to, how it just automatically shifts their tone. 

So, you know, changing the way I present myself changes those around me, and I can see that day to day, whether it's with, you know, another staff member or with, whether it's with Tom or whether it's with a patient, you know, when I pay attention, when I pay attention to my own presence and my own energy, and then just really wholeheartedly listen to whoever's before me. 

Whoever before me is, you know, they are the most important person right now. You know, when I bring that mindset, beautiful things happen for you know, I feel like I benefit just as much as they do. So I'm not sure if that was just a really long winded way of not answering your question, but that's kind of what came to my heart.

Nicole Vienneau  42:21

Well, what I heard was that what you've learned and through the process of creating this course, specifically through the Nursing lens, right? This is for Nurses, by a Nurse, you know, with, of course, Tom's functional medicine background too, but this is for Nurses. 

And that the things that you have witnessed and seen and learned open you up, and using your... knowing your own self, being yourself when you go into the room, and understanding how much you, just your presence and the way that you're showing up can positively affect another. That's a beautiful gift.

Elizabeth Sult  43:06

Yeah. And just having that compassion and the ability to pause and to listen, yeah, it's really foundational I think, in everything that I do, I feel myself pausing a lot more than I did before.

Thomas Sult  43:24

One of the foundational tenants of functional medicine is we call it the patient story retold, and storytelling is a therapeutic intervention in every culture on Earth, right? And it really starts with Shamanic traditions. In functional medicine, we have this mnemonic called go to it. And the details are not so important for this conversation. 

But one of the things is taking the story, listening like Elizabeth was just talking. But the second part of that is okay, the story told us how you're going... how you went from ease to disease, right? And but the story retold is, oh, well, this happened and this happened and this happened, and here is the path out back to ease. 

So I like to talk about it like I'm listening to the story and Elizabeth's listening to the story, and we hear I was fine, and then my health broke, and so did it do this and come back? Or did it break down, and now it's here, and did it break again? And right there, right where it broke, we're listening, and we're looking for antecedents, things that pre existed. 

We're looking for triggers, things that you know caused the break. And then we're looking for mediators. And mediators are things that either keep you sick or help you get better. And so it's through this lens of listening deeply. So one of my favorite stories of listening, which it will illustrate that I probably didn't listen well enough. 

I had a patient, she was in her early 30s, and she had all kinds of gut issues, so we did this, that and the other thing, and I wanted to put her on an elimination diet. And, well, guess what? She didn't do it. And, you know, she didn't show up for her coaching appointment. She didn't do blah, blah, blah. Well, I was just too busy. 

She said I was just too busy. I said, Okay, well, you were too busy. How about now? Yep, I'm ready. Let's do it. Let's do it. Okay, doesn't show for a coaching appointment, you know. Doesn't do the thing, come back. So I'm a slow learner. So it takes me a few of these iterations, and I finally learned something. 

And what I want to say is that the most important moment in medicine and in Nursing is not when they did what you asked them to do, but when you they didn't. When you discover why they didn't, that's magical. So in this particular... this is going to sound like I made it up, but this is God's honest truth. 

She comes in and, okay, I didn't do it again, and we have this long conversation. And it turns out that her mom died when she was, like, 10 years old or something, and her mom, when she was sick, would give her milk toast. Now that sounds terrible to me, but for this woman, that was mom, that was like, Oh, I'm feeling terrible, I need milk toast, because that's what my mom would have given me. 

And we had this long conversation, and she realized that her mother didn't care about milk toast. Her mother wanted her to be well, and now she had permission from her mother to do the elimination diet, right? So it's listening to the story and not deny, Well, that's ridiculous. Milk toast isn't going to help your belly. You know? 

That was mom. What could be more powerful a healing agent than mom, right? But then she had to realize that mom didn't really care about milk toast, she cared about her daughter feeling better, and bang, she's able to do these things that are hard. You know, therapeutic diets are not just take a pill. They're more complicated. And so anyway, listen, that's really important.

Nicole Vienneau  47:02

And many of our listeners here, you know, we're Nurses. We're used to listening. So... and Karen I know I asked for, Karen Laing, I asked for, you know, an example, but you know, as we're talking, yeah, Nurses are great listeners. But how is this listening to story or the use of lifestyle, how is this different than just regular Nursing that we already know?

Karen Laing  47:31

Well, I think two things that I've heard Elizabeth and Tom both say that are very important and overlap with lifestyle Nursing is listening and hope, because lots of times that patient that we're listening to sees no positive end to this story, so they're sharing their journey. 

But like Tom said, you know, they're just expecting it to continue in this trajectory. And we're listening, but we're listening to find out where there might be opportunity. I always call it areas of opportunity, you know, you didn't screw up, it's an area of opportunity, you know? 

Because I always tell people when they come in and they're like, Oh, I eat junk food and I don't exercise. I'm like, that's great. If you were a vegan marathoner, I don't have much to work with, you know, we got all kinds of stuff to work with. Where do you want to start? You know? 

So we give them hope, but we're listening for, where are they ready to start? What are they interested in doing? One of the examples I frequently will use— Tom, you may remember this as well— you remember Joe Piscatella? Joe Piscatella had a heart attack in his early 30s, and he became a motivational speaker, and he wrote a book called Life is Better than Steak. 

And frequently, I will have conversations with patients where I will say, life may not be better than steak for you. You may decide you want the steak, and that's something you're willing to do, and you'd rather take the pill to go with that, and that's something that we can do, but we need to have the conversation so you get to make the educated choice. 

So you know, listening for what's important to them, and knowing where they're ready, what they're ready to change now, because they may be ready to make that change later, but they may not be ready to make that now.

Nicole Vienneau  49:45

Listeners, are you having as much fun as me? This is so great. We could talk about this all day, but I know we have to keep it limited, so we have a few minutes left, and we're tying things up now and so, hmm. I would love to hear and I think I'm just having this intuitive hit of what our listeners might want to know this too. Like, why should I take these courses? How about from your perspective? Karen Avino, why don't you start with this one? Why should we take these courses?

Karen Avino  50:20

They'll want to take the courses because not only does it improve your practice, but it improves your own personal life, right? So it's not the usual thing where in our traditional Nursing area of practice, it's also about the Nurse, and I think that that is a huge piece of, again, finding joy in your work, right? 

And also it's about transformation of the healthcare system. This is making Nurses a leader, a leader in transforming towards lifestyle health and well being, and that's where Nurses, I think, shine. We can have, you know, we shine in a lot of things. We have a lot of things that we do to patients. But Elizabeth kind of alluded to being with patients, right? 

That's a huge piece of what Nurses do, but it's so much more than that. It's about being a leader in your workplace. I mean, one of the things that we do now with people who take our coaching program is we have another little branch of the course integrating it in organizations. Because why is, forgive me, Tom, why are physicians the chief well being officer in the hospitals when that's the Nurse's role?

Thomas Sult  51:59

Especially when they have no training in it. 

Karen Avino  52:02

Thank you. So Nurses have the opportunity. So now we go through a whole process of assessing the organization, collecting the data, writing an executive summary, practicing this speech to present it to their leaders, if you will, because I think Nursing is on the path to this. 

This is what, you know personally, when you look at the Nursing profession, and there's, you know, different levels of Nurses and but they all use the term registered Nurse. And I think that's where a lot of confusion comes in where Nurses can find their own path and their practice, and this is what, again, it gives a lot of people joy. 

I mean, we, you know, the students that we have at graduation actually cry, and we cry with them because we're so happy for them that they feel joyful and now what they can bring to clients, but to their families, to their communities and to themselves. So it no longer just becomes a job, right? 

You know, they're not going in just to make the money, do the job, go home. It's really again transforming them to look at health in a different way, to recognize they have the power to transform health care in the direction that we want to see it. And so, you know us in Nursing, we keep striving towards getting recognition about that, getting CPT codes that should be recognized for Nurses to be able to bill for lifestyle, you know, and coaching sessions, and not everybody should be called a health coach. 

You know, there are definitely wellness coaches, but Nurses are health coaches that include wellness, of course, but really can bring in a whole new dimension, I think, to the healthcare system in general. I think that's my greatest driver, is to see that we can make a difference in the Nursing profession.

Nicole Vienneau  54:23

Thanks so much, Karen. Elizabeth, what are your thoughts? Why should we take both of these classes together, or even just one, but we're talking about both together? 

Elizabeth Sult  54:35

Yeah. So a lot of students already, Nurses have voiced that. I think every single one I've talked to so far are doing them both together, and they just feel they fit beautifully together, and they're very excited to have this opportunity. So for one, everyone's doing it. No, I shouldn't say that, but they kind of are. 

And I think that, you know, when you think of lifestyle Nursing, because I had someone actually reach out to me and ask me, Should I do both? And, you know, she goes, I already know stuff about lifestyle and then, so I actually looked up lifestyle Nursing, and I was like, but look at this, like you don't know, I said, there's so much more. 

There's so much more to learn that we don't know. And the thing with functional Nursing is, and probably with them both, they change, I think, who you are. They change how you show up as a Nurse, how you show up as a person. And like Karen was saying, when, you know, students walk away from Nurse coaching and they're brought to tears at graduation, it's because they found joy again. 

They found enjoyment in Nursing. They fell in love with Nursing again. And that's really what INCA for Nurse coaching has done for me. And then now, along the lines of functional Nursing, I'm just falling deeper and deeper in love with being a Nurse again, like with, I think I'm gonna cry, with the heart of Nursing, you know, like the real heart, like the Florence Nightingale heart. 

And just, you know, creating those conditions, being that presence that really allows others to feel safe in healing, and that also allows myself to feel safe again, and, you know, to feel like I'm making a difference as well.

Nicole Vienneau  56:41

Thank you, Elizabeth. Tom, what are your thoughts?

Thomas Sult  56:45

Well, it's like you wouldn't, I guess, unless you're Michael Jackson, you wouldn't walk around with one glove on, right? I mean, they're a glove for each hand, and they are so inter-connected and inter-collated, and it is powerful. I mean, you know, like people say, Well, gee, does that stuff really work? 

Well, you know what? No, it doesn't work if you just hand them a sheet and let them go. You have to have systems developed to help people be successful. Because, you know, when we have built a medical model where what happens is, you go to the doctor, he gives you a few pills, and that's going to fix you, except it doesn't. We're putting band aids on bullet holes in conventional medicine. 

There is, with very few exceptions, there is no medicine that is treating the fundamental underlying reason you are ill. You know, a statin doesn't do that, a blood pressure medicine doesn't do that, an antibiotic, maybe you could argue it does that. But I would argue that there's a bigger terrain issue. You're probably susceptible to illness because you're not eating your broccoli or whatever it is, right? 

So it is so fundamental to wellness and health that I don't know why anybody wouldn't do them both, even if they were only doing it for their own family. And then, you know, learning those self regulation techniques through a core tenant of lifestyle medicine is stress management and relationships. Well, who doesn't need help with stress management relationships, right? 

And that's a big piece that we talk about in functional medicine as well. So I just, gosh, they're just, I would argue you would need... you'd be hard pressed to find a reason why you shouldn't do it.

Karen Avino  58:43

And Nicole, I might be able to add that, you know, my idea of it really is the lifestyle Nursing gives a lot of guidelines for all of those core topics, you know, related to lifestyle, as well as then talks about the chronic conditions. And you know what you can recommend where. 

Functional medicine also does, really, I think, cover a lot of systems, and so I think that's how I kind of visualize the difference between the two, but they are so closely intertwined that... Tom used the word powerful. It makes it a much more powerful approach when you incorporate the two.

Thomas Sult  59:35

And one other thing, you know, Elizabeth has made it sound like the functional medicine class is all about stress management, and there's a piece of that, but I will also say that we both have lectures where we start by saying, buckle up. We're going deep into the physiology here. We're going deep into the science. So neither of these courses are fluffy. These are deep, these are serious, these are powerful.

Nicole Vienneau  1:00:02

Just what us Nurses like, a challenge. And we want to know, we want to know all of these pieces of information. That's why, one, we're listening to this podcast, because we are helping to move the needle. And really, really helping ourselves, that then extends to the populations and the communities, the patients, the clients, the healthcare systems that we serve. So Karen Laing, we want to hear what's your reason why? Why should we take both of these classes together?

Karen Laing  1:00:35

So Tom and Elizabeth have given a couple of good examples there for why it's really a powerful combination, how they really... you're going to walk away with totally different skills and a totally different feeling about your Nursing practice. 

One thing that I haven't mentioned about the lifestyle Nursing course, Tom was talking about those chief wellness officers, should, you know, be Nurses, not physicians, right? And one of the things that is in the lifestyle Nursing course, in each of the modules, I've interviewed a Nurse that is using lifestyle in their practice. 

And I wanted to do that, because I wanted all the students to get to see lifestyle Nursing from different lenses. One of the people that I interview is Josie Biennewill, who is actually holding that position at the University of Mississippi Medical Center. So you get to hear from the bedside Nurse. 

You get to hear from the, you know, somebody with a C in their title. So, you know, you get to get a lot of different perspectives for how people put this into practice. And the thing that is true in lifestyle as well as functional is the bringing that joy back into your practice, because that's the big thing. 

You know, none of us went into this to do 10 or 15 minute appointments with patients, write them a script and send them on their way. That is not why we went into this. We may have ended up there for a period of time, but we found another way out, and we want to help you do that too.

Nicole Vienneau  1:02:26

Beautiful. So to wrap things up, listeners, we have this link into the show notes: Functional Nursing and Lifestyle Nursing dual certificate pathway. You can start this course tomorrow, if you want to, and you, by the time you complete these courses, you'll have 150 CEUs, whoo! And when you take both courses together, you save 10% so why not? You don't want to just take one. 

You know, maybe you're on the fence and you're like, just take one. I'll see how that is. Well, you could save money, just sign up for both, because you're probably going to want to do both anyways, right? Yes. And if you're still on the fence and you just want to have a little bit more information, I would challenge you, or I would just ask you, please listen to our podcast. 

Number 96 is with Karen Laing. She has a beautiful podcast called Ignite Your Impact with Lifestyle Nursing. And then we have our podcast episode number 95 with Elizabeth and Tom Sult: Functional Nursing: Tools, Presence, and Hope for Modern Nurses. And if you want to get to know Karen Avino just a little bit more, you can go back, way back to episode number 85 from February of 2025, where she talks about celebrating integrative Nurse coaching. 

And, you know, kind of brings us up to speed where we were back in 2025, and now you see all of these changes happening. We want you to be part of this amazing journey that we're on to shift the way that we're showing up in our healthcare spaces, whether that's at home, in our communities, at the bedside, or in your own private practice. 

I mean, we can do all of these things as Nurses, and these frameworks are giving you the foundation and the ways in which to be able to elevate your own spirit and elevate those that you work with, that you see, that you live with, and to, just like everybody keeps saying, bring the joy back into Nursing. I mean, why not? It's worth a shot. 

So listeners, we will put all of these links into the show notes, and you can reach out, and we're going to put the contact information for Karen Laing, for Tom Sult, for Elizabeth Sult, into the show notes. We also have amazing admissions Nurses who have taken our programs that can answer all of your questions and help you make the decision that's best for you. 

Which is ultimately what we all want to see happen. So thank you for being here, thank you for listening and thank you for all of our amazing guests on our podcast today. Let's just say our goodbyes. Let's start with Karen Avino.

Karen Avino  1:05:16

Thank you for coming and listening to us today. I hope this has given you, or perhaps planted a seed, right, within you, that you can continue to think about and grow on and realize there is more. If you want it, it's here for the taking.

Nicole Vienneau  1:05:36

And Karen Laing.

Karen Laing  1:05:38

Oh, thank you so much for allowing me to be here this evening, to meet with all these wonderful folks and have this fantastic conversation. I hope that your listeners will join us, because this is the way we're going to make change in healthcare. It's got to be more than just the five of us. 

Nicole Vienneau  1:05:57

Yes. Tom?

Thomas Sult  1:06:01

Yeah, I agree with that. It's got to be more than just the five of us. Let's create a tidal wave. And I hope, I hope, that you guys out there in listener land have had as much fun as I have, because this has been a great conversation. And thank you for being with us. 

Nicole Vienneau  1:06:17

Awesome. And Elizabeth?

Elizabeth Sult  1:06:20

Yes, thank you to everyone listening. Thank you to Nicole for bringing us together, for Karen and Karen and Tom, I really enjoyed our conversation. I really enjoyed sharing things with you all and and listening to what you had to share as well. And I hope that those listening are as excited as we are about these courses, and of course, we hope to see you on the other side.

Nicole Vienneau  1:06:48

Yay! Bye, everyone!