Ep12: Nurse Coaches, Innovative Healthcare Leaders- Nicole Piotrowski BSN, RN, HWNC-BC Transcript

Nicole Vienneau  00:00

Welcome, everyone, to Integrative Nurse Coaches in ACTION! This is Nicole Vienneau, your host, and I'm also a Board Certified Integrative Nurse Coach. And today we get to welcome Nicole Piotrowski, who is a Registered Nurse and Board Certified Integrative Nurse Coach. And she's from Chicago, Illinois. So, we welcome Nicole.

Nicole Piotrowski  00:21

Nicole, thanks for having me. Excited to be here.

Nicole Vienneau  00:23

Oh good, I'm so glad you're excited because I too am excited, because I love to speak with fellow Nurse Coaches to hear what they're doing in their lives. So, I'm hoping that you could just give us a brief background on why you got into Nursing. What attracted you to Nursing?

Nicole Piotrowski  00:41

I decided that I wanted to be a Nurse and work at Children's Memorial Hospital in Chicago when I was about eight years old. At the dinner table, my grandpa asked me what I wanted to be when I grew up, and my grandmother was my idol and she was a Nurse, so I decided I wanted to be a Nurse. And that dream never left. I went to Nursing school, I got my dream job at Lurie Children's Hospital, and stuck with it.

During my final exams of my senior year in college is when things changed. I got very sick with debilitating headaches, dizziness, nausea, brain fog, and a whole host of seemingly random symptoms. And no doctors were able to pinpoint why I, a healthy young woman, was suddenly unable to do my basic activities.

So, after many years, many diagnoses and treatments, I went to Mayo Clinic and was diagnosed with an autonomic nervous system disorder called POTS, for postural orthostatic tachycardia syndrome. And so, I needed to have my own health journey and figure out how to get myself better, which is what led from Nursing to Integrative Nurse Coaching.

Nicole Vienneau  01:45

So, you had your own health issues that you were trying to figure out. You realized that, oh my gosh, I need to start taking better care of myself, which then led you to find the Integrative Nurse Coach Academy or International Nurse Coach Academy. And what really called you to that type of work?

Nicole Piotrowski  02:04

Through my own health journey and seeing healthy family members of mine get sick, and some of them dying, I knew I was meant to do more with Nursing. And I knew that there was something missing within the healthcare system in America. It was more about sick care and disease care than about health and wellness.

And so, I started looking at what else I can do with the Nursing. And, also, I was working nights as a Nurse, and with my health, I wasn't able to do that. It's pretty grueling, working nights. And so, I needed something that I could, you know, work during the day, make my own schedule and kind of go on a different path in Nursing than traditional working nights in a hospital.

And so, I started doing a deep dive on the internet, and I found that Nurse Coaching was a thing I had never heard of. And holistic Nursing was a specialty I was unaware of, as well. And then I found the International Nurse Coach Association, fell in love with the philosophy, and just watching YouTube videos of Barb and Susan, I wanted to learn more.

And so, I found their Nurse Coaching program, I signed up, started studying, and packed my bags for Boston. I fell in love right away and I knew that's what I wanted to do.

Nicole Vienneau  03:12

Wonderful. Can you tell us a little bit about your time in Boston?

Nicole Piotrowski  03:17

Yeah, it was wonderful. That program truly changed my life. It was a different program than I'm sure it is now, with the pandemic, having to be online. At the time, my cohort met for five days in Andover, Massachusetts, one of the most beautiful places I had ever seen, on this lake retreat center. And for five days you were fully immersed in learning Nurse Coaching and learning awareness practices and guided meditation and learning about yourself -- doing a lot of self-discovery.

It was as educational for me, learning how to be a Nurse Coach, as it was for me as an individual and learning more about myself and really diving deeper and forming lifelong bonds with the Nurses that I was in that program with that I still talk to, to this day. It was a truly wonderful experience.

And then you go home and do multiple months of learning, in addition, and then we got to go back to the same retreat center eight months later and do my second round before I take my boards. And it was just so wonderful, and I will never forget the experience that INCA gave me. It was life changing.

Nicole Vienneau  04:24

Can you tell us more about what life changing means to you?

Nicole Piotrowski  04:27

I previously hadn't thought much about my own health. I was always a young, healthy person. Played soccer my whole life, had no real health issues. And I hadn't done any real self-care, other than what you think of: "Okay, I'll exercise occasionally, or I'll take time to read a book or take a bath." I hadn't done any dive into myself and I, in Nursing school, also lost my mother to pancreatic cancer and hadn't taken time to process that, either.

And so, a lot of what happened during my awareness practices and during a lot of the reflection time and journaling time allowed to us, as part of our Integrative Nurse Coach program, I thought a lot about that and was able to do a lot of journaling, and even some poetry writing, which is not me at all, not a skill that I have. But it was wonderful. And it really taught me that my health was in my own hands.

And I had a really transformative experience, even just walking in the woods and spending time with these older, wiser Nurses that knew so much about life and were able to teach me and guide me along the way. And then realizing that that could be my job, to help other people learn that they can take charge of their own health and have that same transformation and to guide people in doing that.

I was probably overly excited about the idea of being a Nurse Coach, and I'm sure my friends and family were probably sick about hearing about how excited I was about it. But realizing just that, yeah, through what I was learning at that program, I could also help patients learn that their health was in their own hands, felt really powerful.

Nicole Vienneau  06:08

Very powerful, isn't it? And I can tell, just by listening to you and your energy, you love what you're doing. So, I'm curious to know exactly what you're doing in your day-to-day life as a Nurse Coach.

Nicole Piotrowski  06:22

I consider myself dedicated to working with preventative healthcare through working in primary care and integrative medicine. As I mentioned, I think the current healthcare system is pretty flawed. We focus on sick care and not health care. And primary care, to me, is taking care of the whole person. It's your main doctor that you go to, your main Nurse practitioner provider that you go to, to take care of you when you're well and when you're sick.

And so, using my Nurse Coaching skills, I work with innovative teams, mainly in the startup world now, that are on a mission to create a new kind of healthcare delivery system focused on relationship-based care -- taking care of the whole person instead of the bottom line, that value-based care. And so, while I enjoy working with solo patients, one-on-one, I love working with teams and innovative teams.

I think healthcare is better when your providers know everyone. It's not: I see one doctor and then I go see another doctor, and then I see a physical therapist, maybe I see a personal trainer or a health coach and nobody talks to each other, or knows what you, as the patient, are going through.

Right now, I'm working with a company called Vori Health and they're a dedicated, innovative team on a mission to empower humanity to lead a healthier life. You can find me there for one-on-one health coaching, but we also have physical therapists, Nurse practitioners, doctors, dieticians, all working as an integrative team, doing virtual healthcare through an app right in your own home.

And so, it's really wonderful. I love being able to be part of a team and do coaching and help patients from all around the country. And then also be able to, right after I see them, hand them off to a physical therapist to help them with their back pain and teach them exercises and then have them see a dietitian right away to help with their diabetes. And it's a wonderful thing that I hope healthcare continues to move toward in the US -- that more integrative care, focused on a person and not a payment.

Nicole Vienneau  08:15

Absolutely sounds amazing. First off, I heard you say that it's great for the patient or the client, because they can then be connected right away to different practitioners who know them and stay connected in that way to, you know, make sure that their health remains in their own hands, which I heard you say, too.

But the one thing that really stuck out for me is your excitement in this role and the collaboration that you're expressing here. And so, tell us a little bit more about that and how that feels for you, as a Nurse who's doing this important work, working in a collaborative space.

Nicole Piotrowski  08:58

It feels wonderful to have found a space, and that's why I also love the startup world, because it is a world where innovation is encouraged and there are far fewer rules and boundaries, which is where we, as Nurse coaches, within large organizations, large hospital systems, have to try to find our niche and where we can fit in and all the billing rules and things like that.

And with Vori Health, where I'm at right now, we are welcomed. We're looking for Integrative Nurse Coaches. Actually, people should keep an eye out for job openings in the very near future, where we will be hiring a large quantity of Integrative Nurse Coaches. And be able to work with patients one-on-one. They see the value in what we do and also the value in what we know about Nursing, what we know about health and wellness and developing programs for patients, deciding care models for patients and using the other side to Nursing that's not just task-based care.

Nicole Vienneau  09:56

Sign us all up!

Nicole Piotrowski  09:58

I will (laughter).  I am actively making sure that we hire Integrative Nurse Coaches that are board certified rather than just health coaches, because I think it's really a different background. Where as Nurse Coaches, we have the knowledge of a registered Nurse and the empathy of a registered Nurse, and all of that background caring for patients.

And then we learn health and wellness coaching on top of it, and help clients, you know, deepen that connection to their inner healing resources. Promote wellness, promote resiliency. That's something that I feel sets us aside from any other health coach that you could hire that has a very different background.

Nicole Vienneau  10:36

I agree with you 110%, probably more like 200%. Having Registered Nurses in this role really makes sense because we are all so skilled in both the science of healthcare, but then the art of Nursing. Nurses lead the way in health and wellness. Just makes sense.

Nicole Piotrowski  10:59

Absolutely. I agree. The revolution I hope continues of promoting wellness care in the United States, I think starts with Nurses. We're that frontline with patients, we're that trusted profession. They know that we will guide them in the right direction.

And so, hiring Integrative Nurse Coaches just to help people make small meaningful change, establish goals, make little lifestyle behavior changes, can make a huge difference in someone's overall health. And especially with things like chronic disease management, which we need a lot of in our country. That's where the science of Nursing is really necessary to be paired with the art of coaching.

Nicole Vienneau  11:37

So agree. So, it makes me think of your work and the types of patients and clients or communities that you're working with. I bet our listeners are really interested in understanding, maybe, a patient scenario or maybe a potential patient success story that you've encountered.

Nicole Piotrowski  11:57

Yeah, I work with a few different kinds of patients. One is one-on-one with patients that I work with, and I've had wonderful patients. A lot of our patients are older adults. A lot on Medicare and Medicaid. And working with people that haven't been able to exercise, haven't been able to eat well, because they're limited by chronic pain.

We are a musculoskeletal based company, and every patient has a physical therapist in addition to a health coach. And so, they see me for their diet and water intake and exercise and sleep and mindfulness and everything they may want to work on. At the same time, they're seeing a physical therapist to make sure they can move safely and teach them exercises to help with their back pain.

And so, we've had patients go from not being able to move much, can barely move around their house -- it hurts to stand up at a sink and do dishes for more than five minutes -- to walking around their whole property and getting exercise and meditating in the mornings and drinking lots of water and just being overall happier.

 I love doing Nurse Coaching because you get to see the difference in patients just by looking at them on video chat, as it is now. Being able to see their demeanor completely changed from visit to visit and see them light up and be excited and feel lighter and healthier and happier. And being able to see that in my patients -- especially my older patients that think that chronic pain is just something they're stuck with. That's what I've seen a lot of, is that they're like, well, I'm older, I have back pain, it has to be that way, but it doesn't.

And so, to get them moving, get them happy and see people playing with their grandkids, calling their grandkids their pride and joy, having them be their motivation. It's beautiful. I love it.

Nicole Vienneau  13:53

You spoke of you realizing that you had been diagnosed with an illness, then you took the steps to say okay, I'm going to do something about that. You took the steps to move into another profession within your profession that spoke to you and your abilities to help other people.

And so, I bet our listeners are curious, because we always talk about this, is about the self-care piece. What are things that you're doing to really care for yourself? Because as you talked about this patient population, they're struggling with their health. They're struggling with things within their life, and yes, you're able to help them. But how do you manage the effects of listening to people who are really struggling with your own self-care?

Nicole Piotrowski  14:42

That's a very good question, and something that I think applies to Nursing in general. We're very often very empathetic people and we tend to take on a lot of what our patients are telling us, especially in Nurse Coaching. People are opening up and telling us all about their lives, a lot of which has been a lot of hardship.

And so, to be able to kind of step back and take care of yourself -- I am an introvert, so I recharge by being alone. And so, things like taking a calming bath, taking a walk. Lately, it's riding my bike outside, now that it's getting warm, and I just kind of meditate and ride and the wind and I love it. Doing yoga -- things like that all help me in self-care.

But to back up to your initial question, with the fact that I also have a chronic illness, it takes a lot of mindful attention to my body and being very in tune with how I feel because there are many times of day when I know that I can't stand any longer and I have to sit and put my feet up. I have to drink very large quantities of water throughout the day, maintain an anti-inflammatory diet, take supplements. Lots of things that I have to do to maintain my own health that, since it's been a few years that I've been doing it, I've gotten good at.

But it's very challenging to balance in the beginning. And that, I feel, helps me in my Nurse Coaching because I help a lot of patients with chronic illness, and I can genuinely empathize with what it takes to manage that and help them through that.

Nicole Vienneau  16:07

Yeah, the first thing that came to my mind is just being a role model. Being a role model for your patients, and really, truly understanding what it is that they are going to be committing to as well. But then they also see that it can be achievable.

Nicole Piotrowski  16:23

Absolutely. And that's why I decided to be open and honest about my chronic illness. At first, when it happened, I hid it from my Nursing community and would try to make sure jobs didn't know so they didn't think I couldn't do my job. And there are a lot of limitations, often with patients that have POTS, because I mean, 25% end up in a wheelchair because they physically cannot stand without fainting.

And so, it's something that I decided, the more open and honest I am about it, the more people can see that you can be self-managed. And there are things you can do, and you can live a happy and fulfilling life and work and find a niche where it works.

I've actually spoken to many Nurses that had POTS, that have reached out to me, of just, "How do you manage? How did you find a job that you can physically do that you like doing? And how can I use my skills now that I can't be on my feet for 13-hour shifts?" And so, being able to help people, not only with POTS but with any chronic illness, realize that being sick doesn't have to be your whole life. It's just part of it. And there's a way to incorporate it with the rest of your life that you want to have.

Nicole Vienneau  17:30

Beautifully said. And it comes from a real space of authenticity, as well. And your ability to express it and not be fearful of expressing your needs and your desires and being able to share that, must, I feel like, as I listened to you and just the energy in which you possess and the passion in which you talk, it just must feel liberating.

Nicole Piotrowski  17:56

Yeah, absolutely. It feels empowering. Like I said, I wasn't always open and honest about it, but I feel it helps me, personally, and it helps my patients, more, to be honest. People want to know about us, people are naturally curious to learn each other's stories. And that's why I love primary care, because you're caring for the person throughout their whole life rather than that one episode of care.

I'm there with their whole family from birth through the end of life and being able to form relationships with people. And I think being open and honest with them in an appropriate way is really important in forming those relationships. People want to know they're talking to another person. And that's, I think, why people trust Nurses so much and Nurse Coaches so much. It's just, they see us as equals, and they see us as one of them because we are. We're all people, we're all just trying to help each other, in my opinion.

Nicole Vienneau  18:44

We are just trying to help each other. We're just walking each other home.

Nicole Piotrowski  18:49

Exactly. We're just here to hold your hand and help you there.

Nicole Vienneau  18:53

Or healthcare consumers or, you know, maybe patients who are listening to this podcast, would love to know, like, a mock session with you. So what would that look like? If they decided okay, I think I'm going to call up Nicole Piotrowski at Vori Health and I'm going to jump in to what she's doing. So tell us about that.

Nicole Piotrowski  19:14

Yeah, so the way a Nurse Coaching session goes is it's... a first session is just trying to get to know you as a person and learn what's motivating you to make change. So, those are the things that make you get out of bed in the morning. The things that make you want to feel better.

Is it wanting to play on the floor with your grandkids? Is it wanting to start hiking again? Is it simply: I need to be able to walk around without being in pain? Whatever motivation you have -- figuring out what that is, and then we figure out little steps to help get you there.

So, I will talk with people about every aspect of their health. I want to know about the bio-psychosocial aspects. So, I want to know about your relationships and your living situation and your work in addition to your health. Any illnesses you may have, any medications you're on, how you sleep, how you eat, what type of exercise or movement you do. And then your mental health. Are you taking any mental health breaks? We can learn meditation. I teach guided meditations and offer those, as well.

Taking care of people's mental health also means making sure they have healthy relationships and are seeing people outside the home, or talking with friends, taking time for themselves, especially if they're parents. Taking time for themselves and learning how to make the space to do that.

And so, the first session is a lot of just learning about you. Every aspect of you. And then we turn that into making small, meaningful change. I say small amount -- it can be very small. It can be once a day for five minutes; I'm going to walk around the block. It can be I'm going to drink one glass of water, in addition to whatever I was currently drinking. It can be very small.

But those small changes add up, over time, to big changes. It doesn't need to be I'm going to go from my couch to running a 5k next month. It doesn't have to be I'm going to make you eat handfuls of kale, which seems to be a common misconception with health coaching. I'm not going to make you eat kale. It's making changes that are important to you. Basically, you tell me where you want to go, and I help you get there. That's my only job.

Nicole Vienneau  21:19

I'm thinking of the kale... it is a common misconception, isn't it?

Nicole Piotrowski  21:24

It's a common misconception. If you want to eat kale, I'll help you do it, but it's not a requirement.

Nicole Vienneau  21:32

I love it. So, this is very important, though, for people to understand. One of the main differences within healthcare, or our present healthcare system, is that we tend to tell patients what to do. So, for example, you must eat a handful of kale. Where as Nurse Coaches are shifting that completely. So, what are your thoughts on that?

Nicole Piotrowski  21:58

Thank you for bringing that up. That leads into something I actually wanted to talk about. One of my big passions, and one of the things I do on the side, is I train other clinicians in motivational interviewing. So, that's what we're talking about in that we, in the current healthcare system, tell people what to do.

Doctors, providers are used to and trained to -- they tell patients what to do. And when the patient comes back and hasn't done it, they label them non-compliant and don't figure out why it is they didn't do it. And often, it's because the patient never actually agreed to do that. We just told them to and then they left the office. They have to have additional... they have to have buy-in, they have to want to change. And they have to have it be a change that they're physically able to do and mentally willing to do.

And so, I work around Chicago and, hopefully, at one point, larger than that, teaching providers motivational interviewing. And so, I've worked with Northwestern Medicine, teaching their residents. I've worked with AmeriCorps volunteers, training them to be miniature health coaches and learn motivational interviewing techniques to elicit that change, whether you're helping people quit smoking, or helping them lose weight, or just working with teenagers on their mental health.

Anything can be helped by teaching clinicians how to speak to patients in a way that empowers the patient, and lets the patient choose what they're willing to change, and kind of, like I said, give them that buy-in. So, it's more of an equal relationship and not being told what to do and then being told you're doing something wrong when you don't do it.

For me, I do not tell people what to do. And if I even want to give advice, I ask permission before I do. And so, it's really about -- and all of Nurse Coaching -- is really about the patient first. We're your quarterback and there to guide you along the way and hold your hand, but you choose where that direction is, and you choose what you're willing and not willing to do to get there.

Nicole Vienneau  23:47

Right. So, we are giving the power back to our patients.

Nicole Piotrowski  23:52

Absolutely. I love that. Very good way to put it.

Nicole Vienneau  23:54

And then that shifts their perception of healthcare to a much different approach, yes, but it also gives them the ownership of making those shifts. I loved how you said that at the beginning. You're putting healthcare back into the hands of the people who can actually make the difference. It's no longer the healthcare provider directing the ship. Now we have all the patients directing their own ships and what direction they want to go in.

Nicole Piotrowski  24:23

Exactly. They need to direct their own ships. Imagine if when you went to the doctor's office, instead of every time you went in, them telling you you need to lose weight, you need to lose weight, you need to lose weight -- and in your head, you're thinking, yes, I know that, I am well aware, please stop just telling me that -- and instead, they asked you, "What do you feel like you need to do to be healthier? What do you think is stopping you from losing weight?"

And everyone has an answer to that question. Everybody knows what it is they need to do. It's just a lot harder to actually do it, to make the time, to be motivated, for someone to keep you accountable. And that's why if we had a Nurse Coach in every office In America, we'd all just get way healthier, wouldn't we?

Nicole Vienneau  25:04

We would. In fact, I think we should start having Nurse Coaches at the grocery stores, at the CVS, at the local store...

Nicole Piotrowski  25:14

That would be wonderful.

Nicole Vienneau  25:16

Right? You could check in with your Nurse Coach and you just make it part of your life.

Nicole Piotrowski  25:21

Absolutely. And that's why I like working in telemedicine too, because I'm just, I'm right in people's phone now, it's an app in your phone. And to be able to have that at the tip of your fingertips, to be able to chat with your coach, have a video session, weekly even, and be able to have that constant accountability and someone to talk to really makes lifestyle change so much easier, and so much more sustainable, to be able to have that accountability partner.

Nicole Vienneau  25:47

Absolutely, yeah. Someone to check in with and be your cheerleader. And yeah, and for those hard times when you just need to talk to someone. We cannot discredit the open willingness and presence of an Integrative Nurse Coach.

Nicole Piotrowski  26:06

Absolutely. Sometimes you just need someone to listen.

Nicole Vienneau  26:08

Yes, we do.

Well, Nicole, this has been an incredible discussion. I've loved hearing all of your perspectives on Nurse Coaching. I know our listeners are going to be jazzed to hear your story. And I bet you they will also be interested in how they can find you. So how can we find you, Nicole?

Nicole Piotrowski  26:27

You can find my business at nicolepiotrowskicoaching.com for group programs, motivational training, and mindfulness trainings. And for one-on-one coaching you can find me at Vori Health, either vorihealth.com, or through our app also called Vori Health.

Nicole Vienneau  26:46

Alright, and we will include all of these links in our show notes so people can find you easily. And I just want to express my gratitude for you coming on to our Integrative Nurse Coaches in ACTION! because you are making action happen in your community.

Nicole Piotrowski  27:04

Thank you for having me, Nicole. It's been a pleasure.