OR_SONSIEL_Andrea Jaramillo: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Hiyam Nadel:
Hello, everyone, and happy last Thursday of August. Welcome back to the SONSIEL podcast. Today, I’m so excited for you to meet Andrea. She’s a nurse farmer. So before we get into all of this really interesting and exciting career, I would like Andrea to introduce herself. Welcome!
Andrea Jaramillo:
Hi, Hiyam! Thank you for the introduction, and thank you for having me in the podcast today. My name is Andrea Jaramillo, and I have been a nurse for about five years, and in this process, I have tried many different types of nursing. So my innovation would be how to really find what nursing means to you and design a career that is sustainable for yourself and that makes you happy. I practice clinically as a hospice nurse, I’m also part-time as a research nurse, I do some consultancy. I have been certified as a Forest therapy guide, and I do, I’m a nurse farmer. A part of this is also learning about the traditional medicine from the Andes, where I am from, I am from Ecuador, and all of this has become what I believe nursing is for me, it’s a diversified career that, in a way, makes it more sustainable for myself and keeps me, not only busy, but it keeps me happy and learning about many things I can do with my career.
Hiyam Nadel:
So fascinating, Andrea, I have a lot of questions for you about everything you just said. But first, I always like to ask our guests, what inspired you to work in healthcare? How did you even get involved?
Andrea Jaramillo:
So for me, healthcare has always been something I loved, I loved it, but nursing in particular was not something that was in my radar. In my country, nurses and the nursing career, it’s different. So I thought, you know, I will go into nursing, into medicine. But once I came to the States, I really found what nurses do, and I was, the first job was doing, a clinic, an interpreter in the NIH. I was a volunteer there, and I saw how nurses really were involved with the clinical research process, how they were explaining patients, how to become part of the projects and part, you know, finding new medications and really seeing the future of medicine, seeing how we can care for people in the future was really amazing to me. So I decided then that I wanted to be a nurse.
Hiyam Nadel:
Very interesting, and, you know, I really love what you said about how really going down a journey of discovery and we, connecting what nursing means to you again, rather than, as you know, there’s a lot of burnout and a lot of concern, and instead of leaving the nursing profession and leaving our patients for the reason why we get into nursing. So what does that mean to you coming back and reconnecting to what nursing means to you? Can you just elaborate on that?
Andrea Jaramillo:
Yes, so I started as a labor and delivery nurse seeing patients and I became burned out and I sought to do something outside the bedside, and for a while, I was enjoying that job. But after the pandemic, I decided I was ready to quit nursing, but something in me really wanted to go back to patients, but in a way that it was more sustainable and that made me happy. And that’s when I really took the time to rediscover what nursing means to me and come back to the patients. I was very lucky to be able to take some time off to consider and do intentionally, this redesign of my career. And I found this amazing book called Designing Your Life that actually uses design thinking process to design the, your career path or anything in your life, really. So it was very innovative for me to think outside what can I do with my career that, you know, with my degree that could help people be sustainable and make me happy? And that’s kind of how I went back to seeing patients. So I went from labor and delivery to hospice, which is totally the other end, but it’s still part of the transition. Transitions for me are, for me, what nurses do, you know, accompanying people in their most vulnerable times, in their lives, but also in their transitions. And we have all these tools that we can help support this process. So I thought, I want to do this in a per diem basis so I can have control of my time, but also give when I have a lot to give and rest when I’m able, when I need that. So cyclically, I am observing my cycles of energy and how much I can give and receive. And these really, I feel it makes me very, it makes me a better nurse because I, having the time to connect with my patients in a way that is very intentional has made a whole difference in how I practice. And then going to the farm, it’s a way for me to reconnect with the Earth, reconnect with my ancestors, reconnect with my community. And I think we all should have a way to go back to the cells, either, you know, farming or cooking or exercising or being with family, we just need to find what recharges as nurses.
Hiyam Nadel:
And do you feel that nurses know how to do that just on their own, or do you think did, you get any help to try to rediscover who you are and what your interests were, and what can you tell the audience? So they learn from that, like where do you start to rediscover?
Andrea Jaramillo:
So, I think in nursing school sometimes we are told there is different tools and things, but the practice, I think, nurses need to help nurses. So for example, I have some mentors, Hiyam being one of them thankfully, and you know, just having support from each other is very important because we’re not always going to be in our best. We are humans first and giving each other permission to take that time to rest is very important and supporting each other, and changing the culture of nurses that, we don’t need to take it all, we need to ask for help. We are also caregivers, you know, and the caregiver syndrome, it can happen, you know, we can all get burned off, especially in a system where we’re always producing, we’re always trying to get to the next thing. We need to slow down. I think one of the best recommendations from one, with my current manager, he told me, Andrea, just slow down. You know, I never had that told before, and for me, those words were giving me the permission to be present.
Hiyam Nadel:
Yes, yes, and I love what you said. Nurses need to help nurses because I think, you know, there’s been lots of, you know, articles and things about how we eat our young and things like that, but really, when you say that it’s helping people recognize that we understand what we’re going through, so not what, so why not help our fellow colleague through their rough times? So I really love that. And I know you said you’re working per diem and doing other things. Can you tell us a little bit more about the forest therapy certification? And again, through the pandemic, we learned so much that just being outside, being in the woods, and how much that contributes to our mental wellbeing.
Andrea Jaramillo:
Yes, so the forest therapy came from the pandemic, when I, when we were really inside and I wanted to connect more to my surroundings, and I found an ad that said there’s this forest therapy. And there is an organization called the, I’ll send you the correct name because it’s a little long, but I will send it to you, and they have this course that you go through, through it with a group of people. And this type of therapy or therapeutica thing, is, comes from Japan where the boom of electronics and technology started, and they started seeing that a lot of people were having increased cancer, increased stress, increased depression, anxiety, and they put a lot of resources in researching in nature-based therapies, and what they found is that people who are in nature doing certain types of connections with nature get, their whole health gets better. Their whole, they have done some research on measuring cortisol levels in saliva, for example, and they have seen cortisol levels decrease. They have done blood tests with NK cells and they have seen increase in NK cells which take, gets rid of cancer cells. They have seen decreased levels of anxiety, stress, depression, and most importantly, this connection and this feeling of wellness that people have when are interacting with nature. So bringing people who maybe in the past have not had these interactions or are not used to being in nature and interacting with trees and just touching and feeling and seeing and being in touch with their own senses, it’s definitely something I love, and for me was very helpful and I want to give to other people. So that’s how I got certified, and if ever you want to come with me in a walk, you’re more than welcome.
Hiyam Nadel:
Yes, and at the end, we’ll let the audience know how to reach out to you. So that’s very interesting, I didn’t realize. I know, I heard a lot about mental well-being and being out in nature, but just really some of the blood tests that you just mentioned or saliva tests, that’s pretty impressive, and I don’t doubt that, just very interesting. So I want to pivot a little bit because, Andrea, I heard you speak about the nurse farmer and about the food cycle, and I cannot to this day forget that lecture, and I really want our audience to really hear about that. So first, let us know how you got into being a farmer and then maybe a little bit about how to think about our food. Because, you know, so many times we go through, you know, social determinants of health and we ask our patients about food insecurity or living insecurity, but some of the stuff you brought up that day just really resonated with me because I didn’t ask those questions, so I thought I was doing a good job.
Andrea Jaramillo:
We can always do better. So as part of being nature, I, you know, I have a friend who goes to an urban farm. I live in Boston, so farming in the city is a little different than farming in the outsides. And the, our city has a couple of lots that they have turned into urban farms, so that’s kind of where I started. And I started, you know, when I took some time off, I wanted to go and be with plants and be with Earth, and that’s just what I wanted, my body, my spirit was calling to do. And I started just working the soil, waking up my senses, just touching the different vegetables and seeds and learning the process of growing things, and for me, that was like magic. It was like, I can’t believe this little seed becomes a plant and gives me food and everybody can eat from it and just take care of our community in a very healthy way, everything is organic. And I remembered, because before, you know, I had lived in different cities and one of them was Detroit. I lived there for three years and my nearest grocery store was about 30 minutes away in a car. So for a while, we didn’t have a car and we had to like, really it was hard to go and find food, good food. And, you know, I started reading more about the food deserts and cities have a lot of, you know, not great food. So the options our patients have in grocery, in their local stores sometimes is not the best. So we, when we are telling them, oh, you should eat balanced food, we need to think about what they are really, what their options are, and how can we turn these empty lots into spaces of, you know, of just sharing foods and growing things that are good for our spirits, for our bodies, because what we eat is what we are. You know, it’s the main ingredient of what our bodies are and how they function. So having this opportunity to share these foods with people has been a blessing and really learning how people are making their choices. And when we ask, you know, if you ever have a patient where you can ask them how they gather their food, where their food comes from, it’s very important because that’s part of the social determinants of health. And a lot of hospitals now have access to food pantries. I know a couple of hospitals now have a farm in their spaces, which is great, and they can share with their patients, but mostly it’s being aware of how our patients are eating, you know. It doesn’t have to be that you don’t have food, but the quality of food yourself. There’s also the Fifth Vital Sign that’s called, and that’s, you know, they started doing it for patients, for pediatric patients, and it’s two questions. And the fifth, it’s called the Fifth Vital Sign. And I can share with you the two questions, it’s very simple to implement. That is, you know, about hunger, and it’s important to ask our patients these two questions because then you can identify who needs help. You can measure it. You can see it in a qualitative and quantitative way, what, how can we solve these problems in our communities?
Hiyam Nadel:
Amazing, and tell me, go ahead and tell us those two questions.
Andrea Jaramillo:
Let me look them up.
Hiyam Nadel:
And what’s interesting is I know we have so much to do and we see a patient and rather than going rogue, do you have this, do you have that? But really paying attention and really figure out how to ask the question to get to the right answer, right? So, and that also takes a little bit of experience and confidence and really getting to know your patients.
Andrea Jaramillo:
Yes, yes, and it makes it more holistic. It’s not just about their disease process, but it’s also about prevention, and all of that comes back to how people are living, where they are, how they’re living.
Hiyam Nadel:
And while you’re looking those up for us, you said about innovating in the design thing. When did you first recognize you were an innovator?
Andrea Jaramillo:
Let me see. I think we, we’re all innovators. Every nurse is an innovator. I think we have said that so many times.
Hiyam Nadel:
Yes, I agree with that.
Andrea Jaramillo:
And I’m going to say it again, we’re all innovators. But really, when I learned about the design thinking process and had a meeting with Rebecca Love, you know, I think she inspired every one of us into dive into this space. I was like, oh, I can create something, I can think outside the box, I can, you know, redefine what has been done before, and there is a process to it. So I think being part of SONSIEL especially, and the nurses who are thinking differently and are teaching us and are mentoring us, and organizations that support this type of thinking and the projects that nurses have, have really inspired me to continue looking into what innovation means. And that can mean so many things for different people. It can mean to create a product, it can mean to make a process, a new process. It can mean to recreate your career, you know, and how you see yourself in the world and how you move more intentionally in the world.
Hiyam Nadel:
I love that because I think you’re right. When some people hear innovation right away, they think, you know, technology or medical device, but as you stated, it can be multiple of things. It’s really how you approach to get to that solution, really, is what defines and allows innovation to stand out.
Andrea Jaramillo:
Yes, so I found so how do you screen for food insecurity? Is hunger the vital sign? And you have these two questions and is within the past 12 months, we worry whether our food will run out before we got more money to buy more. And the other question is, within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more. If any of these questions, the responses are either often true or sometimes true, they will be positive for the screener.
Hiyam Nadel:
Got it. See, I don’t ask that and on social determinants of health, it’s not on there, and so we need to change that for sure. And you made me think about something else too, in addition to a really important question is also the financial toxicity. If patients don’t have enough money to buy their drugs or take their medication and things like that, it’s so critical that we also understand that. So, again, asking those questions in a different way, as you’ve stated.
Andrea Jaramillo:
Yeah, and I think there’s so much work to be done. You know, we can do downstream interventions at the very individual level, at the, you know, every time we see a patient, but also we can do upstream interventions where we are working with organizations and policies and even laws in our states and our cities and get involved in the different parts that affect the system. Because I think sometimes we see our practice as seeing one patient, but everything is connected. So even though I have multiple jobs and I do many things, you know, my hospice patient might be eating the food that I am making and might need the therapy from the nature, and maybe I’m consulting with a nurse who is producing a product and there is clinical research on that product. So I think finding ways that as an individual, you can touch multiple spaces, I think makes us more connected and gives us a different perspective of nursing and how we can really approach our careers.
Hiyam Nadel:
Beautifully said, and I know you mentioned I’m your mentor, but I just want you to know, always learning from you as well.
Andrea Jaramillo:
No, I think we all, I, that’s how I see you and there are many nurses that have come through, you know, I have in front of the, and have taken further steps and we’re just behind you and behind all the nurses who are so brave to open those walks for the next generations.
Hiyam Nadel:
That’s exactly right. The next generation, because we need to take care and mentor and bring up our next generation because we’re all here for our patients and for each other, and it’s really important. So, Andrea, you know, what do you, what are you most excited about innovation, nursing, and science? I feel like we’re on a cutting edge of really just exploding in a good way. Would you agree?
Andrea Jaramillo:
I would agree, and the reason why I agree is because in my family, we have a saying: time of crisis is time of opportunity. And right now, the nursing workforce we have heard over and over, it’s, there’s a crisis, we don’t have enough, there’s, you know, there is change happening, and I think that’s the opportunity we have. It’s a window of opportunity where we can recreate. We have a lot of leverage right now to recreate what nursing means to really make it something that is sustainable and to better the care that we provide for our patients.
Hiyam Nadel:
I agree, I agree, and everyone wants to talk about the nurse burnout and even our own physicians, etc. and I always say, don’t come up with all these solutions because you haven’t asked us. And I think that’s one big critical piece that’s missing is, tell us what do you see as the problems, and also tell us what you see as solutions.
Andrea Jaramillo:
And also, we, like we say in innovation, don’t fall in love with the solution, fall in love with the problem.
Hiyam Nadel:
That’s right. That’s so right, and I agree. This is the time, and I hope the attention will be given to the entire clinical field. So wrapping up Andrea, what would you like to leave, what is the one thing you would like to leave our audience with today?
Andrea Jaramillo:
First, I would love first to thank you, but to tell nurses out there that you have control over your career, that you can make the career you really imagine, and maybe you’re not even opening that space to imagine what’s possible. So take the time and move in this world with intention, and I think we are going to see great results in the future.
Hiyam Nadel:
I believe as well. If people wanted to reach out to you and talk to you more about anything we discussed today on the podcast, are you on LinkedIn, or is there a better way?
Andrea Jaramillo:
Yes, please. You can find me on LinkedIn, I’m happy, I’m on Twitter. If you want to schedule, I’m always happy to grab coffee if you are in Boston, but I’m always happy to help people and, you know, bounce ideas and just tell you more about my story and whatever you need. We’re nurses helping nurses. Thank you.
Hiyam Nadel:
Thank you so much, Andrea.
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