Vital Views

Joe Gaccione 0:01
Welcome to Vital Views, podcast for UNLV School of Nursing. I'm Joe Gaccione, communications director for the School of Nursing. We are excited to have Justin LeMay in the booth with us. Justin is currently a UNLV Nursing graduate student on the nurse educator track. He previously earned his bachelor's in nursing from UNLV back in 2019. He currently works in the cardiovascular intensive care unit at University Medical Center of Southern Nevada. As if grad school and full-time work wasn't enough, he's also in the National Guard. Justin, thanks for coming by.

Justin LeMay 0:30
Thank you for having me, Joe. And I just wanna take a second to highlight you and I appreciate you and what you're doing. I appreciate you trying to bring a voice to nursing and nursing culture.

Joe Gaccione 0:38
Thanks Justin, I appreciate it. Let's talk about your role at UMC. What does a cardiovascular ICU nurse do?

Justin LeMay 0:44
Oh man, I can't even summarize that. So, cardiovascular ICU nurses, we really see a whole lot. As much as I'd like to say I'm specialized in just cardiac medicine, it's a general icu, so I see septic patients, respiratory failure patients, I see kidney transplant patients, I see patients with chronic heart failure exacerbations. But then again, as a cardiac, cardiovascular icu, I see my regular cardiac surgery patients, so we have CABGs, valve replacements, whether open surgery or endovascular. And so, we care for them, you know, we provide a whole, a whole lot of nursing care and that can be as simple as, you know, oral care, can be as complex as intubations and, you know, open heart surgeries at the bedside. So, I guess you could say as a cardiac ICU nurse we do a lot of general nursing care, but there's also a lot of anticipation and intervention on our part, you know. We have to watch out for a load of complications, especially when it comes to our heart surgeries, because these patients can go from zero to a hundred really quick, and so you always have to be on the lookout for those kinds of things. Oftentimes, you know, we find that we are having to be quick and adept when it comes to our interventions. We have to have a lot of know-how when it comes to our interventions, and we have to know how to quickly relay information and vital information to the physicians so that we can respond at adequate time.

Joe Gaccione 2:05
And that's your primary role at UMC, but you also, you're also a charge nurse and you're also a preceptor there as well, correct?

Justin LeMay 2:11
Yep. And on top of that, I also do education. I teach the new grad to ICU program. I teach hemodynamics and pulmonology for them.

Joe Gaccione 2:19
Well, I can't even spell that. Preceptors, big role in nursing. You are teaching the grad, the younger nursing students that are coming in. You're a relatively new nurse, relatively young nurse, graduated only a few years ago. What's that dynamic like considering you were just there a couple years ago and now you're on the flip side teaching the new nurses?

Justin LeMay 2:41
Honestly, it, the dynamic is expected, you know. I, I have a very, you know, according to other people, this isn't me flaunting, you know, anything that I have, but I have an in-depth understanding of a lot when it comes to, you know, cardiac medicine and when it comes to ICU care. And so it's, I already assumed the role pretty early on, you know, of, of preceptor, of educator, you know, because I have that knowledge and I easily and willingly, you know, give it to others whenever it's necessary. So, it was already expected of me to become a preceptor, to become an educator, and I willingly and gladly accepted that role.

Joe Gaccione 3:16
The cardiovascular side, was that an interest you had during nursing school or was that something that grew on you starting in this role?

Justin LeMay 3:22
Oh, cardiac has always been interesting to me. Cardiac and, and nephrology has always been interesting to me. I appreciate the interrelationship between the kidneys and the heart. I appreciate the heart for what it is, the, the huge beating muscle that it is, and I think that it governs everything that we do outside of our brain. And yeah, I just think there's a lot of interesting dynamics between the body and the heart, and I appreciate it.

Joe Gaccione 3:45
That preceptor role goes right into your focus right now in graduate school, the nurse educator track. First, what's it like balancing grad school with working full-time?

Justin LeMay 3:56
It can be tough. There are a lot of times when I'm, you know, caught up with assignments and work. I'm trying to make sure that I have everything planned out accordingly, because not only do I have those two, but I, of course, I have to maintain my social life and then on top of that I have to keep in account my military dates that I have to work for the military. You know, it's, it's tough, but it's doable. It's doable to anyone as long as they put in the time and the effort and all it takes is adequate planning, adequate consideration, just like anything else you do in your life.

Joe Gaccione 4:26
Do you feel like you have to plan out free time or fun time? Just so you have it in the book, says, “I need to remember to take a break”?

Justin LeMay 4:33
I think that I'm good at taking the time anytime it's available, so that I don't need to plan out time. I take advantage of it whenever it occurs and whenever, whenever it comes up. And then when I can see some fun time or like some free time ahead when I'm looking at my calendar and my schedule, then I'll for sure try to plan something. But otherwise, I, I'm very good at, you know, maintaining my free time and, and utilizing it accordingly in between assignments, in between classes, in between work, so that I don't get overwhelmed and so that I maintain my, you know, mental status and whatnot.

Joe Gaccione 5:05
What do you think are the biggest challenges for young nurses coming out of school?

Justin LeMay 5:09
I think that newer nurses have a harder time adapting because of the lack of knowledge secondary to COVID. I feel like COVID screwed up a lot of our educational processes and the learning process, and so therefore, like newer nurses, I feel like they didn't get the education and knowledge that they would have if COVID wasn't around, you know? And that's, that's because of the change in the way we had to conduct our learning exercises and our learning processes. You know, it's understandable, I'm very patient. I try to, you know, preach patience as much as possible, and it's something that we as older nurses just have to watch out for, like we have to educate them accordingly, educate these new nurses on the proper way to do things. Wherever there's a knowledge gap and that's okay, it's anticipated. There's always gonna be knowledge gaps, there's just a slightly larger one now and that's understandable and we'll work with it as always.

Joe Gaccione 5:53
I was gonna bring that up. You graduated in 2019, so you get maybe six months to a year of quote unquote, “normal nursing,” and then the pandemic hits. Talk about that shift when you realize that, “We're gonna have to radically change what we do.”

Justin LeMay 6:08
So I actually love questions regarding this because it gives me a chance to encourage people to develop healthy coping mechanisms, but these questions also make me feel a little self-absorbed because being a new nurse, I felt that I had adequate knowledge depth and, you know, an understanding of what was going on around me to where I didn't feel overwhelmed when, you know, there was something new going on or an intervention that I hadn't experienced before because I have a general understanding of what's going on otherwise. Now, people may not always have that. People don't have that depth of knowledge. People might not have those coping mechanisms to help deal with the additional stress from COVID. So generally speaking, I don't think that there was too much change when it came to COVID and non-COVID times. The hard part was dealing with the additional stressors of COVID patients, dealing with additional stressors on the healthcare system, not having the staff to compensate for those stressors, You know, the additional amount of patients coming into the ED with COVID that we normally wouldn't have. Like that obviously adds stress to the healthcare system, we have to find nurses to accommodate for those patients, and so there's not much of a shift in terms of role, there's a shift in terms of expectation for how much work you have to put in. So, you know, we're all, like, for example, UMC had to enforce mandatory overtime throughout, in the Valley, and that's, it's well, it's known and understood and it's something that we had to deal with and it's okay. We went through it and we moved on. But at that time, of course it was exhausting. It's, you're working more than you're accustomed to or than you want to. And so that takes a toll on some people and that would be the only shift that there is if you're not accustomed to that. But there's plenty of people that overcame that, there's plenty of people that came through and, you know, did overtime when it was necessary and it was much appreciated.

Joe Gaccione 7:50
You could look at it and say that as a nurse, you did grow stronger. Maybe not the way that you would've liked, but you, you know, you learned more coping skills and now you have pandemic-related experience, God forbid you have another, we have another time like that.

Justin Lemay 8:07
For sure. Yeah, no, I think it gave the US a little bit of insight into how to handle the next pandemic, whether it be in terms of, especially in terms of logistics, but, you know, if, if we need to, we understand how to better adequately staff things in a better, or how to better adequately adapting our healthcare system to handle something like that, hopefully.

Joe Gaccione 8:24
What motivates you as a nurse educator?

Justin LeMay 8:26
So when I first got into the nursing workforce and I started working bedside, you know, you come into contact with a lot of experiences, just with patients, with fellow nurses, with nursing students, and you start to notice these deficiencies from your own perspective, like what I want. I want people to come in and feel confident, be empathetic, have a very in-depth understanding of what's going on in the ICU and have a very in-depth understanding of ICU knowledge. And so, when you don't see that and it doesn't meet your expectation, you want to change that and that's always something I've been about, is being the change that you wish to see. And so the best way I can implement that is by educating and teaching. And so, you know, whether it's orienting our new grads or new nurses to the unit or precepting, you know, I precept, like you said, some of these nursing students coming in and I can give them the insight on how I suggest and prefer them to behave, you know, when it comes to values, when it comes to treating patients with empathy, when it comes to, you know, having a very good understanding of you know, pathophysiologies and medications and stuff. And so nursing education gives me those opportunities, and that's why I wanted to pursue that.

Joe Gaccione 9:35
With your teaching style, do you have one fixed method regardless of the student or do you try to be flexible depending on that student's skillsets or needs?

Justin LeMay 9:43
Flexibility is key, but I have expectations and I have a standard, and my standard is I am no better than you, you can always be smarter than me, and I will always treat you as a peer and as an equal, but I will still be the educator. I will still, I will do what I need to do to give you whatever insight I have, but I am never superior to you, you can always ask questions. It's about a very welcoming, approachable environment, and I'm very passionate about that. Now when it comes to expectations, I have expectations that you will, you know, do your best to further your education. You'll, you'll do your best, you know, to be present and to be inquisitive, because that's how you learn and that's how you gain the experience that you need to be a good nurse. And so I make sure that my students are aware of my expectations, of course, at all times, and I never set any expectation that's unfair or unattainable. So those are, that's how I, I, but I remain flexible in that not everyone learns the same, and I understand that, that's why when I've tried to expose students in new grads to new things, it's through different avenues, whether in person, you know, seeing a patient and a new experience, or whether it be having them watch videos on certain content related to nursing.

Joe Gaccione 10:51
We've talked about being open to knowledge. We've talked about time management. What would you say is your biggest piece of advice for young nurses, nurses that are about to get out of school and become a registered nurse?

Justin LeMay 11:02
I think my biggest piece of advice to incoming nurses would to be flexible and resilient as best as you can, because nothing is going to pan out the way you want it to, there is nothing that is ideal in this world, and there are always gonna be things that change consistently, i.e. a pandemic just popping up in the middle of nowhere. So it's, it's important that you be flexible in that you can adapt to any situation and it's important that you be resilient in that if something comes along that you're unfamiliar with, you know, you learn from it, you grow from it, you understand that you're not perfect, and that you're not gonna have every single experience under your belt at all times, and you bounce back if it impacted you in a negative fashion. You know, it's important. ensure that you have healthy cope, healthy coping mechanisms to ensure that you are the more, most proficient nurse that you can be, and that you're not being negatively impacted, negatively affected by negative emotions. So those are my, those would, that would be my biggest contribution.

Joe Gaccione 11:56
Justin, you've been fortunate to receive financial help from others as you've come along in your education. Did that play a role in you donating to UNLV Nursing annually?

Justin LeMay 12:05
Oh yeah. So, generous donors helped fund my success and I couldn't thank them enough. They gave me the opportunity to step back from work to excel and get good grades so that I could go on and be, be a successful nurse, and that then allowed me to return the favor by supporting other future nurses. Now, as time progresses and my income grows, like I'll absolutely contribute more because a lot of these students are just like me in that they're first generation low income students, and I think that they deserve every opportunity that donors or anyone in that matter can give them. And you know, I actually listened to your podcast with Elizabeth Gardner, the wonderful person that she is, and I aspire to give as much as the individuals mentioned in that podcast. You know, I think that they're doing wonderful things for the School of Nursing, and I recognized a few of their names actually from some of the scholarships that I've received. You know, so, shout out to all those individuals, your work and contributions are not underappreciated or unnoticed, you know, and I sincerely thank you from the bottom of my heart, and I hope you hear.

Joe Gaccione 13:01
Elizabeth Gardner, for those of you out there who may not know her, she's the student services director for UNLV Nursing and she is a invaluable resource for the school, especially when it comes to scholarships and financial aid information. It's, it's easy to say too, it doesn't matter how much you give, even a little bit’s a lot, but it really does make a difference, you know. No matter the size, even just a few hundred bucks, for some people that's a lot, for some people that may not sound like much, but for a nursing student, that few hundred could make all the difference.

Justin LeMay 13:29
A hundred percent, you know, just a couple hundred bucks to the frugal financially and fiscally responsible individual can stretch for, you know, a very long time. Like especially if it's going towards something, you know, such as something, such so, so minuscule, such as groceries like that, that can be stretched for months, you know? And that gives them the freedom to take that money that they would put towards that and put it towards something else, i.e. schooling or allows them to take a step back from work so that they can ensure their success when they're actually in nursing school. So any, any amount matters, like, it's not even about the quantity. It, it, you don't have to give a large amount. It can be a summation of smaller amounts that, that count just as much.

Joe Gaccione 14:05
When you were a nursing student, what were some of the costs that were associated with nursing school that you weren't aware of or that kind of snuck up on you?

Justin LeMay 14:12
Oh, man. Fees. Fees is one, trying to get immunizations, trying to get TB tested because we all have to in order to ensure student safety. You know, those are some of the costs that sneak up on you. Textbooks, textbooks always are, are, you know, are costly. So those, those are some of the things that you're not really, you don't, you don't really anticipate, but that kind of sneak up on you.

Joe Gaccione 14:35
Does age matter when it comes to donating? Do you have to be a certain age to give back?

Justin LeMay 14:39
I don't think that there's a age in which people need to start considering giving back. I think that it's important to start considering it when you realize you have a surplus of money that you can potentially give. You know, I live a very comfortable life. I don't need to, you know, purchase things outside of my means, and I save enough for retirement, save enough for my future child, so therefore, the rest can be given back to someone who can utilize that money and better their future and have a better opportunity to ensure their success, and I can give them the opportunity that I needed at that time.

Joe Gaccione 15:11
Have you heard back from any students that you've donated towards? Or has it just been more of like a general donation?

Justin LeMay 15:17
Oh yeah. No, I hear back all the time. School of Nursing always writes every time I donate, you know, and it's very appreciated. I always appreciate the letters that they send out from, whether it be from the students or the dean, you know, recognizing my contribution as little as it is relative to the amount that people give, like, it's always, I, I, it makes me feel acknowledged and it makes me feel that I, that I'm appreciated, you know, for the amount I give.

Joe Gaccione 15:39
Do you feel like as a grad student there are still costs associated with grad school that maybe might, might be different from undergrad?

Justin LeMay 15:47
Yeah, there's some costs. Fortunately, I got some, I have some assistance from the military, but there are still things that that cost, you know, my TB test wasn't covered by my insurance, so that, that didn't help, and there are certain things that popped up here and there for my graduate program, and that's okay. It's anticipated, it's school, it's gonna cost some, and so I, I've already expected and anticipated that.

Joe Gaccione 16:07
You're also in the National Guard. Talk about your role in the National Guard. What exactly do you do?

Justin LeMay 16:11
So currently my role in the National Guard is that of a supervisor. So, when we go to our drill, which is a couple days outta the month, and then two weeks in the summer, I will be managing and supervising lower enlisted soldiers, which are soldiers beneath me at a lower rank. They're going to be working on, you know, maintenance procedures on vehicles and I'm going to be kind of there as a resource and an overseer whenever I need to adjust and shift focus because either we're not meeting a time or we've already finished and we need to move on to the next thing to maintain our time or, you know, if, if something pops up and we have some kind of, you know, lecture that we need to attend or some kind of presentation that we need to attend, I, you know, ensure that our soldiers are aware of that and that we actually shift focus from working to go, to attending that and then shifting back into, into work afterwards. And so there's a lot of that, there's a lot of ensuring soldier like health and wellness in our off time, you know, because it's not just those couple days and we're done talking, you know, I, I never talk to you or see you again, you know, for the next month. I reach out and I have to ensure that they're taking care of themselves on the outside as well, in the civilian life, make sure they have jobs, adequate income, you know, to support their needs. If not, find them the resources, you know, that they need and also try to push education. You know, the National Guard gives us very good benefits when it comes to our in-state tuition, and so it's, I try to encourage them and influence them to look into that and give them the resources they need to try and enroll and better, and get the education they need and hopefully better their future.

Joe Gaccione 17:40
These leadership qualities you have in nursing and military, do they bleed together? Are they interchangeable? Like the things you learn in nursing, can you apply some of that to military life and vice versa? As far as the people that you care for, so to speak, the people that you're, that you're teaching, those skills go back and forth?

Justin LeMay 17:59
Well, for sure the approach is, is, they, they complement one another. You know, it's, the dynamics are different of course, in the different fields. However, like teaching individuals is the same and it's universal no matter where you go. You should always encourage a very open, welcoming environment, you should never humiliate because humiliation never taught anyone anything. You should always ensure that you’re guiding them to the right path and not always giving them the answers so that they're actually learning and you're not doing everything for them. And so, I think, again, I do, I do it whether in the nursing field or whether in the, whether doing my, or working on vehicles with my soldiers.

Joe Gaccione 18:38
That dynamic you talked about before, where you're not just dealing with them in a job-related role, but outside of work in the civilian life, you're trying to keep tabs on them, making sure they're, they're okay. What's that relationship like? I mean, do you check in daily, weekly, I mean, what's, what's that like?

Justin LeMay 18:57
So we check in weekly and the check-in weekly is just pretty much them stating, “I'm good, like, I'm okay, like I don't need anything,” but oftentimes, like, I'll find myself just calling them. I just wanna make sure that they're actually okay and that they don't, they're not just checking in and saying that they're good because they have to, you know? I wanna, I want to actually ensure that they feel well, that they're taking care of themselves, that they don't need anything from me if, if, you know, and if they do, “What can I do, you know, to, to help you out?” And I always try to ensure that they understand that I'm here for them. I'm not just a, a, again, it's not just a two a day, three or two, two days a month, three days a month kind of deal. Like, I'm here to help you if you need it. I have a, a wealth of resources, I know plenty of people, I know, you know, I, I have plenty of different avenues that I can guide you down if you need something. I just need to know that you need it. So oftentimes it'll be like maybe once a week on top of their check-in. I will also follow up and ask them, you know, if they're truly okay and it'll be more than just a text, like I'll actually call them up and see if they need anything because I feel like oftentimes people will just text to text and they won't actually express how they feel as, as much as they're forced to if they're actually on the phone.

Joe Gaccione 20:04
Have you had situations where you did reach out and initially they say, “I'm good, Justin,” but then you follow up and you realize that they're, maybe there's more than they're letting on?

Justin LeMay 20:16
Unfortunately, I feel like people in the military, they try their best not to ask for help. They try their best to be independent. They don't want to feel like a burden. And you know, all we can do is one, outside we, we of course reach out, but secondly, like we try to ensure that they understand that they're never a burden, that they can always come to us at all times. And you know, there have been times where, you know, people will say that they're not doing okay or that they're doing okay when they're really not, but oftentimes, given the environment that I create, like people will just come to me when they're not having a good time. One of my, one of my soldiers calls me whenever he's having a tough time because he’s been through stuff and I always ensure that he understands that that's always okay. “Call me whenever. If I don't get to you, I will get to you, you know, there's, there's always a reason if I can't answer the phone at the time, but I will get back to you.” And so people, fortunately, come or feel comfortable enough to confide in me and to come to me whenever they need something and I don't have to pull teeth to see whether or not they're doing well.

Joe Gaccione 21:08
And that relationship building, you know, not to keep using analogies, but nursing life and military life, they're similar in that they are team-based. It's, every individual has an important role to play, but at the end of the day, you are part of a unit. And to have that support from your leadership is critical because it makes you perform better. That support, you know, you, you can't say it enough, positive work environments, regardless of the profession, can only make things better, the, the, the, the product better.

Justin LeMay 21:35
A hundred percent. I think that positive work environments are, you know, very fruitful for the, the betterment of everyone. You know, it only uplifts everyone. It only educates everyone. It only helps people feel more comfortable and welcome and accepted. You know, if you keep pushing people out, they're gonna leave and, and this is in regards to the nursing field, more specifically, like you are going to understaff yourself by not being welcoming, by not being accepting, by not being willing, especially in regards to education or, you know, in, in regards to providing assistance to newer nurses. And so, it's really important to, to have that sense of being a good leader in that you will take anyone under your wing, you will always try to provide education where it's necessary. You'll never humiliate, you will never berate people or belittle them and you'll always do your best to uplift them.

Joe Gaccione 22:26
How long have you been in the National Guard?

Justin LeMay 22:28
Six years. And I, I had just signed for two more because I make good decisions.

Joe Gaccione 22:34
What inspired you to join?

Justin LeMay 22:35
It was a bit more selfish on my end. I needed assistance with school and it was something I was willing to do. You know, I knew that Nevada National Guard gave a hundred percent free in-state tuition assistance, and so it was something I was willing to sacrifice in order to ensure my success. You know, it was just an obstacle I had to get through. It's just six years of my life. And, you know, there's, it was mostly, you know, monthly drills and two weeks in the summer. And if worse came to worse, I would get deployed, but after all, like it was a, it was a smaller obstacle for what I was trying to obtain in the bigger picture. And I would, 10 out of 10, do it again.

Joe Gaccione 23:08
Well, Justin, thanks for coming in. That is all the time we have for today. Thanks for listening out there. Hope you have a great day.