Nurse Julia on Diversity in the US Healthcare System

Season 1, Episode 8

Listen to Julia Eze, MSN, RN, NP-C, a board certified Family Nurse Practitioner and entrepreneur, talk about what led her to a career in nursing, her early experiences in the COVID-19 pandemic, and the issue of diversity in the US healthcare system.

Transcript

Eric Sutton [00:00:08] I’m Eric.

Briarley Laban [00:00:09] And I’m Briarley, and you’re listening to Financing Ambition a Laurel Road podcast.

Eric Sutton [00:00:16] In this month’s episode, we’re very fortunate to be speaking with The Nurse Julia, a health care provider, fitness expert, entrepreneur, nursing mentor, and social media influencer. Nurse Julia describes herself as a student of life on a path to purpose.

Eric Sutton [00:00:33] And we’re thrilled to sit down with Julia today to hear about her background and the impact covid has had on her personally and professionally. And we’ll shed some light on the very real issues the country is facing when it comes to diversity in the US health care system.

Briarley Laban [00:00:48] Can you please start by providing a bit on your background and what led you to decide on pursuing a career in nursing?

Nurse Julia Eze [00:00:55] My name is Julia Eze. I’m an Atlanta based family nurse practitioner and I’m extremely passionate about health promotion and disease prevention. Believe it or not, I come from a big family. I have seven siblings and I’m fourth of eight, so I’m right in the middle. And I was constantly caring for a younger sibling in some capacity.

Nurse Julia Eze [00:01:18] But around the time of 16 years old, my mom started helping out people in our church. And it’s so funny because I went on to write a paper in college about how my mom’s mission became my profession. But long story short, there was this quadriplegic lady that I had seen around town and she came to our church one Sunday. And sure enough, my mom’s like, OK, we’re going to be helping her out. And we’re like, oh, gosh, here we go again. Like, is this ever going to end? But can you guys believe I became best friends with this lady? Turns out she’d been hit by an 18 wheeler when she was just 19 years old. And at the time she was in her early 60s and had been confined to bed that entire time. And I just remember thinking, wow, this time I’m 17. I would be so pissed, you know? Like that happening for me and what that would look like to be in her position. But when I tell you guys she was so resilient, this lady would sing and, you know, we’d dance and listen to music. And she was a great comedian. We just had a great time. And we formed a friendship.

Nurse Julia Eze [00:02:31] And, you know, one day just dawned on me that, hey, what she wouldn’t give to be able to do the things that I came in here cringing initially to do, what she wouldn’t give, to do the simple things that we all take for granted. So I thought to myself, “you know what? Then really made me feel fulfilled.” That allowed me to give in a way that I hadn’t given before, but it also allowed me to operate in a space of gratitude. And so I knew at that point I was like, you know what, I’m a nurse. And the rest is history.

Eric Sutton [00:03:04] Wow, wow. That’s a really awesome story.

Nurse Julia Eze [00:03:08] Yeah. Not the journey you guys were probably expecting but I got there nonetheless.

Eric Sutton [00:03:14] But that’s great. That’s great.

Eric Sutton [00:03:17] So Julia, being a nurse, a nurse who calls both Atlanta and New York City home, two cities that have been particularly hard hit by covid-19, but also happened to be two of the biggest hubs for social and racial activism in the conversation happening today, you know, I can imagine it’s it’s probably challenging dealing with the work that you’re doing as a nurse, you know, in conjunction with everything else going on in the world. So we’re wondering, how are you doing with that balancing act?

Nurse Julia Eze [00:03:53] Well, for starters, I’m doing OK. That wasn’t always the case. I think one beautiful thing that has come out of this scenario in the field of nursing and health care, in general, is our own fragility. We’re perceived to be caregivers. And, you know, we hear these very well understood and recognized terms, such as nurse burnout and burnout in the health care industry. And they’re real. But I think covid-19 is really shown a light on the need for better coping mechanisms for resources for health care workers and their own mental health and awareness.

Nurse Julia Eze [00:04:38] And so at the height of me being in New York, I’d been there maybe about 60 days. And I think the first 30 days I was running off of adrenaline, to be honest. We were working a pretty hectic schedule, seven days a week, 12-hour shifts. And I’m someone in the way that I practice, I really like to connect with patients. I really like to hear their story. I want to check on their mental wellness and ask them how they’re doing. And things were so fast-paced that there was not enough to do that at all. It was a numbers game, truly. And because of that, I didn’t feel like I was operating in my full capacity until.

Nurse Julia Eze [00:05:20] And so like I said, about two months into it, that’s around the time when all of the social and racial unrest began. And I remember getting off of the bus coming in from the hospital one evening and we were told that we wouldn’t be able to leave the hotel. Watching the news and seeing that there, my mind really began to run away from me a bit, to be honest. I’m thinking everything. You know, even if I wanted to get out of here, there’s not even a normal flight schedule going on, you know? So I was definitely a fight or flight space. I just didn’t know what was going to happen. And protesters were outside of our hotel windows. I’m just seeing the police.

Nurse Julia Eze [00:06:09] And, you know, when we really talk about that uncertainty and not really knowing what to expect, you know, I think we’ve taken our normalcy for granted. And so much like everyone else I was oftentimes at a loss for words. I found myself being down at times and just really scared of what the future holds or held.

Eric Sutton [00:06:35] Absolutely. I think all of us can feel that pretty deeply these days.

Eric Sutton [00:06:41] So a whole lot to unpack there, really, Julia, right? I mean, there’s just a whole lot going on. And so I think, though, it’s a good segway into the meat of the discussion that we want to have today. Right? Which is about diversity in health care. So as I see it, there’s really there’s no secret that the field of medicine in this country has historically been a homogeneous field that serves an incredibly diverse population, meaning, you know, medical positions were mostly male-, white-dominated, just to be frank. And even when, you know, white females or eventually individuals of color, were gradually allowed to enter that field in prominent positions, it feels like the core of the industry is still very much white-, male-dominated. And so we wanted to talk to you a little bit about where you might have seen fragments of those origins lingering still in today’s health care industry.

Nurse Julia Eze [00:07:51] Well, to be quite honest, I think that we’re still in that space. I know you said the word fragment but, you know, hashtags like “representation matters” exist for a reason because we are very much still in the thick of that phenomenon. And when you talk about the field of nursing, minority nurses only represent about 12 percent of the nursing population. And when you really put that in perspective and think about the fact that nursing is the largest sector of the health care field, there are more nurses than anything. And even in that majority, minority nurses are still just a small percentage. So there is more work to do in that regard.

Briarley Laban [00:08:37] Yeah, and so it seems like the field is still far from a true reflection of what you’re actually seeing with your patient populations as well.

Briarley Laban [00:08:45] So one of, if not the most important reasons for increasing diversity in health care is cultural competence, which is a fancy term for having a wide range of knowledge about the attitudes and behaviors of different people. So, Julia, how important do you think it is to have a culturally competent workforce and providing the best possible care to all patients?

Nurse Julia Eze [00:09:12] I think it’s extremely important. Even when I think about my nursing education, sure, we all heard the word culturally competent, but that was what we learned in school, was so surface. You learned about the Jehovah’s Witness who may be refusing blood or other scenarios that you may be faced with and have to be sensitive to. But the true meat and potatoes of the actual issue, I don’t think is in textbooks enough. This should be a huge part of the training, because lots of times when you walk into a patient’s room, you knowing your stuff is only half of the battle.

Nurse Julia Eze [00:09:56] I think patients, especially in minority, feel there is a huge lack of trust. When you think about historical incidents such as the Tuskegee trials, that left many African-American patients, especially our older generation patients, really in question and fear of actually going to the doctor. And you don’t see anyone who looks like you. Are you going to be inclined to take that medicine? Are you going to be inclined to believe that, you know, what you’re being told isn’t for monetary gain? Or it’s not to boost pharma’s back pocket? So when you think about some of the deep-seated issues behind some of this. And these are concerns that are then passed on. Let’s talk about all the people who can’t go to the doctor because of lack of resources and lack of health care and access to a healthy diet, that then, in turn, make them more susceptible to something such as covid. So there are so many factors at hand.

Eric Sutton [00:11:00] You know, and I think it happens on the flip side, too, right. I think when you don’t have a diverse population of providers, then they’re not really equipped to care for a diverse population either. So it reminds me of a story I saw about a med student who was unable to find guidelines for how certain symptoms appeared on dark skin. And so he had to go out and create one himself, which just blew my mind. I mean, it’s really unfortunate that something like this would have just been created. But I think to your point, we’re still very much not there, right?

Nurse Julia Eze [00:11:42] Yeah, I definitely saw the article. I even saw some exposure floating around on social media surrounding the story, which I thought was phenomenal. Yet at the same time, to your point, very mind-blowing that something like this doesn’t exist at this time. But, you know, really, I think that it really goes to show how much work there is that needs to be done and that can be done.

Briarley Laban [00:12:07] Absolutely. But also, I think that having more diverse representation in health care is also really important to provide wider access to health care services. So, Julia, in your opinion, how does a diverse workforce help to provide underserved populations with improved access to high-quality health care?

Nurse Julia Eze [00:12:32] It can go either way, whether you’re someone who’s on the receiving end of care and you have someone who looks like you so they can recognize the symptoms, whether it be skin tone or it could be the opposite end in that someone who comes from a diverse background may be more understanding of your cultural preferences. And so they may know that you want to pray at a certain time of the day. And you praying is actually going to give you that peace of mind for your healing. So there are so many different ways that it could work. But diversity definitely matters, representation matters.

Nurse Julia Eze [00:13:16] I think people’s willingness to oftentimes, like I said before, come in and actually be seen and not only that, but then for them to come in and be seen and listen. You know, there are so many times where patients, they go in a room and when they’re in there, something goes in one ear and out the other. And there’s even the phenomenon of white coat syndrome where people come to the doctor, and because they’re at the doctor now, their pressure skyrocketed. But if you’re there and you feel more comfortable, you’re more trusting of what you’re being told, because maybe you see the diversity there. You see people that look like you, maybe you’re more receptive of the environment. So feeling received in that space really matters.

Nurse Julia Eze [00:13:59] Even my dad had an experience where he was already hospitalized and his legs started going numb and he was indeed having a mini-stroke. But he told the nurse and she came to the room and said, oh, I’ll come back. And he said he overheard her laughing in the hallway and he continued to have those symptoms with he didn’t call her back anymore because he didn’t feel that he had been heard. So I think for a more well-rounded health care system, a more welcoming health care system, and a more productive health care system, we really have to get this cultural diversity piece under our belt. We have to get we have to diversify the field.

Eric Sutton [00:14:44] Absolutely. I mean, it makes sense that people want to see themselves reflected in their medical providers and that being able to see that instills trust. And I think as a result increases access to quality and trustworthy medical care, which is obviously everyone’s right.

Eric Sutton [00:15:07] So, Julia, do you see any particular medical sectors where you really think we need particularly stronger work to build more access for BIPOCs?

Nurse Julia Eze [00:15:23] I honestly, I think all areas, all areas could stand to improve.

Eric Sutton [00:15:28] Just across the board, right.

Nurse Julia Eze [00:15:30] Across the board. I can really think of one area where I could say, you know what, over in derm, you know, they’re diversified, they’re good, you know, you could stand to sit out on this round of cultural competency. And, you know, I think across the board, really no area really comes to mind. And even, like I said, speaking on behalf of nursing, you know, there’s just a lot of work to do. And that’s what I really appreciate in value about having the opportunity to have a platform on social media because it’s such a huge way to impact others and encourage them to further their education. To give motivation that they, too, can do it. That’s why I actually started my The Nurse Link page, because so many students and fellow nurses reached out and said, oh, wow, like your goals or how did you do this or how do I struggle with this course, how did you overcome it? And at that time I felt that, wow, you know, my story is maybe beneficial to someone, but everyone has a story and everyone can encourage someone, you know? How cool would it be to have an organization of nurses that serve the up and coming and serve as mentors, serve as someone just to bounce ideas off of, or someone just to give an encouraging word to someone on that same journey because you’ve been there and done that?

Eric Sutton [00:17:04] Yeah, I think that’s an excellent example of taking action. Julia, it really is a really impressive example of that. And I think what we’re agreeing on here is that diversifying health care is a long-overdue problem, and the solution seems clear. Diversifying is a requirement if for nothing else, for the sake of patient wellness. And, you know, I was reading another article about the Maryland hospital system and where they’ve developed a five-step plan to address diversity. And their first step is mandatory unconscious bias training for their entire staff. So do you think that’s a good example of the most important action item? Or if you don’t, you know, what would you think maybe we should be the first line of attack, apart from, obviously the work that you’ve already kicked off?

Nurse Julia Eze [00:18:01] So, for me, the mandatory unconscious bias training, while it’s important and necessary, to me, that seems like something that should have obviously been done during your hiring process. You know, people are going to maybe they’re going to do it, maybe because they have to. So I think a more hands-on approach or a more team-building based approach would be better to address that. However, I think in light of covid, the timing, you know, because obviously covid has shed a huge light on these health disparities and some of the ways that certain populations are really suffering from this. So I thought that step number two, actually to identify care disparities would be more important to actually improving those outcomes. I also love the one about the report, race and ethnicity breakdown of the community, because knowing who’s in your immediate community would be a very effective way to say that, you know, within a hundred or two hundred mile radius of this hospital or the health care system, we have X amount of minorities or X amount of this population of people, the chances of them coming in. And they have these comorbidities, whether it be high blood pressure, you know, like encouraging medication adherence, encouraging diet and lifestyle in the communities while this is going on to help keep some of those people who may be more at risk out of coming into the hospital. And doing some focused training to try and prevent that escalation, I think would be more practical. And not that this is something that needs to be done just due to the pandemic, but because the pandemic actually uncovered some of these greater underlying issues.

Eric Sutton [00:19:57] Yeah, that makes sense. And I feel like part of that is then doing the work of matching up the health care provider population in that area to the findings of the sort of local community audit that you’re talking about, right?

Briarley Laban [00:20:14] Yeah. And it’s it is interesting. One of, I guess the more positive outcomes of 2020 with the pandemic and the Black Lives Matter movement is that they are a huge catalyst for this type of change, that we’re just not as far through as we should be.

Nurse Julia Eze [00:20:34] No, I couldn’t agree more.

Briarley Laban [00:20:40] Honestly, I feel like there’s so much we could talk about with you. I really am interested in everything you’re doing right now. I honestly don’t know how you have the time, especially in the midst of the pandemic. You have a really successful Instagram page, you have your blog, you have nurse link that you’re also running. Can you share a bit more about how you’re using your platforms to maybe talk about everything that we’ve been discussing today, including representation in health care and the racial justice movement?

Nurse Julia Eze [00:21:15] First of all, thank you, I really appreciate it. Let me just tell you, it’s not running as fast as maybe it appears but I definitely appreciated it. It can be challenging trying to juggle so many hats. But, yeah, when I was in New York, I definitely felt that it was necessary to kind of share some of the things that I was noticing. You know, we all have platforms. And I think using them to provide awareness and to be catalysts of change and get information out is extremely important. So, you know, like I thought, hey, let’s get together me and some of my Instagram buddies and I thought it would be really cool to have a segment there talking about the importance of cultural diversity in the nursing field. And it just seemed ideal that in our field we’d address some of the things that we’ve seen. So we did host a very successful black nurse experience on The Nurse Link IG Live, which we had a huge attendance and we got tremendous feedback. So many people were in support of it, so many people tuned in from so many different channels to listen and to learn and really just to engage and be supportive. So I’m so grateful that everyone came on board and really rallied around it. I think it was very insightful and impactful.

Eric Sutton [00:22:47] That’s awesome. Julia, I imagine you probably, like most of us, have some source of inspiration on social media. So I’m curious to know, what’s been the most impactful way that you’ve seen any individual on social join the fight, right, and use their social platform for good? Really, in other words, I’m just trying to give our listeners an idea of who else they might be able to take some notes from.

Nurse Julia Eze [00:23:17] So one thing that I saw that happened on social that was really cool was that there was this share-the-mic day where celebrities swapped their pages with other influencers of color. And Danielle Belardo, who’s a cardiologist and I’m a huge fan of hers, in particular, she’s been really amazing. They did a medical one where doctors of color took over other doctors’ pages and engage with their audiences to maybe see a day in the life, answer questions, and address some of the different disparities in health care issues regarding race. So I thought that that was such a huge and creative and impactful way to really use their platforms to reach other people, to provide understanding, and really give an inside look at those experiences. Long story short, there’s lots of really cool people on Instagram. I love Dr. Mike’s page. He’s been doing a lot to actually inform the masses about misinformation surrounding covid. Lots of people in the health care field, like Novice Is the New Nurse, and Ashley The NP, and Aisha CRNA. They’re sharing on their platforms their experience and they’re really being transparent around what it means and feels like to be in the health care profession and to be a minority and some of the experiences that they’ve gone through. So I definitely salute their transparency and their willingness to really put themselves out there that way. Also, Dr Belardo, she shared on her page, created like I think maybe over two hundred black doctors and nurses that you should follow. I mean, she’s just done a huge amount. She really comes to the top of my mind because she’s definitely been an advocate for change. But kudos to them all for sure.

Briarley Laban [00:25:29] And so are there any kind of final messages or anything else that you’d like to share with our listeners before we let you go today?

Nurse Julia Eze [00:25:38] I would just like to say self-care is the best care. I hope you guys are taking care of yourselves, making time to really just sit with yourselves and be. I’m just sending lots of love and light and gratitude and hoping that everyone is really taking care of themselves and staying in a good mental state.

Eric Sutton [00:26:01] Thank you so much, Julia. We really appreciate you joining us on our podcast today. I know you mentioned some of your influences and inspiration, but I know that a lot of our listeners are looking at you as a role model and inspiration and have learned quite a lot from your insights today. So before we let you go, why don’t you let us know where we can keep up with you on social?

Nurse Julia Eze [00:26:28] I can be found on social media on IG @TheNurseJulia, or @TheNurseLink, or thenursejulia.com, or thenurselink.com.

Eric Sutton [00:26:39] Excellent. Thanks so much again.

Briarley Laban [00:26:42] Thank you.

Nurse Julia Eze [00:26:42] Thanks for having me, you guys. This was awesome.

Greg Fullum [00:26:50] Any opinions, findings, and conclusions expressed in this podcast are those of the participants, and do not necessarily reflect the views of Key Bank. In providing this information, Key Bank is not acting as your agent, or is not offering any financial, tax, accounting, or legal advice. Our guest, Nurse Julia Eze, has promoted Laurel Road and received compensation in the past. Laurel Road is a brand of KeyBank, NA, Member FDIC, and Equal Housing Lender. NMLS #399797.