Join Dr. Andrew Tisser (Talk2MeDoc Podcast) with Lily Werenczak as she talks about the significance of communications in the healthcare industry. She explains the problems with team-based communication and how hierarchy within organizations and teams lead to a power gradient that hinders progress. Lily shares her experience in the matter and also touches on burnout that she noticed among her fellow nurses. They also go into detail about her new project aimed to address the gap in communication in the field.
By the end of the episode, you will recognize who your team is, value each member, and be more open to changes. Enjoy!
Lily Werenczak, RN
Lily is a 30-year-old wife and mother of two, thirteen-year-old Maya and two-year-old Lincoln. She has been a registered nurse for ten years. Half of that time, she worked in emergency medicine, and the other half in the inpatient psychiatric setting. Lily is currently the charge nurse of the 24-bed acute care inpatient psychiatric unit, a local community hospital in upstate New York, She’s on the Quality Committee for her organization and has had multiple opportunities to present quality projects and initiatives to the board and administration of the organization.
Lily also began the first unit-based shared governance council for inpatient psychiatry, of which she is the current president. She is a credential trainer of the New York State Office of Mental Health, preventing and managing crisis situations curriculum that focuses on communication and relationships as a basis to both preventing crises as well as de-escalating crisis in the healthcare setting. Her newest project has been a Facebook group called collaborative inpatient psychiatry that is focused on creating a platform that allows providers of care in the inpatient psychiatric setting to communicate and share ideas beyond their own units and organizations in hopes that this will lead to better patient care and outcomes.
- Lily feels mental health is underserved and unrecognized
- She discusses that the hierarchy within organizations and within teams leads to a power gradient that is not favorable to open communication
- Lily states that these issues are both within the team and top down from the administration
- Leadership that refuses to listen to their people due to power struggles stifle the ability of caregivers to advocate for their
- Her opinion is that nurses have been hesitant to be interviewed due to increasing burnout and hopelessness
“Nurses start to feel like: no matter what I do…I’m not seeing a change. Sometimes I feel like nursing school was one big lie”
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All opinions expressed by the guest in this episode are solely the guest’s opinions and do not reflect the opinions of Andrew Tisser DO, Talk2MeDoc LLC, or any affiliates thereof. The guest’s opinions are based upon information he considers reliable, but Andrew Tisser DO, Talk2MeDoc LLC, nor any affiliates thereof warrant its completeness or accuracy. The guest, Andrew Tisser DO, Talk2MeDoc LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest’s statements and opinions are subject to change without notice.
Andrew Tisser 0:04
Lilly Werenczack, welcome to the Talk2MeDoc Podcast!
Lily Werenczak 0:14
Thanks for having me. I appreciate it.
Andrew Tisser 0:17
Absolutely. So happy you can be here. So I recorded a bio that you provided for the listeners, but in your own words, if you could just give us a few sentences about who you are, what you do and what your role is in healthcare.
Lily Werenczak 0:30
Yeah, my name is Lily. I am a registered nurse. I’ve been in this profession for 10 years, about five of those years I’ve spent in emergency medicine and then the other five I’ve spent in inpatient psychiatry. Currently, I am the charge Rn for a local community hospital inpatient psychiatric unit 24 bed patient unit.
Andrew Tisser 0:59
So why do You decide to leave the emergency department.
Lily Werenczak 1:05
So, emergency medicine is a passion of mine, but probably even more. So I really have a passion for the psychiatric aspect of care. I’ve always been sort of a router of the underdog. And that’s kind of kind of how I see psychiatry and the patients that I work with. I feel like it’s an underserved area and an area that’s needs a lot of support from the community and goes unrecognized and underserved a lot of the time so that’s kind of what brought me back to psychiatry.
Andrew Tisser 1:47
Fair enough. I think a lot of people don’t realize how much how closely intertwined emergency medicine and psychiatry really are. You know, you think about like we’re seeing gunshots and heart attacks all time but unfortunately, a lot of our mental health patients don’t have anywhere else to turn.
Lily Werenczak 2:06
Absolutely. We see a lot of mental health within the emergency departments. And no matter what you’re you’re talking about gunshot wounds to coming in with abdominal pain or whatever may be going on in the emergency department. There’s psychiatric factors and psychological factors that go into all those different cases. So no matter why you’re in the emergency department, there’s always going to be a psychiatric, psychological or social component to that as well.
Andrew Tisser 2:42
Absolutely. So the show focuses on a number of different things communication within the team itself. The healthcare worker experience burnout, among other things, as far as your role from being a staff nurse in the emergency department. To now a charge nurse on an inpatient psychiatric unit. How do you feel that communication with your team has changed?
Lily Werenczak 3:11
Do you mean how has it changed from the emergency standpoint now to go into inpatient psychiatric care? Yeah. So in emergency psychiatric care, or I’m sorry, in emergency room care. The communication is very fast paced. You’re working with a team, that’s all right there all the time. And you’re making very quick decisions with your team based on the communication that you have inpatient psychiatric care, although you sometimes do have those components, say in
Lily Werenczak 3:52
instances where you may need to de escalate a patient, you’re going to have that acute stages of communication between nursing staff, psychiatric assistants, psychiatrist, you’re still going to have that. But there’s also a different type of day to day communication about the patient, what’s going on throughout the day with their care how they’re responding to treatment, that nurses need to be able to communicate with providers with each other, between the shifts.And so, in some ways, there can be a lot of similarities, but also, there are quite a few differences as well.
Andrew Tisser 4:42
Do you feel that within healthcare as a whole there are issues within within the team within team based communication?
Lily Werenczak 4:51
Yeah, absolutely. In my experience,I feel like the hierarchy of communication In the hierarchy within organizations and within teams, sometimes can lead to a power gradient that’s not very fair favorable to open communication. And in fact, those hierarchies within the organization and within the team can sometimes stifle or prevent communication from happening in a really meaningful and continuous way. And I think a lot of a lot of those times it causes a barrier, and in the end, creates a problem as far as providing positive patient outcomes. So I do think that is a big issue within communication within organizations and within the team.
Andrew Tisser 5:50
Are you talking about top down as from administration down to the rest of the workers are you talking about within the team itself from like the physician Down to the tech.
Lily Werenczak 6:02
So, I mean, I really think both is something that we need to think about.When you’re talking about from the top down.There’s a lot of communication that needs to take place between me, for example, and my manager and my manager with the middle management and the middle minute management with the CEOs to make our processes especially on inpatient psychiatry work. And I’ll give you an example of where I think communication in these power gradients really has affected our ability as nurses to provide really adequate care for our patients.
And it can relate back to the current Corona virus epidemic. I had been On vacation for about two weeks right when this Coronavirus, started amping up where we were starting to see a lot of panic from our local community hospitals and the people around us. And I was a little anxious coming back to work because I was wondering what would be prepared for my unit what action my unit had taken while I’ve been gone to address what was coming with the Coronavirus in our area. And my manager reassured me when I reached out for the Hey, you know, we got things under control.
I sort of took a deep breath and I said, Okay, and I went back from my vacation and went into work to kind of find that that really wasn’t the case. And that the attitude on my unit and within my organization was that impatient psychiatry wasn’t really going to be affected by the corona virus, and it really wasn’t going to come here. And there’s not a whole lot that we need to do. And I was really taken aback by this because I just think it. It showed a lack of insight and judgment from, you know, some of the management to really think that it couldn’t, it couldn’t affect us in this way.
So I really wanted to take an active approach on my unit to say, Hey, we really need to get ahead of this in the game and we need to be prepared. And if management can do that for us, that’s okay. We can do that. So I took it upon myself to do a little bit of research in regards to the Coronavirus and how it’s affected other places and inpatient psychiatric areas, and how it affected those units elsewhere. And I did find a number of articles that discuss that inpatient psychiatric care and how it was kind of that exact attitude that Coronavirus wasn’t going to come here.
It wasn’t going to affect psych. It was those attitudes that actually caused massive outbreaks in multiple inpatient psychiatric facilities throughout China and other nations. So I had, I had a decent amount of concern. And I took some of these articles. And I brought them to my manager, and to my colleagues, and I said, You know, I think we should all try to read these as a group and see what we can learn from what these other people have already experienced, and see what we can learn and see what we can implement as far as trying to prevent an outbreak on our unit, and my manager looked at me and she said, we’re not doing anything Anything we do comes from the top down.
Lily Werenczak 10:07
I was so taken aback by that to first be just returned with like that type of attitude. It just sort of took my breath away. It’s not really how I like to work. I really pride myself of being part of a team and working towards a team effort. And when you have power gradients like that,I think it becomes very difficult for people to speak up and be an effective part of their team to advocate for their patients. So it’s a big issue and luckily for me, I am not really the person who’s going to step down to a challenge like that.
So I, you know, in that instance, I was able to say, hey, like, no weed To talk about this further, and I was able to get some things implemented that were necessary and have actually probably protected us from an outbreak thus far. But not everybody is just like me and not everybody would be willing to sort of go out there and take that risk towards somebody above them in the hierarchy because there is, you know, retribution. There are things that go on within organizations at times. People don’t always want you to speak up. So, that is a big issue organizationally, when you’re talking about CEO down to the housekeeping staff.
Andrew Tisser 11:49
I yeah, I want to unpack that story a little bit. So I mean, first of all, you did all that work to try and protect yourself and your patients and then your your You’re met with that kind of response, which just completely undervalues you as a person. And not to mention all the work you’ve done. But like you said, a lot of other people would be like, Well, my manager said, that’s what we’re going to do. Whereas you had a lot of valuable information. I mean, I think that’s pretty naive approach to say, it’s not going to happen here. Better to be over prepared than not.
And from at least what I remember, of our interactions, you definitely were not someone to back down from a challenge. So no. Yeah, that I mean, that’s, that’s wild. But I mean, good for you for advocating for yourself. I mean, because it’s not just you and your patients. It’s also all of your staff and the rest of your staffs families in the event of a outbreak. So yeah, that’s a really good example. Thank you for sharing that.
Andrew Tisser 12:53
I have a kind of an interesting question. I don’t know if you’ll know the answer to this, but so I’ve had the show. No for since around January, and I’ve been interviewing all different members of the team. And I’ve had a lot of challenges, recruiting nursing to be on the show. And when I started the show, I thought that nurses would be the first people to want to come on and talk about communication within the team. But that really hasn’t been the case. And I know I’ve run it and I know a lot of nurses over the course of my career, any idea why nurses would be hesitant to come on the show?
Lily Werenczak 13:30
Um, yeah, I mean, I sort of noticed that you were having some trouble with that myself. And I asked myself the same question, actually, why you were having trouble getting nurses because I thought for sure that there would be nurses grabbing out for that opportunity. And, you know, I guess I would say I’ve been seeing, you know, increasing burnout in nurses, nurses start To feel like, you know, no matter what I do,I’m not seeing a big change.
Sometimes I feel like maybe nursing school was just one big lie.Which I don’t mean to say that, you know, nursing is a big lie, but what they teach you in nursing is that there’s this sort of organizational structure of communication and teamwork, and it’s sort of this idealistic place that once you’re in the workforce that you’re not really seeing. And I think over a period of time that sort of begins to wear on nurses, and they sort of become disenchanted with the situations that they find themselves in in their organizations. see a lot of people giving up, to be honest, a lot of the nurses that I work with They seem like they’ve sort of given up trying to fight the good fight.
And it really, it really bums me out. Sometimes I feel like, jeez, this is tough to to keep fighting the good fight and keep talking about, you know, these major issues and keep striving to make it better because sometimes I feel like I’m just banging my head against a wall. And it’s falling on deaf ears. So I think there could be part of the reason you’re not seeing a lot of nurses reach out, at least from my perspective.
Andrew Tisser 15:32
Yeah. Even I had a lot of good relationships with nurses over the course of my career and, and people didn’t want to I don’t know if there is some fear of retribution. I know we’re seeing that across the country for both doctors and nurses and other personnel speaking out against their employer for unsafe conditions. Right now, but I think the burnout issue is a good point. We talked about physician burnout and nurse burnout, and it’s becoming More and more of a serious problem both.
And it’s not just late career people anymore. We’re seeing it within the first five years of being in the workforce. So I think that’s a, that’s a really major issue that we’re that we’re dealing with. So hopefully, we can work on getting some of these issues resolved and improving care for our patients, because that’s all of us really want to do across the entire the entire entire field of medicine is take care of our patients. And unfortunately, the current working conditions don’t always allow for that.
Lily Werenczak 16:32
Yeah, absolutely. I definitely think over time, people start to lose sight of that common purpose. And when you think about just, you know, since the corona virus is obviously what is happening to our world right now, if you think about that, and us being part of our own organizational team, within our department within our organization, but reaching for into our communities and hospital to hospital communication and a hospital, the hospital teamwork, and then outside of our counties and our states in our country.
And then globally, we really are a huge team of healthcare workers. And we really need to, you know, we really feel like we need to remember that our common purpose is to provide good health care to our patients and do no harm.
Andrew Tisser 17:28
Yeah, absolutely. couldn’t have said it better myself. So I hear you have a new project. You’re working on a Facebook group. What’s that about?
Lily Werenczak 17:37
Yeah, so this is a brand new Facebook group that I just created. It’s called MP collaborative inpatient psychiatry. And the reason I made this was because I don’t have a lot of people to bounce ideas off of and I don’t have for example, All this group of people that I can go to and say like, Hey, how are you guys doing this? Or hey, how is this hospital doing this, and I thought people within different hospitals work in very different ways.
It could be a very similar unit, but you have very different processes of doing things. And some may be better than others. And I thought it was really important to be able to share those ideas of different ways that we handle things, including, for example, one of the big things that we do on the inpatient psychiatric unit is to search patient’s belongings. There’s a process to that and I found over time that the process has a lot of holes in it. It has a lot of leaks in it and I want to know, what can I do and what can we do about Our organization to make that better, so that my unit is safer so that my patients are safer.
And I’m I don’t have a way to, you know, bounce ideas off of people. And I thought there really is a huge gap and communication in this field as well as other fields within healthcare, and I thought what’s a better way to then to form a group of like minded individuals in the same health care setting to have a platform to be able to bounce ideas off each other? discuss current events?
For example, I just threw out a question to some of the people in the group like, hey, what is your healthcare facility doing in regards to patients wearing face masks? Is that something that you guys are asking the patients to do? How are you going about it? What type of education Are you doing with the patients? What issues have you found? Are people compliant? So I think it’s a really it’ll be a really good way and a good platform for just information exchange and for people to communicate with one another to improve patient care.
Andrew Tisser 20:18
That’s a great initiative. Is that open to all psychiatry professionals? Is that just nursing there?
Lily Werenczak 20:25
Yeah, no, I definitely would like to keep it open to anybody who’s working within the inpatient psychiatric field. So nursing, psychiatrists, social workers, discharge planners. There’s all sorts of people within our field that I would love to see join in. Anybody really has interest?
Andrew Tisser 20:45
Great. Well, I’ll put a link in the show notes for people to be able to find that group. Well, this point in the show I want to transition a little bit get to know you a little bit better for the guests. What do you like to do for fun?
Lily Werenczak 20:59
Oh, So I have two kids, I have a 13 year old and a two year old. So I’m pretty busy. But in my free free time without my kids, probably one of my very favorite things to do is to go mountain biking. We have a lot of awesome trails around where I live. So I like to do that. I did just start doing some downhill mountain biking last year, which was super cool. So that’s one of the big things and then with my kids, you know, we really like to spend a lot of time outside. And I recently just had to drag my 13 year old daughter out of the house for some physical activities, and she’s sort of hanging home a little too much.
And, you know, I had to beg her to come outside for me. And she complained and complained and complained and I said my promise, I promise you this is gonna be awesome. We just had butter how A couple of years ago, and we haven’t really explored the woods too much. But I happen to find this beautiful Cory at the back of my house with the most beautiful Creek.
I was able to get her there. And within about 15 minutes of being there, it was amazing how much fun she was having and how much she was enjoying herself and to the point where she, she wanted to stay and we were out there for almost three hours and she was just really enjoying being in nature. So that was super awesome. And you know, anything outside is always great for us. That’s kind of where we like to be
Andrew Tisser 22:40
Yeah, I you just transported me there so I could feel how beautiful it was. That’s great. Do you do you have a book recommendation for the listeners?
Lily Werenczak 22:51
Yeah, absolutely. So um, when I was doing my bachelor’s in college, I really tried to focus on a lot of stuff. Sociology and Anthropology. It’s just one of my favorite sections. And a book that I read was called the spirit catches you and you fall down by an Fadiman. And that book is about a family from Laos, a Hmong family. And they have 13 children 12 of who were born in Laos. But then the family had to flee with the rise of communism, and they fled to California, and in California was where the 13th child was born.
And within a very short period of time that child was diagnosed with severe epilepsy. And it talks about and discusses the experiences of this among family in this child named Leah And how it really turned into a tragedy because of not only the cultural differences between the Hmong and Western civilization and Western medicine, but the language barriers as well and it ended up being kind of a tragedy but it really teaches you the importance of communication, especially between cultures.
I just found it to be such an interesting book that can really be applied to, you know, my current situation as a nurse, especially I live in a melting pot area. So I have people that I meet of all different backgrounds, they come from all over the place so I find it super applicable to my work, and I thought it was a super good read and I definitely recommend them.
Andrew Tisser 24:58
Cool off to check that one out. This one’s free. Good. So if you could give physicians and other clinicians just a single piece of advice in the area of communication, what would that be?
Lily Werenczak 25:15
recognize who your team is, and recognize who those players are on your team, from nurses, to technicians, to word clerks, to housekeeping to dietary. I think that something that happens is that we forget that we all do have this common purpose no matter where we are in this hierarchy. And we tend to fall into what should I do? What should I do instead of realizing who our team is and what resources they actually have to offer and really recognizing the value in each team member.
Because I really think that recognizing the value in each person sort of lends itself to a more open communication between the team, especially if those power gradients are just a little less steep.
Andrew Tisser 26:21
That’s fair. Yeah. That’s great advice, and kind of the purpose of this show. So thank you for that. Well, if people want to reach out to or learn some more about you, how can they connect?
Lily Werenczak 26:33
So you could definitely hit me up on Facebook. In the impatient collaborative psychiatry, Facebook group or any questions that you have, you can email to me at [see above]
Andrew Tisser 26:56
Perfect and I’ll put that in the show notes for the listeners. Well, Lilly, thank you again for coming on the show and sharing your insight with us. It’s really been a pleasure to have you. And I hope we can continue to keep the dialogue open.
Lily Werenczak 27:12
Yeah, absolutely. Thanks a lot, and I appreciate what you’re doing too.
Andrew Tisser 27:15
Sure. And good luck with your collaborative. I have a few people I think call refer your way. So. All right, well, take care, be safe out there and keep advocating for your patients.
Lily Werenczak 27:29
Thank you very much. Bye.