No one really has it all figured out. Some people might look like they do — and they might even believe it — but healthcare is an ever-evolving industry. A better approach is to remain curious; that growth mindset serves us so much better.
Today, more than ever, wellness is at the forefront of societal discussions. From mental health to physical well-being, women are making significant strides in bringing about change, introducing innovative solutions, and setting new standards. Despite facing unique challenges, they break barriers, inspire communities, and are reshaping the very definition of health and wellness. In this series called women in wellness we are talking to women doctors, nurses, nutritionists, therapists, fitness trainers, researchers, health experts, coaches, and other wellness professionals to share their stories and insights. As a part of this series, we had the pleasure of interviewing Jessica Reeves.
Jessica Reeves is a Board certified Nurse Practitioner as interested in the well-being of her fellow clinicians as that of her patients — and she’s on a mission to help Nurse Practitioners to stop charting at night and on weekends. She earned her Master’s degree in nursing at Simmons College and her Master’s degree in public health at Dartmouth College. She writes, works, and lives in the town that holds the world record for most lit jack-o-lanterns (really). Her latest project is a monthly membership for Nurse Practitioners called Chart Club.
Thank you so much for joining us in this interview series! Our readers would love to “get to know you” better. Can you share your “backstory” with us?
Nursing is a second career for me; before this, I spent over 15 years in nonprofit management, with more than 10 of those years in “showbiz” (performing arts presenting and broadcasting). When I got to a point that I couldn’t ignore the pull of healthcare, I made a shift and went back to school. It’s been about 12 years, and where I am now looks way different than I ever imagined. I thought I would become a nurse, work my shifts for the week, and maybe volunteer on the side. That has not been my experience at all! I’ve definitely spent plenty of time in clinical practice, but I’ve also written a book (on time management for clinicians), worked as an Investigator for my Board of Nursing, coached fellow clinicians, and am currently completing an Op-Med Fellowship at Doximity. None of these things were in the plan, but were a product of being open to opportunities.
The constant for me, in both halves of my career, has been people and problem solving. Whether it’s working with performers, patients, or fellow clinicians, I find myself using the same core skills of strategy, relationship building, and communication (not to mention time management). I’ve actually been surprised at how well the skills that I sharpened in the first half of my career have followed me, and blossomed even further, in the second half of my career.
Can you share the most interesting story that happened to you since you started your career? What were the main lessons or takeaways from that story?
Nurses seem to love stories with a gross out factor — I want to put that disclaimer right at the beginning!
A colleague had a patient, the last one of the morning, who had come into primary care with “worms in her fingers.” The patient claimed that they hid, so you couldn’t see them, but she knew how to get them out so that we could see them. The trick: a bar of chocolate.
My colleague came out of the exam room looking for a second set of eyes and hands for this case. She wanted to get one of the worms in a specimen cup so that she could send it to pathology for identification, but she couldn’t coordinate it all on her own. I went in to help.
“You’ve got something that seems to come out of your fingertip if you wave a piece of chocolate in front of it?” I asked the patient. She agreed, enthusiastically, and produced a partially eaten chocolate bar from one of her bags.
I had a magnifying lens and a pair of forceps; my colleague had the specimen cup. I got up close, and the patient waved the bar of chocolate, and . . . out came a small, white, worm-like wiggling thing from her fingertip, maybe 5MM in length. I got a hold of it with the forceps and expected to pull it out smoothly, but no. That little guy HELD ON. My colleague held the patient’s hand steady, and I applied as much traction as I could without breaking the little guy, and after a few attempts, we managed to get it out, in the cup, with the lid replaced.
The patient was eventually seen in dermatology at the nearby academic medical center. The diagnosis? I don’t remember the name of the organism, but it was something that came off the patient’s dog and found its way into the patient’s cracked, dry fingertips. And apparently, it liked chocolate.
For me, the main lesson was to keep an open mind and follow the evidence. This patient had already been seen by our local dermatology and emergency departments, both of whom decided there was nothing there and that, essentially, she was imagining things. I can understand that the story sounds unlikely, and when you are busy it’s hard to find the time to ask for another set of hands and to coax something out with a chocolate bar. If this patient hadn’t had the last appointment of the morning in our office, this visit might have gone the same way. But as it worked out, we were able to approach this with curiosity and an open mind, and we got the payoff of capturing a sample and eventually getting the patient a diagnosis and plan to treat.
It has been said that our mistakes can be our greatest teachers. Can you share a story about a mistake you made when you were first starting? Can you tell us what lesson you learned from that?
One of my most compelling mistakes, and one that I learned a lot from, was literally at the beginning of my Nurse Practitioner career. I decided to take a job out of state, about two hours away. I got an apartment thinking that I would commute down on Sunday nights, work during the week, and drive two hours home on Thursday nights after work.
But as it turned out, during my training period, I ended up going to clinics all over the state — the regular commute was 30–45 minutes one way, but at times as much as one hour. This is in addition to having already commuted down for the week. And did I mention that I was also working on a Masters in Public Health? And I was a brand-new NP?
It was a horrible fit, but I did learn a lot from this misstep. If I needed any further clarification on what works for me and what doesn’t work for me in a professional setting, this gave it to me in buckets. I also learned so much about time management; at this position, appointments were every ten minutes, no matter how complex the reason for the visit. And then I had to juggle my work life and my academic life and my life life. It was a lot, and although it was draining, that learning was high yield.
Let’s jump to our main focus. When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?
I stumbled across Atul Gawande’s “Doctor Hotspot” Nightline episode shortly before starting Nurse Practitioner school. I was so intrigued by both Dr. Gawande and Dr. Jeffrey Brenner (featured in the episode); I went directly to the internet to learn more about both. I was so inspired by Gawande’s combination of experiences as a physician and public health practitioner that I went on to get my second Master’s in public health immediately after finishing my Master’s in nursing (literally — one ended on Friday, and the other started the following Monday).
I knew, ever since watching that program and following Gawande’s career, that I wanted to combine the “micro” of working one on one with patients with the “macro” of doing work that would benefit populations. After working for a few years in clinical practice as a Nurse Practitioner, it became so clear that little to nothing was being done to take care of clinicians. We work so hard, and sacrifice so much, to get to the point of being able to serve patients — only to nearly immediately risk burnout. And no one really talks about it!
I realized that sharing the methods that I used to be efficient with my clinical practice and time management actually fell under the umbrella of public health — the population being clinicians, rather than patients with a certain diagnosis, for example. If we don’t, as an industry, address the upstream factors of clinician burnout (and administrative burden is a leading factor), we are in trouble. We’re already experiencing the ramifications of a large segment of the healthcare workforce aging out and retiring, and another large wave of people leaving the profession because of burnout. Application rates to nursing schools and med schools are decreasing. If concrete action isn’t taken to address the causes of burnout, to take care of the carers, that’s not only bad for the clinicians, it’s bad for patients and it’s bad for the bottom line. Everyone suffers.
Solutions coming from the top down have been in short supply, and the problem persists. My approach is to address the issue from the grassroots level — to equip the clinicians with tools that they can use immediately to improve their efficiency, to empower them to identify other areas of waste in their work life, and to use their voice (and the time that was previously spent on excessive administrative burden) to advocate for themselves and their colleagues.
We waited for the problem to fix itself, and it got exponentially worse. It’s time for us to make the changes we need to treat (or, ideally, prevent) our burnout.
Can you share your top five “lifestyle tweaks” that you believe will help support people’s journey towards better wellbeing?
1 . Boundaries — this is relevant for everyone, clinicians and non-clinicians. You need to know where you stand on the things that impact you the most. This can be things that impact you on a day-to-day level (like my bad-fit first NP job), but also big picture things like whether you are philosophically aligned with a workplace, colleagues, or even friends. As women, many of us weren’t taught to say no without feeling like we need to give an explanation or rationale, but I think this is shifting. When we get more clear on our boundaries, and more comfortable enforcing them, that frees up so much bandwidth to address the things that are truly important to us.
2 . Know yourself / reflect — reflecting back on your experience or performance is essential. Businesses do this all the time to evaluate decisions or justify expenses, and make adjustments as needed. Here’s the spoiler: you can do this, too! You can be your own one-person quality improvement department, and you can choose the things that are up for evaluation. Looking at what is working for you, what is not working for you, and what you’d like to be different is a basic foundation for improvement. You can use this in any aspect of your life — work, relationships, health, you name it. Bringing awareness is the first step, and that can be as simple as regular reflection.
3 . Don’t suffer in silence — no matter what you are experiencing, you are probably not the only one. When you keep it to yourself, it can seem that way. Real change, improvement, happens when we are brave enough to talk to others and realize that not only are we not alone, but that there are enough other people experiencing the same challenge that it makes sense to work together to address it. There is strength in numbers.
4 . Say no — I wish that I could say this will be easy, but your mileage may vary. What’s important with this one, though, is to give some thought to it. If you don’t want to say yes to something but feel pulled toward saying yes anyway, ask yourself why? What purpose would that serve? What would it “cost” you? Are you really willing to pay that cost? And on the flip side, what would it mean to say no? How would it feel? What would be the cost? Do the quick emotional math, and THEN make your decision. But realize that no is always an option.
5 . Find support that works for you — there are so many ways that you can make this happen, but the most important is that you get the support that you need. This is true for patients who want to improve their health and just as true for clinicians who want to improve their work life. Whether it is working with a coach, joining a group, or even reading books that can help to shift your thinking on what you have identified that you would like to improve, the most important thing is to find your peers who want the same thing. Giving and getting support, and accountability, is a game changer.
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
Better advocacy for clinicians. There are so many forms that this can take, but it’s so essential; until we start looking at the upstream factors that are contributing to (or directly causing) burnout for clinicians, and doing something about them, we can’t expect things to improve. If you don’t have clinicians, you don’t have a healthcare system. And if the clinicians that you do have are teetering on burnout, not only is it unethical to let it persist, but it impacts patient care and outcomes, not to mention the bottom line.
I would love to see clinicians advocate for themselves as strongly as they do for their patients. To see clinicians talk, openly, about the things that make our work worlds so difficult to navigate. About how the excessive demands of their work impacts their lives, their wellbeing, their families. Suicide is high in healthcare, but we don’t talk about that, either. We need to shine a light on these dark things that hold us back.
Sometimes we talk about “health care” versus “sick care” when it comes to caring for patients. It’s time that we do the same when it comes to our workplaces. And I think that all starts by talking about it, sharing our stories, and pushing back against the unreasonable demands that so many of us experience in our work.
What are your “5 Things I Wish Someone Told Me Before I Started” and why?
- Things don’t just magically click one day. It was really freeing once I realized this; it helped me to reframe where I saw myself in terms of progressing. When we start practicing, I think a lot of us expect to wake up one day and have everything make sense. If only it were that simple! It’s much more gray and much more gradual than that. I think you only recognize this looking backward, not so much in the moment.
- Being a Nurse Practitioner (or any kind of clinician) can easily take over your whole life — if you let it. I started a new job and as I was orienting, the IT people had me grab my phone to install the charting app. As if this was normal! In that moment, I realized it would be way too easy to be too available in my off hours, and that I definitely did not want that. I declined to install the app on my (personal) phone, and I never regretted it. Leave work at work.
- “Expert” is a relative term. No clinician will ever know everything. It’s not possible, and new evidence is always emerging that requires us to learn more or shift our thinking. Roll with it, but don’t expect to reach a saturation point of knowledge; it doesn’t exist.
- No one really has it all figured out. Some people might look like they do — and they might even believe it — but healthcare is an ever-evolving industry. A better approach is to remain curious; that growth mindset serves us so much better.
- Sometimes you don’t see the burnout until you are knee deep in it. I left a job because I thought I saw the burnout on the horizon. What I didn’t realize until much later was that I was actually in the early stages of burnout at that time; it can be hard to see and appreciate it in the moment. About a year later, I looked back and realized that it had already started.
Sustainability, veganism, mental health, and environmental changes are big topics at the moment. Which one of these causes is dearest to you, and why?
I would say a fusion of sustainability and mental health. When I think about the issues that clinicians are experiencing in the workplace on a regular basis, those are both cornerstones. We can’t continue like this; the systems and methods that we use to approach these issues are simply not sustainable. Likewise, it’s eroding our mental health as a profession. That’s a rough combination. How do you simply look the other way? I can’t.
What is the best way for our readers to further follow your work online?
I have a couple of irons in the fire. I have a weekly newsletter, Pizza In The Breakroom (Pulling Back the Privacy Curtain on Healthcare To See What Stinks), which is available on substack. I love getting new subscribers!
I am also an Op-Med Fellow at Doximity; I write there about things that are on my mind regarding the current state of affairs in the healthcare industry. My goal is to not only share my opinions, but to encourage others to think about where they stand on the things I mention.
And people are always welcome to visit me online at jessicareeves.net and see what sort of schemes I keep coming up with. My latest endeavor — which I am really excited about — is Chart Club. It’s a monthly membership for Nurse Practitioners, and it’s focused on things like charting, time management in clinic, and professional development. I also include monthly live workshops on things like how to chart efficiently, there are office hours available for support during the week, a vault of podcasts/worksheets/templates/resources, monthly 1:1 coaching, and the content of my course Chart Magic! Is also included. I think it’s a great way to get a variety of different kinds of support and learning.
Thank you for these fantastic insights! We wish you continued success and good health.
Links:
Pizza In The Breakroom: https://pizzainthebreakroom.substack.com/
Doximity: @ Jessica Reeves, NP
Chart Club: https://tinyurl.com/cwszwy37
About the Interviewer: Wanda Malhotra is a wellness entrepreneur, lifestyle journalist, and the CEO of Crunchy Mama Box, a mission-driven platform promoting conscious living. CMB empowers individuals with educational resources and vetted products to help them make informed choices. Passionate about social causes like environmental preservation and animal welfare, Wanda writes about clean beauty, wellness, nutrition, social impact and sustainability, simplifying wellness with curated resources. Join Wanda and the Crunchy Mama Box community in embracing a healthier, more sustainable lifestyle at CrunchyMamaBox.com .
