#64 They Did NOT Just Say That!

Description

In this episode, Justine and Sarah Lavonne respond to the MOST appalling things that nurses have heard at the bedside. They dive into a candid conversation about language and communication in healthcare, particularly focusing on cervical exams. They share personal experiences, insights, and practical tips for improving patient care and comfort. They discuss the impact of language on patient care and offer alternative phrases and strategies to ensure respectful and compassionate communication. They address issues such as consent, pain management, and terminology used during exams. Join Justine and Sarah for an engaging and thought-provoking discussion that challenges traditional norms and promotes a culture of empathy and respect in healthcare. This episode is a must-listen for labor and delivery nurses seeking to enhance their communication skills and provide exceptional care to their patients.

Justine: Hi, I am Justine.

Sarah: And I’m Sarah Lavonne. And we are so glad you’re here. We believe that your life has the potential to make a deep, meaningful impact on the world around you. You, as a nurse, have the ability to add value to every single person and patient you touch.

Justine: We want to inspire you with resources, education, and stories to support you to live your absolute best life, both in and outside of work.

Sarah: But don’t expect perfection over here. We’re just here to have some conversations about anything, birth, work, and life. Trying to add some happy to your hour as we all grow together.

Justine: By nurses, for Nurses, this is Happy Hour with Bundle Birth Nurses.

So if you’ve been around for a while, you know that the reason this podcast really started was as Sarah and I would just get on the phone, I would share a story, we’d send texts, and we’d just have this whole conversation. And then we’d be like, “We should just record these conversations. These are so helpful for both of us.” And yesterday, I shared a text and it was like, “Yeah, that’s a podcast episode.” So I heard … I don’t know how to share, protect people, but this was something that was said to a patient by a nurse, and based on a vaginal exam. And I’m going to share this phrase to Sarah, and then we’re going to get on with this episode because we want to actually talk a little bit more about what we should not say and some of the most common ones, and then what we can say instead.

Sarah: I think if you’re a patient, this is your warning that this isn’t going to represent probably … And I would say even an accurate representation. But there are moments in healthcare that are not our highest moments, and it does not mean that every nurse is saying stuff like that or thinking stuff like that.

Justine: Proceed with caution.

Sarah: But it does … I think also here at Bundle Birth, I don’t want us to be people who shy away from really addressing the issues. I know you’ve sent me this text and I was like, “Oh, what? Stop. It’s not okay. It’s not okay.”

Justine: And I posted this on stories yesterday. So when this episode comes out, it’ll be weeks after. But I asked you guys for your own cringey things you’ve heard, and actually I feel like 98% of the answers were revolving around a cervical exam. And so I wasn’t really going for that. But that’s what happened. Okay, so on an exam, the family described that the person doing the exam was pretty rough and stated, “If a penis can fit, so can my finger.”

Sarah: Brutal.

Justine: And it’s one of those things people have thought it. I’m not going to lie.

Sarah: Oh, yeah.

Justine: People doing the exam and you’re like, “How?”

Sarah: How did you get pregnant? Yeah, a lot of those. Heard that a lot.

Justine: And the first thought is how we were raised. The second thought is who we’re becoming. So if you’ve had this thought, you’re human, it’s okay, you can have the thought. But then the next thought is, “Okay, how can I reframe this?” I think for every exam and every person, and so I check a lot of cervices at night as this little charge for a bunch of new grads. And I am just meeting these people for one second doing an exam and then leaving. And so I know that my role is like it’s so important that I build that rapport really fast and let them know I am a stranger. We need to take time, whatever, all the things. And we can go over that more scripts later. But the second thought is, “How can I make this better? You’re uncomfortable. What do we need to do?” And it’s just not okay. But the thing too is, Sarah, I was thinking about this episode, the people listening to this podcast aren’t probably the people going to say these things.

Sarah: Yeah.

Justine: So that’s hard because they’re like, “Yeah, duh.”

Sarah: Right. Well, and we hope that we’re all growing in our therapeutic communication and how we approach our patients out of dignity and respect. And it goes back to everything we talk about. Pause at the door, don’t write their story, don’t fix what’s not broken. Giving them the benefit of the doubt. #teamunderwear. All of this is very much encompassed in this statement that is not at all what we’re looking to do as a healthcare profession. And so while sure, aha-ha-ha, courtesy laugh, this isn’t a courtesy laugh. I think you got to remove yourself from the situation at times too and be like, “Wait a second. First of all, it is so disrespectful. It is so disrespectful.” A penis in a vagina in an intimate moment is with somebody that they know and love and that they’ve given consent to and that they have a relationship with likely at some level. That is a different context than you as the power driven provider that’s in a system that doesn’t center patients and doesn’t put patients first.

In the generalizing, obviously there are places where it does. But there is a hierarchy, a clear hierarchy, a clear power play. You do not have that same relationship. And they hopefully are consenting. We better be consenting our patients for it. But they’re saying, “In a non-sexual place, that I am letting you giving you permission to touch me in a very intimate way.” There is no comparison. There is no world in which that statement is ever appropriate. And so this is mom coming down. I feel like a parent right now. I’m like, “You’re hearing mom and boss Sarah call out. Let’s think about this for a second”

And if we are hearing this, I think like you said, this isn’t likely the people listening to this, whether you think it or not, think it or not. But we think these things and we don’t actually break it down. It’s not the same. It is not. There is no world in which it is the same. And so what do you do when you hear a statement like that? And we’ll go through some other statements in a second, I’m sure. But if you’re not the person saying that, but a provider does say that, what do we do?

Justine: I think there’s two scenarios. So there’s one. Let’s do the easier route. And that’s like someone says … And I told her at the nursing station and being able to come to that one if it’s a fellow peer. And being like, “Well, that’s not the same.” Even just saying that’s not the same. And there’s no world that that’s the same in describing any of your guys’ fingers versus my husband’s penis, is very different when in regards to the comfort level of a cervical exam. I would literally just say that. And that might just catch them off guard and be like, “Whoa.” And they might realize it. Yeah.

Sarah: That’s actually … I love that response.

Justine: I went to an OB appointment yesterday and I had to get an exam and a pap smear and all the things, and I was a mess the whole morning. And my husband was like, “What’s the matter?” And I was like, “I realized it was like I have to spread my legs for an OB that I know and I understand what’s happening.” I wasn’t into it and it was weird. And I was like, “I can’t. It’s hard.”

Sarah: I think we’re desensitized because it’s like a vagina is a vagina blur to me. The number of vaginas we’ve seen and the number of cervical exams. And a body’s a body. Like, “Okay, you pooped, I don’t care.” And all these things that we’re so comfortable with that it does. It pulls you back and we become very crass and inappropriate in how we talk about the body, about genitalia, et cetera. And I think while I think …. Live your life. I love me in an inappropriate joke. But not at the expense of a patient and not in this context. This context is very different to me.

And if you’re hearing that at the nurse’s station, I’m tempted to say … I’m the one that is not the likable one. You’re the very likable nurse. So your response is much better than mine, I will be honest. But I would say, “I don’t actually think that’s funny and I don’t think that’s appropriate at all. In fact, I think it’s pretty disrespectful.” I would say that at the patient’s bedside, but talk about put a person in the spot. It’s not going to go over well. But that’s what I want to say. “I don’t think that’s funny. I think that’s inappropriate.” It goes to crucial conversations of state the facts.

Justine: Yeah. I’m just more of a coward. You say, “I’m nice.”

Sarah: That’s not a coward. No, you’re not a coward. I think I don’t always speak up either. I think when we talk about these things, I feel like I have very pointed direct things to say. But that doesn’t mean I’m actually saying them. And you think about me as a doula. I’m a nobody in the room. And for me to speak up? Ooh, I am navigating a whole lot of drama by opening my mouth ever at the bedside. And so do I [inaudible 00:08:26]?

Justine: Let’s go to the bedside because that’s a much harder conversation. That’s much harder and in the moment and in front of the patient. And I don’t know what I would say. I don’t know.

Sarah: I feel like your response is still, “That’s not the same.” Or the comment was if a penis can fit, so can my fingers. Almost like joking back, “Your fingers are very different than …”

Justine: “Yeah, I’m sure your fingers are very different than her husband’s.” I don’t even know. That’s hard.

Sarah: I don’t want to talk about his penis.

Justine: [inaudible 00:08:57] in there.

Sarah: Yeah, no penis talk. “I’m uncomfortable.” I think then that circumstance. Or, “These are very different circumstances, doctor.” Like, “No, ha-ha.” Because again, it’s like would I love to be able to be like, “That’s really disrespectful”? Yeah, I do. I would love for people to have those conversations and say, “Doctor, I know you mean well, and I know that that was something that you say. But I just would encourage … But it is inappropriate.”

Justine: And that could be … You could do the outside, “That’s very different bedside.” And then pull them out and be like, “Hey, listen, that made me uncomfortable.”

Sarah: Yeah. Well, and I would be very tempted to follow up with the patient. If I’m their birth coach, when everyone leaves the room, I’m going to say, “That statement was inappropriate, and that’s not true. And I’m sorry that happened to you.” It’s acknowledging that, no, I’m not putting them down. I am stating the facts. And anybody that in my mind … Here I am mama bird protecting our nurses. That anybody that’s going to argue with you, the reality is you said the statement and I’m the one cleaning up the mess. And my responsibility is to the patient and to their nervous system and to their safety that they feel with those caring for them. And that everything that happens is their consent.

And when statements are made like that, I’m the one that will follow up. I’m the one that will respond to help soothe their nervous system because it’s completely inappropriate. If you wouldn’t have said it … I wouldn’t say this part. But if they wouldn’t have said it, you wouldn’t have anything to say. This is harsh, but I don’t really care because it’s so not … It’s not it, guys. We can do so much better. So much better.

Justine: So on the theme of this because I can see this going in two directions, this episode. So cervical exams, yeah, they’re our norm. We do them all the time. If you don’t do them, you probably see them being done if you’re a nurse, like the midwives do it or the MDs do it. And they also can be really hard. I had a nurse literally leave labor and delivery, and one of the main reasons was because of the pain she caused during cervical exams. She couldn’t do it anymore. That’s so hard. So there are ways to make it easier on both you and the patient. And there are strategies that Sarah and I have both seen and many of you have seen happen. And just again, building that trust, helping their nervous system regulate and then avoiding certain phrases. And so two of the phrases that were mentioned in the chat box that I wrote down, were it doesn’t really hurt that bad as the patient’s crawling up the bed.

Sarah: Oh.

Justine: Yes.

Sarah: Oh, so cringe. Cringe my soul.

Justine: So yeah. And so it’s like, first of all, we learn all these things, like their pain is their pain. Whatever they say their pain is, is their pain. And I don’t know how you can say that while watching that happen and then telling them that. So-

Sarah: It’s so de-validating. We talk about anything trauma informed that we want them to be seen safe and soothed. It is the complete opposite of it, is being trauma uninformed.

Justine: Yeah.

Sarah: That is what it is.

Justine: And here, the first thought could be like, “What’s wrong with them?” And then the second thought is, “What happened to them? What happened?”

Sarah: Exactly.

Justine: That’s not a typical response that we see, but we have seen it. You probably listening, you’ve probably seen it. And yeah, so what can we do?

Sarah: Well, and it is a typical response if we know anything about what women experience in the world. So you also potentially have had hard things happen to you. And where’s our compassion for our fellow sisters? It’s so heartbreaking. And the other thing is what happened to them, I’m not entitled to know. I don’t actually need to know. I know that they’re struggling and it’s my responsibility to help be present for them and be a support to them in that moment, and help advocate for what they need. And if they’re saying, “Stop”, it’s stop.

Justine: Well, let’s talk a little bit about that. So The Feminist Midwife has amazing cervical exam, pelvic exam scripts. And one of the things that she’s really made famous, and I actually heard a doctor use this script once, and I was in triage behind the curtains and I was like, “Oh my gosh, there’s a space right now.” I was like, “What? Yes!” So this actually has some background. So I want … Can you share a little bit? Because I love the idea and the learning we got from Krysta Dancy when we did our trauma informed class for mentorship. You want to talk a little bit about that and then we’ll go into the script and why it’s so helpful?

Sarah: Yeah. So we have four trauma classes available on demand on our website, Trauma: Preventing Trauma Level One and Two, those are teaching about how to be trauma informed in your practice. And then there’s a healing trauma in the birth professional that’s for your trauma. And then grounding techniques. So this comes from Trauma Level One. And one of the things I remember recording this class with Krysta, who’s a perinatal psychologist, and she was talking about we need more clear communication, particularly during a cervical exam, of what stop means and how that might be communicated. Because I remember sitting there and looking at the people in the room and us being like, “Oh my gosh, this is it. This is such a nugget.” Because what do we see? We see them run up the bed, we see them say, “Ow, ow, ow, ow, ow! Oh, oh my God! Ow, ah, ah!”

Are they saying stop? Not always. But in their minds, if you are saying, “Ow” … We’re so used to ow for everything. “Ow, [inaudible 00:14:15].” We’re like, “Oh, I don’t care.” I mean I care, but I don’t really care because I’m so used to it. But if they’re grimacing. If they’re retreating, if they are saying, “Ow, ow, ow”, that might be their way of saying stop. And what happens is there’s a full miscommunication. Because for us, we’re like, “Okay, you’re good. You can do this. It doesn’t hurt that bad.” And then next thing you know, they walk away saying, “I said stop and they violated me.” And so while-

Justine: She was saying that in her visits?

Sarah: Yes.

Justine: And she would ask, “Did you say stop?” And they said, “Well, I was screaming.”

Sarah: Right.

Justine: And they didn’t stop.

Sarah: Yes. And so that to us is … First of all, if you haven’t taken the class, take the class. Second of all, like a, “Whoa, whoa, whoa!” And so what I’ve started doing actually as a response is prior to a cervical exam, to say, “Hey, if you ever want them to stop, you have full control. But you need to use the word stop. Actually say, “Stop.” And it’s a hard stop.” And I typically try to do that education in front of the doctor. And I’ll say it like, “I’m sure this doctor will stop. I’m sure Dr. So-and-So, she’s listening. You have control over your body. If it is a stop, it is a stop. We can wait.”

And then they hear it and they’re like, “Oh, okay. Yeah, you’re right. Okay.” But if we don’t hear stop, how often … I’m like, “Oh my God, it’s so true.” How many cervical exams have I watched that they were probably trying to say, “Stop”? Oh, that’s so heartbreaking. “It doesn’t hurt that bad?” No, no, no, no, no. If it hurts for them and they’re pulling away, that might be, “Stop.” And so if you haven’t had that conversation prior, just say, “Do you want us to stop?” And I would say that as a nurse in front of the doctor. And they’d say, “Yeah, yeah, yeah, stop.” And the doctor keeps going and we’re having a conversation outside the room.

Justine: Yeah. So that’s a good little segue into the Feminist Midwife script. So she has two words that she’ll set up. So the way I’ve integrated it is the first thing I say is, “You’re fully in charge of this exam. You’re the boss. And so there’s two words that I would love for you to remember. And they’re stop and out. And so if you tell me to stop, I will stop my fingers and help you get acclimated to the pressure and give you a second. You just tell me what. And if you say out, I will take my fingers out.” And so it’s been really helpful and I’ve never, ever, ever, since using it, I’ve probably now, pretty regularly for now, three or four years, I haven’t been asked to go out. Just to stop. I get asked to stop a lot and then continue to move in through the pressure and breathing.

And then I was looking at it … And we’ll link the Feminist Midwife’s scripts in this podcast episode. But I was looking at it and I saw another tip, which I never thought about, was to wear the smallest glove appropriate for your hand to avoid baggy material pulling on tissue unnecessarily. I’ve never thought of that. And so little tip. I have a large hand.

Sarah: [inaudible 00:16:59] does. You hear that. Or your thumb pulling on the labia. Yeah. Yep. That’s such a good point. And you can hear where it’s the outside. The outside, just lube it up.

Justine: Oh yeah, copious amounts of lube. And remembering that too because I think sometimes we get really in the habit of epidural, lots of fluid down there, a little bit of lube. And then remembering you’re like CERVIDIL, first couple checks, lots and lots of lube.

Sarah: Well, and that’s because the CERVIDIL makes your vagina so sensitive, especially if it’s slid out a little. If it’s around the [inaudible 00:17:35]-

Justine: It’s like fiberglass feeling, which is … And letting them know that as well is really nice. “It can make your vagina more sensitive, so please let me know you’re not going crazy if it feels different”, kind of thing. Just letting them be fully aware and understanding.

Sarah: And it won’t feel like that likely forever.

Justine: Yeah.

Sarah: That right now it might be extra sensitive, but as time goes on and as the baby comes down, it’s more easy to reach. And so the vaginal exams get a little easier and quicker, hopefully.

Justine: Yeah, that’s good. Okay, so on the same genre, “Open your legs for me.” What we can say instead of. And I usually say to butterfly your legs. In the scripts I read today, it said to, “Let your legs fall open like a book.” What do you think?

Sarah: I’ve heard, “Frog your legs.” I’ve heard, “Let your knees drop.” Yeah, even just, “Bring your feet together and …”

Justine: “Let your knees fall or drop.”

Sarah: Yeah, “Let your knees drop”, is probably what I’d say.

Justine: Yeah.

Sarah: Why is that though?

Justine: I don’t know. Why?

Sarah: Why wouldn’t we say, though, the other one? “Open your legs for me”?

Justine: It feels very assaulty.

Sarah: Yeah. And we want to be-

Justine: Before #MeToo. That’s all patriarchy. Nothing. No for me.

Sarah: There’s nothing happening for you.

Justine: [inaudible 00:18:49].

Sarah: It’s not about us, it’s for them. “When you are ready, you can bring your feet up closer to your butt and drop your knees when you’re ready. You tell me when. You have all the control.” I like the stop. I’ve never used it. Stop. I’ve heard pause. But it’s the same concept of pause. Because if I hear stop, I want to stop stop. I want to like, “Ah, I’m ready! You say, “Stop. I’m listening.” And so the idea that you can just pause and wait. Yeah, I haven’t seen that a lot at practice. But I love it. And then, “Let your legs fall, drop”, I think sounds better.

But otherwise, it’s like we have to really pay attention to the words that we’re using and what we’re commanding in a power position. We are positioned in the hospital as a powerful entity that has “authority”. Whether you do or you don’t, the patients feel like we have authority. The doctor has authority. And so really continuously reminding them that they are in control. It’s your decision. “You tell me to stop. You tell me out, I’m done. This is not about me. It’s when you’re ready. There’s no emergency here.”

Justine: Yeah, that’s good. I feel like this should have been said before and everyone knows, and we’ve already mentioned it, of the consenting for a cervical exam. Because I see it’s still every shift that I’m going to check you now.

Sarah: Really?

Justine: Oh yeah.

Sarah: No!

Justine: I’m going to check you now.

Sarah: What! I’m seeing so much more. So I’m all around LA in births when I’m there and I’m hearing what people are doing. And I am seeing so much more consent than the past.

Justine: Well, they’re doing it in front of you, Sarah. I’m just kidding.

Sarah: Maybe they are. That’s funny. But I never ask every time.

Justine: Right. It’s not like malicious, they’re not doing it to be mean. It’s just so habitual of like, “Okay, I’m going to check you.” And so just motivating you guys to change that language and so many of you have and written in that you have, of that, “Is it okay if I checked you?” Just totally different. “Would now be [inaudible 00:20:53]”-

Sarah: “Is it okay if I check you and you tell me when?”

Justine: Yeah. And we can use some of these strategies. And then last but not least, this isn’t about cervical exams, but this whole episode became it, because this is a hill that we will die on. While you’re doing an exam saying, “Hey, mama. I’m going to check you now.” You have so many things wrong with that sentence. Okay, so this is a big thing I get in my … Whenever I bring this up, there’s a camp of people. One, it’s very, very common to call people mama, in the south is what I hear. And so I understand that culturally, if it’s culturally appropriate in the south, and that’s the thing. “Sweetie, honey”, it’s a lot of terms of endearment. But I’m not from there, so I can’t say that. And I’ll respect your best judgment.

Sarah: It sounds cute when I think about someone saying it in the south. Like, “Oh, that’s [inaudible 00:21:41]”

Justine: In their accent, right?

Sarah: Yeah, totally.

Justine: But for my nurses that so many have started it because once you hear it, you can’t unhear it, the how many mamas you’re hearing. But for the nurses, that will just like, “Can’t do it, can’t do it without names.” They’re just so adamant, like, “Can’t do it.” And I’m like, “You could do it. You can.” Just say the name a million times at the beginning and I’ll tell them. I’ll be like, “Okay, your name’s Jessica. I’m going to remember that. I’m going to say it a hundred times in this first encounter that I’m in your room and I’m going to really get it in my brain, Jessica. Is that cool Jessica?” And they laugh. And then I really try to get it/have/ A lot of you have a little paper brain, and I know Sarah’s going to cringe when I say this. And you put your stickers on your brain. And so-

Sarah: [inaudible 00:22:26].

Justine: Look at the name before you enter or write it on the thing. Not their last name, but write whatever you need to write to remember their name before you walk in the room. It’s just [inaudible 00:22:36].

Sarah: Or like the whiteboard. What about … Because this is PHI. Especially in the land of HIPAA right now, I’m like … I know more about HIPAA than I ever have in my entire life and ever intend to ever again. But the whiteboards filled out. Write their name yourself, erase it and write it again. Because when you do that practice of writing, something happens to your brain to remember their name.

Justine: That’s good.

Sarah: Why do we care about remembering their name though?

Justine: For me, I feel like it makes them feel more … It’s like a humanity thing, makes them feel like a person. Not just another number in our little Pitocin factories that we have in the United States. But yeah, it’s just respectful, kind. What do you think?

Sarah: I agree.

Justine: Some people don’t like being called, “Mama”, before they’re a mom. Some people aren’t ready to be called mom. Some people don’t identify as a mom.

Sarah: It feels a little talk downy.

Justine: Yeah, I could see that.

Sarah: So does sweetie. Of like, “Okay, mama. Yeah, mama.” It has a little … It could be misinterpreted. I’m sure that’s not what people mean and I’m positive it’s because we don’t remember their names. If there’s a patient listening to that, I know that might break your heart, but there’s just a lot of patients and a lot of names. And it’s just easier to call them something nice versus patient. So I get that.

Justine: And what [inaudible 00:23:53] floors? They’re not like, “Patient number one.” They’re not … What are they calling? I’m sure there’s things like-

Sarah: Yeah, Mr. So and So, probably.

Justine: Yeah, I think last names are used-

Sarah: That’s cute.

Justine: A lot on other floors. And it’s okay, especially if you’re a resource nurse running in for something or helping them turn them or whatever. Literally asking them, “What was your name?” Because you haven’t met them before. And that’s okay. Just ask them their name.

Sarah: And by the way, you shouldn’t ever be walking in a room and not introducing yourself. I know we also do that too. But you walk in and oh my gosh. Probably every client I’m with, they’re like, “who are they? Why are they in here?” I’m like, “Oh, they’re the baby nurse, whatever.” But if you’re a baby nurse, just sneak up. “I know you’re pushing hard. I’m Sarah. I’m your baby nurse. I’m going to take care of your baby.” “Oh, great. Okay.” And then all of a sudden, they’re like, “Oh, I’m safe. They’re supposed to be here.” Versus, “Who are these people staring at me?”

Justine: Yeah. So yeah, those are some of the things.

Sarah: That was a juicy one.

Justine: Yeah.

Sarah: Love it.

Justine: Thanks for hanging out. Sorry if that ruffled some of your feathers. And then also, I hope it just helps you think a little bit about comments and phrases and how we can just continue to grow because we’re not perfect. And a lot of you are tired and sometimes saying certain things and making certain jokes help you cope. But it’s not pushing the narrative. I’m thinking about too, just pushing the narrative of our healthcare system and reproductive health. And my first child’s, I had to get a pap smear and I had to wear that little paper gown thing, just the top and then the bottom. It’s really paper, really skimpy. Very much like a man created this.

Sarah: Open.

Justine: Why are we wearing this? This is dumb. And my husband was in the room at the time. It was fine because I wanted him to be there. And then it was just like, “Ugh.” And then my one yesterday, it was a regular gown. She was like, “I’m not going to bring your husband in for the pap smear. That’s weird.” And it was just very, just more … It was pushing the dial of making this visit more comfortable for people than have to do it than four years ago. And changing the way we say things and the way we do things will help change it even more. Because everyone’s watching you. Residents are watching you, your providers are watching you, your nurses are watching you. And it will change the more we just push the needle forward.

Sarah: Well, and think about all the things that you’ve learned from other people just by observation. Most of our practices are probably developed that way, whether it be through precepting or just baby nursing in a room. And you’re like, “Oh, I like how they say that.” Or, “I like they tried this”, or, “Wow, that was really interesting. What’s that med?” Et cetera. And so that’s how we’re going to do it, and that’s how we are doing it. And that’s where … Whether it be because in the room or not, there’s a lot more consent happening than there was pre #teamunderwear. Let’s be honest. So thank you for doing the hard work because it is hard work and all of this stuff, this specialty is so underrated. Or is it overrated? What’s the right word?

Justine: Underrated.

Sarah: It’s underrated that people think it’s just la-dee-da. And-

Justine: Well, then maybe.

Sarah: It’s so much more. And it requires so much more of you, than people give it credit to. So we know that. We see you and you’re doing it. And so one patient at a time. One starfish at a time.

Justine: Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us both if you subscribe, rate, leave a raving review and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com or follow us on Instagram.

Sarah: Now it’s your turn to go and rethink how you say some things at the bedside, so that they may be just a little bit more safety provoking for your patients. We’ll see you next time.