Babbles Nonsense
Welcome to my verbal diary where I want to discuss any and all things that is essentially on my mind or have wondered about. Sometimes I will be solo and then other times I will have some amazing guests to bring all different perspectives in life. The ultimate goal is to hopefully bring some joy, laughter, inspiration, education, and just maybe a little bit of entertainment. Don't forget to like, rate, and share the podcast with a friend!
Babbles Nonsense
Unpacking Nurse Practitioner Misconceptions w/ Ivy
#168: What does it really mean to be a nurse practitioner in today's healthcare landscape? Beyond the stereotypes and assumptions lies a complex profession that's frequently misunderstood by patients, physicians, and even nursing colleagues.
In this revealing conversation, two practicing nurse practitioners pull back the curtain on their profession, tackling the most persistent misconceptions head-on. From the notion that NPs are simply "wannabe doctors" to questions about clinical competence and financial compensation, no topic is off-limits as they share their unfiltered perspectives from years of practice in various healthcare settings.
The discussion delves into the educational journeys of nurse practitioners, comparing different pathways and addressing the controversial question of whether nursing experience should be required before NP school. They explore the unique value nurse practitioners bring to patient care through their nursing background, explaining how this foundation creates a different—but equally valuable—approach compared to physicians.
Particularly eye-opening is their candid assessment of nurse practitioner compensation and how gender dynamics in this female-dominated field impact salary negotiations and professional respect. Their experiences working in a collaborative practice state offer insights into how regulatory environments shape NP practice across the country.
Whether you're considering a career as a nurse practitioner, work alongside NPs, or simply want to understand your healthcare options better, this conversation provides an authentic look at a profession that continues to evolve and expand its role in modern healthcare. Ready to separate fact from fiction about nurse practitioners? This episode delivers the straight talk you've been looking for.
You can now send us a text to ask a question or review the show. We would love to hear from you!
PodMatchPodMatch Automatically Matches Ideal Podcast Guests and Hosts For Interviews
Follow me on social: https://www.instagram.com/babbles_nonsense/
What is up everyone? Welcome back to another episode of the Babbles Nonsense podcast. On today's episode I have my good friend Ivy back where we are talking about misconceptions of a nurse practitioner. I don't really talk about my job field that much. I know we've kind of done this healthcare series here lately and I really enjoy doing it. So today we were just like let's just talk about the misconceptions of becoming a nurse practitioner and once you are a nurse practitioner, so we talk about everything from education to comparison to salaries. If there was a misconception out there, we tried to cover it.
Johnna:But I do want to just say this is from our own personal experience and our own opinions. This is not to say this is everyone's experience or what they deal with in their day-to-day practice or lives. So just keep that in mind when you listen. So just listen with an open mind. But yeah, we're just going to dive on in and get started. I know that this week I said that we were going to talk about ghosting. However, that inspiration has come and gone. Maybe when the inspiration hits me again we'll do that episode. But for the past several weeks I've kind of talked about, like, my experience in health care and, for some reason those episodes are doing really well. Y'all seem to like those episodes and I keep getting more questions about it. So that's also interesting to me, because that's initially what I was going to do the podcast about, but then I shied away from it. So so hindsight's 20-20.
Johnna:But I have Ivy back with us today, hi, and we want to talk about misconceptions about nurse practitioners. We're both nurse practitioners. I don't talk about that a lot on this podcast. I'm not 100% sure why. If I feel like it's like boasting or if I'm just trying to protect a little privacy about my life. I don't know. I know I say I'm a nurse a lot. I typically say that when people ask me what I do, or even on dating apps, I'll just be like I'm just a nurse. You know, I don't know. I don't know why I do that. I don't know why I shy away from it because you would think like one would be so proud of the education and stuff. I don't know if that's a childhood trauma thing. I don't know. That's a question for my therapist. I don't know. But we kind of just want to get into some misconceptions, but before we do that, obviously a little bit of background from both of us. I know I mentioned a little bit of why I got into nursing. But, ivy, why did you get into nursing?
Ivy:I honestly don't know. It seemed like a good idea at the time. You know I was out of the Navy, needed good idea at the time. You know I was out of the Navy, needed a career path. It seemed very prestigious.
Johnna:And, like you know, of course people think about money. What age did you decide, like that's the career path you wanted to go down?
Ivy:What late 20s in college?
Johnna:Well, see that, and to me that's awesome Because, like, that shows that you don't have to have it figured out in high school, like when everybody's like you got to get, you got to figure it out, you got to, you got to get your career together, you got to know. So that kind of is inspiring to some people that may be listening, like, I think, at any point in your life, like I have. I have a friend, um, that is also a nurse, nurse practitioner. She had been doing it for gosh years 20 something years and she decided after, like during COVID, she was like I don't want to do this anymore and she's a whole ass engineer. Now what? Yeah, she was like I don't want to do this anymore and she went back to school and I commend her. Yeah, she gives no f's about, like, going back to school, she doesn't care what people think about her, she doesn't care how many times she changes her mind, and I love it. I think it's so empowering. Number one she's paying for her own schooling yeah, so who cares?
Ivy:right, who cares?
Johnna:so I just, I love that for. But yeah, she's got three whole ass degrees, probably even more, who knows.
Ivy:That's amazing.
Johnna:So you decided, like, after you got out of the, how long were you in the Navy? Speaking of Only four, four years.
Ivy:Yeah. So that's like maybe what early-ish twenties and then you go, you know undergrad and whatever, and the nursing student you know it always seemed so I keep going back to prestigious.
Johnna:It seemed. So I keep going back to prestigious. It seemed prestigious. It's not the microphone, it's you. So, ivy can, how close do I need to be to this? You have to be like almost your lips touching the mic.
Johnna:Oh my god, guys we were having issues earlier and we were in the podcast and then the echo, I was like, well, let me change the mic. And Ivy was like let's just restart. And I was like I don't want to restart, it's like we were on such a good roll. And then, of course, I switch out the mics and like she's like, oh, it sounds better. And then she keeps backing up, backing up, backing up my lips are on the fucking thing yeah, pretty much. That's how it has to be.
Ivy:I guess I haven't done it in a while. Yeah, but literally like I'm, it's like a big microphone wiener in my face. Oh my god, I cannot with you anyways can't.
Johnna:Oh great, I just dropped my phone. It has all my on it.
Johnna:Guys, we are not together this morning nope anyways, I kind of mentioned on a couple weeks ago like why I decided to get into nursing and, um, I hadn't always wanted to be in nursing, like when I remember like in elementary school and junior high school not junior high because that's too old, but like in elementary school I would like just play, make believe in my room by myself like I was teaching a bunch of okay, this is embarrassing, this, this thought. So it wasn't just any kind of teacher that I wanted to be. I wanted to be a music teacher, someone who cannot carry a tune to save her life. Anyways, yeah, I did. I wanted to be a teacher, which I know is comical because it takes a lot of patience, but I had a lot of patience back in the day. Okay, my patience has worn thin through childhood trauma and through my experience as a nurse.
Johnna:That is why I have no patience at the ripe old age of 37 it's gone anyways, in high school we had um a teacher that was I'm from a small town and the teacher was my friend's dad, who was a nurse, and I he always talked very highly of his career and so he um had the opportunity to take us from high school to a nursing home and we got to like help um, you know, just kind of be like techs, I guess, like pass blankets, help bathe patients, whatever. And there was this one guy in there that really was so mean to everybody. He had like verbal issues but look, looking back, maybe he had a stroke or something and he just couldn't articulate the way he wanted to, which would make someone angry, and he would always throw things at the nurses. And the nurses were like, don't even bother with his room, don't go in there.
Johnna:And what did my little brain think? Challenge, challenge, accepted, which is what I do in my dating life, apparently. So that's where it comes from. Another thing I should talk about in therapy. But yeah, and then he ended up really liking me, like we, like I felt like we could sit there and talk to him, like, even though I know he couldn't talk back like he, I think he just appreciated someone taking the time to sit with him and my little feeble brain thought that's what nursing was like. Oh, you get to sit, you get to like love on people, you get to show them that you care and compassion, which is what nursing should be right.
Johnna:It should, yes, but that's not what it is.
Ivy:It wrings out your soul.
Johnna:It does. And then, fortunately, also because I'm from Tennessee and I had a nurse practitioner as my quote unquote doctor when I was in high school and she was just the best. She listened, she cared. She as my quote unquote doctor when I was in high school and she was just the best Like she listened, she cared, she spent time.
Johnna:And so I just in high school was like, okay, I want to be a nurse. Oh, you can go further in your career. Oh, I want to be a nurse practitioner. And then that's when that love for it. So I'd always wanted to do that Number one, probably because I wanted to get out of the small town and I knew you had to go to college to do that, because it was either factory work or, you know, working at Walmart. Nothing wrong with that career, but I just wanted more, I wanted to get out. So I always wanted to do that from a very young age. So when did you decide since you decided very late in your career, when did you decide to transition from being a nurse to becoming a nurse practitioner?
Ivy:Like immediately, and I know that you know this is very taboo because it's frowned upon, you know, because we'll get into this, I think, later, but the whole role of the nurse practitioner is based on prior experience. But for myself and maybe my vision is cloudy or I have rose-colored glasses on, but I think I've done well.
Johnna:I went immediately from graduation undergrad to np school and we will get into that on under under the first misconception. So let's just get into the um before I get into the misconceptions. Like what made you decide even though you didn't have experience like which? I guess that's where my brain can't are like understand, because we have different experiences. I don't under like how did you know you wanted to be a nurse practitioner without having the experience as a nurse first?
Ivy:they just to me. They were so like even more prestigious than nursing. You know I was like, oh wow, this is how you can take care of people you know truly like, so I don't know their knowledge base.
Johnna:Interesting that you say that, because well, and you wouldn't have this feeling because you you didn't do nursing, which I mean I'm sure you worked as a nurse while you were in school. I did, yes, so like for me, because I was a nurse for five years before I was a nurse practitioner, I had a really hard time adjusting from being a nurse to being a nurse practitioner because in my mind, I felt like I actually wasn't helping the patient Because I wasn't the hands on, I wasn't starting the IVs, I wasn't taking them upstairs, I wasn't getting them to CAT scan very fast, I wasn't performing CPR. So in my mind, because I wasn't doing the physical work, I'm not doing anything for this patient. It took me a good six to eight months to realize you are still helping this patient by the knowledge that you have. But it was really hard transition for me.
Ivy:That makes sense. I think, like we all probably have imposter syndrome, but maybe mine was a no. It wasn't easy to get over. Honestly, I make probably because of the experience I got getting immediately into the hospitalist group.
Johnna:So you know like the knowledge base is insane, like oh yeah, that's a whole different and, before we get into these misconceptions, I forgot to say in the intro like we're coming from a state that is a collaborative state. It's a deep south state. We're also a state that is very far behind on everything everything like where it be, whether it be politics, healthcare, whatever we kind of women's rights.
Ivy:Maternal fetal death rates.
Johnna:Stop, we're not getting into that. That's not the podcast for it.
Ivy:Poverty.
Johnna:You're about to get kicked off. The podcast is what you're about to do, but we are. We're just behind, for whatever reason, on a lot of things. So when we talk about this experience, just kind of keep that in the back of your mind. We're not in an independent state, we're not a Midwestern state or a what's a progressive.
Ivy:Would it be a?
Johnna:progressive state. So the first misconception we're going to kind of talk about is nurse practitioners quote unquote are want to be doctors. So how do you feel about that statement? My blood pressure has risen. Nurse practitioners quote unquote are want to be doctors. So, um, how do you feel about that statement?
Ivy:My blood pressure has risen. Why? To peak levels? It makes me maybe sad is a very elementary word for that but I it just feels like people don't know what nurse practitioners bring to the medical table. Um, and that we compliment maybe physician practice, especially when we're taught well no, I agree, and I think that they're.
Johnna:This is just my own personal experience. Okay, just stop worrying about the microphone. I'm sorry, okay maybe.
Ivy:Okay, that's better it's just it's.
Johnna:If it's gonna echo, it's gonna echo. We can't control it so okay, I'm sorry guys, the mic from ivy's side might be echoing.
Johnna:I'm not sure if it's an equipment malfunction or what but we've been trying to fix it for like 3045 minutes, but it may just echo. So I do think and this is my personal opinion and I know we differ on this opinion and I think, and I truly now like sitting down talking about it I think the reason why we have a difference of opinion is because you went straight through school when I did not. And so I do think because and I've, we went you went to UAH, correct, we also had the same schooling, yeah, and I feel like there is a gap in the knowledge that we're taught. I feel like NP school is very you have to be self-motivated to learn. I think that there's a lot of schools and I'm not saying just the school we went to I think there's a lot of schools that they want a passing rate, so they allow passing when certain people shouldn't pass, especially in such a field that you shouldn't.
Johnna:Yeah, that's true, like there should be no room for stupidity, error, dumb, dumbness, I don't know like it's, it's tough right and so and like because I know, and when you're in doc, like when you're becoming a medical doctor, there's not any like, if you fail, you fail. Like there's not any room for that. And when we're compared to physician's assistants, which are usually what we're compared to because it's similar, I do think their schooling is more in depth to the pathophysiology, the biology behind things. No, they don't have the nursing side of it that we do. It's a very different learning, so our brains operate in a different way that they do. But when you look at their schooling, it is more in depth. Like they can't even work during school. Yeah, like it's more. It's more along the medical model, where ours is. On the nursing model. It is, and there is no challenging that. That's just facts. That's what it is.
Johnna:And again, in any career whether you're finance, business, teacher, nursing, nurse, practitioner, physician's assistant, doctor there are going to be levels of people's education based on the personal driven factor. Like do you want to learn? Some people are just naturally smarter, some people have higher IQ, some people struggle, some people need the experience to learn, some people don't. You're one of those people I would put in a high category, just along my friend Brandy, y'all don't need that experience to learn. I think that when you learn something, you're very self-motivated and it just clicks with you. My friend Abby's like that too. When you hear something, you're like, oh, that makes sense For me.
Johnna:It wasn't like that For me. I needed the experience because I struggled in nursing school, like I, like we said I don't think we said it on this podcast, but when we were recording earlier when I was in high school, like my teachers begged me to go into engineering or math because I excelled in math, I actually struggled in my science classes because my brain works in a linear fashion like this rule, this rule, this rule here's answer. It's always going to be the answer. My brain doesn't work in a gray area where it's like all these roadmaps can lead to a different outcome, but all the answers are correct. Yeah, so I struggled with that, even though I did so good in high school when I got into nursing school. It was a struggle for me, whereas for you I feel like your brain operates in that fashion, like you can see the bigger picture, I guess.
Ivy:Maybe that's it. But then there's really the difference, I think too, between nursing and nurse practitioner is that you get that, maybe that medical piece where you get to be a problem solver more so.
Johnna:Critical thinking.
Ivy:Yes.
Johnna:Well, you do, and that's where I've seen some practitioners go straight through from RN, BSN to MP school and they do not do well. I've seen that. Then there's people like you who do very well. So it's always on the end of the spectrum and that's fine. That's completely fine. But where the misconception about want to be doctors? I've never wanted to be a doctor ever. I don't want the responsibility of a. I've never wanted to be a doctor ever. I don't want the responsibility of a doctor. I think that they're very smart. I take nothing away from them. Yeah, I want to learn from them. I want to pick your brain. I want to understand why you're ordering something a certain way. I want it to be a collaborative thing, Like I'm here to help you. I'm here to make your life easier. That's just my perception of it.
Ivy:Okay, I can see that. So it's multi-layered for me because, like it, there's a little bit of that that feels like an assistant and I know you're not meaning it to feel like that, but okay. So, yes, I agree with the collaborative nature up to a certain point. Like I believe that maybe after, let's say, 10 years of collaborative practice or five dependent right, it's all well, that's, that's I, and I know where you're going with that.
Johnna:It's very hard to say a year, because again, we're not all at the same education level no and we're all don't practice. I personally do not want to practice independently. I know you do, I know you can do that. I personally don't practice. I personally do not want to practice independently. I know you do. I know you can do that. I personally don't. I want to have a doctor there to ask questions.
Ivy:Yeah.
Johnna:That's just my personal preference and it's, and I don't think either preference is wrong.
Ivy:No, it's not Absolutely. And then like, although you know I felt that way, um, I think in the hospital, but, um, this outpatient journey that I'm on for just a smidge over a year, um, it's kicking my ass. And you know like I'm good collaborating right now. You know not to say that, um, I'll ever think that, oh, I'm too big for my britches or I can do this independently. I'm starting to see things through a different lens.
Johnna:Well, and I I see it that way in general because, like number one, I worked in an emergency room, right, so my whole experience was very critical patients.
Ivy:Yeah.
Johnna:And I'm not saying that nurse practitioners cannot take care of critical patients because our licensure allows that, because if you're in an independent state which my friend worked in an independent state in the ER she was doing everything, yeah. So again it goes back to your training, the knowledge that you have, the self motivation that you have. But me personally, I like that collaboration because to me that scares the shit out of me and it should.
Ivy:Yeah, absolutely. There should be a healthy lover of fear, no matter what I think, even if you have 20 plus years of experience. There is, there should be fear.
Johnna:And and I'm not saying like I practice quote-unquote independently with my patients, but I still have the collaboration with my doctor in the job that I do now, like I still see my patients independently, but if I run into any kind of trouble, he is there to answer my questions and I just personally feel comforted by that because I don't want to make a mistake. This is not just someone's account, bank account, yeah really this is someone's life and like their loved one's life.
Johnna:So what? The misconception to me is that a lot of times and I think this comes from the medical doctor's side of things yeah, like when they're old school and I've had doctors tell me this y'all just want to replace us. Well, personally, I don't. Personally, I want to help, I want to learn from you, I want to be able to take some of the burden off of you and I want to collaborate with you. That's how I think it's misconceived sometimes.
Ivy:Absolutely. I believe, yes, we were seen and still probably are, as, like, competition and not compliment Correct, but we are supposed to be. There's like bajillions of patients and there's plenty to see out there and you're right like it can be a great collaborative relationship where, like, yeah, we take great care of our patients, they take great care of their patients. I think, though, a lot of this hate is fueled online.
Ivy:I made the mistake we're going off on a tangent here, um of getting on a um like reddit thread yeah, I don't do reddit and it is oh my god, I think my blood pressure skyrocketed the hate and the vitriol out there from I think it's called it's like a resident reddit and it's called our nocturne because they there are people online that like um, call nps nocturs, which means not doctor, um, and it's so hateful and disgusting I can't like I'm getting flustered even you know, because like they probably have never worked with us or maybe they've worked with. I can't speak for that right. We can only worry about ourselves and the physicians we work with. But that side note tangent, is it?
Johnna:it's, it's horrible it is and, like I think, again, we can't speak for everyone. We don't know what their experience was. Because I've had some terrible experiences with some not so great residents and I and that could cloud my judgment to say all residents are idiots, you know, and that would cloud a judgment based on the experience that I've had. Right, yes, so I. That's why I like I don't understand the forum is because, like, speaking, okay, for example, I worked with a doctor in the ER that his wife was a nurse and you know he has children that are all female and initially, when the nurse practitioners were getting a larger role in the ER, he had a hard time adjusting to that because he had been a doctor for years and he had that mindset that you know we were coming after their jobs, which I kind of understand. You think about it like, kind of like it's no different than when nursing a lot of, a lot of RNs are now going back to NP school. You have that fear of like these new people are coming for my job. So I can understand that.
Johnna:But where him and I disagreed was I've never thought I wanted to be a doctor, otherwise I would have just went to medical school. Like I want to help, I want to learn, but I don't want the full responsibility that a doctor has. I just don't. That's a lot of responsibility, that's a lot of weight on you emotionally. I'm not saying it's not on a nurse practitioner, but I think it's on a higher level and um, so me and him had to have like a come to Jesus talk and I was just like you know, I'm not here for your job Like your.
Johnna:Your wife is a nurse, you're. It's not farfetched that your kids might not want to be nurses or nurse practitioners someday. How would you feel if a doctor spoke to your children the way you speak to me, and it was like a light bulb went off in his head because like no one had presented it to him like that and now we have a really great working relationship and stuff like that. So it's just, I think people don't think sometimes like about other experiences because you're so locked into the experience you have.
Ivy:Yeah, that's fair. It's hard to look outside of our own bubbles.
Johnna:It is. So anything else we need to add to the misconception of nurse practitioners or just want to be doctors?
Ivy:Probably not. Yes, you know, I think it's. You're right, it's never going to change. I don't. I don't think there's going to be change.
Johnna:I think whoever is going to hate us is going to and is going to, and there will be nothing to change their views. And then I actually don't. I never say never. I actually think my personal opinion is just because our health care system is such on a rocky downward slope, I personally think that one day I don't know, have you ever watched dr quinn medicine woman? I don't know if she worked on animals or who she worked on, but it was house call physicians.
Johnna:I watched this when I was like a little kid with my mom and I personally think that our healthcare system will end up back where, if you can afford a doctor to come to your house, you will be one of the lucky ones, or you can afford a nurse practitioner to come and we would be cheaper than a doctor. And that's just what it's going to be. Because I don't foresee in 30, 40 years, our healthcare system withstanding what it's undertaking. I I don't foresee in 30, 40 years, our health care system withstanding what it's undertaking. I just don't because at the end of the day, we have to remember hospitals and doctor's offices and clinics. Our business is at the end of the day and if you don't turn a profit, you're going to file bankruptcy and that's just what it is let's get our horse carriage and our little you know bag of supplies and it's not like we can't turn a profit.
Johnna:It's like, think about it, we're not in control of the profit. Our government is and they determine, and health care insurances determine how much reimbursement there is, and it's less every year, and then insurance is more expensive every year. So logically, that just seems like it's on a downward spiral.
Ivy:Oh, this is great.
Johnna:So, when it comes to want to be doctors, I think that eventually, when that happens, I think the respect will be there. But I also think that, just like I had the conversation with the doctor, I think that once you have a conversation and it's a meaningful conversation with somebody I do think people can change their mind, but it has to be in that experience that they experience.
Ivy:That makes sense to me. Yeah, yeah, I think yeah.
Johnna:All right. Misconception number two NPs nurse practitioners only handle minor cases. The gasp, the gasp. So yes and no, right, it depends on what kind of state you're in, whether it's collaborative or independent, because if you're independent you're doing it all. Yeah, and it also depends on are you family practice or are you acute care.
Ivy:Yeah, that's critical care.
Johnna:It also depends on your hospital rules and regulations, because your licensure can say that you can do. For example, I'm acute care. My licensure says I can intubate, put in chest tubes, art lines, all the things critical care, right Like I'm licensed to do that, but I'm not when the hospital that I used to work for what's it called when you like, credential. Yeah, I'm not credentialed in the hospital to do those things because the hospital doesn't allow it, despite my licensure allowing it. So in the role that I was in, yes, the nurse practitioners only handled the minor cases. That's fair.
Ivy:Yeah, in some ways, though, you're right. We couldn't do anything, but at least we could manage, like the medical care of an intubated patient or on, you know, non-invasive positive pressure ventilation and xyz right well, we also work two different roles.
Johnna:You were a hospitalist, I was in the er. My role in the er was to handle the lower acuity patients, so the doctors could focus on the critical patients yeah and that was the role, so it wasn't necessarily a misconception.
Johnna:Where I worked now, we were allowed in the trauma pods and stuff like that, but we weren't running a trauma, we weren't running a code, um, and that's where I said it all comes down to self-motivation to learn, because once you're kind of told you can't do all those things like do you, do you harden your heart and you say, fine, screw it, I won't learn anything else? Or do you still push past that and say, no, I still want to learn, I'm going to come in here usually harden your heart and just put your head down and do the minor stuff right.
Ivy:But you've had an experience right at a hospital in a different state where nurse practitioners were running the traumas yes and no, we weren't running the traumas oh, okay physicians and the residents were running them.
Johnna:we were still helping but we did round because I worked in another state where we rounded on the trauma patients without the physicians doing procedures like chest tubes, like pulling trachs and stuff like that, and so you were managing their care. You had to know if something was going south or not. So yes, working in a different state where the collaboration was a lot different, I did have that and it scared the bejesus out of me.
Ivy:That's fair. It's good yeah.
Johnna:It just scared me because but there was always a physician there you could call, but it still scared me because I came from 10 years of no, don't do that. No, don't do that, no, don't do that too. This is all yours and I'm just like what.
Ivy:But that that you're like a healthy level of fear, no matter how long you've been doing it is normal like that.
Johnna:Right, that's our protective mechanism, probably so and I know this is completely different, but I think I've heard, like, when people like musicians and stuff like that and artists, when they get on stage, like people ask them, like are you still nervous, are you still terrified? And even the ones that have been doing this 10-15 years say, yes, still get nervous when I step on that stage. I want to see. It was chris Brown's interview I was listening to when he was like the moment I don't become nervous. I know I need to hang it up or something like that. Maybe it was him I don't know if it was him or not but like that first jitter, like when you go out there, we should feel that.
Ivy:Yes, I think you're right. Like when, if or when? Probably when we get burnt out. It's time for a vacation, it's time to step back.
Johnna:Right and so and the difference is this misconception, like sharing real cases where you've managed complex patients. So, like I, have managed some complex patients. Like you said at my other role when I was in trauma, I remember one night it was July 4th, it was a crazy night.
Johnna:Our role as the nurse practitioners I was working night shift it was a crazy night, like we, our role, what as the nurse practitioners I was working night shift was to go around on all the trauma patients which in the summertime it was so hectic, like, for whatever reason, traumas in the summer, whether it be car wrecks, shootings, I guess because it's warmer and people are just outside, I don't know and just rounding on all those like everything you could imagine was going wrong, like I think me and another part, like we had a partner you always had somebody with you had like 35 patients to round on. You would think that was fine. But then you also had to respond to all the level one traumas, all the like pages and everything that not there was like five level ones, like every. All the nurses were paging us like this chest tube was clamped, this person had a fever, this and like we, we couldn't get through the rounding to save our life and I was just like that's insane.
Johnna:Um, but going back to the misconception of nurse practitioners only handle minor cases. People do need to remember that nurse practitioners do still diagnose, prescribe and manage acute and chronic diseases. And you did that more so in your role as a hospitalist than I did in the ER, because our hospital privileges didn't like allow us to discharge and admit patients or, you know, contact the physician that we were admitting to, or or consults and stuff like that. But yours did so kind of talk about your experience.
Johnna:A little bit about handling critical patients.
Ivy:It was expected, which was, honestly, that my first job. It was a blessing, like it was expected that you be like the top of your game, you, there's no room to be a dumb, dumb, you know. So it was expected absolutely that you collaborate, but also like you're there admitting patient and you get the job done, no matter how minor or critical they are. And then you, you know, report back with the highlights like hey, you know, here's what I did for X, y, z, right, if they came in with, I don't know, respiratory failure and they're intubated or they've had a STEMI, of course you're going to call cardiology X, y, z, but here's what you've done to, you know, stabilize, admit, and we also took like um, like hospital call. So you know you were expected to respond to the code and to know what to do Exactly.
Johnna:No, I think, and again I think, some of these misconceptions are all dependent on case by case basis, right, like it depends on what state you're in, it depends on what role you're in what, what your hospital privileges are versus your licensure. But the third misconception would be, quote unquote nurse practitioners don't know as much as doctors, and this kind of goes back to what we were talking about in the first misconception. So how do you feel about that?
Ivy:I think you're right. We don't like, absolutely we don't. Our education is not a doctorate and that's fine. I think there's a role for us and there is a place. I think there's a role for us and there's a place. And but sadly, to piggyback off of what you said in the beginning, that it's an unfortunate statement that I'm about to make, that NP schools are not all created equal. They're not, and it's embarrassing, it is. And because it gives us a bad name overall, because you know it only takes one dum-dum to ruin up, to muck up the whole mess, but I'm not even going to say like a dumb dumb and a nurse practitioner, because any, any field is going to have that.
Johnna:That's true Any field is going to pass someone that barely skated by. I've worked with some doctors that I'm just like how did you pass medical school? How?
Johnna:Yeah, there's going to be a goober, you know everywhere everywhere and like I've seen it in the real estate business, I've seen it in accounting, I've seen it ever, like teachers, I'm like how are you teaching students? Like that's true, so I've seen it in every field. So I'm not even just going to say that's a nurse practitioner field, I'm just going to say like I've seen that everywhere. But it is unfortunate that there isn't like a standard practice for nurse practitioner schooling. Like there is a standard when it comes to, like the Board of Nursing. And it's like because we all have different Board of Nursing's right in all 50 states. So it's not a national standard, if you will.
Johnna:Like each Board of Nursing says you have to have this many clinical hours, but there's no real guideline on here's the things you must know. Well, I guess, to pass boards. There's a guideline of here's the things you must know. Well, I guess, to pass boards. There's a guideline of here's the things you need to know. But again, I personally just think physician assistant schooling is more in depth and I think that theirs is more nationally recognized, as this is what we do. Yeah, versus, where nurse practitioners is so individualized based on what school you go to.
Ivy:Yeah, that's true, because you're right like they, I think they see it as okay.
Johnna:Well, you've been to nursing school, so you know patho and you know blah blah right, this is just an extension of what you should already know yes and that's where we can get into the misconception of do you think it's a misconception that people should or shouldn't go straight through nursing school Because there's a? I personally, just because I know you have and I think that you've done and excelled well, but I have seen a lot of people not who don't?
Johnna:who don't do well because they don't have that experience. Because, again, nursing background experience is completely different than the physician world of biology, completely different than the physician world of biology, pathophysiology, treating a disease process. You do learn that from experiencing in as a nurse.
Ivy:You learn that, like you're right by mistakes, unfortunately that's true and, seeing like what the physicians do for each of your patients, that you have like, absolutely do.
Johnna:For example, if a doctor is in school and they're learning about the krebs cycle, they're learning about electrolytes okay, wait, wait, wait a whole.
Ivy:We learned about the stupid ass krebs cycle, but continue.
Johnna:Sorry, got fired up fired because you completely interrupted me without knowing what I was going to say or where I was going with that. For example, a doctor goes into depth about that. They're going to spend weeks on that. They're going to go into the electrolyte exchange and all this stuff. They're going to spend weeks on that. Then they're going to go into the electrolyte exchange and all this stuff. They're going to spend weeks on that. Then they're going to go into what disease processes could happen from that.
Johnna:We learn a snippet of that, maybe a day in nursing school. And then when you get on the floor, when you have a patient who's in DKA, which is a diabetic ketoacidosis and their potassium sky high because they're in DKA, and then you have to ask a physician or a physician to teach you well, how do we bring that down? Why is this happening? Because we didn't learn that there is a difference in a day of schooling, in a day of a critical patient going south for a doctor teaching you that, something you will remember for the rest of your life and you'll memorize it to know what to do in the next case. But is it memorization? Or is it actually knowing what to do in the next case? But is it memorization, or is it actually knowing what to do and why?
Ivy:so I mean, well, mp school is still a blur to me, like I don't remember a lot of it, but I want to say that they went over that not like you're talking about an mp school full-time is a year and a half.
Johnna:You're done in a year and a half full-time. It's two, two years part. Oh, I did, yeah, I did part-time, never mind, sorry, right, so you're talking about a year and a half. You're done in a year and a half full-time.
Ivy:It's two, two years part. Oh, I did, yeah, I did part-time, never mind, sorry, right, so you're talking about a year and a half of learning everything a doctor learns in eight years.
Johnna:There's and I will agree with the the consensus on that. There's no way there's no eight years of stuff in a year and a half yeah, there's no way there's no way. So that's what I'm saying, like yes, you have four years of nursing school, but really it's only two years, because the first two years are your prereqs yeah so then you're learning two years of nursing school, which are going through however many modules, so you're only spending what a day or two on that.
Johnna:You see what I'm saying. So the level of knowledge and I'm not saying nurse practitioners aren't smart because they are, but you have to learn, you have to be self-motivated to learn, because that's where it comes into the fact that nurse who learned about DKA that day, they can memorize what to do for the next patient. It can be a game of memorization. Or I can go home and be self-motivated to say, but why? And those are the nurse practitioners and nurses, in my personal opinion, that do excel and do do well, because you have that motivation to say that's great that you told me how to fix it, but why?
Ivy:That's true. Yeah, you're right, that's. And I think that, like on top of that, it's not only your ability, but it's the experiences that you get, like in nurse practitioner school and then in the working world.
Johnna:Right. And so in my personal opinion and I like I know I'm going to get a lot of hate for this and that's fine, my personal opinion there are certain people that can go straight through RMBSN to NP. You're one of them, you've done wonderful, your mind is set up to do that. There are some nurses that I have worked with that if they would have done that, I would have just been flabbergasted because I would be like because their motivation for MP school money, money.
Johnna:Yeah, which is another misconception we can talk about. Do you feel that nurses should be allowed into MP school if their only motivating factor is to make more money?
Ivy:No.
Johnna:Same, because that is. That in itself is a misconception with money and how much nurse practitioners make.
Ivy:Yeah, and especially if you work for different hospital systems. Rns make more money than MPs anyways, but that could be a whole different topic.
Johnna:No, I think I want to get into that as a misconception, because I think it's important. I don't think money should be a driving factor, because I think that takes the heart out of it. Because, again, we have talked so much on this podcast already about how you have to have the heart and the drive and the self-motivation to become really good Because of the lack of what's the word Standardized formal education.
Ivy:Yeah.
Johnna:So I don't. And then I think, and again, this is just from the state that we're in. When I graduated, I made four more dollars an hour.
Ivy:Absolutely.
Johnna:As a nurse practitioner than I did as an RN. And now I have all this debt with way more responsibility. And if I would have done it for the money?
Ivy:I'd have been real pissed, correct, real pissed.
Johnna:And I actually had this conversation with a colleague recently that she just thought we made as much as doctors did and I was like wow no, no like we're lucky in this state if we make six figures correct. Yes, it's considered a very lucky job to be in and people may be like what? Yeah, we're very like, and I get that a lot. People are like, oh, wow, you're a nurse practitioner, you must make really good money. And I'm like, yeah, because I work three jobs correct.
Ivy:You have xyz numbers of experience because yes, like in, uh, yeah, around here it's probably about what, 80 000 I would give it probably 87, 90.
Johnna:Okay, yeah, I wouldn't say 80, because a nurse was. A nurse is like 75, 80, uh, not sure.
Ivy:Yeah, nurses are like 75 absolutely, and there's not much difference no, no and um, I know that's probably shocking, but like.
Johnna:But just to put that into a misconception, I, and like, even like some of the doctors I worked with, thought that we were making just a couple dollars less than them, and I oh, my god once we had like conversations, I was just like they were actually shocked as well, because not that like.
Johnna:Like we said in the first misconception, we're there to compliment. I'm there to make your life easier. So if I'm going in and doing your laceration, repair your abscesses, doing the little tasks that do take time to like, get that off your plate so that you can go see more critical patients, I do expect to be paid more because you're getting the RVUs for that, like doctors and again, doctors nowadays are not paid as well as they should be either just because, of our healthcare system and, like the insurance reimbursements and stuff like that, they're not paid what they should be paid either.
Johnna:But if I'm making you, you're number one. You're making an hourly or a salary wage plus your RVUs, which are if y'all don't know what that is it's just basically what they make based on procedures. So procedures are going to make more money If I'm doing your procedure and I'm just only getting my hourly wage, which is not even livable at this point. I know that sounds very privileged when I say that. I just had to think about that, but I'm just saying, as a nurse practitioner, you wouldn't think someone would have to work two and three jobs, which that's just what it is in our economy right now. But there is a misconception that nurse practitioners make a lot of money, and I'm not saying that. Some don't, some do, oh, yeah, they do.
Johnna:In other states they do. There's more independent states where they do make as much as a doctor because they're running the show and they should make that, because it is a very demanding job and it's you know you're, you've got someone's life in your hands and sometimes the the work is dangerous and you know, depending on where you're at. But it is a huge misconception that people think nurse practitioners are going to get rich off the job.
Ivy:Yeah, so that's just from my personal experience.
Johnna:So if you are a nurse practitioner out there listening to this and you are making a lot of money, please DM me. Tell me what you're doing, so I can not work three jobs. Anyways, getting back on track here, did we cover everything you think for the misconception of MPs don't know as much as doctors I think so.
Ivy:Yeah.
Johnna:All right. The next one is um. Seeing a nurse practitioner means you're getting lower quality care.
Ivy:Oh my God, oh Jesus, that was just straight up hurtful.
Johnna:I have, you know, there I've worked in, you know, outpatient clinics where I have had some of you know my elderly patients who are used to just seeing a doctor, say that to me, say, like you know, know, I'm not going to see a nurse practitioner, I'm only, you know, I'm only going to see the doctor, and that's fine if that's their preference. But then I've also had patients say to me that they've gotten better care from a nurse practitioner than a doctor and I think and I'm not saying like better as in smarter- I'm saying better as in.
Johnna:We still have that nursing background where we want to still dote and care on the patient. We still have that in us to be able to educate a little bit better, to be able to see the patient as a patient with their family there. They're not just cells and biology when we look at them. So I don't think that you're getting lower quality care. I think that's a huge misconception. I think that you're still getting great care from a nurse practitioner, if not sometimes better care.
Ivy:I think we overall maybe I can speak from personal experience there's always that drive to be better than average and show maybe quote unquote, show people that you are as good as you A doctor, yeah.
Johnna:Well, and here's some quotes from online. Studies show nurse practitioner patient outcomes are as good as, or better than, doctors. So they have studied that Nurse practitioners often spend more time with patients, leading to better education and adherence. I agree with that. Even in my past experience, the doctor would walk out of the room and I would be in there with them while the doctor was trying to educate them, and the patient would just look at me and go. What did he say? Because it wasn't quote, unquote, dumbed down from this level of education. You know where. Sometimes we have to. We have to remember we're not. We're talking to people that aren't medical people, just like if an engineer came at me and started talking to me.
Johnna:I'd be like could you dumb that down for me, can you? Put it in layman's terms, like I'm not. I'm not an engineer, so I think sometimes they forget that. And so we're there and we remember that as nurses and if you're delivering bad news, know to put a hand on the shoulder, we know how to squat down to their eye level. There's things that we do and think about from our nursing background that does give more of a compassion.
Ivy:That bedside nurse, yeah us, if that makes sense is yeah and I think that goes a long way it does absolutely, because we do think about like oh okay, you just like for our maybe post hospital visit follow-ups in the office, while I am worried about you know their risk for sepsis and have they pooped and peed you know? X, y, z, are they running fevers? Blah, blah, blah. Right, I also am worried about do you have food in your refrigerator? What is your support system? Look like, were you able to drive you? Like things like that? So probably there is a difference right.
Johnna:And then the last thing, um, that there was a quote online. Um, it just says, like it's all about the personal approach to patient care. You know, um, and again, I think that we just remember we have that nursing background and I think that's what separates us from physician's assistants. Right, like I remember working in the er and because I had worked in the same place as a nurse, like if an ivy pole is beeping, I know how to, I know how to operate it and I can fix it and I don't have to call the nurse in there yeah but a physician assistant can't.
Johnna:And I don't blame they, just never yeah, they just correct they didn't have that bedside nursing so they would have to come out of the room and be like, hey, can someone help me with this IV pump or something where we can be like I got it, I can fix it or I can still, if the nurse is busy, I can start your IV. I can still do all those things that I did as a nurse. So I think it's just a difference.
Ivy:But and in the hospital, like not to toot my own horn but toot um. You know, like things that we would do, that maybe physicians or physician's assistants wouldn't like help with a boost or clean your patient up that you're going to see, yeah.
Johnna:Which is odd. It's funny that you say that because you know, like all these medical shows like oh, my God yeah. Number one. If you haven't watched the pit, I've been talking about it on the podcast. It's fabulous and like it's so. It's probably the most realistic that I've seen where it shows actual nurses and what they do and stuff like that. However, there isn't a nurse practitioner in there I just realized that last night. But it still does really good at like showing like the physician side of it and the nursing side of it.
Ivy:Okay, that's nice.
Johnna:So it's really good, like.
Johnna:but then you see things like Grey's anatomy, where the doctor standing on the trauma Bay waiting for their patient gowned up, and I'm like no patient gowned up and I'm like, no, yeah, not real life, but you're right, we do. We do still stay in the room and help with stuff like that. Like if the patient's like, hey, can you get me a blanket, can you get me some water, like we do that, all right. The next misconception is that nurse practitioners are just for primary care. I think we've kind of already debunked that with a lot of the examples that we've talked about.
Johnna:I think people forget that, that there's different specialties of nurse practitioners, just like there's different specialties of doctors. Um, there's a lot of nurse practitioners that specialize in trauma, cardiology, oncology, psych. Um, I know the ones that were offered at my schooling where family nurse practitioners versus um, acute care, adult gerontology, and then I know at Vanderbilt they offer psychiatric MP degree emergency room nurse practitioner. So there are schools that are more in depth with the specialties, where you learn more for that specialty. That's yeah, yeah, and which I mean, just like a doctor would do that, like when they're in their residency, they, you know, narrow down their residency. Do you want to be a cardiologist? Do you want to be a gastroenterologist? So there are schools out there, there are more of the. I don't know if UAB does, I think it probably does, but I know Vanderbilt for sure has like a lot of different specialties for a nurse practitioner program.
Ivy:Oh, that's nice.
Johnna:Yeah. Is there anything else we need to say about that?
Ivy:What do you think? Not that nothing's coming to mind?
Johnna:Okay. So the next misconception is nurse practitioners should not make as much as a doctor, which I know. We were kind of talking about money a little bit, but I do want to bring up something, because nurse practitioners are more of a female predominant field. I think the misconception there, like we've already talked about how we do not make we I mean, I'm sure there are some States and there's some nurse practitioners that do, but I it has not been my experience to make near what a doctor makes, not even come close to touching it Um nor has it been my experience, um, that people it's been my experience that people do find this to be true. They're like, well, you make as much as a doctor or whatever.
Ivy:We don't know.
Johnna:But I do feel like our pay is not what it should be for what we do. Yes, no, we are not doctors. No, we don't have the same education level as them.
Ivy:However, what we do bring to the table deserves to be compensated.
Johnna:It does and we still are, in some aspects, taking a like 50 to 75% of your load off of your plate. Yeah, whether that be, see some of your patients independently, whether that may be doing your all your procedures, running room to room to room to do your procedure so that you can focus on more critical patients, whatever capacity that may be, the compensation should be more than a nurse, because we almost fall into that category of we're not nurses anymore, but we're also not physicians. But we have not recognized your field yet. And that's just speaking from the state that we're in.
Johnna:And that's not all of Alabama, because I do know that there's other. I have some colleagues in Alabama. They work in Birmingham, but they're not treated that way. They're treated more independently.
Ivy:And probably paid. You know, yeah, I blinked out, but probably paid as such.
Johnna:Yes and no, I still think that their pay is not as what it should be. Because if I'm managing patients, like, let's say, in an ICU at night and you know I'm barely making six figures I have a problem with that because, number one, we're on night shift. We're staying up because a lot of people like doctors that are nocturnists are going to make a lot more money than a day shift doctor and that's just a normal thing because you're on night shift and it's taking away from your typical schedule. Yeah, but where I was going to go with that is female nurse practitioners are predominantly a female field. There, you know, there are some male nurse practitioners and there's some male nursing, but it's still a female predominantly driven field.
Johnna:And I think that when nurse practitioners initially, you know, go from nursing to nurse practitioner school, we're not taught as females to negotiate our salary as a man would. Because I have recently been having to do that in my job because we're switching from 1099 to W2, which is a whole nother podcast I need to do. But whenever I'm trying to negotiate my salary, like, I've been talking to my aunt a lot and I was like why do I feel so bad negotiating this salary? And she was like because you're a female. She was like because we're taught don't talk about money, don't share that experience, don't ask for what you deserve. We're taught that internally from a very young age and if it were a man asking like, they would be like no, this is what I'm asking and I, this is what I'm asking and I do not feel guilty about that.
Ivy:Absolutely. We're taught to shrink, yeah, to be diminutive, don't be rude or don't be perceived as rude.
Johnna:Absolutely Be happy, be accepting of whatever you're offered, correct, you know. Just be excited that you have a job.
Ivy:Well, there, that also um, is where we live, and the predominantly um. You know like, yeah, absolutely Like my first job, I know, probably with yours too. You absolutely did not even negotiate because you were told, probably in no uncertain terms, to be happy with it.
Johnna:Pretty much. So that is a huge misconception. But I don't think it's a misconception that we are. I don't think it's a misconception for the nurse practitioner or the medical world that nurse practitioners don't make as much as doctors. I think it's a misconception for the nurse practitioner or the medical world that nurse practitioners don't make as much as doctors. I think it's a shock to people who are not medical when they hear that.
Johnna:I think that they truly think that we do make that that's wild because, like I said, I had a conversation with a colleague the other day who is in. She's an audiologist, and I had a conversation with her and she was like, oh, I just thought you made as much as a doctor. And I was like what? Like people still think that and that's like one person.
Ivy:Can you imagine no wonder there's so much hate online? You know, like who knows all these misconceptions and then you just light a fire under it and then it goes haywire I think it was brought to light a lot during covid, like with the year of the nurse or whatever.
Johnna:I think that a lot of people were like rallying behind nursing staff saying, no, they don't get paid, like nursing and teachers, we know, do not get paid what they should get paid for what they do correct yeah like teachers are teaching you, teaching your children, life skills, education. So, no, they do not get paid what they should get paid to do that. And nurses are literally wiping your ass, taking you to the bathroom and saving your life for 20 bucks an hour yes correct, you know.
Johnna:Anyways, enough on that and the last misconception we have um, actually, oh, that was it. That was the last one. Do you have any other misconceptions after we went through that list that you can think of?
Ivy:that we didn't cover honestly, I think we covered everything from education to pay to how we're perceived.
Johnna:Yeah, and I mean it is a huge thing. But I think that you know, did we? Did we like talk? Yeah, we did talk about like going straight through school, like I think there's certain maybe there should be some kind of litmus test that you have to pass to be able to go straight through. I'm just saying, like you, you did well. I know brandy would have done well if she did that, because, gosh, y'all could have went to medical school. I, my brain, I just I can't like the way, like when we have conversations about patients or whatever, and I'm like what would you do? And you'll like explain your whole theology on it and I'm just like what, how did your brain like come up with that?
Johnna:not to say that I don't think critically. I just have a different way of doing it than you do you know I kind of yeah, it's too late.
Ivy:Now I got what I got.
Johnna:But now thinking about it, like, thinking about, like. If, thinking about some of the nurses that you have worked with, if someone came up to you and said, ivy, I'm going straight through, I'm just working this job because I need to pay for nurse practitioner school, would you then bat an eye or would you be like, great, go for it I, I'm like torn between that because, like I, I don't think ever honestly that it would be my place to discourage somebody mine either.
Johnna:I'm not saying I don't want to discourage anyone either. I'm just saying like I'm. I'm very mixed on it because I think that there are certain people that can do very well at it, and I think there's other people that need the experience.
Ivy:Yes, and maybe, if they asked, me I would be like hey, you know what do you think about getting a couple more years before you apply? But that, you know, can be all with a grain of salt. Maybe they'll figure it out and get their ass whooped medically. You know, I don't know. Yeah.
Johnna:And I also like and I just not to discourage anyone from going to nurse practitioner school If you want to be a nurse practitioner, you know we need great nurse practitioners. But if you're just doing it for the money, like I do think that at some point you'll regret your decision. Maybe you won't, because in the area that we're located the money's just not there. Um, for now, maybe it'll improve, maybe, um, but I also think you have to have some kind of like want to do that, like it has to be like a passion.
Ivy:I think so. But then that also gets into like people, should you know. People always want to say like oh, nursing should be your passion, so how dare you even argue about money, you know?
Johnna:like yeah, um, I agree, like I understand, but nursing. Nursing is one of those fields that if you don't have a passion for it or some kind, of want or some kind of like.
Johnna:I like this, you will burn out faster. Oh yeah, you would hate it like I burned out probably a year. I want to say six or eight, just because of the type of work I was doing. It was just non-stop, all day, everyday work, and I also probably signed up for too many extra shifts when I should have just worked my three and went home but, I I still, when I first started it wasn't like I initially hated my job.
Johnna:So if you get into it and you already have this disdain for it, I think it's just my personal opinion. Again, I don't know, because I did have a passion for nursing. I lost my passion. I talked about that openly on a previous episode, how I kind of lost my passion over time because I, like I said at the beginning of this podcast, I went into nursing thinking it was going to be this sit by the bedside, talk to the patient, listen which is now that I think about it. I probably should have been a therapist if you just wanted to listen to people. But, um, that's what I thought. It was like it was more of a I'm here to support you type type. Because that's what we did in high school, like we just sat with the patients, brought them the things that they needed.
Johnna:Um yeah, florence would be a shame, or should be worn out maybe my high school wasn't doing the best job, like maybe we should have shadowed the nurses a little bit more, versus being like here y'all are just like techs, you know, like filling up water bottles and stuff, because that's what I thought it was. I had a feeble mind, didn't, didn't investigate any further, but and and a part of me did go into nursing, like I said, to get out of my small town, cause you had to choose a career if you didn't want to be working in a factory. But again, I still. I was like I figured out what I wanted to do, cause I knew I had to decide in high school. I was like what do you want to do? Do you want to be an engineer? Do you want to be a nurse? Do you want to be a teacher? And I had to make that decision. And then I did fall in love with it, with that one old grumpy ass patient this history the rest is history.
Johnna:But anyways, guys, thank you for listening to the misconceptions. I hope this was helpful. I hope. I hope we did not offend anyone. It was not our intention to do that. We were just sharing our personal experience and journeys along the way. Of course, this is just thoughts. You know what my podcast is about. Just a streamline of thoughts. But, ivy, thank you for having this conversation with me, thank you for having me. All right, guys, until next time. Bye, thank you.
