Podcast

International Nurses Week 2021: Three Nurses Share Stories of Commitment and Resilience


Listen time | 12:18


In honor of International Nurses Day, which was held on May 12, 2021, TeleTracking's Maria Romano sat down with three nurses to talk about how they led through the last year amid the COVID-19 pandemic.

The conversation features:

  • Shawn Mabry, System Director for Sinai Chicago's Patient Transfer and Navigation Center

  • Tom Tsitas, an RN with Halifax Health in Daytona Beach, Florida

  • Kelly Cushman, an RN with Maidstone & Turnbridge Wells, the NHS Trust in the UK

Each nursing leader shares the important role, and incredible care, their teams provided to their communities during one of the most challenging times the profession has faced in more than 100 years.  They also share stories of colleagues who went above and beyond for their patients, including a nurse who created a “clothes closet” for patients who needed clothes upon discharge; a nurse who went to a patient’s house to care for his dog throughout his entire stay; and nurses who developed protocols to improve patient outcomes by reducing the time it takes to place an emergency department patient in a critical care unit.

More about this episode

About the Experts

Shawn MabryShawn Mabry, System Director for Sinai Chicago's Patient Transfer and Navigation Center

Shawn’s experience also includes working as the House Director and Bed Placement Coordinator at Adventist Health System.  She has a MSN in Executive Leadership from Benedictine University and is currently pursuing an MBA at Benedictine University.

 

 

 


Tom TsitasTom Tsitas, Manager, Patient Transfer Center with Halifax Health in Daytona Beach, Florida

Tom combines his background as an RN with his experience in nursing administration to improve patient access in his role as the Manager, Patient Transfer Center at Halifax Health.

 

 

 

 


Kelly CushmanKelly Cushman, an RN with Maidstone & Turnbridge Wells, an NHS Trust in the UK

Kelly utilizes her nursing experience to improve access and throughput for patients at Maidstone & Turnbridge Wells, an NHS Trust in the UK.

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View Transcript

Shawn:

My title is System Director for Sinai Chicago, Patient Transfer and Navigation Center.

Speaker 3:

Patient Transfer and Navigation Center.

Shawn:

Center. Yes. PTNC is what we're affectionately known as.

Speaker 3:

Okay, Shawn, how many beds are at Sinai Chicago?

Shawn:

So, we have 300 over here at Mount Sinai.

Speaker 3:

Okay.

Shawn:

And we have about 200 over at Holy Cross. We don't utilize 200 and then we have about 85 over at Schwab.

 

Speaker 1:

And Happy International Nurses Day.

Shawn:

Thank you for having me.

Speaker 1:

Well, I am thrilled because I have just enjoyed so many of our clinical conversations that we've had and to the audience, I would love to introduce you to Shawn Mabry, who is Assistant Director of Sinai, Chicago. And she is in charge of the Patient Transfer and Navigation Center and is doing such a great job with ensuring that no patients have to wait for the care they need and has been an inspirational leader, as she has deployed TeleTracking at Sinai Chicago. So, I count this a privilege, not only that it's International Nurses Day but also because I'm speaking to Shawn Mabry. So thank you, Shawn, again for-

Shawn:

Thank you. Thank you.

Speaker 1:

Yeah. Hey, can you give us a little bit about yourself? Like when did you become a RN and why?

Shawn:

Sure. So I've been a nurse since 1989. I started my career as a critical care nurse. I worked as a student on an organ transplant floor and when I graduated, I continued there. My travels have taken me to Queens Medical Center, where I worked in the float pool and I worked pediatrics and I traveled back to the mainland and worked at [inaudible 00:02:54] and another float pole. Cardiac telemetry is my love. Critical care, as well. And then someone introduced me to nursing supervisor and that's where the leadership bug bit me. And so I felt that I could make changes from a leadership perspective because I think you can learn a lot from great leaders, not great leaders. So that's where my leadership has taken me to. After [inaudible 00:03:26], I worked at Cook County Stroger. I did some quality. I worked at University of Chicago and very much like a department that I have now. I was the manager of the patient transfer center and also what they call bed access. And I've been here since 2017, coming up on my four year anniversary, June 5th of this year.

Speaker 1:

Wow. Wow. Well, congratulations. And man, do you have a lot of vision? Great. You have a lot of wisdom. You've got a lot of vision to drive nursing [inaudible 00:04:05] right. And to help to make changes in organizations and you're driving value as a result. And just working with you at Sinai Chicago, with what you're doing with patient throughput there. So again, thank you.

Shawn:

Thank you.

Speaker 1:

And what a great vision and it goes along with our theme for International Nurses Day, which is a voice to lead, a vision for future health care. And again, with your years of experience, I mean, you are definitely absolutely making changes how the future of healthcare is delivered at Sinai Chicago by ensuring that no patients are waiting for the care. And I know it's a daily daily struggle. Let me shut my phone off. You're going to have to get that blooper. Sorry. Okay.

Speaker 3:

No worries.

Speaker 1:

All right. So with all of the wisdom, right, in your expertise, Shawn, it aligns directly with the theme for International Nurses Day. And the theme is a voice to lead, a vision for future healthcare in 2021. And if there's not such a time as this, that is needed with this theme and this vision. I mean, you know. So, it matches what you're doing here at Sinai Chicago. So one of my first questions that I have for you. From your point of view, Shawn, can you please share a strategy that you used and believe that it has been effective in creating a thriving nursing culture during the pandemic?

Shawn:

Absolutely. So leading with compassionate empathy served as the greatest strategy utilized during the pandemic. During unprecedented times, I served as the operations section chief within the hospital incident command system at Holy Cross Hospital. Very little was known about COVID-19 and how it would impact our patients, our caregivers, the community, the city, the country, and even the world. What I did know required me to be visible and present, to uplift, encourage and listen to the concerns and fears of the frontline nurses. COVID-19 can be characterized as a battle ground. And we were there fighting together on the battlefield.

            As a servant-leader, it was important to ask and determine the needs of our caregivers and provide support the best way possible. Caregivers appreciated having a leader, help move a patient round, offer words of inspiration, deliver PPE, or just ensure that there were enough staff to take care of our patients. As a result, caregivers trusted that leadership genuinely cared for the patients and their wellbeing. Sinai Chicago nurses displayed remarkable dedication and resiliency during the COVID 19 pandemic. It is the dedication and the resiliency that allowed us to get through some of the most trying and challenging moments during the COVID pandemic.

Speaker 1:

Wow. Wow. That is beautiful. Reminds me of the mother of nursing, Florence Nightingale.

Shawn:

Oh yeah, absolutely.

Speaker 1:

I mean the heroism that throughout this and with your leadership and with your senior leadership at Sinai Chicago, leading with compassionate care, you know, to the employees and to the patients. Honestly you brought tears to my eyes, as you were saying all that.

Shawn:

Aww.

Speaker 1:

Went back to those months.

Shawn:

Yeah. Looking back, nothing could have prepared us for this. So, what we had to do is just lean to our own devices and just use common sense and just be a support. Support all the way from my colleagues that were in the command center to the people that are at the frontline. So, we were there, we understood, we listened, people vented and we were just there for them. So, I think that was the greatest strategy just being there, being present.

Speaker 1:

Yeah. And so many people have to have a voice all the time and they don't sit back and listen.

Shawn:

Yeah, absolutely.

Speaker 1:

So I think that's the greatest strategy to in nursing. With assessment skills, you've got to listen to what's going on, with the compassionate care. So yeah, you absolutely display that and captured that strategy, which I love. And you should write a little book about that too.

Shawn:

Okay. I will.

Speaker 1:

The second question I have for you. Can you share a story that demonstrates the main theme for Nurses Week, for International Nurses Week, which is today, and it's a voice to lead, a vision for future healthcare in 2021. So with that being said, was there a compelling story throughout pandemic times which are still going on, right?

Shawn:

Mm-hmm (affirmative). Absolutely.

Speaker 1:

Beyond pandemic. If you could share a story I would love to hear.

Shawn:

Absolutely. So this is a passion of mine. So critically ill patients in the emergency department, as we know, require efficient specialized care and are left vulnerable when in the ED for prolonged periods of time. There's evidence-based literature that demonstrates that when patients are left in the ED, they have poor outcomes. Sinai Chicago has been challenged with efficiently managing patient throughput from the ED to the intensive care unit. Any efficient throughput can lead to prolonged ED stays and overcrowding, which has a direct impact on patient safety, quality of care, patient experience, length of stay and patient outcomes. It was evident at that time that nursing can play a role to significantly decrease the amount of time for critical care patients to transfer from ED to critical care, by implementing some nurse-driven protocols.

            These nurse-driven protocols will help meet metrics for critical care patients to arrive on the critical care unit within two hours of the admit order or less so that they can get their proper treatment. These nurse-driven protocols involve standardizing the handoff report between the ED and critical care nurses, which will improve the safety and quality of care communication and escalation system to take a team approach to address barriers to throughput and identifying and transferring a downgraded critical care patient within 60 minutes. Nursing represents the largest workforce within the hospital, and it is very important to utilize nurse-centric and nurse-driven protocols for process improvement. Nurses have a voice to lead and drive practice changes to enhance patient access and improve patient throughput.

Speaker 1:

Wow, well, that's a great story. Thank you for sharing that, Shawn, very much.

Shawn:

Absolutely.

Speaker 1:

Taking the time. I mean, and this will be off recording, but thank you for taking the time with us.

Shawn:

Oh, yeah.

Speaker 1:

Yeah. That was great. You did beautiful.

Shawn:

Absolutely. Off of recording too. There's so many things that we can point to as to what we can do. We could change triage. We can change the middle part of patients in the ED, but some things are beyond our control and what we need to do as nurses because we have power. We really do. And when we band together and we are driven and empowered and supported, we can make things happen. So, that was my focus. Actually, I shared this was my capstone project. So it was just timely that you asked that question because I was pushing nurse-driven, nurse-centric for patient centric care. So thank you.

Speaker 1:

Well, I liked that power. So I like how you were just saying that. So I hope we can capture that into-

Speaker 3:

I was just thinking, that's my big sound bite. I love that.

Speaker 1:

Please.

Shawn:

Oh my goodness. Okay.

Speaker 1:

And then again, she's going to put this all together and edit it. Shawn, is there just like one nurse story that you can share? Actual like a nurse doing a compassionate act.

Shawn:

So many. Oh my. Okay.

Speaker 1:

Is there something that can come to your mind? Can you show a story of compassion from a nurse? Compassionate?

Shawn:

So I'm going to tell you about one nurse leader that we have. She's committed to her team and her name is Candice [inaudible 00:13:12] Ross. And, we service a vulnerable population with healthcare disparities and healthcare inequities. And we're in on the north-west side of Chicago. Unfortunately we have a lower social economic status here for patients. And when we have patients come and they're discharged, they have no clothes to go home. And so this nurse took her time, created a closet on her unit and she has clothes lined up. I mean, clothes, rolls and rolls of clothes. Patients go in there and it gets to choose what they want to wear. And it really makes them feel good about themselves. They get some shoes, they get a shirt.

            And it's so much more than them just having the clothes. It's really making them feel that they are important. And so to me, I think that is the way that we're giving back to the community. It's not that we're just going to take care of you, but also when we return you to the community, we're not going to return you in a gown and no shoes or socks, anything. We're restoring dignity and having these clothes. I think that is like an awesome, awesome thing that she does.

Speaker 1:

Oh, that's beautiful. Honestly, that's a beautiful story. And again, that vulnerability of that homeless person, or all of the social determinants, right? The poverty and things like that, that really make someone more ill, physically and help restore that dignity by giving them clothing to return back, it's just ... And, a nurse does that along with everything else that she's responsible for doing.

Shawn:

Absolutely.

Speaker 1:

What other profession thinks so holistically for the care of a patient?

Shawn:

Absolutely. We have to look beyond ... These are patients, they're grandmothers, they're mothers, they're fathers, they're people, and may not have a lot of money, but whatever we can do to restore dignity and just give them respect because that's all, all of us want. And that is an opportunity just to say, "Here, we care." And the fortunate thing is that we do have our patients, they come back and they remember that. And that's very important. And then they'll tell one friend or two friends, "Hey, when I was at Mount Sinai, they gave me some clothes and it really made me feel good about myself." And so it's just, that's what we need in this world to be kind to one another. And everyone needs to know that someone out there cares for them. And that's the biggest takeaway that I have from that story.

Speaker 1:

Caring goes a long way, for sure.

Shawn:

Oh, yeah. Absolutely. 


Maria:              I want to welcome everybody to TeleTracking's feature on International Nurses Day and I have such a special guest and I can't wait to introduce him to everybody that's listening. And his name is Tom Tsitas and he's from Halifax Health, which is located in the world's most famous speech of Daytona Beach in Florida.

Tom:                That's right.

Maria:              Yeah. So Tom, I mean, you live in Daytona, you're an RN there and we are celebrating International Nurses Day. And thank you for joining me.

Tom:                Oh, the pleasure is all mine, Maria. Thank you very much. As you are aware, I'm a big fan of TeleTracking and I'm thankful for all the nurses as well. So I'm happy to be here.

Maria:              Well, I'm honored to have you as one of the nurses that works at Halifax Health using TeleTracking, but not only you use TeleTracking to ensure that no patients wait for the care that they need. And, being the manager of the patient traffic control department is his responsibility. And I just want to thank you for all the work that you do each and every day to ensure that those patients are not waiting for the care they need. So for today, I had a few questions because it is International Nurses Day. And the theme for International Nurses Day is a vision for future healthcare. And it's a voice to lead a vision for future health care. And with that being said, I would love to ask you three questions. The first question is what was your decision to become a registered nurse?

Tom:                Well, it's kind of a funny story. I was 17 years old and I wasn't sure what I was going to do with my life and me and my uncle sat on the computer and we were trying to figure out, well, you can't play sports, you can't sing, you can't dance. What's what are you going to do? And I've always had a passion to help people. So I randomly picked nursing and then fell in love with the profession that I've been doing for 20 years.

Maria:              Wow. Well, that's a great story. So, 20 years you've been an RN. And I would love to hear, from your point of view, can you share what strategy that you used and believe has been effective in creating a thriving nursing culture during this current pandemic for the nurses in your organization?

Tom:                Well, I've got to tell you, I'm just super proud of the nurses in my organization. I mean, our whole ... Halifax Health is big believer in community. We focus on the community. We're here for the community. This hospital is built for the community. And when COVID first came to the scene, every nurse stood up and was ready and prepared to do whatever they could to help the community. We created a special unit that changed out the air. We had architects involved, administrators, leaders, nursing, everyone was involved to try to promote this, to make a safe, smooth transition for these patients in time of need. In fact, I was one of these patients and I was super duper sick. I was in critical care for 10 days and-

Maria:              Oh, man.

Tom:                These nurses were incredible. I can't thank them enough. I actually have in my office a giant picture that I had them all sign because I'm just so appreciative of them, of all the care they provide and what they've done for me and for everyone else in the community.

Maria:              That's beautiful. Now, you said that you were in the ICU for 10 days?

Tom:                Correct.

Maria:              Wow. Wow. And, being a nurse and being sick in the ICU with COVID must've been very difficult, right?

Tom:                It sure was.

Maria:              Yeah. Yeah. So, that really is something else. Honestly, Tom, I think that as a nurse and a nursing leader, that you were at your hospital seeing what the nurses ... So, that picture must mean so much to you that is on your wall in your office.

Tom:                And, I tell you, Maria, I really appreciate the ... It's the first time I've ever even had an IV placed in me and I oversee the vascular access team. So we place a lot of IVs here. And this is the first time I've ever been a patient, first time I've ever been sick. So it really opened my eyes to a patient experience that I've tried to incorporate for, to help promote throughput as well and be a [inaudible 00:06:44].

Maria:              So, that really has helped you to lead having a new vision for the future of healthcare, right. From you being-

Tom:                Absolutely.

Maria:              From you having that experience. And then I guess that goes into my next question. Can you share a story? That was a pretty good story so I don't know how you can top that one. But can you share another story that demonstrates the main theme for Nurses Week? Nurses [inaudible 00:07:08]. yeah.

Tom:                So, this story just recently happened in our facility. It's one of my vascular access nurses who is a phenomenal leader and patient advocate. She was actually outside of a room. Her name is Chloe. She was actually outside of a room, going to place the line when she heard a gentleman tearing up because when he was taken to the emergency room and then brought to our facility, he had his dog at home and nobody was there to care for his dog. And he was so worried about his poor dog. This was his whole life, his dog. And she overheard this and Chloe went in the room and spoke to him. She then spoke with him, went to the house, got the dog, took care of the dog until he was discharged so that the dog would not be taken to The Humane Society.

Maria:              Oh, my word.

Tom:                I mean, I just was in awe of her for doing that. I don't think compassion. I mean, it says it right there. She went above and beyond and now we're talking ... she drove 30, 40 miles to go get this dog because we're a level two trauma center and this gentleman needed a higher level of care so another hospital sent him to us. And she was there placing a line, overheard this and took it upon herself to just be there for him, console him and then brought him back his little puppy after he was well and ready to leave.

Maria:              Oh, my word. I mean like what a story that is. I've got chills just about that compassionate care. And Tom, we know that when patients come at their most vulnerable times. It's a vulnerable time for all patients in a hospital. Right?

Tom:                Right. Absolutely.

Maria:              Right. And, nursing goes above and beyond, you know, just their call of starting IVs, of giving medications. Right. They're going above and beyond with this compassion that you just talked about, and this is what helps to shape healthcare in the future because they lead and they know that they have emotional intelligence to say, "This patient is so worried about his dog." And she could have turned her back on this patient and said, "I'm not going to do anything." But she took the initiative to lead and go above and beyond that call, to go pick up that dog and to care for that dog. So what a great story, honestly.

                        Honestly, I would love to send her a thank you card from TeleTracking for doing that. That's awesome. So, Tom, I really appreciate all of your 20 years of nursing experience at Halifax and for what you're doing to ensure that no patients have to wait for the care and to ensure that they are being cared for compassionately. And they're also getting the best care at Halifax. So, I appreciate. Again, your time for this and have a great day.

Tom:                Thank you. It was my pleasure. You have a great day as well.


Maria:              Yes. So many questions and I want to get started with, because it is International Nurses Day next day, and I'm going to speak as it's International Nurses Day right now, because we are celebrating. The theme for International Nurses Day is a voice to lead, a vision for future health care in a time such as this, for that to be the theme and especially within the use of TeleTracking at your organization, it's needed right now. So you can lead as the head of nursing for patient flow, for your organization. So it is quite an exciting time right now in healthcare. And you have a strong ability to voice... To be able to lead with a strong voice, right about patients have to wait for the care. So from your point of view, I would love to hear a strategy that you've used and believe that it has become effective in creating a thriving nursing culture during the pandemic, which is going on still currently. So I'm going to pause and let you speak about that strategy that you believe has been effective.

Kelly:                Yeah. Lovely. Thank you. So creating a work environment for nurses is obviously the most important for patient safety. So, TeleTracking is able to do that. And as you've already said about the patient in the right place at the right time and real time as well. So, that's the fundamental changes that we've done through TeleTracking, and it's just making that work environment safer for the patients and the staff on the wards and the cultural change as well with the organization and understand how that implements with the patients on the wards and the flow through the hospital. And so where I come in is about the leadership style and the transformation of TeleTracking.

                        You might need to reword this bit, but it's been difficult to empower that within the nurses on the wards. So, the best practice hasn't always been followed. And we're now encouraging the nurses of the importance of using that TeleTracking and why that is important. And it's all goes back to the patients, [inaudible 00:03:36] the behavioral change and the organization research and the effectiveness of TeleTracking and using the raw data and the real data to show the ward staff of how important it is and how many hours would be saved throughout the day for each patient of implementing TeleTracking.

Maria:              Absolutely. So, I think it's important because to drive value, you've got to drive that vision for nursing culture change, right?

Kelly:                Absolutely. Absolutely. And it's the constant monitoring and of the hospital admissions. The discharges, patient flow within the hospital and identifying those beds early to get the patient out of the ED department onto the right ward with the right consultants looking after them. And it's just to make sure that each patient's placed in the right care on the right ward, ideally the first time.

Maria:              Right. And then they can have any order started effectively, efficiently. When they're in the right place at the right time and being able to drive that value to the nursing staff to really make their job... I don't want to use the word easier cause it's never easier, a nurse's job, but to make it be more strategic and it's planned. To make sure that they're getting the resources, they need to heal their bodies in an effective and timely manner.

Kelly:                Absolutely. So if they're referred to the right specialty and a decision towards met, this improves the length of stay for the patients as well. So it would knock off a whole day if the patient's in the right bed at the right time.

Maria:              Absolutely. And then I have a second question for you and can you share a story that demonstrates the main theme, going back to our Nurses International Day, of a voice to lead, a vision for future healthcare? Is there a story that you can share, throughout COVID with a staff nurse or you that can represent this?

Kelly:                Oh, I wasn't expecting that question. Sorry.

Maria:              All right.

Kelly:                Say that again. Can you say that question again? Sorry.

Maria:              Can you give me a story that you can share? A compassionate nursing story that you can share that really represents nurse's week, which the theme is a voice to lead a vision for future health care.

Kelly:                I suppose going back and thinking about the pandemic and looking at the stories, I suppose the hardest thing for the nurses was about the patients not being able to see their relatives. And I think that was probably one of the hardest things for nursing on the wards to be able to deal with. Because as nurses, our communications skills... Majority of us are very effective at our communication skills and it's the foundation of the good nursing care. And that was really difficult to be able to do that over the telephone continuously and different ways of learning the digital way, Face Timing relatives of the patients that are in beds, effective nurse-patient communication. It was probably one of the biggest challenges for the nurses on the wards.

                        And if you think about our overseas nurses, so majority of our nurses in hospital are overseas nurses. So, that was a different element of nursing. I think that would probably be one. I don't know whether I'm going off track here, Maria. So that would probably be one of the biggest stories for us is there are different effective ways of communication. And do you know when we got it, we got it right. But putting that into practice, it was difficult at first, but it was a different way of working and building up those relationships with the relatives.

Maria:              Did your hospital systems, or I should call them trust in the UK. Did they supply a phone so they could FaceTime or were-

Kelly:                Yes, they did. Every ward had iPads, so they could FaceTime their relatives. We'd got nurses, we got more iPhones. So they could communicate. We also employed runners as well for the wards. So they were called runners. So they would be on the wards helping support the nursing staff, phone all the relatives. Cause its different type of resources. Obviously, it didn't necessarily need a trained nurse to do that. But yeah, I think it's something that once was embedded, we actually did really well, but it was really difficult to be able to do that at first.

Maria:              Did the nurses voice their concerns about that?

Kelly:                At first, they did. So then it was a different way of working. So then it was... Let's get some runners in, let's support the nursing staff with this. So we basically looked at all of our admin staff, surgery obviously stopped during the pandemic, that's surgery for patients. So then it was looking at the admin staff to go onto the wards for support the wards and the best feeling was everyone pulled together. You could see that on the wards, you had admin people coming onto the wards to look, to help support the staff on the wards. And they probably wasn't given that opportunity before to be able to do that. Well, they couldn't do it before because they were doing different jobs, but that was a nice pull through, working together, and a different way of working.

Maria:              Absolutely. And the adaptability of that, for the nurses, they had to adapt to this new workflow. To ensure compassionate care for their patients. The whole patient and not just the piece of the patient.

Kelly:                Yes.

Maria:              That's a beautiful story. Yes.

Kelly:                And effective communication between the nurses and the patients, obviously, to achieve the effectiveness patient communication skills. But yeah, it became really emotional when you got really attached to the relatives, as well as the patient, which you don't always get given that opportunity when you're face to face with somebody. So yeah, I must say that that was a real learning curve for everybody within the wards, but it was lovely. It was really lovely to see and the relatives would phone up and FaceTime the nurses and get an update. Yeah, it was good.

Maria:              Beautiful. Yeah, absolutely. Absolutely. The pandemic definitely has reshaped healthcare and nursing, with their leadership, is reshaping healthcare to a picture of it. So tell me, Kelly, how will you be celebrating today, International nurses day? What festivities will you have for your nurses?

Kelly:                We will be going around to the wards to say, thank you to all of the nurses. We will be giving biscuits. And we also have a tea trolley as well to go around-

Maria:              Tell me about that, a tea... What is that?

Kelly:                A tea trolley is literally tea, coffee, biscuits, a box of biscuits for your night staff as well. So we can capture both day and night and we will make them a cup of tea that they can have, which is hot. Yeah. And every ward will get a box of biscuits. And we will probably... The chief nurse would to be involved with that as well. And the deputy chief nurse and the DDN keys and all of the matrons. So, that is a really nice thing to do. And actually, or even a muffin.

Maria:              Oh, nice. [inaudible 00:12:14] Couple of warm tea and a muffin or a bis-

Kelly:                We've been very lucky within our organization. And you can really see everybody pulling together. So, we've been given lots of free food in the restaurant. Our restaurants are only open to staff only. So no members of the public are allowed into the restaurant. And the trust has been providing free food for everybody since November. And it's still ongoing now, just as a little gesture of thank you.

Maria:              Well, that's a big gesture sometimes, that the nurses don't have to worry, about bringing that money or having it deducted from their salary.

Kelly:                It's really nice.

Maria:              So, those little things mean a lot in, in the daily service of what you and your staff are doing. I want to thank you for the time that you could spend with me today on this podcast. And I really want to say thank you for all the service that you have done in the work that you are doing in the UK to ensure no patients have to wait for the care that they need, Kelly.

Kelly:                No, thank you. I hope that was okay.

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