My guest for Episode #223 of the My Favorite Mistake podcast is Alisa Applewhite. She is the CEO of Top of the Line Healthcare Staffing, TOTLHS Heart of Gold Inc., and The Real Alisa Applewhite Consulting. Alisa describes herself as a Nurse, CEO, Wife, Mom, Child of God, Friend, Daughter, and Sister.
In this episode, Alisa shares her favorite mistake story about hiring 18 family members based on emotion, paying them too much. How did she discover performance issues and her mistake? Did she have to let some of them go?
We also discuss a number of issues in healthcare, including working at the bedside during the early days of COVID, setting proper staffing levels, “travel” nurse staffing, and the mistake of not listening to the patient's family about how they're doing.
Questions and Topics:
- Working at the bedside when Covid started? What was it like?
- The story of starting the staffing company?
- How Covid affected her mentally
- The business need for a staffing agency like hers?
- Staffing level mistakes in healthcare? What’s standard vs. what’s sufficient??
- Determining the “true” ratios for staffing?? What’s standard vs. what’s practical?
- The dynamics where nurses are increasingly wanting to be a “traveler” nurse? More to it than just higher pay?
- “Stigma” of travel nurses can be unfair?
- Videos — 5 nursing mistakes
- Mistake to NOT listen to patient’s family about how the patient is doing?
- A time your listening saved a patient’s life?
Scroll down to find:
- Video version of the episode
- How to subscribe
- Full transcript
Find Alissa on social media:
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Automated Transcript (Likely Contains Mistakes)
Mark Graban (0s):
Episode 223. Alisa Applewhite nurse and CEO
Alisa Applewhite (5s):
My favorite mistake is making business emotional.
Mark Graban (14s):
I am Mark Graban. This is My Favorite Mistake. In this podcast you'll hear business leaders and other really interesting people talking about their favorite mistakes because we all make mistakes. But what matters is learning from our mistakes instead of repeating them over and over again. So, this is the place for honest reflection and conversation, personal growth and professional success. Visit our website at MyFavoriteMistakepodcast.com to learn more about Alisa, her companies, and more Look for links in the show notes or go to markgraban.com/mistake223. thanks for listening. Well Hi, everybody. Welcome, back to My.
Mark Graban (55s):
Favorite Mistake. I'm Mark Graban. Our guest today is Alisa Applewhite. She is the CEO of three organizations. Top of the Line, Healthcare Staffing, TOTLHS, Heart of Gold Inc, and The Real Alisa Applewhite Consulting. So Alisa describes herself, I'm sure it's a long list. I'm sure not there. There might be more, but nurse, CEO, wife, mom, child of God, friend, daughter, and sister. And we will now add podcast guests. So thank you so much for being here. How are you?
Alisa Applewhite (1m 27s):
Thank you. Thank you for having me here. We, we summarized it with three companies to just CEO, three times
Mark Graban (1m 35s):
CEO, three times guest here one time. And, and maybe, maybe there'll be more, but I will put, I will put links to all of Alisa's companies and, and websites in the show notes. And there's, there's a lot we can talk about here today in the realm of, of healthcare and nursing and staffing and, and we'll tap into Alisa's expertise and experience. But you know, first off, as we always do here, Alisa, I'm gonna ask the question we always start off with here from different stages of your career and different businesses. I'm curious, you know, looking back, what would you say is your favorite
Alisa Applewhite (2m 11s):
Mistake? My. Favorite. Mistake is making business emotional. So like, when I think about how I made business emotional as far as how I care for patients, that was the same way how I, I was thinking of hiring my employees and it cost me a lot of money.
Mark Graban (2m 34s):
Alisa Applewhite (2m 34s):
It cost me a lot of money. So I, I learned to get the emotional part out of hiring people when it comes to hiring people and actually hire people based on their skill and what they can offer to the business. So my biggest, biggest favorite mistake is doing things emotional when it comes to hiring.
Mark Graban (2m 55s):
Yeah, when, I mean, do you remember the first, well maybe, you know, know, you can tell us a little bit about your businesses too, like the first business you started, do you remember the first hiring mistake that you're kind of thinking back to here? Oh,
Alisa Applewhite (3m 8s):
Definitely. So we started Healthcare Staffing, Top of the Line Healthcare Staffing in May of 2021. So it's a little bit under two years. I was a nurse myself for 14 years. I traveled as a nurse for seven years in healthcare altogether for 18 years. So like, healthcare is my thing. I, I love healthcare, I love taking care of people. It's like very natural to me. And when I first started my business, I actually got a consultant to help me on how to do it. And they gave, she gave me the order on how I should hire people and what I should hire and, and the positions. But I was like, you know what, this family member needs a job. This family member needs a job.
Alisa Applewhite (3m 49s):
So I did it based on the emotion of them being my family. And when I looked, when me and my husband looked at the business almost two years in, we had hired almost 18 family members and we paid them these ridiculously high, high salaries. And it, it was based on emotion. It wasn't based on the skillset that they brought to the company. 'cause everybody came from different skillsets and it was, healthcare staffing was new to everybody. It was especially new to me 'cause I wasn't on the business side. I've always been on the nursing side. So I'm like, you know, 50% of this I got packed. I I you don't have, I could break down the travelers contract. I, I now negotiate my race when it comes to recruiting.
Alisa Applewhite (4m 31s):
But the other part was like learn from my consultant. So my whole thing was let's go ahead, let's get the family in. Let's do a family business. Other people had very successful family businesses, why can't we? And it was, it was based on emotion. It wasn't based on how the person's work ethic was prior to starting my business, you know, how, what's the normal rate that you would hire people as far as schedulers and recruiters or HR team. So it wasn't based on none of that. It was based on the emotional part of you're my family and I wanna make sure you're getting the best salary as possible.
Alisa Applewhite (5m 12s):
And I, I did that the first year with my nurses too, based on, oh man, I remember working 72 hours a week, so you should get paid this. Not knowing that there was a percentage breakdown on why you should pay a people a certain amount because you gotta pay taxes and insurances and all that stuff. Right? So I didn't entail all that information until it was probably a year, a year in, a year in It took me to do that. And then the reason why we started a nonprofit is because we, we gave away so much financial, so much money in our business to our medical professionals that my accountant said, it just makes more sense for you to start a nonprofit, you know, so you can donate to your nonprofit.
Alisa Applewhite (5m 56s):
And we have the Heart of Gold Gala, which we had our first one last year. This was, this will actually be our second year in business. So I'm excited 'cause it's two more weeks and then I'm gonna celebrate like a crazy woman. Yeah. So last year we had an event called The Heart of Gold Gala where we celebrated 52 nurses and medical professionals. And they got up, it was at the Hilton here in Charlotte. They got up, they got to tell their speeches about their stories about, you know, why they love nursing and how it's impacted them and just to be, to be heard for so many years. And I had one nurse, I absolutely love her. She goes, I've been a nurse for 18 years. No, I've been a nurse for 20 something years and I've never had this opportunity to tell my story.
Alisa Applewhite (6m 38s):
And I'm just like, that is what I want. I want people to hear what healthcare workers go through. And with that particular event, we had a chance to get 5,000, $5,000 to five different medical professionals to help them with debt. We had them to sign up with the credit specialist to help them understand their credit. And then we had them to sign up with the financial advisor that we used that broke down how they should apply the money to help them get outta debt to manage their credit. And for those who didn't want, who didn't own homes, they had a chance to partner with a realtor and a mortgage loan officer from a bank to help them prepare to buy a home within the next six months to a year.
Alisa Applewhite (7m 20s):
So we, we did a lot of giving. And we have the initiative this year is a hundred nurses for a hundred medical professionals. So we can educate medical professionals on how to own homes. 'cause that's really big is we make decent money as medical professionals. But when Uncle Sam takes 40% of that, you know, af after a while you almost live and check to check, but you still make enough money. You just have to know how to manage it to buy a home. And it's, it is, it was always very interesting to me how so many medical professionals, they work so many hours and they still didn't have a home. And it wasn't because they didn't have the money, it's because they didn't have the information.
Alisa Applewhite (8m 1s):
So that's why we started the nonprofit T L T L H Ss Heart of Go Inc. It is to educate the medical, medical professional on how to manage their money but also give them assistance that they need. I specifically remember being a nurse. I had my son when I was 14, so I was a certified nursing assistant when I first started. And I remember walking to work, riding a bike to work. I remember him sleeping in the office rooms while I worked at night because I had nobody to watch him. So like my heart goes out to medical professionals that are just getting into it and they just don't know how to manage their money and they need a little bit of assistance. So we help with utility assistance, we help with rental assistance, mortgage assistance.
Alisa Applewhite (8m 46s):
So that is why I did the nonprofit. She's like, you wanna sit here and raise all this money and you're gonna give, you know, put your money in the nonprofit yourself. This is where you can have something dedicated to medical professionals. And I love teaching. I love teaching because I done taught so many naked patients about medications and you know, what to say to the doctor, how to say it to the doctor just about life, right. And how to take care of themselves. So the real Alisa Applewhite Consulting came about because one of my good one people kept contacting me and one of my good friends was like, you just need to teach people how to do what you do.
Alisa Applewhite (9m 27s):
And I'm just like, half of the time I don't even know how to do. Yeah. You know, so that is how that started. And I help medical professionals to either just hone in on their craft to become very, very compassionate medical professionals. And then I also help healthcare staffing owners to target premium clients because I'm very, very blessed and fortunate. Less than two years, we have 70 plus clients. Our clients are really, really great clients and sought after clients. But there's a method to it. And I learned the method and I actually learned the method from being a nurse. That's the crazy part. So I learned the method to it and I, I wanna help other healthcare staffing owners who have been in this industry.
Alisa Applewhite (10m 10s):
I have, I have two that reached out to me. They've been in the industry for like five years and no clients. And I'm just like, yeah, no, we need to talk. Like we need to have a heart to heart because there's clients out there. And I feel like every time as a staffing owner, if you are not staffing a medical professional, that's one more patient on the floor, that's one more patient that has to sit in their urine or feces for several hours, that's one more patient who don't understand what the doctor said when it came in the room. You know? So I feel like it's like an obligation and a duty. It's as, as a nurse, I knew I had to take care of patient. 'cause that's the oath I made. So it's the same thing as a staffing manager. As a staffing owner, I have to make sure that nurse is compassionate enough to go to that bedside and truly, truly advocate for that patient.
Mark Graban (10m 55s):
Right, right. Well thanks, you know, for giving the overview of, of the different things in your professional business portfolio, I'd love to hear more. Going back to starting the staffing company or maybe even a little bit beforehand. Were, were you working at the bedside in early 2020 when Covid came upon us?
Alisa Applewhite (11m 15s):
Yes. So when 2020 came, I was here working in Charlotte, North Carolina at Atrium Health. And they were cutting people hours. And my husband said, you know, they really need help in New York. And I said, I know. So we kept watching the news and I was like, babe, I know you don't want me to go. 'cause I had just had a baby. I'm talking about she was, she was like six months And. he was like, I was like, I know you don't want me to go, but I have nurses over there that's dying that were actually friends and family. I said, it is, it is bad. And I, they need people with experience. And I knew that at that point I came with 11 years of experience with including six years of I c U experience.
Alisa Applewhite (11m 60s):
So I'm just like, they need people who, not a work vent, they need people, you know, who not a, do drips and take care of the patients to the best of their ability. And I convinced my husband, I convinced my husband to take a risk and, you know, potentially lose his wife to go fight this battle. And I went and I, I always tell people this, mark, like I was prayed up. I've always been prayed up and I prayed, like from when I got there, I prayed every night I left. It was so rough when we worked in New York that we would not get off. Like I would be scheduled, I would work from seven in the morning till seven at night and nurses wouldn't show up.
Alisa Applewhite (12m 43s):
So sometimes I would work till 11 at night and I would do that for seven days straight. It, it became like almost habitual as when you walked in that building, you won't guarantee the leave. And then sometimes it was so bad you would have nurses, like literally in doctors just cry and break down. Because I always tell people this, you are not, when you are in the healthcare field and you're in the I C u, you're in the er, you are in the field of recovery. You know, you're not used to seeing this much death. And when you are in hospice or something, you're expected for it. You know, when you're, you're expecting people to pass away, it's almost expected. But when you are put in five to 10 people in a body bag per day, oh gosh.
Alisa Applewhite (13m 27s):
That, that's, that's just mentally on anybody. And that is what I experienced myself in New York specifically, putting that many people in bags and the nurses that I worked beside that we, we just all, you know, we all knew we was in it and we would show up and then the next day you would see the nurse didn't show up. And you are like, what happened? You're like, oh, you know, she died from Covid. And it, it just, it's like, wow, that could be me. You know, this, this nurse left five kids, five kids with her spouse, and she was just here trying to defend the virus and stick to her oath. You know?
Alisa Applewhite (14m 7s):
So I particularly remember we had one patient, And, he was 18 years old. And I'm just like, I, I couldn't hold it together. And the doctors are there with me. The doctors in New York were awesome. I'm telling you, I've never worked with doctors that were so hands-on. Like they help us bathe the patients, change the patients. They were there. I've never had doctors like that. And we, we are sitting here and we're crying and I'm just like, man, this this 18, like I remember when I was 18 and I was complaining to my mom, you know, like I, I don't, I, I don't know why somebody should be looking at their death at 18. And the doctor said to me that click, he said, you know, he's 18, you know, and we're gonna do everything we can to save his life, but he doesn't look like he's gonna make it Alisa, so we gotta live our lives for him.
Alisa Applewhite (15m 1s):
And it just clicked for me, like, wow, you know, and I said, that just makes so much sense. Like, I'm here to intake these stories. I'm here to, you know, console the family members and you, you can only console 'em over the phone 'cause they couldn't come in person, you know. so it was like every patient I was there with, I was singing gospel songs. I'm really heavy on gospel songs because they motivational, they keep you going. Like, I didn't need to hear nothing that was going to get me angry or something. I needed something to keep me going. Yeah, yeah. And keep me spiritually motivated. So I was sing gospel songs to them. And I would always say to them before I put 'em in a body bag, I would pray and I would say, I'm gonna live my life for you.
Alisa Applewhite (15m 42s):
I'm gonna, whatever your dreams and aspirations were, you know, God, just help me get 'em so I can live my life. Any excuses from this point on, I'm not gonna have any excuses. So I remember going from there, I went to California and did the same thing in California. I mean, I think California patients were, it was totally different. Those body bags, they were probably 10 to 15 a day. It was, it was a lot. So when I got home, I told my husband, I found myself traveling home every week as it was calming down. And I told my husband, I said, we're starting a business And. He said, well, why are we starting a business? I said, because I've wanna start a business for the last four years.
Alisa Applewhite (16m 24s):
And I've been putting on excuses. And one thing I realized is that when you put somebody in a body bag and they held these things so valuable to them, like their clothes, their jewelries, you know, their, their jewelry, their shoes, whatever. It was valuable to them. You had a lot of people with rosaries on, you know, and that was valuable to them. And now this stuff had to either be burnt because we didn't give it to the family, or it just had to be destroyed. And I'm like, I'm tired of focusing on materialistic stuff and I wanna focus on things that's gonna help me build wealth for my family and my kids so I could spend more time with my kids, you know, and teach them how to be better people. I'm like, I have to live my dreams for everybody that I zipped up in this body bag because they don't have the option anymore.
Alisa Applewhite (17m 11s):
And that's what we did. So covid affected me mentally. And the crazy part was my kids didn't pick up to it. My mom, my sisters, nobody did. My husband sat me down And, he said, babe, something is wrong. We need for you to go talk to somebody. And that is when I went to talk to my psychologist, And, he just helped me get through that traumatic era. But Covid was, COVID was the game changer for me. Yeah. It, it, it turned me into the CEO that I am now. Wow.
Mark Graban (17m 43s):
Well thank you for your service to people as a nurse and running to where the need was, to where the problem and the, the sickness and the death was. That's really special. So thank you for, for taking that on in a time when a lot of people, for their own reasons and understandably so, right, we're moving away from healthcare and, and there had been trends happening before Covid. So I mean, there is a real need. Maybe you can tell us a little bit more about why there is this need for the staffing agencies for providing quote unquote traveler nurses or, you know, what some people might call temporary, that's not the right word, travelers what people say in healthcare.
Mark Graban (18m 28s):
But can you talk about some of those dynamics of, you know, why healthcare organizations use a firm like yours to make sure they have the right staffing levels?
Alisa Applewhite (18m 39s):
Well, I always say, mark, this is what I say. You have a CEO or somebody who's making the decision, Hey, let's build this extra building, right? They, they have this decision of let's build this extra building. And it is great because they're trying to help the population, but they never really figure out the true ratios of the nurses on the floors, right? They never really figure out the true ratios that a medical professional can have on a unit as far as a, a doctor, a respiratory therapist. So they say, you know, okay, as a MedSurg nurse, it's standard based on the areas you can have anywhere from five to seven patients.
Alisa Applewhite (19m 19s):
And they never look at that MedSurg nurse that has the max of seven patients and say, Hey, this is seven pneumonia patients, meaning I'm gonna be passing antibiotics until the time I leave. Or, you know, this is five cardiac patients and one, just two just had a cardiac calf. One, you know, they have the heart, the t e e, and then you have another one that's getting ready to go to a cardiac cath. Like they never say that. And Oh God, let's, let's not get one that gotta get ready for a prep, you know, for indu endoscopy or something. So it's like you, you gotta prep patients and that five can be enough to drive anybody crazy. And I think that is why we need more medical professionals and in the ears of the CEOs and the people that are making the decisions to say, Hey, the number looks great.
Alisa Applewhite (20m 12s):
Yeah, five patients for the number. But we really have to look at what is, what is included in the number. So until somebody truly sits down. And that is one of our goals here with top of the, the consulting company, is we coming up with a program and we're working on it, on how to educate hospitals on how to maintain and keep their staff and the importance on, you know, why it is important to do certain things when it comes to medical professionals. Because nurses literally staff about 80% of any hospital. Right. And you can't operate institutions without a, a registered nurse. So I know how to do that from the back of my hand, right? Right. Like, right, I've been charge nurse in the ER I c U meds or tele psychiatric.
Alisa Applewhite (20m 57s):
So it's like, it, it is, it's swaying that way to go and make that plan to help hospitals. But you need temporary staffing because number one is, is really hot. It is really expensive to hire staff that don't stay. Right? So you're going to all this expenses of hiring a staff member and then they don't stay. But when you have a temporary staff coming in or a travel nurse coming in, you're paying that travel company one rate, right? And then hospitals have to worry about insurances. So you have to worry about liabilities and workers' comps when it comes to these medical professional. But that's all in one when you pay for a travel nurse, right? That's all in that one rate.
Alisa Applewhite (21m 38s):
And if something happens to that medical professional while they're there, this is no longer your liability. And some of them costs can cost you hundreds of thousands of dollars. Where now that's the staffing agency's liability to come in and pay for that. So that decreases the cost for the hospital. But I'm not gonna lie, sometimes the travel rates can be very, very expensive in hospitals and them, they cannot expand that for such a long time. And the great thing with Covid was they had, they gave in so many incentives and tax breaks and credits and that's, that's how they were able to bring in so many medical professionals at one time.
Alisa Applewhite (22m 18s):
So I think that that is why medical professionals, when it comes to travel staffing, they'll always be around because we just haven't figured out how to truly staff, you know, and medical professionals, they, they get exhausted sometimes. They get tired. And after you can only work short so many times, you can only, you know, cheer in and stick in so many times before you don't get the help. And it's just like, all right, I can go somewhere else. You know, I can go somewhere else. And that place may still end up beating being the same way, but at the same time I'm willing to take a new risk because this place might gimme five or $10 more.
Alisa Applewhite (23m 0s):
And I don't know how they, I really don't know how they come up with their pricing for medical professionals. But I remember being a rn, a registered nurse in the ER making $22 an hour and then as I traveled as a registered nurse, I was making anywhere from 40 to $50 an hour. so it, it's a big difference. You know, when you, especially when you have experience, you're just like, nah, I got too much experience. And as a RN working in a staff facility before I, I went to travel full-time, I think I maxed out at like $38 an hour. This was a very, very, very prestigious hospital. But it was like, Hey, you're working for this prestigious hospital, that should matter.
Alisa Applewhite (23m 42s):
It matters, but you know, the government's gonna take 40% of that. Right?
Mark Graban (23m 48s):
Well, pres prestige doesn't pay the bills. I mean,
Alisa Applewhite (23m 50s):
Fair enough. Right? Right. So that's, I think it's,
Mark Graban (23m 54s):
Yeah. So I wanna talk more about staffing and some of these dynamics, but I wanna maybe close the loop on the story that you told upfront, Alisa of, you know, hiring family members into different types of roles. Did you, I mean, did, did you see performance issues? Did you end up having to let some of them go? I imagine that must've been really hard to work through.
Alisa Applewhite (24m 20s):
It was so it was performance issues and it was like, you know, my child is sick and I I gotta be off. Or can I work virtual? I have a doctor appointment. Well, I don't feel like coming in the day, oh, I'm sorry, I overslept. so it was, it was, they were as dedicated as I believed they could be. But I gave them no structure. I was like, you know, hey, we're family. You need a day off. Just be off. You know? And that, that's not how you run a business. And you know, if you're late, it's okay. There's no punitive or anything that we're gonna do because we're family. We're here to work things out.
Alisa Applewhite (25m 1s):
Now granted, with my family and us working, we generated about over less than two years. 'cause two years would be May of this year, we generated over $5 million in revenue. So we did something effective to do the revenue, but it was a lot of chaos and it lacked structure. And when I get from now from my consultant that I'm seeing now, which is Brandon Dawson that works with Grant Cardone's group, him and his wife, Natalie Dawson, it is just that I didn't give the structure, I didn't give them direct direction on where we were growing. I would just motivate them, but didn't give them the steps on, okay, this is what we need to do.
Alisa Applewhite (25m 44s):
This is what we need to do to grow. So what ended up happening is because of their salaries, we won't, we wasn't bringing in enough revenue to cover their salaries alone. I had to let a lot of them go. So it's like now we in the restructuring phase, but we still have the medical professionals, we still have our clients and we are trying to restructure it in a way where it can be better organized and it can be, you know, repeated. 'cause our goal is to franchise in the next year. Hmm.
Mark Graban (26m 17s):
New, new goals ahead. Yes. Interesting to see. Well maybe we'll have you back, you know, for, for other appearances as you do new things and look, doing new things making means making new Mistakes. So I appreciate your willingness
Alisa Applewhite (26m 32s):
Mark Graban (26m 34s):
To, to share with us here. But you know, I do wanna go back though because you know, listeners might not know, but you know, Alisa and I have some professional overlap. Or even though I'm an engineer, I've done a lot of work in healthcare since 2005, trying to help people improve. And as an industrial engineer, like such a core issue to my background is this question of staffing levels. You mentioned Alisa, that there was a standard, but that might not be sufficient. Yeah, right. We might have staffing level Mistakes and you know, I've, I it's been eye-opening and frustrating, you know, to, it's funny, you know, on one hand, healthcare leaders will kind of, you know, my start my career manufacturing and they'll say, oh, what we do in healthcare is far more complicated.
Mark Graban (27m 22s):
What could we learn from manufacturing? But, and they'll say, well our, our patients are so unique and there's so much variation. But then the staffing is based on like this really simplistic rule, right? Wait a minute now I'm arguing the other side. But I think there is, even if we're not gonna learn from manufacturing, like you have to look at the actual workload and listen and observe if people are overwhelmed and overloaded. You've gotta look at the right staff and levels that ensure safety and quality and then that, when that's not happening, I, I know I'm giving a little speech here, but I'll hand it back to you Alisa. That's where people get frustrated and discouraged and quit.
Mark Graban (28m 3s):
Then the hospital's short staffed and if they can't hire people full time, then they go to the staffing agency. And like you said, it might be people now who, who are saying my words not yours, but you know, I've heard people say, well if this is, if this is the way it's gonna be, I'm gonna, at least I'm gonna make more money. Yeah. And that doesn't make everything okay. But it's just, it's it's, it's frustrating to see sometimes healthcare will say, Hey, we're different. But then they won't do the things that you would expect a different type of industry, if you will. Right. Do in terms of caring for the nurses so that they can better care for the patients.
Mark Graban (28m 43s):
So I, it resonates what you're saying there of, you know, every patient is not the same amount of workload and Okay. And, and of, I'll climb down from my soapbox. What? No, I
Alisa Applewhite (28m 55s):
Mark Graban (28m 56s):
Lemme turn it back to you.
Alisa Applewhite (28m 57s):
I love it. Mark. Like, because you understand you, you said the key word workload. People don't understand, like as a medical professional, if you are on a med surg floor, they're just like, okay, you're on a med surg floor, all you're doing is giving antibiotics. You know, all you're doing is preparing people for testing. But what if they're just not regular people? What if you have psychiatric patients? You know, the ones that attack you, the ones that hit you, the ones that throw their own stool at you. What if you have those patients? You have to clean that up, you know, plus still deal with the other patients that got procedures and tests. And God knows I love people to death, mark. I do. But nurses know family members, they can make stuff extra.
Alisa Applewhite (29m 37s):
They can make it extra, extra. And they're just like, I want my mom to have this at one o'clock, at two o'clock. You know? And then I honestly believe that before nurses used to say, the older nurses, well we used to do this all and didn't have to do computer work. That that's a difference, right? You could write down your notes at the end of your shift or you know, write whatever you had to. Now you gotta learn this computer system, tap into this computer system, scan this medication with this, and god knows if you have an error going on with the medication scanner. Like if that doesn't work, you have to wait on pharmacy to bring your medications. And in some hospitals, I remember some rural hospitals where I had to make my own IV medications.
Alisa Applewhite (30m 20s):
They would tell you one drug and this drug and how to mix it and you would have to do it 'cause they didn't have night pharmacy. But it didn't matter because this is what we said is set in the patient ratios for this particular medical professional. Regardless on if these patients are on this floor. This is supposed to be a cardiac floor. But what about overflow? What about when the other units are folded up and now you only have cardiac beds and you have to fill it up? They even put med-surg patients in I C U beds. Those beds are like 20, 30,000 a night. Like it's, so, it's like, as I've heard nurses say that all the time too, if I'm gonna sit here and work this hard anyway, I might as well work hard and get extra money.
Alisa Applewhite (31m 4s):
You know? And with top of the line, what we say to our medical professionals is, you know, we want you to work not hard but smart, but we want you to do it with compassion. I don't want, they have this stigma that, hey, oh, travel nurses coming in, they're not gonna do their paperwork, they're not gonna take care of their patients. They get missing. And I'm living proof. I've been a travel nurse for seven years of my career. And no matter what hospital I went to, they always wanted to hire me full-time. The nurses, like I built these relationships with them. I can go in any state that I've worked in and live in these nurses' homes because they knew that I gave the patients all that I can give them. You know? And me, because it's not about how much you pay me, it's about me taking care of that patient right now.
Alisa Applewhite (31m 49s):
Yes, I know that I'm gonna be a bad nurse. I know that when I go into a building, I, I'm going to give them all, I'm gonna give them all the education, I'm gonna give them all the compassion and I know I'm gonna give 'em all the care. So why not get paid for it? You know? So me as a owner, it's like now you can advocate for your medical professionals to not only pay them premium pay, but say now for all those hard works, for all those moments, you felt like you was forgotten for all those times. You felt like nobody was hearing you. We hear you here. We have monthly meetings for our medical professionals where we get together and we talk as with me with the CEO. That's a big thing to me. How can you work in some institutions and never meet the head of the building?
Alisa Applewhite (32m 32s):
Like, I get it, you're busy, but if you didn't have these people working here, you wouldn't have to CEO job. Right? Right,
Mark Graban (32m 39s):
Alisa Applewhite (32m 41s):
You know, come down and meet me. And there's so many institutions I worked there where I never met the CEO or the, the, the nurse, what is it? The director of nursing. And like, you're, you're in my head, I supposed to report to you. So it's like we have that, like I'm, I tell people I'm a person, I'm a person, I'm a wife, I'm a mother, you know, first and foremost, I love God and fear God. And I just want people to know that I really care about what I'm doing when I give care to patients. I want patients to know that I really care. And even as a CEO now, people think it's crazy. I, when I have my clients, I will go work in my client's facilities just to see what my nurses are going to experience and do like a survivor's package or something for my nurses.
Alisa Applewhite (33m 27s):
But also to say to my clients like, Hey, I'm, I'm not good. I'm not too good to ever come off these shoes and come down there and help you out when you're in a crisis. Right. I'm there to help. So when you are speaking just now, mark you like you were in my mind, like people don't know that part, the workload, the patient care. So I appreciate that. And no, don't ever stop, keep talking about it 'cause it's so true. And I just wanna have nurses say, okay, we can't quit. Right? We all can't quit. But what we can do is we can't fight for higher pays. And what we can do is show patients that it is truly about compassion. Because at the end of the day, Mark, and I mean, I don't understand why normal people don't think about this.
Alisa Applewhite (34m 13s):
You could be driving the car and become a patient. You could be walking, becoming a patient. I could be talking right now and have a stroke. You know, like at any moment you're going to need a medical professional to have enough compassion to care about you, to still treat you with the dignity and treat you as a human when you are at your most vulnerable needs. And why can't you invest in these people so they can be the best they can. 'cause we sacrifice a lot, you know, emotionally, mentally we sacrifice a lot. So I'm the advocate on the nurses side and the C n A side and medical professionals.
Mark Graban (34m 46s):
Yeah. Well, I'm, I'm glad that you are because when leaders, you know, directors, vp, chief nursing officer, chief executive officer, when they stay in their offices all day long, they, they're not exposed to the real reality that the nurses and other healthcare professionals are, are going through. And like you said, just showing for one, showing that you care. Two, you know, I think helping Eliminate barriers, you know, what are the reasons why people are having to work so hard problems with the IT systems or E H R that could hopefully be fixed.
Mark Graban (35m 26s):
Why is it so hard to go find your supplies and medications? Why are certain systems so slow? If you don't fix those things, people might quit no matter how much you're paying them or how many bonuses or rewards that you're giving, like leaders, I mean, we'll, we'll climb up in the soapbox together. 'cause like to me this is lessons from good business management or manufacturing management of, of, of executives need to really, really understand what, what, what is causing struggle for their staff.
Alisa Applewhite (35m 54s):
Mark Graban (35m 55s):
That's the first step.
Alisa Applewhite (35m 56s):
It's that small thing, like you said, supplies. It, it doesn't make sense. How can we not have supplies to take care of the patients, but we got the orders to do it. You know, and that little thing could be like, oh, I'm tired of looking for supplies, I ain't coming back tomorrow. Right.
Mark Graban (36m 11s):
What's the last straw? But you know, you, you, you talk about patients and you know, I would be the, the, the first to help amplify a message that, you know, patient families or or patients look their role's important. They shouldn't be disrespectful or demanding. Yes. That's, that's a problem. But you know, in one of your videos about nursing Mistakes, there's a really common problem you describe where for whatever reasons, nurses don't always listen to the patient member's fam the, the patient's family member about their condition changing. I interviewed a woman once, I think 2009. It was in a different podcast, Rell King, whose daughter Josie was, was really young and died in the hospital.
Mark Graban (36m 55s):
And basically like as the mother, she knew her daughter was getting dehydrated and her condition was getting worse. And, and nobody listened to her.
Alisa Applewhite (37m 2s):
Mark Graban (37m 3s):
And you know, she started a foundation, the Josie King Foundation to try to help here. But one of your videos, I was gonna ask you, Alisa, you said there was a time where listening to the family led to saving a patient's life. Yes. I mean, this is really, really serious. Do can, can you share some of that story with us?
Alisa Applewhite (37m 23s):
Oh, definitely. I'll never forget that story. So I was a travel nurse again in the hospital charge nurse. The crazy part was, I was a travel nurse that was in charge and the doctor had called me. I had formed a relationship with the doctors there, the emergency room, the I C U. 'cause they would, they would change me throughout the whole building because of my skillset. And the doctor called me, she said, look girl, I'm sending you up a patient. And they did the scan and everything. We just gotta keep him till tomorrow where we can do a M R I. We could send 'em out for a M R I, this particular hospital, I don't think they had the M R MRI during the night. Anyway, we could do a M R I in the morning and we'll, we'll check him out then.
Alisa Applewhite (38m 7s):
But he's really antsy. I wanna give him some meds to calm him down. And I'm just like, okay, you know, send him on up. So they sent him up and he's very antsy moving and doing all this stuff. And I'm just like, there's no way you have no care at home. So I'm reading the report and the report says he lives at home by himself, And. he just started acting like this 48 hours. And I'm just like, okay, this is all on the report. And I go in the room and thank God the family member was there and she was sitting there in the chair and I said, well, there's no way. He lives at home by his self.
Alisa Applewhite (38m 49s):
And he's acting like this, like presenting like this, like who's watching him? I said, did anybody ask you? She said, I told them this story three times. He drives his car by hisself. He lives by hisself. I said, what about his talking? I had did a, a stroke assessment on him really quickly, And, he everything, slurred speech, everything spoke stroke, everything. Spoke stroke. And I said, how was his talk? She said, ma'am, he talked perfectly fine. She said, I'm, I'm so tired of repeating this to people. And I said, no, it's okay. I'm so sorry for your frustration, but talk to me. Tell me I think I can help you.
Alisa Applewhite (39m 29s):
And she said, well, he woke up this morning and when I got up, this is how he was. He was antsy. He was moving his, his speech was slurred. So I brought him to the hospital 'cause I thought he had a stroke. They kept him down in the emergency room. And she said, I kept telling him that, you know, this is not him. He was just driving. And everybody kept looking at me like I'm crazy. And I'm just like, I, I don't believe you're crazy. I said, so tell me what scan did they do downstairs? And she said they wouldn't let me go with him. They went down, they took him by his self to go get a scan. So I said, okay, I could look it up.
Alisa Applewhite (40m 9s):
So I go and look in the report and Mark, no lie, the only scan they did on this man was a X-ray. I said, what? I said, who, wait a minute. So the only thing they did was a x-ray. So the doctor, she was coming in her shift and you know, again, doctors get overwhelmed and overloaded. So she was coming in her shift and I called her and I was like, look, sis. 'cause we were just real close. I said, they only did an x-ray on this guy. He is strictly, he, I said, he's presented as a stroke. I don't know what type of stroke, but this is a stroke presentation if I ever seen it in my life. And she was like, okay, let me see if they did a ct. And she looked, she was like, oh my god, they didn't do a ct. So I was like, I'm working in the emergency room tonight.
Alisa Applewhite (40m 51s):
And she said, well, you know, they had so many people to call out. They got some new grads there, And, he was assigned to a new grad. You know, and it's okay to be a new grad in the emergency room long as you're a new grad with an experienced nurse, right? As long as somebody's there looking so you can be learning. And I'm like, look, you need to send him to a ct. And she's like, yeah, okay, I'm gonna do it. I said, look, you gonna send him to a CT or I'm gonna call a cold stroke all night long. You, so she, you know, when you call a cold stroke, everybody come, you just interrupt the whole process. So she's like, no sis, I'm gonna listen to you. We send this man downstairs to get a head ct. He had a hemorrhagic stroke.
Alisa Applewhite (41m 32s):
Right? So what, for people who don't know what a hemorrhagic stroke is, is a, a brain brain bleed. So it's when something, a vessel has busting your brain and it's literally pushing your brain to one side of your, your cranial area where you having pressure, you're having confusion, you just not yourself. Some people can't walk, some people can't. They'll, they'll fall. And you know, so he was presenting exactly like a stroke patient. We got a chance to rush him to Duke Hospital in North Carolina where he got that help that night. And the lady, I remember her coming up to me the next morning and she was like, thank you so much for saving my dad's life.
Alisa Applewhite (42m 12s):
And I'm just like, girl, look, let me tell you something. This is what I tell all my people. When you know that you know, that you know that something is wrong with your family member, you don't stop talking until somebody does something. I wanna see the doctor, I wanna see the administrator, I wanna see the owner of this floor. I wanna see the CEO. Like you don't stop. Because sometimes you are the only voice that can save their lives. And it's, it's, it's crazy. But like, I'm trying not to cry 'cause it happened with my daughter. I I I've never been a l and d nurse. I've never been an l and D nurse. I have five kids of my own. I didn't wanna see anybody's vaginas. I was corporate mark, I was overseeing that stuff.
Alisa Applewhite (42m 53s):
Yeah. So my daughter came out breathing, she came out breathing funny. And the nurses said, oh no, that's normal. That's how children breathe. And I'm just like, ma'am, I'm, I've been a nurse. I threw a nurse card. I've been a nurse for us 18 years. I know this is not how anybody breathes. I need for you to go ahead and get a nurse in here with more experience. She got a NICU nurse in there. That NICU nurse came in. She was like, no, she can't breathe. Took her in the nicu. She ended up in NICU for two weeks. Her nose had swelled up from a latex reaction that she had from the suction canisters that they gave. And I remember that nurse coming in.
Alisa Applewhite (43m 33s):
She was like, I'm so sorry. And she was in tears. And I said, don't be sorry but listen to the family. And whenever you are in doubt or whenever you feel like you hear the families in doubt or you just need a second opinion, this is what your team is for. Go get them. You know, you're not in this alone. You don't have to feel like, oh, you are bothering them. 'cause some medical professionals will say that, don't keep coming. Ask me questions. I'm gonna ask you questions As long as I'm taking care of somebody's life, I don't care if you're irritated or not. Somebody gonna answer my questions because this person, if they died, ain't no coming back from that. No. Right,
Mark Graban (44m 9s):
Right. Wow. Our guest today, Alisa Applewhite, as she said, CEO three times nurse, mother advocate. I'll throw that word in there. But you know, I want to thank you so much Alisa for, for one, telling your story and being willing, you know, to do that with, you know, Mistakes that you've learned from in, in your business. But, you know, thank you as, as a nurse and as a leader for helping others, for speaking up and for, for being an advocate for others and, you know, for providing the right care and doing the right thing for people. So, you know, thank you for all of that. There's, there's so much we could, we could probably, maybe we can do another episode sometime just again on definitely medical Mistakes and you know, your guidance not just for nurses, but for patients and family members for administrators.
Mark Graban (45m 1s):
There's, there's a lot we could talk about. So thank you for having some of that conversation here today.
Alisa Applewhite (45m 6s):
You are truly welcome. Thank you for having me. And I am diving into that Lean Hospitals book. 'cause I was just like, yes.
Mark Graban (45m 15s):
Well thank you. I, I hope that's helpful and no, I appreciate you reading it and thank you for mentioning, mentioning the book. There's, there's gotta be a book in you at some point before we wrap up here, just to plant that idea.
Alisa Applewhite (45m 26s):
I appreciate… gave you the book. I created a book, it comes out May 23rd. Yeah. It is called The Real, I mean, Lord, “Make the call to get the client,” how you can help, how you can help healthcare staffing owners create seven figures in their business. So that is the first book that will be out May 23rd. And I'm actually working on my second book. So I'm excited. I'm so excited. Well good. Because I really wanna change healthcare before I die. I wanna make sure that I did everything I could to help people, to educate them because it's just education that we don't have. That's all. Yeah.
Mark Graban (46m 5s):
Oh, well congratulations with that. And good luck with the, the other books. We'll, we'll find an excuse, plenty of reasons to talk again. So thank you. Thank you so much for being here, Alisa, it's been a real pleasure meeting you.
Alisa Applewhite (46m 17s):
You are welcome. Thank you for having me, mark. I appreciate this.
Mark Graban (46m 21s):
Well, thanks again to Alisa for being our guest today. To learn more about her, look for links in the show notes or go to markgraban.com/mistake223. And don't forget to check out my book, The Mistakes That Make Us at Mistakesbook.com. As always, I want to thank you for listening. I hope this podcast inspires you to reflect on your own Mistakes, how you can learn from them or turn them into a positive. I've had listeners tell me they started being more open and honest about Mistakes in their work, and they're trying to create a workplace culture where it's safe to speak up about problems because that leads to more improvement and better business results. If you have feedback or a story to share, you can email me MyFavoriteMistakepodcast@gmail.com.
Mark Graban (47m 5s):
And again, our website is MyFavoriteMistakepodcast.com.