Empathy in Action: How a 14-Year-Old Dreamer Became a Nurse Practitioner

Rev. Dr. Keith Haney: 00:00:01

My guest today is Dr. Deborah Palmer. She is a nurse practitioner, educator and wellness promoter.

She is author of Between Wounded and well Lessons in Healing, a memoir about a 14 year old mother with a dream of becoming a nurse. We welcome Deborah to the podcast. Well, Dr. Palmer, welcome to the podcast. How you doing today?

Dr. Deborah Palmer: 00:00:22

I'm doing great, thank you.

Rev. Dr. Keith Haney: 00:00:24

It's good to have you on. So I'm going to ask you my favorite question to get you off to a good start. What's the best piece of advice you ever received?

Dr. Deborah Palmer: 00:00:32

You know, I've had a lot of good advice, but the two pieces that really stick it to my mind are the ones that were the hardest to embrace. And the first one was just be who you are. Just be yourself. Be true to who you are and your values and your beliefs.

And the second one, my dear mother, who liked to keep everything as simple as could be, would always say, just keep it simple. Debbie, why do you have to complicate everything?

Rev. Dr. Keith Haney: 00:00:58

Right?

Dr. Deborah Palmer: 00:00:59

Yeah, I think I used to overthink too many things and that just caused what they call analysis paralysis.

Rev. Dr. Keith Haney: 00:01:06

Of course. Yeah, we can, we can get into our own head and never let ourselves really kind of breathe a little bit.

Dr. Deborah Palmer: 00:01:12

So, yeah, yeah, yeah.

Rev. Dr. Keith Haney: 00:01:15

I'm curious, as you think about your journey in life, who were some people who served as a mentor for you or an inspiration to. Here's your chance, kind of give them a thank you for playing such an important role in your life?

Dr. Deborah Palmer: 00:01:27

Well, dear Grandma up in heaven, she just was the model of kindness. Why not want to use that as a mentor? So I would say, first of all, my grandmother.

But the other one comes to mind is all the nurses in my life, particularly my first two head nurses, who really help me understand empathy, leadership and a work ethic. And my last mentor that was a nurse, Dr. Roberta Haley. I wrote about her in my book.

She was my first mentor as a nurse practitioner and she volunteered in the orthodontist office. When she found out I was going to go to NP school, she handed me my car, her card, and said, if you ever need a mentor, let me know.

Not only did she mentor me as a nurse practitioner, she mentored me in the art of relationship building. Never once did she leave me to go to lunch on my own. She always included me or a staff meeting or a social event for work friends.

And that was the beginning of a lifelong friendship that is woven throughout my story.

Rev. Dr. Keith Haney: 00:02:35

Oh, that's so neat.

You know, you need those people in your life who kind of take you under their wing and kind of Help you along the way, because then you can pass that down to another generation of nurses.

Dr. Deborah Palmer: 00:02:46

Absolutely.

Rev. Dr. Keith Haney: 00:02:47

That's great. So, Dr. Palmer, your story begins with you becoming a mom at 14 and dreaming of becoming a nurse.

Can you take us back to that time and kind of share what kept your dream alive with all the challenges you might have faced?

Dr. Deborah Palmer: 00:03:01

You know, the only thing I can think of is a quote that I just read recently, and it was something like this. Your calling is your calling, if it keeps calling you.

And from a very young age, I just felt called, or another way to phrase it, I just had this desire in my heart, and I've come to identify that as desires from my creator to go into that field. I also had wonderful people who were modeling compassionate nursing care to me. That probably inspired me as well.

Rev. Dr. Keith Haney: 00:03:36

I love that. Yeah, it's kind of like we, as a pastor, we always have that same thing.

There's that calling that gets you to go to the seminary, but you don't know if it's really verified until you actually get that first church that you're at.

Dr. Deborah Palmer: 00:03:48

Nice analogy, right?

Rev. Dr. Keith Haney: 00:03:51

And I always tell people, make sure the calling is not just bad pizza, but it actually is God calling.

Dr. Deborah Palmer: 00:03:56

Well, it's funny you've said that, because my first day as a nursing student, I was only 17 years old when I entered nursing school. And back then, everybody wore white. And I walked into the cafeteria to a sea of white uniforms, white caps. I almost fainted.

And then that first time, having to take care of a wound and suck the pus out of it, I almost fainted. So I questioned it for a few moments where that was in the right calling.

Rev. Dr. Keith Haney: 00:04:25

Right.

Dr. Deborah Palmer: 00:04:25

But I kept going.

Rev. Dr. Keith Haney: 00:04:27

I love that. What were some of the biggest obstacles you faced on your path to becoming a nurse practitioner, and how did you overcome those?

Dr. Deborah Palmer: 00:04:36

So as a nurse practitioner student, I would say that was the first set of obstacles. It's always money, finances. And then I was married, and I had a teenager, and then I had an unexpected pregnancy.

In the middle of my training, my husband and I were both told we'd never be able to have children, so I welcomed it with joy. But in the middle of my training, it was a bit of an obstacle. And I was scheduled to undergo facial reconstructive surgery.

My whole upper jaw was realigned, broken and realigned. So I kind of interfered with getting through the school. So to overcome all those things, I would say the first thing I had to do was ask for help.

I needed financial assistance as a student. I needed everybody to Step up at home. We needed to share duties at home because work life balance got really tough.

So working that out with my husband and my teenager, asking neighbors and friends for help, we started co oping. I had a colleague who was also a nursing student and we both had babies. So we kind of shared a little bit of that for a short period of time.

So asking for help and really being honest with myself what my limitations were, I had to swallow my pride and decide to graduate a little later than planned. I had to delay that gratification for gratitude for graduation and cut back my work hours.

And I had this profound sense of gratitude of having this baby when we were told we would never have children together. So I decided no more working on Sundays, not at all. Even though weekends were my only time to work as a student with clinical hours during the week.

So giving up my work hours, honoring the Sabbath, it really did help. And I prayed a lot. I prayed expectantly and it helped.

Rev. Dr. Keith Haney: 00:06:30

I love it. So let's talk about your book.

Dr. Deborah Palmer: 00:06:33

Yes.

Rev. Dr. Keith Haney: 00:06:34

Between it and.

Dr. Deborah Palmer: 00:06:35

Well, my new titles I have to choose from are behind me. Yes. What would you like to know?

Rev. Dr. Keith Haney: 00:06:43

So tell us about what led you to write this book.

Dr. Deborah Palmer: 00:06:49

I recognized a pattern in myself called codependency.

And I discovered a lot of people in the caring professions, social work, clergy, nurses, also have the experience of codependency, where we care for others to the point of not caring well for ourselves. So that was one reason. But also this post Covid time is when I first summarized 40 years of my journals to start writing.

I recognize that that time in our history amplified what was already happening. And that was an epidemic of mental health challenges.

And that just watching on TV what was going on in the hospitals and the nurses just kind of triggered my own experience as an ICU nurse in the HIV wards. And so I just had this empathy for nurses and this recognition that our country needs to heal.

There is a tremendous problem with addiction and depression and suicide. And I knew those firsthand in my own family background. So those were some of the triggers that prompted me to write it.

Rev. Dr. Keith Haney: 00:08:00

So tell us about your title. I'm sure as I was writing my book titles were the hardest thing to kind of come up with. What does that title mean to you?

Dr. Deborah Palmer: 00:08:10

Sure, between is a key word. You see, everybody's wounded. It's a given at one point in time or another. I believe it's as universal as the weather. And weather is important.

It's not good or bad, but it's necessary. And I think that's true. Of our wounds. So we all start with some kind of woundedness at some point in time.

But if we expect, getting well is something you can measure, you can't. It's the process, the cycle in between. The time you feel wounded and you experience the feeling better, the improvements. It's a.

Between that cycling of a consistent giving and taking, sharing and receiving, acknowledging when you need to take on or. Or be taken.

It might be gifts, talents, skills from another person, kind words, a pat on the back, but it's a daily thing, and it never happens alone. It's always in relationship. So that's. And it's a gift. The gift is when we give and we receive, and it's always reciprocal.

So that's kind of the essence behind my title.

Rev. Dr. Keith Haney: 00:09:26

I know when you do a book that's so much about yourself, there are always difficult parts to write. What did you find to be the most difficult part of your book to write or revisit as you kind of put together this memoir.

Dr. Deborah Palmer: 00:09:41

To be truthful? Every bit of it. Yeah, every bit of it was hard. And I shed a lot of tears. And through that process, I learned a lot about myself.

And when you learn about yourself, when you examine yourself deeply, you understand what gave purpose in your life, what was meaningful in your life. And so it was healing me as I was writing it, which kept inspiring me to keep writing it.

And I realized that it's an important process, that constant reflection. And we get too busy in our lives sometimes to take time out to reflect on that. Now, I'm not sure if I answered that fully.

Rev. Dr. Keith Haney: 00:10:30

No, you did, because I think that's very helpful, because I think when you really think about any book, about ourselves, we have to, first of all, go deep into reflection about what emotions was I feeling? And you may relive some of those emotions.

And you're right, it gives us a chance to heal, forgive that particular phase of our life that maybe we never. We never really addressed, we just kind of tried to move on from.

Because oftentimes when we're in the middle of something, we just want to get beyond it, and we just don't want to deal with. We just want to get beyond it and feel better.

Dr. Deborah Palmer: 00:11:02

And one thing that helped me get beyond it was the aha moment when I said to myself, this book isn't about me. This book is about everybody in my life, on my journey that contributed to who I am and how I became who I am.

So it was actually a tribute to everyone whose skills, talents, kind words, embraces, prayers that I Received and that I helped back in some way or another.

Rev. Dr. Keith Haney: 00:11:31

I love that. Do you see yourself as kind of a wellness promoter? Kind of talk about how do you define healing as a nurse?

I'm sure we think of healing as let's just get the body together, but there's, there's so much more to healing than just healing the physical. So maybe talk about your perspective of healing.

Dr. Deborah Palmer: 00:11:53

Yeah, my perspective definitely changed from that 17 year old student nurse. I evolved in my understanding. Initially it was all about measurements, blood pressures, lab tests, the physical side of who we are.

And then I embrace. Oh, with more training, there's a whole emotional wellness.

But beyond that, I recognize for me wellness and healing is really all about acknowledging what we don't have control of and letting go of it and acknowledging when we need something to help us get through whatever the struggle is and to ask for it. Letting go and receiving that which gives you a sense of healing.

Rev. Dr. Keith Haney: 00:12:40

Yeah, that's very touching.

You mentioned something I want to kind of visit back because I remember thinking about the health industry and healing and Covid and how it impacted so profoundly our society. As someone who was going through that time, what was it like for nurses, especially during the whole Covid era?

Dr. Deborah Palmer: 00:13:05

I felt our country was being manipulated and I was angry. Now I try to stay positive.

I wasn't planning to share this, but as a scientist with a PhD in research, I have always used science to back health care decisions. And I saw a lot of misinformation being sent around and people making decisions based primarily on emotion.

Now, emotion is important, but I came from a research background, so it was, it was a big struggle for me to see information manipulated and hidden. And then I saw some divisions in my own profession.

Yeah, I saw my own nursing colleagues, I won't say turn on each other, but not be united in our approach.

Now since then, the American Nursing association has made a huge effort and successfully so, to bring together the minds of nurses to unite in what we believe about health and healing and following science to promote health care.

Rev. Dr. Keith Haney: 00:14:17

One thing I always appreciate about nurses, even so, more than doctors. It's not a slam on doctors, but. But nurses seem to be the ones who really are the front end of the caring and listening to the patient's part.

How have you, in your work as a nurse really kind of refined that ability to hear and communicate what the patient is going through to the doctor.

Dr. Deborah Palmer: 00:14:43

Oh, to the doctor. They don't always want to hear it.

Rev. Dr. Keith Haney: 00:14:47

Right.

Dr. Deborah Palmer: 00:14:49

I've struggled with this as an ICU nurse. I heard the Nurse. I heard the family say he never wanted to be kept alive on machines.

And I would have to go to the doctor or the team of residents and advocate for my patients, bring in the clergy. That was one of the more difficult times of doing that.

Another time that comes to mind is when the doctor wanted the patient to show up for a visit in the clinic, which was seven. It's about a two and a half hour bus ride to get there with a long leg cast and crutches. And I said, Surely Dr. C, you don't have to see him.

Can't I see him much closer to where he lives? Let's book him with me at another clinic and I'll bring the X rays to you. Back in the day when we couldn't send him electronically.

Oh, what do you mean? He has a two hour bus ride. He doesn't drive. He's got a long leg cast on and he didn't drive to begin with.

So just bringing it, the humanity into the story sometimes.

Rev. Dr. Keith Haney: 00:15:49

Yeah, that, that's so important. I remember a couple of times working with doctors and they, they don't, they didn't listen.

They only have a certain amount of time with patients and so they come in with their pre, pre prescribed solutions and never listen. And I remember talking to one doctor just recently. I'm like, you want to up medication? For what reason? Well, you need to meet the double it.

I'm like, but have you even seen any result that would afford doubling something? So I appreciate the fact that you have.

Nurses are sometimes an advocate between the patient and doctor and that very tenuous relationship that you have with the medical profession.

Dr. Deborah Palmer: 00:16:34

As a nurse practitioner, we practice under our own license. We are an advocate of the patient first.

Unlike our colleague physician assistants who practice under the license of an md I feel they're an extension of the md. I don't view myself as an extension of an md As a matter of fact, my first job interview was an argument with the person interviewing me.

What's the difference between a nurse practitioner and a physician assistant? And I tried to explain it and I went home and I said, I didn't get the job. All we did was argue about the role between the two of us.

Well, I did get the job and 10 years later I asked him, do you remember that conversation? Of course I do. Debbie, you're working with 18 orthopedic surgeons. I had to be sure you could stand your ground.

Oh, it was an intentionally setup to see how I would handle your confrontations, which kind of goes back to your Previous question How would I handle something with a physician if we don't always agree?

Rev. Dr. Keith Haney: 00:17:38

Right. How. How would. As you look at the landscape of nursing today and the healthcare profession, what do you see that is changing in.

In that area that you maybe from when you started years ago?

Dr. Deborah Palmer: 00:17:53

Well, there's two huge changes, and that's just in our demographics. For the first time ever on the planet Earth, we probably have seven generations existing.

And in this country, we are the most diverse we have ever been.

And from the perspective of a nurse, it forces us to examine what these differences mean, to get into the mindset of what matters to our patients so that we can personalize patient care. Each generation has different preferences for something as simple as how they want to be addressed.

So understanding the differences and setting aside your own beliefs about what you think the golden rule is, which would be better best for them. And employ the platinum rule that asks what would you like? What matters to you?

And embrace that, honor it and respect it, regardless of what your own beliefs are.

Rev. Dr. Keith Haney: 00:18:48

I'm curious if you were trying to define the difference between how you would define wellness and how wellness is defined traditionally in medicine. Is there a difference or is there a disconnect?

Because I think as a patient we feel like maybe nurse practitioners get it differently than maybe doctors do. When you talk about wellness, am I missing the mark on that?

Dr. Deborah Palmer: 00:19:11

Well, physicians are trained to manage diseases. They base their care on a medical model. They're trying to fix something. They're trying to make something better.

Nurses have traditionally based their care on a wellness model to promote wellness by preventing disease. And then I practice on both. I'm trained both in the art of nursing and the science of medicine.

So I try to bridge both to manage chronic diseases, or I did when I was in practice, as well as manage a person's wellness. So my visits would include, have you kept up with your preventative medicine? Have you had your mammogram?

When's the last time you had your hemoglobin A1C check for your diabetes? As a nurse practitioner, that would be included in an orthopedic visit? Not necessarily so if you're seeing just the surgeon.

However, I have to give credit to one of my former employees. Employers Kaiser Permanente has made a huge effort to include prevention care in all of their patient visits.

However, time doesn't always allow it, and NPs generally will fit it in a little easier than a physician will.

Rev. Dr. Keith Haney: 00:20:30

I love it. So tell us about more about your book. When is it coming out? And when can. How can People find it, buy it.

Dr. Deborah Palmer: 00:20:39

It's due out the last week of September, and I hope to have it on Amazon, a print version and an ebook version. And the Spanish translation just got completed.

I'm reviewing that with somebody who can read Spanish right now, and I hope to have that up by the end of the year. And also, if you want to just keep track on my website, www.debrapalmer.com, i will have updates on my website for how you can pre order it.

Rev. Dr. Keith Haney: 00:21:08

That's so exciting. And what's next for you? Is there another book in the works or is this the last one?

Dr. Deborah Palmer: 00:21:15

No. In my heart, after writing this book, I realized my Native American ancestry meant a lot to me.

So my next book will be historical fiction based on Lakota and Ojibwe, Native American ancestors in my family lineage.

Rev. Dr. Keith Haney: 00:21:35

Oh, that's so neat. We don't have enough books about that to kind of pour into that.

Dr. Deborah Palmer: 00:21:41

to French fur traders in the: 1600

Rev. Dr. Keith Haney: 00:21:56

So what one lesson do you hope readers get from your book?

Dr. Deborah Palmer: 00:22:02

Never give up hope. Hope is what anchors all of our purposes. And without hope, you don't have a meaning, a reason to get up the next day. And it's what keeps us going.

Rev. Dr. Keith Haney: 00:22:17

I love it. If you were speaking to someone who was about to enter your field and just starting out today, what advice do you have for them?

Dr. Deborah Palmer: 00:22:27

Well, it kind of goes back to what I said earlier about really understanding your patients today and employing that platinum rule more so than the golden rule. But aside from that, I would say really take the time.

Invest in understanding who you are, what you believe, and what your values are, what drives you, and where do you get your strength from. If you're not feeling well and strong, it's hard to be that person your patient needs you to be.

Rev. Dr. Keith Haney: 00:23:00

Yeah, the caregiver needs to take care of the caregiver.

Dr. Deborah Palmer: 00:23:03

Yeah. Yeah.

Rev. Dr. Keith Haney: 00:23:06

So in season six of the podcast, we have something new. We have the guest gets to pick a surprise question you did not get ahead of time. So pick a number between one and four for your surprise question.

Dr. Deborah Palmer: 00:23:17

Three.

Rev. Dr. Keith Haney: 00:23:18

Three. All right. Oh. So what's something that most people would never guess about?

Dr. Deborah Palmer: 00:23:31

Well, I traveled to Guatemala three times and ran a medical mission.

Rev. Dr. Keith Haney: 00:23:35

Wow. And how was that?

Dr. Deborah Palmer: 00:23:38

It was the first time, it was confusing. I wasn't the leader. The second time, I took charge and I recruited the team and I loved it.

I got a lot of doctors and nurses from where I was working at the time and throughout the United Methodist Church, which was helping to support this program. And what I learned is happiness does not depend on wealth and things.

Because these clients that I saw very by our standards, poor, impoverished, walked miles in bare feet, dragging six kids behind them to come to a clinic to see us. And while they waited patiently for their turn, they joyfully played with their children and laughed and hugged and it was a sight to behold.

And I was so glad I was able to bring my teenage children one of them each time I went. And that is just that happiness is something we make from inside of us. It's not something that comes from outside of us.

Rev. Dr. Keith Haney: 00:24:43

Yeah, that's so true. And doing something for somebody else is so rewarding when you can actually pour your pour into someone else's life besides your own.

Dr. Deborah Palmer: 00:24:53

Yeah, that too.

Rev. Dr. Keith Haney: 00:24:55

So I love to ask my guest this other question. What do you want your legacy to be?

Dr. Deborah Palmer: 00:25:02

I want my legacy to be that I was an encourager of people to grow in their health and well being as well as their spiritual well being and that I modeled behaviors that helped and I provided support when I was able to. That is my hope and dream as a legacy.

Rev. Dr. Keith Haney: 00:25:21

And that's very commendable because that is such a powerful legacy to leave behind. People say that about you as you're no longer with us.

Dr. Deborah Palmer: 00:25:29

Well, I had people do that for me.

Rev. Dr. Keith Haney: 00:25:31

Yeah.

Dr. Deborah Palmer: 00:25:32

And you mentioned earlier how important it is to give back or pay it forward, so to speak. Yeah, yeah.

Rev. Dr. Keith Haney: 00:25:39

So, Deborah, I'm curious, where can people find your book when it comes out and how can it connect with you best on social media?

Dr. Deborah Palmer: 00:25:48

So I am revamping Facebook and I'm just learning how to use that. But you can go to my website, www.deborahpalmer.com and I will have it online. Amazon, KD, Kindle Direct, and I'm hoping for bookstores.

I'm going to have it distributed through ingramsparks as well. Keep asking for it starting the end of September and your local bookstore will be more likely to order it.

Rev. Dr. Keith Haney: 00:26:15

There you go. I know. I'm doing that myself now with my own book. So we're trying to get into people's hands.

Dr. Deborah Palmer: 00:26:21

It's a process.

Rev. Dr. Keith Haney: 00:26:23

It is. No one knows writing is just one piece of it now. Promoting it's the other, other big hurdle you have to do.

Dr. Deborah Palmer: 00:26:30

Are you self publishing, Kevin?

Rev. Dr. Keith Haney: 00:26:32

No, I didn't. It's actually published through a WIPF press and so it's out on Amazon and Barnes and Noble. So yeah, it's out of several that helps a lot.

Dr. Deborah Palmer: 00:26:44

But I've been told even publishers expect you to do a lot of the marketing on your own.

Rev. Dr. Keith Haney: 00:26:49

They do. I just had to do a one page presser and now I'm trying to get on other podcasts myself to talk about the book.

Dr. Deborah Palmer: 00:26:57

So, yes, check out National Publicity Summit.

Rev. Dr. Keith Haney: 00:27:01

Yes, that's where we met. Good place.

Dr. Deborah Palmer: 00:27:03

Yes, it is.

Rev. Dr. Keith Haney: 00:27:06

So, as we wrap up this great conversation, what would you want to leave with the audience as kind of a takeaway from our conversation today?

Dr. Deborah Palmer: 00:27:16

Be courageous. Don't let fear drive you. I have embraced every interview, every invitation. I got into podcast interviews so far. You're my third one.

And I think if I had let my fear guide me, I wouldn't be doing this. And I have enjoyed it way more than I ever thought I would. So take risks. Be courageous. Don't let fear be the driving force in your life.

Rev. Dr. Keith Haney: 00:27:42

Well, you were an amazing guest and thank you for coming on and sharing with us your heart and your story. And may your book be a rousing success that inspires other people to wellness and not just physical, but mental and spiritual as well.

Dr. Deborah Palmer: 00:27:58

You success with your book as well. You're a great host. Thank you for having me.

Rev. Dr. Keith Haney: 00:28:03

Well, thank you do Deborah. Have a blessed day.

Dr. Deborah Palmer: 00:28:04

As soon as I get my Facebook thing figured out, I will post this on my other.

Rev. Dr. Keith Haney: 00:28:08

Great. We'll appreciate that.

Dr. Deborah Palmer: 00:28:10

Okay. Thank you.

Rev. Dr. Keith Haney: 00:28:12

Thank you.

Dr. Deborah Palmer: 00:28:12

Have a great day.

Rev. Dr. Keith Haney: 00:28:13

You too.