EP 73: Finding Your Calling in Healthcare

Episode 73 of the Hope4Med podcast features DNP Veronica Sampayo. During this conversation, Dr. Sampayo shares with us how a health scare for her husband completely changed the trajectory of her life.  She details the emotional turmoil as well as the mental and physical effects she has experienced throughout her healthcare career.  Dr. Sampayo has had numerous transitions, from bedside nursing to Nurse Practitioner to Doctor of Nursing Practice. It was during those various career transitions that Dr. Sampayo saw a gap in the healthcare field in the form of a lack of sufficient career knowledge to support the transition from the role of nursing to the Nurse Practioner; a gap she now fills through her work as CEO and Chief NP at The Clinicians Life.

 

About our Speaker:

DNP Veronica Sampayo is the CEO and chief NP coach at The Clinicians life. 

To learn more about her work check out her website: https://www.theclinicianlife.com/

DNP Sampayo can also be reached on Instagram: https://www.instagram.com/theclinicianlife/ or Facebook: https://www.facebook.com/theclinicianlife

 

Hope4Med with Veronica Sampayo Transcription

Intro: Welcome to Hope4Med. 

Dr. JB: Hi everyone, welcome back to the Hope4Med podcast. I am your host, Dr. JB, and today’s special guest is Dr. Veronica Sampayo. She is the CEO and chief NP coach at The Clinician Life, she is a former APP manager, who left her administrator role to help nurse practitioners on their own terms. Welcome to the show.

Dr. Veronica Sampayo: Thank you so much for having me. 

Dr. JB: So, I am very excited to learn more about your story, could we start with your origin story? 

Dr. Veronica Sampayo: Sure. So. I’m a doctorally-prepared nurse practitioner, and I became a nurse back in 2008. And I actually got into nursing because of a family member, my husband got diagnosed with cancer, right when we got married, and I was actually by his side during his treatments and everything like that. And I got to know the nurses really well, and I wanted to become that help that they were able to really help us. And in particular, our nurse practitioner in oncology that really made a difference for our lives 

And I always kind of knew that nurse practitioner was the path for me, but I started off in oncology nursing. And then I did that until the time was right and I felt like it was time to go ahead and transition on into advanced practice. And I did that back in 2016; I got my DNP, and I did primary care for a little while, and then I did oncology and then I became an APP manager.

And that means Advanced Practice Providers, PA’s, nurse practitioners, mainly nurse practitioners over about eight different specialties in a five-hospital organization. And I really got to see and really meet a lot of really great people and really realize that there was a gap in knowledge, a gap in transition from the nursing role into the nurse practitioner role, or even in the nurse practitioner role on into a different type of specialty. 

So, I decided to open up my own business called The Clinician Life. And we provide career solutions for nurse practitioners ,and really healthcare workers and clinicians because nurses as well as pharmacists, we’ve done resumes for, where we’re really helping to bring all of this amazing experience that they’ve had in healthcare and really help them shine in either interviews or in their resume and really show their professionalism and that takes them to the next level. So that’s what brings me onto here. 

Dr. JB: Well, we are very happy to have you. Thank you so much for coming onto the show. 

Dr. Veronica Sampayo: Thank you. 

Dr. JB: So, if we were to go back to the beginning. So, before your husband was diagnosed with cancer, what were you doing? 

Dr. Veronica Sampayo: So, I was an administrative assistant and I had gotten a two degree in office systems technology, and I thought business was going to be my path. I worked as a tax preparer. After being an administrative assistant, I kind of started to move up in the ranks of a tax firm, and throughout my husband’s treatment is where I kind of started to realize, “Wow, I can do more, I want to be a part of something bigger,” and that’s really what prompted that transition from business. And I’ve always had an interest with business, so that really never left me, but I wanted to do something bigger and that’s what led me to nursing.

Dr. JB: And what did you think the experience as a nurse was going to be like when you entered it? 

Dr. Veronica Sampayo: I thought that it would be a lot different. I don’t know any healthcare workers, and there’s no healthcare workers in my family. And I think that not really having anybody to ask questions to other than the nurses that we would see on a regular basis. I thought that it was going to be a lot different than what it was. A lot of multitasking; I didn’t expect all of that. I think nursing brought out so much of what I didn’t know was inside of me.

So, I didn’t know what to expect until actually in nursing school. Nursing school was a huge wake up call like, “Oh, this is real, this is as, you know, you’ve got to be on point and you’ve got to be…you have people’s lives in your hands.” And that was a responsibility that I hadn’t—not that I took lightly, but I think it hadn’t really sunken in until you start to go into clinical and you’re like, “Oh, wow, this is what it feels like, this kind of responsibility.” 

Dr. JB: And so, I know you mentioned “It wasn’t what I thought it was going to be.” And I want to explore that a little bit, tease that out a little bit and get a better sense of what exactly did you think the life of the nurse was going to be like, versus the reality that you experienced?

Dr. Veronica Sampayo: So, for me, in nursing, I felt like there was going to be a lot more advocacy, a lot more ability to make a difference for my patients, and really just be able to care for them. And what I experienced was, it was a lot harder to do that with all of their other responsibilities that was entailed in nursing.

So, the coordination, the calls…And it got to a point for me, at least in nursing. I was bedside in an oncology unit, where not only emotionally it was starting to get taxing, because an oncology floor we’re seeing, I mean, we would have hospice patients on the floor, things like that, actively dying patients, that was a real awakening for me. I never even knew anybody that had passed away until I was a nurse. And then, that probably was part of the hardest transition. 

And I didn’t realize all of that coming into nursing, so I think that was probably the most difficult part is: the responsibility, the acuity of patients and all of that was entailed, not just being able to take care of your patients and give them the quality care that I wanted to give them, but also manage everything else that encompassed that kind of care. And how many 

Dr. JB: And how many patients were you responsible for at a time? 

Dr. Veronica Sampayo: We were responsible for… I think it was five to six patients, which is a lot. 

Dr. JB: Yeah. And to go straight into oncology, having never had somebody that you knew die. 

Dr. Veronica Sampayo: That was..

Dr. JB: So, that was very  terrifying.

Dr. Veronica Sampayo: That really was, and I remember my husband, because I think having been the only one in healthcare, especially in such a field that is so emotionally driven. I feel it was really difficult for my husband to support me because he’s a survivor, thank God. But he ended up telling me, “Oh, you’ve got to get out of this, this is taking a toll on you, you’re coming home you’re crying, you’re…” And it was getting to a point where I wasn’t necessarily burned out yet, but it was kind of creeping up into that realm of burnout. 

And it was, I didn’t want to leave the oncology patient because I loved the relationships that we could build with these patients, and the difference that you can make in a patient’s life and family’s life. So, I wanted to kind of keep that, yet not have the caregiver burnout that kind of happens with this kind of nursing.

And I ended up going to oncology outpatient, where I saw so much more light. I got to see people finish their treatments and ring the bell. And I loved outpatient ambulatory care, because I got to have the best of both worlds. And yes, there you grow these relationships with patients and they end up moving, passing on and dying, but there’s a lot more hope, there’s a lot more…It was just such a better environment, I think for me and my mental health at that point.

Dr. JB: Do you remember the first patient who died? 

Dr. Veronica Sampayo: It was actually in school. I remember I wasn’t in oncology just yet. But he was a cancer patient on a med-surg floor that was kind of heavily populated with cancer patients. So, it was med-surg/kind of oncology. And I do remember him and I remember he had come in a couple of times for hospitalization, however, he was so lively and he was just so… Like, his presence, you know, and you could feel it on the floor before you even knew he was there.

And one day, as a student they were like, “Hey, we’re going to do post mortem care.” And I didn’t know, it ended up being him and I was not expecting that, and I think that was such a shock, being able to see some… just kind of that realization of mortality, right? That was my first experience in school. And it was like, “Wow, this person just a couple of weeks ago was so lively and was okay and now he’s not.” So, definitely something that I’ll never forget. 

Dr. JB: And how did you process that experience? 

Dr. Veronica Sampayo: That’s a good question. I think just talking with my…I had a really great cohort. I was part of a program in nursing school where I was able to work alongside nurses as—I think as classified as a nurse tech, right? But I actually was able to do everything that I learned in nursing school, alongside the nurses. So, I was doing assessments for the nurses, and all while getting paid and learning. We got to go to different places like: the ICU, we got to go to the telemetry floors, and we had a whole semester on education.

It was an amazing program that doesn’t exist anymore, unfortunately. But it was like a small core cohort of 10 students in each semester, and those students were the ones that we got very close, and I mean, we’re best friends until this day. And just really relying on people that really understood where you’re coming from, and being kind of in the trenches with you, and understanding that we’re all kind of going through this together. And those relationships really helped me process that, I think. And I think that goes for all of what I’ve experienced in healthcare, is the relationships I’ve built with my co-workers that truly understand.

Dr. JB: So, you spoke to them about the experience and how it affected you? 

Dr. Veronica Sampayo: Oh, yeah.

Dr. JB: So, I think that’s very important, that’s a very important point that you brought up, because not everybody does that. Some people actually keep it inside and they don’t share and they’re just like, “Whatever, I’ll just move on.” But, having a group of people that understand what you’re going through, that you don’t have to explain from the beginning, you just kind of start where you are, Is extremely important. 

Dr. Veronica Sampayo: Yes, those relationships are…because it’s just, the people that are alongside you are the ones that really understand, you know what I mean? Having a great support system at home is great, because you get to kind of take off your clinical hat, and kind of decompress in other ways. But talking about the experience, because some…and you may have heard nurses talk, when they talk about gross stuff and other people are gross out, whereas you’re talking to another healthcare provider, you’re like, “Oh yeah, that was this, or that was funny or disgusting or whatever,” but we could eat and talk about the same things, 

Dr. JB: Yeah, exactly 

Dr. Veronica Sampayo: Exactly. So, it definitely helps.

Dr. JB: But you still experience symptoms of burnout.

Dr. Veronica Sampayo: “Oh yeah. And I would say throughout my career, I’ve had a lot of instances where I maybe took on too much and then didn’t take care of myself and then did get burned out. So, I’ll give you an example. This was as a man…Well, let me talk about my first career job, as a nurse practitioner. In primary care, I went into my first position… and this is actually one of the reasons I do what I’m doing now. I went into primary care thinking that I wanted to do something different.

I wanted to go in oncology after I graduated nurse practitioner school. However, I ended up going into primary care, because at the time there wasn’t really good opportunities in oncology, and I felt like, you know what? Let me do something different. Maybe there’s something good for me in primary care where I can build relationships and not have the same emotional taxing for me.

So, I ended up going into my first NP job and with a lot of red flags, and there was expectations that weren’t really explained upfront in the interview. And then, as I got more and more into the role, I started to find myself super stressed out, palpitations, crying, all of the symptoms of burnout. 

And very quickly, it was overwhelming not only transitioning from an RN to an NP, but also in an environment that wasn’t really supporting that transition. So, there wasn’t a lot of support for the amount of patients I was seeing or the administrative tasks I was doing. So, I found myself working 13-hour days, Monday through Friday, and just really not setting boundaries for myself and just feeling the weight of the clinic rested on me because labs weren’t getting evaluated and things like that. 

So for me, I found myself with back pain, it started to manifest physically into back pain. It started to manifest physically into palpitations. And it got to a point where I said, “This can’t be, this is not for me, this can’t be the way it is.” I did try to set boundaries for myself, however, sometimes organizations aren’t able to accommodate certain requests or the way that they function. And so, after long discussions with administration and higher ups, I ended up moving on after just three months. 

After three months, I gave my notice and then three months later, I left. And I learned so much from that experience that I really—and I found that’s not a unique experience, and I found that there are a lot of other new graduates that end up in positions where maybe they just either took it because they just needed a job or they took it because they thought it was something, they didn’t ask the right questions, they didn’t really make sure that it was in alignment with what was best for them. 

So, that’s kind of where I’m stepping in now, in my role, in my business, is really helping prevent that kind of situation for other nurse practitioners. Because it was a great learning experience, however, it was definitely the most stress I’ve ever felt in a job. 

Dr. JB: So, you said you went into that job and there were a lot of red flags. Can we explore that a little bit? What do you mean by the red flags? 

Dr. Veronica Sampayo: So, I live in Florida, and we needed a collaborating physician at the time and a preceptor coming out of school, especially into primary care when all of my oncology—well, all my experience was oncology. So, I realized after the fact that I hadn’t met with my collaborating physician in the interview. So, corporate had hired me without me actually meeting my teammates, so there was another nurse practitioner in the clinic, and I think I met her briefly, but not enough for her to tell me anything about the clinic or me to ask the—and I didn’t ask the right questions. 

So, they were super excited about me and I was super excited about them. I thought it was really great, it was like a wellness clinic that had…It was patient center medical home, and they had a wellness clinic attached to the clinic, where we were the sole providers that took care of them and we got compensated for how good of care we provided, so value-based care. 

And it was—they basically told me we’re going to give you one patient in the morning, one patient in the afternoon. And then as you feel more comfortable, you’re going to be getting more and more patients, and you tell us the pace that you’re comfortable with. And I said, “Oh, that sounds amazing.”

Well, those people that told me that, don’t even work in the clinic. So, what ended up happening is that: come day one, I meet the collaborating physician, very nice man, but he was on his way to retirement. He wasn’t having the patience to really train me, he gave me three days of orientation and then said, “You’re good. I’m here if you need me, you’re good,” and so I’m like, “All right. Well, my saving grace is that I have one patient in the morning, one patient in the afternoon.” 

Well, what ended up happening is that the other nurse practitioner that was in the clinic was also fairly new and also lacking resources. So, what was happening with her is: she was taking two hours per patient. And so, with poor administration, there was a lot of room for her to just really not even manage that situation. 

So, the patients were waiting two hours and they would get super upset and they were waiting for the nurse practitioner. So, what they would do is: start to add them onto my schedule around 10/11 o’clock during the lunch hour, and so then, I get angry patients that are saying, “Why are you the nurse practitioner taking two hours to see me? and why? And then having multiple problems, like hospital discharge, newly diabetic, right? At 12 o’clock and so what am I going to say? No? Of course, I’m going to see you. 

So, here I am just taking on these patients and then, because I’m the bright eyed, bushy tailed new person, everybody’s like, “Oh, I need a referral, I need you to make this referral.” So in between all of the patients that I was seeing, I’m trying to make everybody else happy by accommodating to their needs.

And then, the physician didn’t really want to work past five o’clock, don’t blame him. I mean, on my way to retirement, I’m sure I don’t want to work past five either. So, he was like, “Hey, let’s—I have a lot of labs to review, I’m going to send them to your inbox.” So… 

Dr. JB: Wow.

Dr. Veronica Sampayo: And so, all of that without having a good, I would say, voice or boundaries and really understanding your practice, right? Was really taxing on me. So I think I did finally step in and say, “Hey, let’s see if we can make things more efficient,” and I think that’s my recommendation for anybody struggling in a practice or in any way that they could—if they find a more efficient way to do something or a better way to do something, talk about it with your leaders.

And so I tried, I absolutely did. I actually went to the physician and was like, “Hey, do you think you can get here like 15 minutes early, just so that we could review difficult cases and just kind of answer any questions that we might have.” And he agreed for two weeks and then was like, “This is too early for me, oh, I’m too old for this,” and I’m like, “Okay.” 

So, I tried to get administrative time, because that was another thing we didn’t have, we were booked from the moment we came in to the moment we left. So there wasn’t really a lot of administrative time to do those labs, referrals, all of those things and review of radiology.

And they tried to change it—for again, like two weeks and then I guess corporate got wind of it. And they said, “We don’t do this in any of our other clinics, so we’re not doing that here.” So, I think that was all of the roadblocks I was just facing on, trying to give ideas of how can we do this better?

And them just not being really willing to make those changes, so that everybody’s life—because the other nurse practitioner was struggling just as much as I was. I mean the same thing, having palpitations, I mean she was there alongside me at night. So, it was definitely like I said, “A learning experience, but looking back it’s, nobody should really have to go through that. That was pretty miserable. 

Dr. JB: And I wonder if the other nurse practitioner was told the same thing with—we get one patient in the morning… 

Dr. Veronica Sampayo: Probably.

Dr. JB: So, then I guess six months later, right? So, you had to give them a 90 day out, is that why? 

Dr. Veronica Sampayo: I did. 

Dr. JB: Isn’t that interesting how we have to give 90 days, what happened to the two-week notices?

Dr. Veronica Sampayo: I know, and I come to find out, I don’t think other providers were doing that. I think they were kind of surprised that I actually stuck to my contract. So, but it is really interesting, but some of the things I teach is: it really shouldn’t be more than 90 days. 90 days is the max. They don’t need more than that

Dr. JB: Oh. So, you’ve seen where they’ve asked for more than 90 days?

Dr. Veronica Sampayo: Oh, yeah. I’ve seen, and now I’ve been doing coaching for almost two years now and I’ve seen a lot. I mean, I’ve seen a lot of contracts that have been really shady and I’ve seen nurse practitioners that have been in much worse situations, and thankfully gotten out of it.

But, because of certain red flags, like six month notice or impossible non-compete, things like that. We’re not taught that in nursing school, we’re not taught any, even in nurse practitioner school, maybe they talk a little bit about it, but they don’t really deep dive into it.Once you get that contract, you’re like, “What is this?.” So… 

Dr. JB: What do you mean by impossible non-competes. 

Dr. Veronica Sampayo: So, I saw a contract—One of my friends actually sent me this contract. It was a contract that basically said—so the whole point of a non-compete is: listen, we just don’t want you setting up shop across the street, taking all of our patients, right? That’s basically what it is. But this one in particular said “You may not work for another specialty that is in competition or deemed to be in competition with any of our specialties that we own or will own.” So they were like a group that was looking to go out into rheumatology and endocrinology. They were like a family medicine type group. And that could be deemed in competition within, and then they had multiple clinics and then they said, “You may not work within”—I think it was like 15 or 20 miles, “of any of the clinics that we own or will own.” And I’m like, “Hm-mm.” Like, we will own, like you may not. And then she was only going to work in that one clinic. It’s not like she was going to go to the multiple locations, it was one clinic. So, that’s what I mean by… that’s impossible, that’s not anything anybody should be signing.

Dr. JB: Because even if you move to another state and they will own practices in that state,

Dr. Veronica Sampayo: Exactly. That when I was like “You got to get a lawyer, I don’t think this is even legal.”

Dr. JB: So six months later, you’re out. What happened next? Where did you go next? 

Dr. Veronica Sampayo: So, I ended up going to oncology. I loved it. It was really great. I got to work my own or actually open up my own symptom management clinic and—not open, but it was the first that they had done in the hospital. And it was alongside two physicians, oncologists that were specialized in GI oncology and sarcoma, melanoma. And oh, I loved it, and I loved the autonomy, I loved the support. I think there was such a difference, going from I would say, that environment into a more structured environment, where they were used to working with nurse practitioners, they had protocols, all of that.

And so, I worked there for about two years until I found they started to build APP leadership in the organization. And I love change, I love supporting people, I love mentorship, and I wanted to be a part of that. I’m like, “I want to be a part of helping build this.” And I hadn’t been a nurse practitioner for very long, maybe two and a half years at that point. However, I definitely utilized my DNP skills and I utilized my passion for really creating lasting and meaningful change in healthcare. And I applied and got the job as the medical manager for APPs in not only oncology, but it was for critical care APPs, hospitalists and other specialties like pulmonary and things like that.

So, I loved that, I loved being able to make—create that change. However, again, there’s these expectations sometimes, especially for me. I have high expectations of myself and I think this goes for a lot of clinicians where we kind of put these high standards on ourselves. And when we don’t want to say no to certain things that we know we should say no to, that’s where that overwhelm comes in, and that’s where—and taking on too much, where it’s like, this shouldn’t be as personal as it is for me.

And looking back, it’s like, wow! I could have done things differently, but there was also a component of like my—I have two kids, so being able to try to manage being a working full-time mom, with a lot of responsibility was weighing really hard on me, and then we had a sudden death in our family. My mother-in-law died suddenly, and so our family had just kind of done an upside-down turnaround. And so, I couldn’t be a hundred percent doing what I was doing as a manager with all that responsibility and be there for my family and all of the things that were encompassed in that kind of grieving process.

So, I decided to move on into a part-time role as a nurse practitioner, and then really pursue something that was going to fulfill me and still give me the fulfillment that I was looking for and that I loved in my manager role without all of the things that I didn’t like. Like bureaucracy and all of the other things that’s encompassed in administration.

And yeah, so, now I work with an amazing endocrinologist and I work part-time and I’m in my business full-time which I absolutely, I’m still thankful for the career path that I’ve had, because I’ve learned everything along…I’ve learned so much along the way that I can teach others, I think that’s my purpose is to take my experiences and really put it in a way to help other people prevent the same things from happening to them. 

Dr. JB: Throughout life, there’s two ways that you can learn. You can learn through personal experience, or you can learn through the experiences of others. And so, it sounds to me that you’ve really positioned yourself in such a way that you can share with others what you’ve gone through so that hopefully they don’t step on those same landmines, right? And really be able to have a career that aligns with what they want. And they enter into that career with eyes wide open, because they know what red flags to look out for. 

Dr. Veronica Sampayo: Absolutely, that is my mission. 

Dr. JB: So, talk to me a little bit more about your day to day in terms of how do you, I guess, balance being a mom, working part-time and growing your business. 

Dr. Veronica Sampayo: So, I would say at first, I had a really difficult time just because now when there’s not structure, I was really good in school because it’s like, this is an assignment, this is when it’s due, this is what you do, here’s your rubric. And when you come out of—and have to kind of—you have a business, it’s like, there’s nobody telling you how to do it, there’s nobody telling you when to do it. You’re kind of self-motivated and so, I found myself kind of just scatter-brained and not really getting a good system down.

So, I did get a coach which really helped to align things in priority for me. And he wasn’t a business coach, he was a personal coach and high-performance coach. And so, I think with that coaching, I was able to really start to see what my priorities were in my business and then also in my family and how to structure yourself in a way where you set limits to your business, but also limits to the family time.

And so that you can be productive, so that you can do the things that you want to do to apply more freedom into your life, and that’s what freedom is. And so, I was after that kind of coaching, I think that the way that I’m able to manage it is understanding priorities and understanding also that even if—for me, I’m about to launch an interview preparation course, and this is a short period of time where I am solely focused on my business.

And maybe there isn’t as much time for my family right now. But with knowing that this is only a short period of time so that I can gain more freedom to have that time with my family in just a few more weeks or in a month or so, right? 

So, it’s being able to just realize that everything has its season and that it’s not forever and you’re able to craft I’m solely responsible for my life, right? And how I want to live it. And every day, you’re crafting that for yourself, so every day I’m very intentional about what I do, how I do it, and making sure that the priorities that I’ve set for myself are being taken care of.

Dr. JB: I think that’s really important. One of the phrases that I’ve heard a lot of people say is: it’s not about work-life balance, It’s more about work-life integration. And this is a prime example of sometimes you’re going to have to focus more on new business than necessarily on your family. But knowing this is just a season in your business that you’re going through, and when that season’s over, then you’re going to end up focusing more on your family than on your business. And it all works out, but getting rid of that pressure of, “Oh, I’m supposed to be with my family a hundred percent of the time, focus on my business a hundred percent of the time, and then I…

Dr. Veronica Sampayo: What about me? 

Dr. JB: I need to focus on me too a hundred percent of the time, you add all those up that doesn’t equal a hundred 

Dr. Veronica Sampayo: Right, exactly. 

Dr. JB: That just doesn’t work out, so… 

Dr. Veronica Sampayo: Exactly. 

Dr. JB: And that’s how burnout happens. 

Dr. Veronica Sampayo: That is help burnout happens.

Dr. JB: That is. So, if my listener wanted to find out more about you, how could they do so? 

Dr. Veronica Sampayo: So, I am on Instagram @theclinicianlife and on Facebook, same, theclinicianlife and on my website, www.theclinicianlife.com

Dr. JB:  Perfect. And lastly, do you have any pearls of wisdom you would like to share with my listener?

Dr. Veronica Sampayo: I think there is so much power in what we do as clinicians. And sometimes I feel we take that for granted, we are touching lives every single day, and in order to fill up other people, we have to fill ourselves first and we have to be full. So, I think making sure that you take care of yourself so that you’re able to pour into others the way that we do as clinicians is so essential for a successful career and a happy career and happy life. Happy life, happy life, happy life. 

Outro: Yeah. Who says a doc can’t rap, D-O-C-T-O-R-J-B. The greatest doctor to ever touch the mic. The greatest podcast ever broadcasted or pre-recorded. Come learn some. Each one, teach one. I’m done.

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