When Nick Escobedo DNP, RN, OCN, NE-BC, director of Inpatient Oncology at Houston Methodist Hospital, started his nursing career, he didn’t expect to land in oncology nursing. During May’s recognition of Oncology Nursing Month, Escobedo says the career has offered distinctive opportunities for personal and professional growth.
“I went into a basic acute care setting right out of nursing school because I wanted to get a good, solid foundation for myself in practice,” Escobedo, a former president of the Oncology Nursing Certification Corporation, says. But the learning process opened up new, and appealing possibilities. “I had an opportunity to learn the skill of chemotherapy,” he says, “and the more I got to learn about it and spend time working with patients, I quickly learned this specialty was for me, and I wanted to do that full time. It chose me.”
What sets it apart from the science and the practice part of nursing, he says, is that cancer affects every body system. Oncology nurses treat patients through a span that lasts from cancer diagnosis to remission or to end of life.
“I got to use my critical thinking skills, and I got to have knowledge of all the latest and greatest therapies available,” he says. Escobedo, a dedicated lifelong learner, says it’s imperative that he stays on top of understanding new technology and the range of cancer drugs and treatment options available to patients and the safest ways to administer them.
Thankfully, oncology nursing is very collaborative, he says, and so nurses work with physicians, frontline providers, therapists, chaplains, nutritionists, clinical pharmacists, and volunteers to understand how the different pieces help drive the care of a patient. Escobedo says a nurse might check in with a clinical pharmacist to find out more about a particular drug to learn about interactions, how a patient might respond to it, and how to use it safely.
Additional education is essential for oncology nurses, he says. “My journey toward certification was big,” he says. “That was one of my ways at looking at my competence as a clinician, to say I was an expert in the care of oncology patients. So my journey to pursue that certification and have knowledge to be successful was key. I’m a big advocate for certification.”
To balance the intensity of understanding the drugs and treatments used for cancer, Escobedo says the relationships oncology nurses develop with their patients is special. “You develop long-term connections with patients and their family members,” he says. “They give so much of themselves.”
Those strong connections can help nurses and patients through the celebrations of successfully completing cancer treatment or the more difficult prognosis or outcome. “This is very hard work,” says Escobedo. “The reward is that we get to do that work, but we need to balance that with resilience. This is tough work and we have to promote and champion a little of that balance. We try to look at the celebrations that happen.”
The success stories are uplifting and have a lasting impact on nurses. “We hear from patients who were treated years ago, and they come back to check in,” he says. Patients relay news of celebrating weddings and anniversaries and the arrival of children and grandchildren. Some have even paid it forward and after being treated for cancer, have embarked on fundraising campaigns to help others.
“Our patients push us to have that drive,” he says, “And we see lots of really good outcomes.” Patients can go through treatment that is long term and so being able to go through the process with them is something oncology nurses find so rewarding, says Escobedo.
Escobedo encourages nurses who are interested in exploring oncology nursing to find a way. “If you think you could be good at it, why don’t you try it?” he says. Find good mentors and be sure to seek out projects and opportunities that will get you out of your comfort zone. “Nurses don’t get lots of oncology nursing experience through training or nursing programs,” he says. “This is a full and rewarding specialty.”
Please tell me a little about your background. How and why did your career path lead you to transplant nursing?
I am an advanced practice nurse specializing in solid organ transplantation, especially for kidney/pancreas and liver transplantation. My scope of practice covers transplantation evaluation and post-transplantation care.
My journey to transplant nursing started in 2013 when I first met the liver transplant program surgery director, Dr. Hoonbae Jeon, at the University of Illinois Hospital and Health System. I was a student of the University of Illinois at Chicago nurse practitioner program and shadowed Dr. Jeon and his team in clinic and hospital settings. Dr. Jeon’s passion for organ transplantation and clinical practice of giving hope inspired me. I first became the kidney transplant coordinator and managed the waitlist and coordinated living donor transplantationat the University of Illinois Hospital and Health System. I also managed post-kidney/pancreas transplant patients as a nurse practitioner.
During this tenure, I interconnected my clinical with my research and defended my PhD in nursing dissertation about kidney transplantation at the University of Illinois at Chicago. With national transplant registry data, I identified the inferior outcomes of kidney transplantation for patients who had impaired physical function.
In 2016, as a nurse practitioner, I joined the transplant nephrology team at Loyola University Medical Center. Working with Dr. Amishi Desai and Dr. Raquel Garcia-Roca, I managed kidney/pancreas transplant patients and acute, chronic kidney disease and renal failure of non-renal organs such as heart, lung, and liver transplant recipients.
Now, I joined the Northwestern Transplant Surgery program and started to expand my scope of practice to managing liver transplants.
What are some aspects of your nursing role that you didn’t expect?
I initially did not expect that there were such various and strict governmental policies in the organ transplant society. Also, each transplant program has its institutional policy and criteria, which transplant nurses should know throughout the transplant spectrum.
The need for organ transplants is increasing. As a transplant nurse, how does that impact your work?
Because the demands for organ transplants have increased, we, transplant nurses, have met more responsibilities to screen suitable donors, optimize the transplant candidates, and maintain the graft functions healthy to utilize one of the most limited and scarce resources, donated organs.
What additional training has been helpful in your career?
I started my nursing career in the cardiovascular intensive care unit at the Samsung Medical Center, South Korea. I learned how to interpret cardiovascular testing results such as EKG, echocardiogram, stress echocardiogram, coronary angiogram as well as to manage the advanced life saving devices such as ICD, pacemaker, ECMO, IABP, and CRRT.
This training helped me significantly screening cardiovascular diseases of transplant candidates on the kidney transplant waitlist. Also, I studied advanced physiology and pathophysiology, including renal, immunology, and heart, in my PhD program. These gave me the fundamental knowledge to manage immunosuppressants and various complications of transplant recipients.
How has the ITNS had an impact on the work you do, your career trajectory, and/or your pride in transplant nursing?
Dr. Joyce Trompeta at the UCSF transplant program has mentored me throughout my transplant nursing journey. She was the president of ITNS and recommended that I join ITNS leadership. Since I joined ITNS, I have met phenomenal transplant nurses who everyday help patients deal with the fear and uncertainty of transplant outcomes and complex health conditions from the complications.
From those nurses whom I met at ITNS, I have learned not only knowledge but also empathy toward the transplant patients. Most importantly, I learned I was not the only one who often felt powerless, anxiousness, and sadness when the transplant outcomes became poor, and grafts were lost. Support and encouragement from these transplant nurses are my utmost motivation to remain in the transplant community.
Have you read Part 1 and Part 2 of our interview with popular nurse influencer and nursing advocate Nurse Blake? Catch up before reading Part 3.
Whether you know Nurse Blake from his Facebook videos, podcast, live shows, or cruises, he’s proven that he’s a force to be reckoned with!
Tell me a little bit about your shows. You had done some smaller ones, but how did it all progress?
It was just trying it out, honestly. I was like, “People like my videos. Maybe I’ll do a show.” I asked people, if I did a show, vote for your city. I think we had 40,000 votes. I thought, “Holy crap! People really want to see a show.” I’m like, oh my god, I’m going to put a show together. What would that even look like? And you know, people came out. First, I did five shows. Then I did 10, then we scaled up and did, like, 50, and they all sold out. I was only supposed to do 14 shows, but those all sold out, so I’m doing 50 again.
I’m lucky enough to be repped by CAA. They’re so awesome, you know? They work with me on what venues I want. I love to keep my ticket prices at a pretty good rate so even nursing students can come.
It’s a one-person show. It is just me. It’s a mix of stand-up but with skits and videos that I show that people have never seen before. I now break it up into three parts–my life growing up, nursing school, and nursing. It goes with my journey and my flow.
One of the other reasons I decided to do my show is that I was speaking at many nursing conventions at nursing conferences and hospitals. They wanted to tell me what I could or couldn’t and what I should say.
And I was like, you know what? I’m a nurse. I don’t advocate for these hospitals. I’m a nurse. I advocate for the nurses. So in my show, I say what I want to say. I feel like I could be vulnerable and share the good and bad that the nurses go through.
But at the end of the day, while it’s funny, and I poke fun at many things, I leave nurses feeling inspired, making them realize that they’re not alone.
What’s cool about my show is that I have audience members who are 18 or 19, to nurses who have been nurses for over 60 years. I have families come–different generations, where the grandma was a nurse, then the daughter, and now a grandson. I have whole units that come–groups of 30, and they make t-shirts.
Listen, no matter which age/specialty you are, we could all get in a room and laugh, right? We could all feel the sense of community and love because I know what the hard days are like. I know what it’s like to have a shitty shift, and you’re wondering, “Is nursing really for me?”
And just knowing that you’re not alone is powerful and keeps you going. So that’s what I like to show through my performances.
What have you learned from your nursing career trajectory?
I learned in just working with patients that you only live once. You can never be perfect, especially in this profession, and as a nurse, you have to do something that you really love. So, never, ever feel like you’re stuck anywhere. If you’re at a point you don’t like or dread waking up or going to that shift, switch it up.
We’re critical thinkers and innovators, so you should do that with your job and career. Mix it up. I’ve also learned to take risks and have fun, not take life so seriously, and live in the moment, you know?
After every show, when the theaters are empty and clear, I sit alone on the stage and think about everyone who came. We know our patients’ stories but often don’t know the stories of our co-workers and nurses. So, I try to get to know where nurses come from, who they are as individuals, and where they’re going because I think so many times, we look at each other like co-workers, but at the end of the day, we’re also patients in our way.
What would people be surprised to know about you?
Oh, that’s a good question. One, that my husband’s 6’7.” And that I have anxiety and depression. I take my Wellbutrin in the morning. I take my Lexapro in the evening.
Many people see me and have misconceptions about people who have a presence online. Because you only see us when we post, right? I try and get raw and real. You see that from me when I’m in my show, and I share. No one knows I’ve ever had a panic attack before unless you’ve seen my show or that I’ve had multiple panic attacks. That’s what would surprise people maybe the most.
Is there anything I haven’t talked with you about that you think is important for our nurse readers to know?
Even though I have this comedy and humor platform, I balance that out with my advocacy. I launched a petition that got over half a million signatures to have organizations like the Joint Commission help us focus on safe staffing. I advocate for healthier work environments for nurses. I know we all hear the term “Nurses eat their young,” so I came out with the campaign “Nurses Support Their Young.” So as much as I love comedy, as much as I love doing shows, I also love advocacy work.
Why do you like doing what you’re doing so much? How do you think you’re making a difference as a nurse advocate?
I felt through nursing school that to make a difference, you had to have a master’s degree, have all these fancy letters behind your name, or go back to school to get your nurse practitioner. And when I was in nursing school back in 2013, I was denied being able to donate blood because I’m gay.
So, I started a campaign called Band4Life. I decided that I would help get the FDA to end its lifetime ban on gay males from donating blood. But I also worked as a patient care tech and went through nursing school. So, I thought that the FDA wouldn’t listen to me. But I started this campaign, shook it up with the FDA, and in December 2015, they ended the lifetime ban.
And that’s when I realized the power I had just as a nursing student. So many people think, “I’m just a nurse, or I just have my RN, or I just have my bachelor’s, or whatever.” But no matter where you are within your nursing journey, you have the power to create change. So, I encourage nurses to use their voices and not be scared. Because if you see a problem, if you don’t try to change it or fix it, who is?
Be sure to catch Nurse Blake’s PTO Comedy Tour throughout the U.S. and select cities in Australia.
Have you read Part 1 of our interview with popular nurse influencer and nursing advocate Nurse Blake? Well, if not, read that here before reading Part 2.
Whether you know Nurse Blake from his Facebook videos, podcast, live shows, or cruises, he’s proven that he’s a force to be reckoned with!
Have you always wanted to be a nurse?
Yeah, I’ve always wanted to be a nurse. My dad has been a respiratory therapist for as long as I’ve been alive–31 years on the night shift. I remember hearing all his incredible stories about the people he helped and saved while growing up.
While respiratory’s really cool, nursing provides a few more opportunities and specialties you could get into. So, in high school, I started in the Health Academy. Then, the summer after I graduated, I was doing my prereqs for nursing. After that, there honestly wasn’t any other career I’d considered outside healthcare, specifically nursing.
I also started in healthcare early. When I was 17, I got my first job in healthcare as a patient transporter, and then I worked my way up. First, I worked as a surgical assistant in surgery, cleaning up all the rooms and sterilizing them before and after procedures. Then I also worked as a patient care tech in the neuro ICU during nursing school.
After you finished nursing school, where did you go from there?
I’ve gone all over. I got my first nursing job on a pulmonary care unit in South Carolina on the night shift, and that’s where I did my new grad residency programs. Then I moved to Houston, Texas. I worked at two of the large systems there in critical care on a liver transplant ICU floor. Then I also worked as an injury prevention coordinator for one of the busiest trauma center centers in the country at Ben Taub Hospital, Harris Health System.
I was part of the trauma team, where I would respond to all the traumas, see what mechanisms of injury came in, and then try to develop programs to prevent those injuries from happening in the community. Then I worked as a care coordinator in the trauma unit, where I worked very closely with social workers and all the teams, ensuring you were preparing patients for discharge and making sure they were ready to go home. Then I started getting into education.
I’ve been fortunate to work as a nurse in different states around this country and have different roles in nursing, too. I think it gives me a unique perspective of the nursing continuum–how we care for patients from before they get to the hospital until they go home, preparing new nurses to get into nursing, etc.
I take a little bit of every job I’ve had and put that into the work I do now. I tell stories in the advocacy work that I’m a part of. Because, so many times, we think the grass is greener on the other side, or you don’t know what other specialties go through. But we all pretty much go through the same shit.
Does Brett work with you?
Yes. I always bring him out on stage. People love Brett!
We run NurseCon, our education arm, where we provide nurses with free CNEs through our app. We have about 80,000 users. Nurses from all over can get their CNEs for free through us. We also have NurseCon at Sea, our nursing conference on a cruise ship.
Last year, we had 3,500 nurses. We take over a whole ship with Royal Caribbean, give nurses CNEs, and have parties and bring on dancers, drag queens, and educators. It was so popular that we’re doing two cruises next year. So, we’ll have about 6,000 nurses go through our conference next year
What kind of CNEs do you offer?
We do a wide array. We do get into specialties a little bit on our app. We are growing that library and have full plans to offer even courses for nurse practitioners in the future. At NurseCon at Sea, we’re going to have 35 CNE hours. We have 20 educators that will come on board, and we break it up into four different pillars and build our courses from there.
Why do you offer the CNEs for free?
Because it’s something I’m really passionate about. As nurses, we get our CNEs all the time, and I always hated paying for them. They were never very good. They were always, like, really boring. So some programs said, oh, we offer free CNEs, but it was typically for 1 or 2, or it was free, but then you had to pay to print the certificate.
So, I’m like, “Screw that!” If we’re going to NurseCon, all our CNEs will be free. So, it’s something I’m super proud of, and it’s totally worth it.
Check back next week for part 3 of our Q&A Blog Series with Nurse Blake and learn how he got into standup comedy and how he’s making a difference in nursing.
When patients consider what they want in a hospital experience, they are looking for excellent and compassionate care, of course. But as patients think about a hospital experience, they are also looking for a factor many don’t know how to describe. Frequently, says Dr. Jesus Cepero, PhD, RN, NEA-BC and CNO of Stanford Medicine Children’s Health, patients describe wanting to be in an environment that doesn’t have a cold, sterile feeling. In short, they want to be in a place where they are being cared for in a way that feels most authentic for their needs.
Cepero says the missing link can be attributed to holistic care–caring for the whole patient–something he first became aware of after working in adult medicine and moving into children’s and women’s health services. “There’s a big cultural difference between the two environments,” he says, noting that he could feel the shift. “I thought it was more compassionate care, and it was more satisfying to patients.”
But the difference, he says, didn’t rest entirely with compassion as compassionate care is already a driving motivator in the nursing industry. “It was how we delivered the care,” he says, “and that has become a guiding principle for how I lead organizations.” Holistic care is a team approach, he says, and one that brings in a team dynamic that includes physicians, nurses, nursing assistants, and support personnel to work together, communicate well, and meet patient needs.
Typically when patients are asked what they hope to happen from their hospital visit or stay, they will say they want to feel better, says Cepero. Hospitals are places you go when you are sick and you need to get better, so that’s a pretty normal response. But there is more to getting better than just repairing the body, he says. It’s really an approach that sees the balance of body, mind, and spirit as essential.
Holistic care honors that and loops the patient into the care by asking, “How can we help you feel better?” The answers often have nothing to do with the science-based medications, procedures, or other therapies needed to help patients’ physical health improve. It can be reading a book or sharing a book with patients, he says, or it could be art or music therapy or a visit from a therapy dog. Patients could have spiritual needs that are feeling unmet so bringing in a faith leader can alleviate stress. Even need something as simple as someone helping them recharge their phone can relieve a stress point and make a difference in a patient’s day.
The psychosocial needs of patients are important to help heal a body and are also part of a holistic approach. If a patient can’t afford to buy enough healthy food or they lack transportation or access to a grocery store upon discharge, that will impact their healing. “If hospitals aren’t addressing things like food insecurity, they are not taking care of the whole patient,” Cepero says. “That’s what I see as holistic care,” he says, “and why it’s so valuable to the patient and the family.”
Despite the proven benefits to patients’ recovery, holistic care isn’t implemented at the rates that match the demand. Hospitals don’t always have the finances to hire additional support and therapy workers. And even if they do, it’s tough to find experienced people to do the work.
But patients expect this level and type of care and healthcare organizations that align the values and mission with a holistic care approach notice the difference. “Healing patients and making them feel better when they leave is what we are paid to do,” Cepero says. “We are not paid for that compassionate care that we provide.” But providing that compassionate, patient-focused care is so important for the patients so they can approach recovery from all angles. It’s also important for the healthcare providers who see the immediate impact of their work.
And Cepero says the patients are the key to creating an opportunity that allows the best chances for the kind of recovery that helps them. He notes, “It is listening to patients and families about their experiences.”
Whether you know Nurse Blake from his Facebook videos, podcast, live shows, or cruises, he’s the most popular nurse influencer on social media and a force to be reckoned with!
Well, at least helping the nursing community and making nurses laugh. And he’s doing that a lot.
He’s also, though, providing lots of educational opportunities for them as well.
Having graduated from the University of Central Florida in 2014, Nurse Blake, 31, has wanted to be a nurse since he was a kid. Born and raised in Orlando, Florida, he’s lived in many other states with his husband, Brett Donnelly. But now they’ve settled back where Nurse Blake came from in Orlando.
Nurse Blake talked with Minority Nurse about everything from how he started nursing to what he’s up to now.
Check back next Tuesday for Part 2 of our Q&A Blog Series with Nurse Blake.
How did all this come about? Now you’re a nurse influencer, but how did this start?
So, I was working in Houston, Texas, back in 2017. I was working in a critical care unit, and after I left my shift, I was driving home and had my first panic attack. Even before the pandemic, in nursing, we’ve suffered because of many of the same issues with staffing and lack of support, etc. I thought to myself that maybe nursing wasn’t for me.
I hadn’t been a nurse for four years at that point. I just felt alone and couldn’t do everything I wanted for my patients because there was so much red tape, policies, and documentation. So I needed an outlet to share my story as a nurse, and that’s when I started my Nurse Blake Facebook page.
And I realized, through everyone commenting and watching my videos, that I wasn’t alone and that nurses all over–no matter what specialty they’re in, how long they’ve been in nursing–go through the same thing.
When I saw that, through my videos, I helped other people keep going, and it helped nursing students get through school. I kept doing them.
As much as I love caring for and helping patients, I also love caring for and helping nurses. So it’s just kind of grown over the years, and I love bringing nurses together. I think that’s one of my favorite things about the live events and shows I do. It’s just so cool seeing large groups of nurses come to laugh and have the best night ever.
But it wasn’t like you thought you’d be a nurse or become a nurse influencer, and then I’ll go into comedy.
Yeah, I never thought I’d be doing comedy or anything on stage in front of thousands of people. In 2019, I started doing little live events. I would throw a party in Salt Lake City, which I thought was a little party, but then 2,000 people would show up, and there would be a long line of people trying to get in.
I teamed up with some MLB Baseball teams where we hosted “Nurse Nights.” I did a Nurse Night at the Boston Red Sox in Fenway Park, and it was the largest event they’ve had there in Red Sox history. We had 9,000-10,000 nurses that came out. Then I realized that nurses didn’t only want to connect online. They want to connect in person. So, in 2019, I started doing little shows here and there in small, 300-seat theatres.
And then it kept growing and growing, and now I’m doing sold-out shows in 2,000-seat theatres and casinos. It’s pretty crazy and wild. I’m just so lucky to be surrounded by so many awesome nurses. I never, ever thought that my path would lead me here.
But I tell nurses that nursing can lead you in many different directions. So many times, we get stuck on one path. Like I’m going back to school to get my MSN, or I want to become a nurse practitioner. Sometimes we’re so focused on that idea that we miss other opportunities. Just keeping my mind and heart open kind of led me here.
Have you had experience being on stage before?
Being from Florida, I worked at Disney World because everyone works at Disney. I worked as Peter Pan at The Magic Kingdom while starting nursing school. That experience did help, especially doing meet and greets before or after my shows.
Check back next week for part 2 of our Q&A Blog Series with Nurse Blake and learn if he always wanted to be a nurse and what he did after nursing school.