Welcome to ACNL in Action, brought to you by the Association of California Nurse Leaders. I'm your host, Charlene Platon. And before we get started, we have a few housekeeping notes. ACNL is hosting its annual program next February in Disneyland, and we couldn't be more excited. We are currently accepting abstracts for podium and breakout sessions as well as poster presentations, but the deadline to submit is July 31st, so don't delay. More information can be found in the show notes. And our guest today is Dr. Jeanette Moreno. Jeanette has served in some of the top nursing leadership roles at hospitals like Cedar Sinai and Stanford Children's Health, in addition to serving on ACNL's board of directors representing our southern region. She recently wrote a book, Human Caring Through Healing Haiku, which combines the gentle power of Haiku with concepts found in Gene Watson's Caring Science and Caritas Processes. We'll talk to Jeanette about the Caritas processes and why mindfulness is so important for nurse leaders. And remember, if you enjoyed today's episode, please remember to leave a review and subscribe wherever you get your podcast. Thank you so much, Jeanette, for joining us. It's great to have you here.

You are so welcome, Shirlene. It's so great to see you again. And I know a couple years back, we also did our video podcast recording. So I'm excited for this opportunity. I appreciate that.

Yes, it's so good to have you here on the podcast. And thank you for being one of our member spotlights as well. And uh and for all of the activity that you do in ACNL. And now I'm super excited to learn more about the book that you have just published. And uh let's just dive in.

Oh, yes, yes, I appreciate that. And I first wanted to take this opportunity to thank uh ACNL. You know, I grew my leadership here, and you've interviewed me for about a couple of years back, Shirlene. And uh I'm in my second year as uh Southern Region Board of Director, and it's been very um eye-opening, and I'm learning so much from a lot of uh the great thought leaders here in California being in this role. So I truly appreciate that. I also wanted to thank this opportunity to highlight um my first book that I've published during Nurses Month, uh Human Caring Through Healing High Cool, that was intended for healthcare professionals, uh, nurse leaders, nurses, uh physicians, any clinicians, any caregivers. And when I say caregiver, it actually covers everybody. At some point, we do have to care for ourselves and each other. So this book is really applicable to everyone in the community.

That's wonderful. Thank you so much, Jeanette. And we're so excited to learn more about the book and talk about that today. And certainly um we appreciate all of your contributions to ACNL. And I think it's been such a wonderful organization in general for anyone who has been pursuing their leadership journey in nursing. So really great to um to have you as one of our active members still in the organization. And for our listeners who may not be as familiar with the subject, can you give us a brief overview of Gene Watson's caring science and its significance in nursing practice?

Yes, yes, thank you definitely. Um if you were to ask I am a caratus coach. What that means is I have been trained um as an expert on caring science. Um, whether I consider myself an expert, that's a different question. Um caring science is a theoretical framework from Dr. Gene Watson's that really was developed and formed in the 1970s, in the late 1970s. Uh, between you and I, we've heard about all of this nursing theories in school. We've done it as a check, you know, we've learned about this theory. I've been also associated with organizations, like, of course, Stanford, that has the theory of caring science within their professional practice model. And okay, great, you know, it's something that we know, it's something that's out there. Not until I became a character coach have I truly realized, you know, how it is the true foundation of our practice and what that really means. We know that it is the true foundation of our practice, but what it really means really brought home to me when I became a caratest coach. Dr. Gene Watson's work is so deep, and I think it's so profound that to bring it to the application level is so important. For one thing, it's all about the practice of caring that we do every day. We'd say it's not rocket science. As nurses and as healthcare providers, we are here to serve, and we are here to serve others, and that's the kind of business that we are in. But the only way that how we have that foundation, you know, for compassionate care for others is really focusing first on ourselves, you know, being able to practice loving kindness, and before we are able to do that to others, we need to be able to have that from within. Right? It sounds easy. Uh, we go to um an airline, and uh the flight sewards us will say, put your oxygen mask first before you put in others, you know. And uh a lot of us are saying, How can we pour from an empty cup when we are not filled ourselves? That's really where it is. And for the longest time, the culture, the expectation of us in service is to serve others. And truly, Dr. Gene Watson's work is around the wholeness of mind, body, and spirit. If we're to be truly authentic and be of service to others, and to really learn to listen and have a trusting relationship with another person and our patient, we need to be able to be sensitive about ourselves, our needs, and our practice, you know, for care for ourselves. Um, those are the theoretical foundations that guide us, you know, if we want to translate our practice to innovations and creative solutions, the only way to transition to that is to be able to be whole, coming into the space, declutter our minds, embrace what is in front of us, and then we would be able to truly be of service to others.

Yes, that's beautiful. And thank you so much for that great overview of caring science. And I think that it's a really great um uh overview and foundation for people who may not be as familiar. And I think when it comes to implementation, we talk a lot about the CARTAS processes. And could you tell us more about that and how they integrate into the caring science framework?

Sure. So there are 10 caretas processes, which are, I would say, the grounded framework and the guiding uh ethical and philosophical professional practice, uh, guidelines and principles that offer tools for nurses on how they could take care of themselves so that they can best take care of others. You know, as nurses, we balance rigorous, evidence-based practice with a lot of compassion and human connection. And we are in service of others at their most vulnerable times. The very first step in the characterist process is the practice of loving-kindness, which I have already kind of like shared. It was so crucial for us to know that we are here for as a whole person for another person. The second caratus process is all about authenticity. Can you imagine coming to work, Shar, and you know, the mind is wondering and really distracted because probably we just hit traffic and we had some road rage going on, or probably we had something going on in our personal lives that we don't really know. But we always say bring your authentic self to work. That's very difficult. Having the authentic present at the very moment, how can we do that? And are all the principles and then be sensitive to what we feel in our needs before we even get to the space. Caracter's process number four is once we are truly authentic and is sensitive to what is going on within ourselves, then that is only when we could truly establish a connection and a trusting relationship with another person, like our patient who we just met right now. We need to develop instead trusting relationship for them to be able to be vulnerable and trusted. Those are a couple of the major basic principles for care and science at the very start. But, Shar, the thing with nursing and healthcare is we all jump to character's process number six, which is finding creative solutions day after day just to solve issues, to solve problems in healthcare that I might say it's broken. And it causes a lot of frustration, it causes a lot of unmet expectations. So if we come in to a situation and not bring our authentic self and be self-aware of what from inside we are experiencing, it is so hard to actually find those creative solutions. Then the creative solutions is not their shar. It's just all tasks. It's not let me just do this, let me just check the vital science, let me just check. I walk into a patient's room and I just go straight to the computer because I am assessing what has been done in the past. And look, instead of me taking the time to make that connection with the other person and truly assess what is truly going on and connect. Right? So carrying science and the characters processes is so profound that we can never do creative, innovative solutions without us bringing our own authentic self into the situation.

Yes, and those are really profound insights too that you shared. And and it is, you know, those concepts uh may really sound simple on the surface, right? I mean, and we hear that a lot, right? Bring your authentic self to work, sure, okay. But it's it's a lot harder to do than to say. And uh, and I think that's what makes the CARITAS processes so powerful to keep in mind when we work. And but like you said, it is challenging. Um, I did want to ask, how how do you see the processes aligning with the current challenges that we face at work and with our priorities and nursing leadership in particular?

Yeah. As I have the struggles are real, you know, as a leader, Shar, you're there, the struggles are real. We are in a situation and we are placed in a situation every day where there are a lot of expectations in an environment that's really truly chaotic and broken. When we go into a space like that, and Gene will always call this we as nurses is the light in this institutional darkness. The institutional darkness, the broken healthcare system is not gonna go away. A lot of the expectations that we have is we try to find solutions for ourselves and for our team, and we get frustrated because we cannot, right? Because a lot of times we tend to look on the outside versus looking from the inside. As nurse leaders, I've been asked, Janet, this caring science means, you know, doing mindful meditation and so that we can avoid the chaos around us. I said, no, it's actually being calm amidst the chaos around us. And that's the only way we can bring in our authentic self. And it's it's truly difficult. It takes a lot of practice and mindful meditation and reflection for us to be able to go to self-awareness and then to self-regulation, that I'm gonna regulate my emotions and I'm gonna stay calm. This situation is gonna go in, let it be a we're gonna focus, right, on this very moment. So, Shar, I know as leaders, we transition from one meeting to another, right? Um, if we are not present right now in this moment during this podcast, the past or the previous situation could be distracting us, causing this interaction to be not so authentic. And we know that by 11 we will transition to another work meeting. And if that work meeting we're worried about it, and we know we have so much to do, this very moment will never be bringing your authentic self. So Gene Watson's work is truly leading us toward, and I love this coat, and I know I have I have badge buddies for this, maybe at this one moment in time, this very moment is the reason why I am here on earth at this time. I love Jean's coat, but every moment is so precious that we set our dedicated time that leaders, I'd say is all about character's process number 10, being open to miracles, being open to miracles. And if you'd allow me, I'd actually like to go through one of my favorite in the Haiku book on character process for leaders that I've written.

Yeah, that would be great to hear.

One of this shar is um it's on page 58. It's called acceptance. Gene's quote says it is how we accept honor and respond to our feelings that makes the difference in our emotional and cognitive life world. I remember so a lot of the haiku that I've written is actually a reflection of how I felt on that day that I created it. I started writing haiku at the height of COVID as a nurse leader and watching my team being pulled left and right, watching all the suffering, you know, not only by the nurses, but by the patients and their family. But I have so many friends who have experienced suffering as well. We felt we felt so helpless. Our um leader huddles were sad and depressing. The numbers are depressing and scary and of the unknown. I have a letter that I wrote to myself um back in November. I said, Dear Jeanette, I recognize you today for being very courageous and brave. Running a workshop and leading with lots of enthusiasm despite the horrible and devastating experiences. I appreciate you so much, love self. And it's great. On page 59, I wrote a haiku that's about acceptance, and the haiku goes, letting go, I breathe, walking away, new paths form, resistance breathing. So, what it that means for leaders is being able to be the calm amidst the storm around them and letting go and letting it be. There are situations and there will always be the situation that is outside, you know, that's outside of our control. And a lot of times in healthcare it is, we let go, we let it be. And sometimes the best solution is just silence.

And I think that that really speaks to the importance of the mindfulness that you spoke to, and how those practices are embedded in CARATAS processes, and and also how you emphasized how this can really support, you know, being calm and those feelings of calm when you're a nursing leader. And I really appreciate how the haiku um has been helping to bring mindfulness into your own practice. And um, I really want to know more about what inspired you to combine the haiku poetry with Gene Watson's Caritas processes in your book.

Thank you so much, Shar. Um, very interesting. So, a little bit about my journey with haiku poetry. And for all the listeners who may not be familiar with haiku, because I've been asked a lot about it. When they saw it, it's like, what is that? It's a Japanese form of poetry. And believe me, I am no expert in haiku. I discovered haiku uh during the pandemic, it became my go-to, um, really fast and quick, uh, mindful, reflective practice to truly survive the chain is around me so that I can be ready for the team and I can be ready for everyone. Um haiku is a Japanese poetry. Um it started in 1644, believe it or not. And um the the Japanese gurus, they it has evolved over time, you know, um, as I as I read through that. Um they're like syllables and some are rigid. I'm gonna tell you a little bit about my story and how I get to that counting the fingers. It's five syllables, seven syllables, five syllables. It's being taught to elementary kids, even by the teachers. You know, that's how I learned it initially. But I've been writing poetry, you know, um, in my youth. And then when we became adults, Adults and we started adult life. We just got so busy, we forgot about it. And then I started writing poetry during my Caratus Coach education program. I have so much poetry for my self-discovery journey during my Caratas Coach program because it's so deep that I have not even shared it publicly. The haiku became my go-to, and haikus doesn't have to be rigid as five syllables, seven-syllable, and five-syllable. The modern haiku, no rules, no rules at all. But mine, if you've noticed in my book, they're all five, seven, five. Because the mindful practice that I started doing at the height of COVID is based on finger breathing. I don't know if you know about finger breathing, but I'm gonna show it and we can do it together, Sean. Finger breathing is at the height of any meeting that's just so pissed, or any conversation, you could actually just trace your finger and breathing in and out, breathing in and out, breathing in and out, and so every morning when I wake up, we scroll through social media, right? Right, I started scrolling through Canva, finding beautiful images of nature, finding images that I could connect with. And as soon as I land on an image, I do a quick coherence, which is a quick one-minute mindful meditation and finding the joy in your heart. And then I started counting syllables. I started counting, and that became my go-to mindful practice to get me ready. As soon as I started doing that and I started putting all of my haiku in imagery, I started putting it in social media. And Joe Tai, one of my favorite authors, he was the author of Florence Prescription, got caught in and said, Jeanette, you need to write a book. I was like, Are you kidding me? I'm no author. I just write things for fun. And I don't have to explain my haiku because it's so deep. Some of them are frustrating, some of them are my disappointments, and some of them are my daily dramatic moments. And then when Joe Tai became the keynote speaker at ACNL in February 2022, he gave me a $20 bill. It was my first time meeting him. I've been stalking him in social media, and he said, Matt, you need to publish your book. I said, No, I cannot do that. But then I felt so guilty with the $20 bill. And here's Dr. David Marshall, the senior vice president, Cedar Sinai. I saw Joe giving me 20, and he gave me another 20. I said, Go great. I have 40 dollars. What am I gonna do?

That's amazing.

So Joe Tai was very resilient. And this is a nurse leader story to because you know, people around you will be there to support you, advocate for you, and will be persistent, especially if they see potentials. He started sending me haiku books. You know, he started sending me books to say self-limiting beliefs.

Right.

And then I said, if I really wanted to share my haiku, I really wanted every nurse, every clinician, every person to understand the foundation of their practice as a basis that nursing is not all about doing, that nursing is all about the multiple ways of knowing and how beautiful this nursing profession is. And I want to make sure my work aligns with a theoretical framework that people can just practically apply, understand without going through an intensive understanding of Jean's work. So that's really where this came about. And I said, I want to co-author with my mentor, Dr. Jan Anderson, who was my care and science program director. And she said yes. And it was what an honor and what a privilege.

That's great. Thank you for sharing about that, Jeanette, and for also going through uh different uh mindfulness practices that you use. I'm actually a big fan of the the real the breathing exercise that you shared, and I think that's such a great tool to use uh during meetings, really just going through your daily life, your daily work. And, you know, I just wanted to also ask, what do you what do you mainly hope that readers and practitioners and clinicians can gain from integrating these haikus and these practices in their daily routines?

Yeah. My aim and my hope, because this book is a labor of love and our commitment to the nursing profession that I so love, that we so love. My hope is to bring back joy and happiness, you know, for nurses. There are so many, you said leaving the profession burned out or coming in just, I'm sorry to say robotic because it's it all becomes a do, let's do this, versus right, truly understanding the core, you know, of the profession and the foundation, you know, of their practice, of their professional practice. My hope is that people have something that they can get used to because it's all about getting used to how do I practice? It's just like exercising the body, exercising the mind. Uh, you know, and I tell everybody I'd love for everyone to just randomly, just randomly flip the page. And where it lands, and if it resonates to you, let it be the anchor for the day.

I love that practice.

Yeah, the book is one to the four different sections in one page. Not a lot of people like reflective writing. It's okay. Some people will read a code, it's okay. Some would want to read it from cover to cover. That's okay as well. But what I really wanted at hope is that for nurses at the start of the shift, just randomly just browse through it open. And right now, I landed on page 10, which is about forgiveness of others. Right? And my hype says free yourself of pain, let go of shame and blame gain. Forgive, heal, and love, and breathe in and let it be.

Right? That's beautiful.

I'd love for them to have some go-to. Some have given reflections to me that the moment they read that and they read the reflection, they cannot stop, and they just keep on writing. Let it be and let it go. Empty the mind, empty the clutter. You know how we actually need to empty our tabs and remove our tabs from our computer? Let's empty tabs, let's stop holding on to those open pages in our brains.

Yes.

Empty clutter.

Yes, that's great. And a great metaphor too, because I think that we can do that so often without even realizing it. And then we never take that moment, you know, if we want to use the same metaphor, we never take that moment to actually shut down the computer, right? Or restart it, or actually have it start fresh and you know, at a new state because it's just constantly working 24-7. And I really appreciate how the Healing High 2 helps with that process and helps to do that refresh and that shutdown and kind of start again, even in the moment when it's so when so many things are happening around us. Uh, so that's that's a really beautiful practice that you're sharing with the nursing profession, with healthcare workers. And as we wrap up today, I just wanted to ask if you had any final comments to share with listeners or readers uh during our podcast today.

Uh my goodness, sure, this is such a great opportunity to um to give this to our community. Um, I wanted to say that one of my best friends who's a nurse, uh, when I mailed this to her, she said, I never got a hold of the book, Jeanette. I said, Wow, what happened? My 91-year-old mom got a hold of it, got curious, opened it, and couldn't stop reading. And I love that. She sent me a beautiful, a beautiful letter thanking me for it, for opening it up to the entire community. Really, didn't really mind it. It says it's for healthcare providers. This is for me. I could resonate to it. She loves poetry, and then the moment she saw me, my mom, my best friend's mom, she started just declaiming Emily Dickinson's poetry, her love for poetry. What I'd love, I think, for the readers to understand is do not understand, underestimate the power of aesthetics. It's not all about poetry, it's all about singing your heart out. It's all about finding the human experiences that you have every day and not be scared to authentically open up and share. Because guess what? This is where we find the human connection, you know, with each other. And we need to find ways to truly be resilient because chaos will never go away. There will always be different things in front of us. And a lot of times, the only barrier for us moving forward is ourselves. So don't let ourselves be that barrier for taking the next steps.

That's beautiful. Thank you so much, Jeanette. Those are such important reminders, and we really appreciate all that you're doing with sharing your work and sharing your authentic self through Healing Haiku and through the work that you do every day with uh the Care Toss processes and implementing that. Thank you so much for being part of our podcast today. It was great to have you on.

Thanks, Jar. Thank you so much. I appreciate you.

Thank you. And our guest today was Dr. Jeanette Moreno, author of the new book Human Caring Through Healing Haiku. We'd love to hear your feedback. Email us at socialmedia atacnl.org and connect with us on LinkedIn and Facebook at ACNLNurse. And as always, if you like the show, tell a friend, it really helps us out. ACNL in Action is presented by the Association of California Nurse Leaders with new episodes on the first Friday of every month. And to learn more about the show or ACNL in general, visit us at acnl.org. Thank you for listening.