Edited by Joel Sharpton for ProPodcastingServices.com
Special Guest: Jessi Grote
Transcripts
Linda:
Welcome into the Talking Total Farmer Health podcast. Linda Emanuel here and joining us today to discuss the importance of agricultural competency in rural health is Jessi Grote. Jessi is a registered nurse, a nurse practitioner, and is AgriSafe’s Professional Development coordinator. Welcome to the podcast, Jessi. Here's your chance to introduce yourself and share a bit of your background in ag rural health and your time here with us at AgriSafe.
Jessi:
Absolutely. Thanks so much for having me. I know I've been with AgriSafe now for almost a year and a half, which is kind of crazy to think about and all the things that we've done. But, so I actually grew up on a kind of a hobby farm, horse, horse ranch, I would say in northeast South Dakota, town of 400 people. So definitely, kind of grew up where I'm living now, which we'll talk about here in just a minute, too. But kind of always been involved with agriculture, kind of different areas of it. We did have cattle growing up, but my parents both worked full time in town, so we did end up selling those when I was probably 8 or 10 somewhere in there. I then went to nursing school in South Dakota, at South Dakota State University. Go, jacks.
Jessi:
Then, there were no nursing jobs where I was in eastern South Dakota. So I ended up coming out to western Nebraska, where my aunt and uncle lived. And they ranched and I had the opportunity to work in a very rural hospital, kind of a bigger regional trauma center, but still very rural compared to many places. And I got to help on their ranch so much, and I just absolutely loved it and, and just really fell in love with the lifestyle. I married my husband now 11 years ago, which is kind of crazy, I remember I was actually going to move back to where I grew up and, my aunt and uncle were like, “gosh, are you sure you really want to leave? And, and just this life, you know, you just fit in so well here.” And, and they were right. I mean, they were so right.
Jessi:
And I now live in a town of 200 people. And, so we ranch, we are on his third slash fourth generation, family ranches, which is wonderful. Unfortunately, his dad had passed away when he was in high school. And so it is just him and I here. So I work with him on the ranch. We've done that, like I said, just us for, gosh, we've been married for 11 years, been together for 13. So just us. He lets me do a lot more things now. I remember one of the first, well, my birthday, the first year we were together, we were processing, yearlings or calves, I guess, at the time, and he wouldn't even let me write tags. He wouldn't let me tag calves. He would barely let me do anything. I'm like, “I can do stuff, boy.” I think I maybe regret that now because, boy, I do the things with him, which is wonderful.
Jessi:
We have since added three kiddos to our family. We also did foster care for a few years, kind of. As we were hoping to grow our family. We had foster children in that time frame. and now we have our three of our own that are kind of our permanent kids and such a blessing with that. But I had where we moved. We live kind of an hour from anything, is what I've said. So there's a hospital about an hour every direction, and I really didn't know what I wanted to do, and kind of where, where my, my nursing career was taking me. So I pretty much kept going back to school. I always said I wanted to, work remotely full time and then nurse a little bit too on the side just to have that, that caring and kind of patient component. So I did a lot of different things in, kind of that rural health space. And when I found that I really loved was that Critical Access Hospital, really taking care of those rural folks. And so I'd worked as an administrator at a rural hospital. I did quality engagement, education, kind of all the things. Ended up getting my master's in nursing education, as we were kind of waiting for little pieces of life to keep moving forward. And then I ended up getting my doctorate, as well in executive leadership with healthcare. So, a lot of different pieces of rural health. and then as we added children to our family, I definitely knew I wanted to be home. And so that's kind of where I fell into AgriSafe. I was at an NHRA conference, had talked to, some of the AgriSafe staff there, and, and we just really thought that, you know, this would be a really cool fit.
Jessi:
So like I said, that was almost a year and a half ago now. And oh my gosh, it's been such a great way to really connect kind of my two lives. I always felt like nursing was just kind of off in its own little world that I was doing. I mean, it was, but it wasn't. I do home health and hospice in my community. I'm an EMT in my community, kinda of all the different pieces I help with the public health, kind of, our local public health department. But then it's really been amazing to pull in that agriculture side, to and talk to my husband about, “hey, this is what we're talking about.” And he's like, “oh my gosh.” And he's actually interested as well in that. So it just is a great way for us to kind of connect and bind, just I guess grow together as well.
Linda:
You have been a busy young professional in in all that you've accomplished in those many hats that you wear and, and I agree, I totally echo your sentiments about being able to combine agriculture as well as the care that you give to to humans, to the populations that you serve. So lots of connections there. And I'm excited to have this conversation with you. I have a great reference in, in my experiences in farming. And we had this conversation before that ranching and farming, two different types of agriculture, although our end goal is always to, you know, to feed the world. So, as we think about our topic, agricultural competency for those rural health care providers, why is it so important that those health care providers understand agricultural specific determinants of health? And those are different than our regular social determinants of health.
Jessi:
They really are, yeah. So I think that's something that, you know, I've always known kind of in the back of my mind, I'm sure you're the same way, Linda. We live in the rural areas. We see all the different pieces. But the more that you research it and see people in rural areas, I mean, our, our access to care, our, you know, incidence of chronic disease, all these different pieces are just so much higher. And I think there's a lot of reasons for that, which I'm sure we'll talk about a little bit, kind of as we, as we go forward today. but I think that it is just really important for healthcare providers to understand that it is different. You know, we we provide a lot of trainings, which we'll talk about some more specifics here in a little bit that we look at and kind of think, oh, it's our rural people that need these trainings, which they do, just to really get a good grasp on some of those different those different challenges. You know, aging. We look at like vibrations. We look at ergonomics. You know, we're always... I remember taking care of a patient in an ER forever ago now. But it was a gal came in and it was the middle of winter and her back was just killing her. And I said, okay, because I too have had back issues. And I said, “okay, when you're, when you're chopping ice and scooping the ice out of the tank, you need to step. You need to take that step and not just turn your waist.”
Jessi:
And she's like, “I can't do that. It's going to take too much time. I have too much, too many other things to be doing.” I'm like, “I understand that, but let me tell you, from experience like that will save you. It will save you so much in the long run, you know?” So just understanding that, like, our lives are different, our lifestyles are different. There is just, you know, I've been talking to my husband a lot lately that we live where we work. And so you look outside and there's a thousand things to be doing. I just was telling him two days ago, actually, I said, “you need to take a day. You need a day. You really do. It's so important, you know?” And he's like, “I can't. There's just too many things I should be doing this and this and this.” I'm like, “but you can't,” you know? So just for people to understand, I think that, that there's so many specific things, but then also looking at like statistically, our health is just worse in rural areas than it than it is in other kind of our compared to our urban counterparts. And like I said, in so many different areas, which is where we do kind of our Total Farmer Health Model with AgriSafe and looking at kind of the whole holistic perspective, which I love as a nurse, kind of looking at every all the different components that really do, do tie into our overall health picture and what that looks like.
Linda:
Yeah. Every day looks different. And encouraging our farmers, for both of us, our husbands, just to take some time away. And it can be done, even if it's an afternoon, just to get away from that farm, to help them reset and just take that so much needed rest. So you touched a little bit. But when we talk about some of those needs of farmers and ranchers, what stands out in your minds that are the unique needs of our farming ranching populations?
Jessi:
So I think again, there’s, there's so many of them that we could talk about and we obviously don't want to do that. You know, our farmers and ranchers, we have found, you know, statistically speaking, that mental health is huge in our farming ranching community. I know I remember being a kid, a local veterinarian had, lost his life to suicide just down the road from us. I mean, just down the road. I was, I was little, I was probably 10 or 12 when that happened, you know. So mental health is definitely a big piece. And it's been an issue for a really, really long time. But it's getting to be more, at the forefront, I think just, just because and I think that's a good thing. And, definitely a unique need that we have. You know, another one that we have is really looking at that so many, components of our lives are just so far out of our control. I know we were just talking about that, that, you know, okay, you have an appointment, you end up being 10 or 15 minutes late, and then an appointment is canceled because a tire blew, when you're, you know, hauling cattle to the sale barn for the neighbor or whatever that looks like. And, and we are, we're just unique in that we just we don't.
Jessi:
I think to get a farmer or rancher off of the place to go and actually have the care provided do that preventative, preventative care. also looking at like insurance components that it's not cheap to go and do these things. We all know that. I know it's a big conversation we're all having kind of as the years coming to a close again is what is that going to look like for next year? so it's just there's just so many of these different pieces that, that it's just so important that we as health care providers know and understand. And also, we often don't want to just hear somebody tell us what to do. It has to be from somebody that we know and that we love and that we trust in that. And I think that's a big reason that like for myself, that I've done like home health and hospice, I've been an EMT in my community, because I can help those that I do know and that they do have that relationship with me already and kind of that trusting relationship.I think it was so interesting when I first came on, we talked a lot about occupational health, and I remember thinking, occupational health, like I'm not an occupational health nurse.
Jessi:
And so what is, why do we, you know, market things those months or do whatever. But the more I think about it, the more that is so true. I know I myself a couple, I think it was last summer I was out pouring insecticide out in our pastures, a ways away, and I was reacting to it. My skin was getting really itchy. Itchy? I was getting red everywhere. I had gloves on, but it was leather gloves. You know, whatever. We don't just like everybody else I know we wear leather gloves when we're working cattle and doing whatever. And so, you know, even some of those conversations about like, protective equipment, prevention methods, some of those different things that we can look at that we really just as a producer, you know, you just you kind of do what you gotta do or do what you've done forever. And don't maybe think about some of those different components and, and how that can affect your life. Kind of in the long run. I know I came back and had shared that with you and you're like, “Jessi, your gloves.” I'm like, “I know,” but I, I was miles from anything. There's nothing I could have done at the time.
Jessi:
But, boy has that brought some interesting conversations to our ranch. And even with some friends and stuff that have been around. And what a blessing that is. And it is true. I think it is very much our occupation. But I think so often as, as producers, we see it as our lifestyle. It's not our job. This is, this is what we do. My, my five year old just the other day said, so mom, you're a nurse and you do this and so and so's whatever. And they do this. She goes, well, dad doesn't work. And I said, well, actually dad does work and his job is taking care of the animals and, you know, doing all these different things and the fencing, that's his job. Checking water is his job, you know. So it was just so sweet of her in her innocence to, to maybe not see that necessarily. But, but I think that can happen a lot of times too, that we maybe don't realize that that is our, our job, that is our occupation is, is providing, you know, feeding the people, like we said, that are providing the food that feeds the world. S,o there's, there's definitely unique needs. And we could go on and on forever. But, but I don't want to do that either.
Linda:
Well, we're we're an interesting species as farmers and ranchers. Right. And and it is a lifestyle without a doubt. But I feel like at AgriSafe what we do well is, is helping folks understand these small changes. and that alone is can prevent a major illness or an injury or a disaster later on. So yeah, small changes and, and that's what we're here for right, is to provide resources. So we think about AgriSafe, and geez, we have so many resources.... what do you feel like? What resource does AgriSafe offer for people in the healthcare industry to better serve the populations that they serve, the folks that come into their clinics and hospitals?
Jessi:
Absolutely. So this has been a big part of my, kind of job. Job, I'll say at AgriSafe has really been growing. I think this kind of this piece of what we do, like we said, we do so many different things at AgriSafe. We take care of, or provide information for producers. We do it for healthcare providers. We do a lot with mental health, you know, all these different pieces. And I really feel like kind of that healthcare industry is my bucket and that I'm so thankful to have that opportunity to share. So probably the biggest resource that we do have, I would say would probably be our Nurse Scholar course. Our nurse scholar course is a 23 hour, course for nurses. It's previously it was really focused on our rural nurses, but I think in some conversations I've had with some maybe more urban counterparts, they're thinking, “oh my gosh, Jess, there's really an opportunity here.” Because when our people are sick here, we go to the rural hospitals. But then if it's really bad, we get shipped to the bigger hospitals and then they send us right back. I know we just, got a I had a home health patient that we were supposed to go in and do labs three days a week and do all this stuff.
Jessi:
I'm like, okay, I get the labs, then I have to drive those labs an hour to get them to... I can't do that. I can't do that with my life and my job anyways. All the things. So helping kind of our, our urban folks to understand that as well. So just kind of in general our healthcare industry anyways, so it's a 23 hour course that we do offer that really talks about a variety of components that are really relevant to those living in rural areas. So talking about ergonomics, talking about ergonomics, excuse me. aging, talking about kind of women and some of our different, or different populations that are in agriculture looking at children and the impact, you know, of our kiddos and, off road vehicles. And just like, what do traumas look like from our rural areas?
Jessi:
But, you know, I think there's just so many different pieces of that. And I feel like that is such a great resource that we have really provided for, I think about eight years now, and I've now trained over 400 nurses in that training specifically. I'm also really excited with that one, is it's kind of transitioning now into more, for more specialties. So not just nurses. So we are working with, a medical residency group for medical residents to be able to come and take this training, kind of learn about those of us living in rural areas. So maybe when they come to our rural areas. These patients come into the clinic and they're like, what in the world? Why are these people 15 minutes late? Why are they, you know, why are they so closed off and they don't want to talk to to me about different things or, you know, they they keep saying they're fine, but they're in here complaining of pain. Like, what does that look like? What are they doing? What are, what does their history look like? Just kind of helping them to understand that that we are different in our rural areas and how do we communicate and what kind of things do we really need to be looking out for. So, like I said, doing that with medical residents, also providing some of that trainings for physicians, for EMTs, really just looking at broadening that scope of who we can provide that information to.
Jessi:
Probably in the last year, year and a half, we've had a lot of continuing education to a variety of the trainings that we do have, and that's been done very intentionally, because we see the importance of training those who are caring for people in our in our our rural areas. Again, our urban folks are more than welcome to take any of our trainings as well, because I think they're just as beneficial. We also have a ton of resources that are for patients available that, I think our healthcare providers can use. So that's something those are all free on our website, which I think is just incredible that we offer all of that talking about PPE, that protective personal equipment, talking about ergonomics, talking about, you know, yoga and stretching and, and just different things that we can be showing or sharing with our patients to help them live their lives better. And for them to have kind of that longevity and that health, as they do grow older and age and continue to work on their farms and ranches, and just living, living the life that they've, they've been so fortunate to be able to live.
Linda:
It is a wonderful life. I have to say that it really is. There's a lot of challenges and, and definitely those days that you want to just put a match to it all, but it really is it's a wonderful life. And and credence to you, Jessi, you have really elevated our space in continuing education credits and the work that we've done. And you're the expert in this field. So we know that CE’s are specific standards for each discipline. And that's important that we make sure that our programs that we offer, have that elevated that standard of care. And of course, all that we offer is evidence based research, but it's connecting that. And you're, you're the one that's making it happen for us in AgriSafe. So thank you for saying yes to a position. And then of course, just really, pushing forward with all of that work.
Jessi:
Absolutely. Well, another big one too, that I didn't even talk about was our FarmResponse program. And that's a really big kind of mental health program that we offer, really looking at all the different factors that tie into the mental health of those in our agricultural workforce, and that is one that I just think is so relevant. And it shows it's relevant because we do have see from, I think 11 disciplines on that right now. and that is just it's incredible. I mean, we have everything from veterinarians to nurses, doctors, therapists, physical therapists, occupational therapists. We have counselors. we're working on adding some additional, CE providers or continuing education providers to that list as well. And I think that does, like Linda said, that really just or like you said, that just kind of shows the, I don't know, just kind of like the clout that that is it is a solid program. And these organizations are seeing that it is important for healthcare providers to have that just to help them understand. I know we've had questions, you know, could bankers take this? Could you know, some of these different places, attorneys. And yeah, I know, I've told my husband, like, “I think you should take this.”
Jessi:
He goes, “why am I going to take it?” I'm like, “it's just good. It's good knowledge. It's good for all of us to know, to understand.” another training we have as our CALM trainings, that is, there are, you know, conversations that OR counseling on access to lethal means. Those are conversations my husband and I have on a regular basis, just with different friends or family members that we have. And so just really, I think we really do have so many resources at AgriSafe. It's almost hard to talk about all of them. And obviously we're not even getting close to doing that now. But, but I think that that that is our focus. It's our focus to really continue to grow those those resources and then really focusing on how we can get those out to the people who need to have them as well. and putting the continuing education on them too. So, so that way people can get credit for it, for taking it, at their different jobs or their workplaces as well. And you may not need it on the farm or ranch. I get that too, but there's still a lot to learn from them.
Linda:
Oh yeah. When you orientated into AgriSafe, right, there's our expectations of, of specific courses that you would have taken some certifications. But after taking some of those courses, did any of that information surprise you or like, oh, I thought I knew about that, but now I really know about that.
Jessi:
Yeah, I think that's honestly that FarmResponse was a big one that, you know, I knew it. And like I said, I you know it. But to actually see the statistics of the mental health components, that was really interesting to me. And then also Nurse Scholar, that was another one that, you know, I remember thinking initially kind of sitting through it and like, “oh my gosh, 23 hours. That's a long time of of sitting here and listening to these trainings” and, but also, “oh my gosh, you know, the fact that there is something that that is virtual. You can do it whenever you want to do it.” How convenient is that to life just for for all of us in the world today? You could do it when you're out for a walk, or when you're doing dishes or folding laundry or whatever you need to do there, too.You know, and there are some pieces that maybe weren't as relevant to me, like we don't have, like migrant workers necessarily in our area and some of those different things. So learning about kind of that big picture of what this looks like for different producers, not just ranchers or not just in my area, because like you just said, we're all a little bit different, right? We're all, we're all similar and we all have kind of the same goals. But the kind of that cultural group there's there's just different needs and different kind of specifics everywhere that you are. And so learning about some of those different pieces too was so interesting to me. and definitely things that, as we're revamping it that we're wanting to touch on and make sure are still there, just to keep that kind of that credibility and so other people can continue to learn and have those options too. And, and kind of choosing the different components of what, what they want that to look like, I think will be really exciting.
Linda:
It is. And we're always trying to keep things fresh and new and innovative at AgriSafe. Right? So again, thank you for your expertise in reviewing things, looking at a little bit of a different eye. So we've talked a lot about all of the things at AgriSafe? Or, trying to touch on, on the core areas as a healthcare provider, if I was coming in to AgriSafe, and wanting to learn more about how I can better care for the population in, in within agriculture. What are some areas do you think are most essential for those healthcare providers? For them to know when they have a producer walk in their office?
Jessi:
Yeah. So I think, honestly, the biggest thing is knowing that kind of to meet them where they are. I feel like that's probably the most important piece is they're maybe they don't want to be there. Maybe their spouse pushed them to be there. but really, as as we've discussed. Yeah, that just is the way it is sometimes. but I think too, like, understanding that in rural we trust people or we will listen to people that we trust and that who we feel are really listening to us. And, you know, I've seen that on both sides. When I can sit down as a nurse, when I sit down on the bed next to my patient or sit down in that chair, you know, across I don't even like to be across the table. I like to be next to somebody and have that conversation when you can really connect with somebody. That is when I think that's like when the magic happens, you know, that's when those connections happen. That's when that trust is there. That's when they're going to open up about maybe something that's happening at home or that. Hip pain that you know, they maybe haven't wanted to talk about for the last however long or, or some different things that they've maybe been feeling and didn't realize it. I think also to kind of respecting what they do and what their goals are, you know, if they're a little bit late to an appointment, not scolding them for that, but understanding that, hey, you know, we do have policies. We're, you know, but things do happen. because they do happen and that can affect so much.
Jessi:
And we all know when we're not in the right mental space because we've just been scolded. It kind of it just not going to say it ruins it, but it kind of ruins that that moment and that experience, and that's important. You know, it's important for us to have those conversations, to build that trust. and really listen, listen to our patients. And then they're also, I think as a patient, we're a lot more willing to listen to that healthcare provider when we do have that trust built. So honestly, I feel like that's that most important thing. We're not dumb. I feel like that's something so often too, that, you know, we hear that or maybe not hear, but you just kind of feel that like, oh, I don't belong here. When you walk into a clinic or, or whatever that is, or you don't feel like you're maybe treated as somebody that that is knowledgeable or really has a huge depth of knowledge and, and experience and all the things. So really understanding that, hey, these here are farmers or ranchers, your producers, your egg workers, they are hard workers and they do so much and put so much passion into what they do. So sit down and really listen to them, you know, get to somebody's level and have that honest conversation. I think that's that's going to be the best way that you're going to be able to really find out what's going on with your patient and be able to help them out, too, in the long run.
Linda:
I couldn't agree more. sometimes, and even here in our farm, too, you know, my husband's a little hesitant to go in. He's like, “I have to clean up. I have to do this and this. I'm like, no, you don't just just go, right? And so if we can have those healthcare providers understand how farmers feel judged, there's a lot of pot shots that are taken against us because people don't understand the work that we do. Right. And so I totally agree with those health care providers. It could be just a simple question like how was harvest this year. I've noticed the combines are rolling. I'm speaking farming. Farmers are rolling right now. Or if you were in the ranching industry, you know, I see the calves are moving about what's going on in the country. Tell me about what your day looks like. Something very simple.
Jessi:
Exactly. But those things, do they help open up that conversation? And then. And that farmer, rancher, whoever farmworker may really have that connection, like, “oh, gosh, they actually care about what I do.” Or “oh, they listened last time when I was in” and I said x, y, z, you know, and, and so those all those little things, those little connections, they really make such a big difference. I think when we're looking at long term caring for our those in our rural, our rural agricultural communities.
Linda:
As always relationships are key. So this has been a great conversation. And I know we could go on and on. but in wrapping up, is there any other information that you think is important or would like us to share something we maybe didn't touch on?
Jessi:
No, I just appreciate, appreciate you having me on today. And and if you ever want to peek at anything, any of our resources, always feel free to reach out to any of us. Have a training, you can always go to agrisafe.org as well.
Linda:
Indeed. Well, thank you for your passion, Jessi.
Jessi:
Thanks, Linda.
Linda:
There you have it, listeners. My conversation with a passionate registered nurse who lives, works, and thrives in her rural Nebraska environment. I hope you found a good understanding of those social determinants of health specific to agriculture, and why this knowledge is crucial for your health care providers to know and apply to lead you to better health outcomes. This episode was created by AgriSafe, directed by Laura Siegel, hosted by me, Linda Emanuel, edited by Joel Sharpton for pro podcasting services.com, with special guest Jessi Grote.
