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Reliably Well brings you thoughtful conversations from those who are shaping the future of healthcare, focusing not just on the technical side of the industry, but on the human element, the stories, the struggles and triumphs of individuals who are driving change. Join us for candid discussions that highlight both the challenges and rewards of working in a field where humanity and healthcare intersect.

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Welcome to Reliably Well. Meredith Wren is our guest today. Meredith, tell us just a piece about yourself and your connection to Relias here. I’m Meredith Wren. I’m a nurse practitioner. I work at Forest General in the ER. I started with Relias when they took on the Forest General contract in 2020 and have been with Relias since. I started as the site coordinator with Relias in 2021, I think. So it’s been great.

And what’s that role as site coordinator? That’s probably not something that people know what a nurse practitioner is. They don’t know what a site coordinator is. Yeah. site coordinator role here is I’m the site person that’s the go-to person and kind of the face here for Relias. am the end-all fix-all. So if they have problems with their

or if they have any issues on shift or if they have any payroll issues, they let me know and then I kind of help coordinate getting that to the right people to get it fixed for our providers. I’m the facility go-to person that can kind of be the in-between between Relias and the hospital. You are the glue that keeps everything running. I don’t know about that. Yeah, the WD-40 that loosens up the stuck bolt and the glue that

sticks the things that are falling apart back together. Including bad drills. You know, the other day my bad drills broken. I’m like, okay, let me see if I can find you a new one. Yeah. Yeah. We, we, know that, that forest general would fall apart without, without Meredith being there. So, so we, we truly appreciate you for your role that you do at forest general. And we really appreciate you being a guest here.

for us on our podcast here as we talk about the humanity in medicine. And so I think this is a unique approach that we’re going to have with looking at the human side of health care. And so thanks for for being a real champ and and trying this out with us. Thank you. And so much of what makes us all human is our story. And to know Meredith is to love and respect Meredith.

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And I think that you have a unique vantage point, Meredith, with your time at Forest General. So tell us how you got first started in Forest General and a little bit of your story to becoming a nurse practitioner in the emergency department. So I always knew I wanted to do something medical. None of my family is medical. I do have an uncle that’s a CRNA, but outside of that, don’t come from a medical family, but really kind of fell in love with it whenever I was in high school.

thought that was something I was interested in and decided that I was gonna go to nursing school. So when I graduated high school, I was looking for a job to do as I started college and I to church with some, actually at the time, the ER director that was here at Fort Shiner Hill and he said, well, have you ever thought about the ER? And I’m like, no. And he said, well, I have some tech positions. You could come in, get some experience and decide if medicine is really what you wanna do.

So I started here as a tech the Monday after I graduated high school. It was a little bit of culture shock on those first few days because I was a young 18 year old that didn’t know a whole lot about what happens in the real world. So I got to learn a lot. Learned a lot about people. I learned a lot about medicine and I learned really that I loved the ER. And so your first experiences at tech didn’t turn you away.

But your first day with Relias is a day that many of us remember who were in healthcare at the very start of the pandemic. So walk us through, Relias comes in and takes over the emergency department. Walk us through that first day. Yes, so Relias came in and I remember Luke standing on the wall on the backside of the blue area.

And he’s standing with his back up against the wall and they’re like putting up plastic sheets in the hallways, making us this PPE area. Nobody knew what was going on. Nobody really knew what to do. We were all just trying to figure it out. It was an interesting day. We learned a lot and we overcame some big hurdles there in the very beginning that none of us expected. What was it? I mean, cause you really did. mean, so for those that don’t know, Luke is, is in reference.

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to Luke West, who’s the CEO at Relias. What was it like having the CEO of this new company that you work for be in there while there’s, I mean, that’s kind of, that’s not typical, especially in a time as volatile as COVID. Yeah, that was not typical. He was there and I was thinking, he’s going to think we’re all crazy because our ER director’s running around telling, off orders. Everybody’s trying to figure out what to do. Everybody’s looking at each other like, what is going on here? So it was really,

more chaotic than it usually is, but it was good to see that he cared enough to be there. I think that meant a lot to all of us who were boots on the ground that here we are in the start of a pandemic and he’s standing in the hallway in the ER trying to be supportive and help us kind of figure out what the next steps needed to be in figuring out COVID. You do a lot in your role as site coordinators.

Dr. Johnsey said you are the glue that kind of makes that operation go. And I think that all of the executive and administrative leaders at Forest General would say that. as Relias employees would say that, your colleagues would say that. Who are you outside of work? You know, everybody knows Meredith, the site coordinator, Meredith, the great clinician, Meredith, the, you know, the Swiss Army knife at Forest General, but take away anything medicine, nurse practitioner, ER, who’s Meredith outside of work?

Yeah, so outside of here, we’re very involved in our church. I teach Sunday school. I teach the children’s choir. I do that whenever it’s time for it to come around. I get stuck with the preschool kids a lot because that’s nobody’s favorite thing to do. And so we do a lot, very involved with our church. I have three kids that involve me in a lot of things. So I have an eight-year-old daughter, seven-year-old son, and then a two-year-old surprise son.

And they are fun. They like to be outside and we get to do all kinds of fun stuff. We watch baseball games and watch gymnastics and we fish and they like to hunt. So my husband who was never a hunter has learned to be a hunter because that’s what my middle son loves to do. So we just do whatever the children want to do and have as much fun as we can when we’re outside of here.

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Meredith, know that, Relias, we have our five passions, people, innovation, and quality, value, and excellence. What is it that you identify with most of those five passions? Which one really speaks to you? I think for me, people is the big thing. I enjoy building relationships with people. I think that’s one part of the reason that I…

I’m successful in my role is that I get to engage our providers. I get to engage the nursing staff, the techs that work here, as well as our patients. So I think people are a lot of the reasons why the other passions are there, but people is probably what I relate to the most. there any story that that resonates with you about that, that that people interaction, how it how it really is exemplified in in one of your roles, either as the site coordinator?

coordinator as a nurse practitioner, something that really stands out to you? So there are a lot of things that stand out to me. I remember during COVID, one of the things that I’ll probably never forget about that time was when family members could not come into the department and patients were here alone a lot. And nobody really wanted to be at the bedside any longer than you had to be. You were masked up, gowned up, and I just feel like that personal interaction could not be there.

So during that time, think that that, you know, I struggled with that a little bit. I didn’t like that, you you couldn’t engage each other like we used to. And during that time, I had a church member who had a family member that came in that was on hospice, but they weren’t allowed to come into the hospital. And so the patient was here and actually passed away in our emergency room and would have been alone, but I was there with them. it was special that I could be there.

and that I could communicate with them like I’m in here with them. I’ll sit here for a little bit. I’ll check back in, you know, as he’s here. But that’s one thing, you know, that was very hard, COVID. I also get stories a lot of times from patients that are just really meaningful. They’ll tell you sometimes their background and some situations that they’ve been through and it helps you remember that everybody has a story and that we don’t really know what people are going on, what’s going on in people’s lives when they’re outside of here. And that may be…

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why they behave the way that they do here or why they’re reacting to things in a way that we may not think is appropriate for the situation. Yeah, I remember in my EMS rotations in residency, you’re often in the ED, you see this patient come in and you’re like, why are you coming in for this? And then you go on a run and you go out to the house and you’re like, okay.

I now understand you’re living in this condition. I would come in to someplace else for a minor complaint now because it’s magnified with the situation that you’re in, that the story, as you say, of the person tells a whole lot more. It changes a minor complaint into something that’s much more significant that you or I, with our support system, with

with things that we have. Yeah, we can blow that thing off. We can manage that thing in a much different way. But somebody who doesn’t have the resources, that doesn’t have air conditioning in the South where we live, man, a minor breathing problem becomes a massive one when the humidity is 95%, things like that. So yeah, I think it’s huge, the stories that people have that…

in the busy pace sometimes forget to hear. I love to hear that. Thank you. And so much of what makes everybody human, whether it’s the patients or the clinicians that we get to work with, is the individuals that we’ve encountered and had relationships over our life. I’d be really curious Meredith, with all the things that you excel at and all the hats that you wear, who are some people, individuals, family members, colleagues?

mentors that have had the greatest influence on your life thus far? Of course my parents have had a huge influence on my life. They supported everything I’ve done including letting me, allowing me to work in an ER at age of 18 and supporting me when I told them I wanted to do something medical and they were like, okay, that’s strange for a family but great. So they’ve been huge. They still are huge. They take care of our children when we both work. husband and I both work a hospital schedule which sometimes can be hard.

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hard to navigate, but we couldn’t do it without the support system that we have. So that’s invaluable. Also, my husband, he’s a great supporter. He has done a lot of rounds of daddy bedtime through the years. my oldest two, they’re 14 months apart, whenever they were very young, I was working shift work and I worked till 1 a.m. half of the month. And so that was challenging, but he stepped up and did an awesome job.

And I’ll say as far as medicine, Dr. Patterson here has always had a very special place in my heart. started the day, the day I started as a tech here, his daughter also started as a tech. We were buds and he just kind of took us under his wing, told us what he needed to teach us. We knew that if we had a question, we could go ask him and he wouldn’t think we were dumb or jump down our throats. And he’s a great example. He’s a great physician, but he’s also great with people. He takes…

Every patient, like they are a person and thinks about them as if they were his own family member and treats them that way. And I think that that’s always been a great example for me. I appreciate everything that he has ever encouraged me with or challenged me with over the years. Yeah. And you’ll have such a special group down there at Forest General that really cares about each other. And so it’s really no surprise that he, for lack of a better term, was your work dad. Yes. Which is, which is really neat.

Kind of along that same line with y’all’s provider group down there, Libbo Crosswhite, who’s the chief people person at Relias. She goes and interacts with a lot of our sites to make sure that they’re cared for and we see them as people while they’re taking care of patients. One of the physicians told Libbo last week, Meredith is like our mom. She tells us what to do even when we don’t want to do it. And I, important here,

respect her for that. Where does that land with you? Well, you know, sometimes I have to be the bad guy. I have to tell them, hey, get up off your honey and go see these patients. We can’t let them sit there. I have to tell them, we’ve got to focus on our length of stays. We’ve got to look at this. We’ve got to look at that. And they sometimes grumble a little bit, but they’re very receptive. And we all know that we’re on the same team and we all have the same goal.

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We’re doing everything that we can to achieve that, is take great care of our patients and support each other in the process. Meredith, how do you think that you get to that level? You know, I think that’s the secret sauce we all want to know because I don’t think that that’s something that you learn in a business school. I certainly don’t think that’s something they teach you in nursing school or when you get a master’s degree. So what’s the secret?

to people being able to take that sort of, know, these are, as you said, these are lot of folks that have much more tenure than you, much more, many more gray hairs. They have, you know, they have MD or DO behind their name, but yet you’re able to tell them, you know, get up off your butt and go see the patient. And yet they respect you when you say it as opposed to say, Hey, you can’t tell me that. And there are people

who said the same thing to them and they don’t take it that way. How is it that you think you’re able to convey that message? And I don’t think it’s the words that you say necessarily. Maybe it is, maybe you do have the exact right phrasing to say it. What is it you think that makes that message come across that way and people are receptive to you and listen?

I think that the secret is I’m in the slums with them a good bit and they know that I know exactly how it feels to have, you know, 18 patients on your list and have four more waiting and you got to decide what of that can I pick up and go see and what else can I add onto my plate at this point. And so I think that that’s one thing. They know that I understand that they’re busy and that they’re drowning. And then they also know that if I need help on my wheel, if they say I absolutely cannot do anymore, okay.

I’ll go see them. I’ve got a lab coat in my office. I’ll go put it on with these street clothes I have on and I’ll go see these patients and then hand them over to you if that’s what it takes. So I think they know that I’m willing to help them do whatever they need to be successful. And I think they know that I understand how it feels to be in their shoes. And so it’s at that point not punitive. It’s we’ve got to do this. We know that we all have the same goal and what is it going to take for us to get to that goal?

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You’re leading from the front. You’re not leading from the rear. Right. Yeah. Yeah. That’s huge. So in your role, what is the biggest challenge that you see now? You obviously have gone through a huge challenge as we’ve gone through COVID. We’ve gone through the travel nursing issues that are there and all the transition we’ve gone through.

I mean, how many nursing staffs have you gone through in five years? You’ve had an inpatient crisis where we didn’t have any, you know, inpatient capacity and those things have sort of resolved themselves now. What is now the crisis that you see or the looming crisis that’s ahead in healthcare that you’re seeing? I think right now, one of the biggest pushes is metrics and throughput times and we’re

all trying to drill down and figure out ways to be more efficient as a department. But you have to stop and think about the fact that we don’t want to take advantage or lose the focus of the patients. You want to still be able to sit in there with them and have the conversation and listen to them talk to you about what’s going on in their lives, even outside of the building. So I think trying to find that balance is a challenge that we all have to face. We want to

keep pushing forward, keep seeing the next patients, work on getting our length of stays down, knowing we need to discharge the next one, but being able to spend a little bit of quality time with the one we’re seeing right now and not worry about everything else that we know we need to address when we walk out of the room. Yeah, it’s a tough mix to know that there’s a whole department to think about, but when you enter that room, forget about all that and focus on one.

one individual. It’s a tough dance. What do you think about the more and more boarding that we have? that subsided? Is that building? that resolved? Some places are having huge issues with it. Is Forest General, is it building? Has it gotten better? How are y’all, or is it come and go? We had a little bit of time of reprieve where it was a little bit better.

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but for the last probably three weeks, it’s been awful again. We’ve had, you know, 20 to 30 patients boarded every day down here and that makes it very challenging to be able to process through patients. So luckily we have great engagement from the leadership here at Force General and we’ve tried to think outside of the box and they have helped us develop some alternate care spaces. So we, over the last year, opened what we call our Fast Lane and Treatment Lounge, which

We converted a waiting room into some areas, some little cubicles with recliner chairs so that we can see our vertical three patients. And then of course our fours and fives through the fast lane and try to process through any patients that we can through those areas since the back just sometimes doesn’t move. So boarding is something that’s here to stay probably. We have to think about other alternatives for how we care for.

for the people that are coming into the department. I have to continue to look at that. The medicine has changed. Other hospitals are not, they don’t have the capacity they used to have. And so the referral centers, the secondary referral centers, they’re gonna see more and more patients come to them. And so boarding in those sites is going to be a bigger, a more constant, consistent issue. And so you have to,

evolve to that new paradigm. What keeps you up at night? What makes you worry? What makes you, you know, just pull your hair out? What’s your worry? Luckily, the only thing that keeps me up at night is a two-year-old sometimes. I’m not a big worrier. I think that worrying doesn’t really do me much good. Just try to focus on whatever I can do for the day. Try to do it to the best of my ability and hope that everything works itself.

I’m not a big warrior. My husband worries enough for both of us. He always says he needs just like one ounce of what I have to help him not to be so worried about things. But yeah, not much keeps me up at night. I rest well during those few hours, but then of course, you know, the next morning it’s back to whatever may be going on here that we’ve got to focus on and try to power through and overcome. That’s so tremendously healthy. So one of the

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One of the threads in this conversation, Meredith, kind of, whether we’re talking about, you you’re the mom of the group or when you’re kind of talking about the boarding challenges is there’s this thread of wisdom or discernment that you have that you’re able to navigate these situations with poise, but I think that there’s a certain degree of kind of wise discernment. What would be some advice that you would give to a younger

clinician or a clinician that is listening to this that is maybe thinking about, man, I want to be more like Meredith. Like, how does she navigate all this? Like, what’s something that’s allowed you to have the wise discernment that you’re kind of displaying in this conversation? I think a lot of it’s just strictly experience and the time that I’ve spent here in this building. I’ve worked, you know, every role that there is out there. I was a tech.

I’ve worked in the secretary role, I’ve worked in the nursing shoes, I’ve worked in the charge nurse role here, and I know what it’s like to work all of those areas. And so I kind of can see from their viewpoint a little bit, you know, what their challenges are. And I think that helps us all kind of work together to figure out, you know, what our next steps can be, what some options can be to try to think outside of the box on things that, you know.

maybe challenges for us and building great relationships with those people, with the nursing leadership, with the hospital leadership, and just always remembering that we’re all on the same team and that we all have the same goal in mind and trying to power together instead of working against one another, even if we don’t always agree with each other. Yeah. And I think you’ve really embodied in that to create a relationship, people need a shared experience. can have a conversation, but to really have depth.

in a relationship, that shared experience is critical and clearly you’ve done a fantastic job of that. Kind of talking about the journey and all the different roles that you’ve had at Forest General and being a fantastic leader in our organization. What’s the accomplishment that you’re the most proud of as you look back on your career or your personal journey as a mom and a choir teacher and an outdoorsman with your kids? are you the most proud of?

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Well, I’m the mom that makes the best chocolate chip cookies. So that’s number one on the list. I’m just kidding. That’s what I always get assigned whenever it’s time for a party. I have to bring the chocolate chip cookies. But no, I would say, you know, here in work and outside of work, I like the fact that people want to be around me, want to know that if I’m here, we’re going to have a great day, whether it’s hard, whether we have to deal with difficult things or not.

We’re going to do whatever we can to make the day good. I’m a glass half full person. So I try to be positive and try to let that pour out into people that I’m around no matter where I am. Okay. So I am a cookie guy. So what’s the secret to the cookie? Are you a salted butter, unsalted butter, don’t let them bake as long? Can you reveal any of your secrets? I like them to be soft. So eight minutes is about all they need.

But yeah, salted butter, I don’t know. I’ll just have to make you some cookies and see. Let’s try them out if you’re guy. Salted butter in eight minutes. I like it. So Meredith, we’ll try this out. This is a tough one. But one of the things that we wanted to ask all of our guests is this idea as we’re talking about the humanity, is this question of kind of prove that you’re human.

and it’s, it’s kind of wild card question. It’s not real specific here, but just that idea of what makes you so human, whether it’s in your, in your role as the clinician, something that was, that was uniquely, you know, a human experience there that, touched you so much, or whether it’s another one of those stories of, of

of those things outside of your role that’s uniquely human. You’ve done a number of those through here, but if you’ll throw us another one that tells us about Meredith, the person as opposed to, you know, the leader and the site coordinator and those more technical things, Meredith, the human being, as we’re talking about the humanity and getting to that human side of the people who carry out.

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this role in healthcare. We’ll try that question on with you. I am as human as anybody else. I make mistakes like everybody else. I’ve got a pile of clean laundry in my laundry room, probably like everyone else. So yeah, I mean, I think that we’re all humans. We all have different backgrounds, different challenges. And something that I’ve always tried to do is focus on maybe the challenges that I’ve had in my life, maybe the things that didn’t go well or the

the things that I did not react in a way that I should have and try to learn from those and do better next time. I just think we’re all very human and can make mistakes and instead of focusing and dwelling on those, I try to just learn from it and move forward. Yeah, I think that, you know, one of the things that I think about in in this kind of question, my wife, when we had our first child, you know, she was looking for a pediatrician and she said,

I don’t really care if we find a male pediatrician or a female pediatrician. The only thing I care about is do they have kids? Because I want them to really know what it is that I’m dealing with, you know, and they can tell me not necessarily what the textbook says, but what they’ve experienced. And I’ve thought about the wisdom in what she said there many times.

as I saw my kids grow up and then I saw kids in clinical experience and I was like, I know so much more about whether that kid’s healthy or not healthy by kind of comparing to my own kids experience. I’m just a better physician than I would be and I was working with an APC last night and they were like, they didn’t know that like a car seat.

after you’ve been in a wreck, you should get a new car seat, even though the car seat looks fine. And she was like, well, I guess because I don’t have kids, I don’t really know that. And I was like, yeah, that’s probably not something that you would bring into it. And I think that’s something that, you know, a lot of all of us that have kids, you know, we bring, we’re better at that role, not because we got more degrees or more letters after our name, but because we got, you know,

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25, 30, 50 years of experience with those rugrats running around in front of us to train us how to be better in that experience. And some of that story, that’s that human side, I think, of making us that better clinician because we’re a more experienced human. Yeah. kind of, I mean, like you said, this was probably a throwaway line from your perspective, Mary, but I think it’s so important of the

You know, I’ve got clean laundry that’s not put up just like everybody else. you’re, you have an attunement to the humanity that’s in everybody. That the hospital administrator is a human, the patient that you’re seeing at two o’clock in the morning is a human. The clinicians that you’re working with are humans. The kids that you’re teaching choir to are humans, right? What do you think has allowed you to have that

kind of attunement because you’re somebody that embodies the culture of Relias Healthcare that we really care about people. And if we really care about people, they’ll really take care of other people who happen to be patients at that particular point in time. I think it’s important that we recognize that in you. And then also, what do you attribute that kind of attunement to? I guess just being around people my whole life. I’ve been

around people. I’ve grown up with many people whenever I was a kid. My mom and dad had some teenagers that troubled teenagers in the area. They lived with us for a while. So I got to experience kind of seeing that side, being open and receptive of anybody at any point in their story and trying to be a positive. My parents always try to be a positive influence for them. I think just growing up with that was something that kind of made me realize that everybody has something they’re going on.

that’s going on in their life and you never know exactly what someone’s story is. So we should treat everybody with respect and try to meet them where they are and be an encouragement in any way that we can. Well, I sincerely appreciate your curiosity about humanity and your care for patients that you excel in. And I’m thankful to be your teammate and thanks for coming and spending a little bit of time with Joe and I to talk about.

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the humanity that’s in healthcare. And thanks for, thanks for embodying that and being a great colleague and friend and caregiver. The best chocolate chip cookie baker that there is. Hey, we’re looking forward to those. Yeah. I’ll have to bring you some to make sure you feel the same way. Thanks, Meredith. Thanks, Meredith. Thank you guys so much.

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Thank you for joining us on Reliably Well, where we explore the intersection of healthcare and humanity. We hope these conversations inspire you to see the people behind the policies, the passion behind the practice, and the purpose that drives innovation in healthcare. If you enjoyed this episode, be sure to subscribe, rate, and review our podcast. Your support helps us to continue sharing these important stories.

For more insights and updates about what we’re up to at Relias, visit us at ReliasHealthcare.com and follow us on your favorite podcasting platform. And if you have any stories that help to demonstrate the humanity in healthcare, please let us know at reliablywell at ReliasHealthcare.com. We look forward to hearing from you and telling your story. Until next time, stay well, stay inspired, and keep bringing humanity to healthcare.