Our guest: Patches Seely MBA, BSN, RN Healthcare Executive
This episode dives into the ever-expanding world of healthcare careers with registered nurse Patches Seely. Together, we explore:
- The Expanding Role of Nurses: How nurses can leverage their experience to identify and address potential diversion risks.
- Building Collaboration: The importance of teamwork between nurse managers and pharmacy teams in creating a proactive approach to diversion monitoring.
- Beyond Reaction: The conversation shifts from reactive responses to proactive measures nurses and pharmacists can implement to prevent medication diversion.
- Words of Wisdom: Patches shares invaluable advice for new nurse managers as they navigate the complexities of medication safety and risk avoidance.
Transcript:
Terri
Hello everybody. Welcome back to Diversion Insights. My guest today is Patches Seeley. Patches is a registered nurse, but that does not even begin to sum up her experiences. Patches and I are both advisors with Pronexus Advisory group, and on the last call we had with the group, she made a really good point. And that was for those of us who have a clinical title such as pharmacist or nurse, we need to remember that after all of the years of experience we have, we really can no longer be classified as just a pharmacist or a nurse because we have gained so much experience in other arenas of healthcare. And patches experience really showcases this. Welcome, Patches.
Patches
Thank you. So glad to be here. Terri, thanks.
Terri
Give us an overview of your career and how your experience base has expanded over the years.
Patches
Yvette, thanks for the opportunity. So it’s true. Registered nurse by background whenever I was in clinical practice, I practice nursing in a critical care environment, level one trauma, adult, critical care units and all that. That means academic medicine in large measure inside of a large healthcare system in Austin, Texas. In that role, in that clinical bedside role, I of course sharpened my clinical skills and really sharpened my skills around teamwork and how to be a member of a greater team on behalf of the patient. Pivoted to nursing leadership pretty quickly and began a career in clinical management. Nursing. Clinical management really enjoyed that work. Really, I would say cut my teeth and operations and learning concepts in budgeting and finance. And then where our unit fit in the larger hospital operation pivoted from there to implementation of electronic health records.
Patches
When were all doing that, if you all remember, probably ten or 15 years ago, and really began to pivot my career more towards a clinical informatics focus and led a clinical informatics and transformation team to continue increasing the adoption of electronic health record use and then adjunct technology around that electronic health record and all technologies that really touch patient care in the inpatient arena expanded from there to looking at larger capacity, hospital capacity, clinic capacity, and how do we get the right patient to the right place at the right time to meet their needs, and what did that look like? And systemness, which took my eyes more towards the global view of hospital space and clinic space, and how do we make sure we increase our access and manage access effectively? And then I would say, most recently virtual work.
Patches
And how do we, I would say, change our care delivery models at the bedside to include virtual professionals that support the bedside caregivers, including virtual sitters, virtual nurses, virtual telemetry techs. And how do those teams work in conjunction to increase patient safety and to develop the outcomes that we hope to for our patients. So, to Terri’s point, amassed quite a lot of varied experience. It’s been a wonderful career that allowed for usually work on the cutting edge of healthcare and what I would like to call disruption, gentle disruption, although some might say we need big disruption in healthcare right now, but so, yes, a long career, wonderful career, and really connecting back to Terri’s expertise and drug diversion and really making sure that we have solid medication safety.
Patches
I’ll speak mostly from my clinical experience as a clinical manager, registered nurse in my time in that space.
Terri
Yeah, I like that gentle disruption. And your comments about a virtual sitter made me think back of back quite a few years ago, there was a hospital that was piloting, had something to do with the mattress and the weight of the patients, I think. And then if the patient moved too much like they were going to get out of bed, then somebody spoke to them because they could sense that they were moving. It wasn’t anybody that was like there. Yeah, they had recorded a voice or something like don’t get out of bed. Like it could have been, you know, their mom’s voice or their wife’s voice.
Patches
Yeah, just a gentle reminder. Just a gentle reminder. Call the nurse first. Don’t try in the spirit of fall reduction. Oh, yeah, exactly. Definitely had some time, you know, developing workflows around that. So thank you for bringing that up. It’s been a while since I thought about that.
Terri
Well, your career history. Yeah, exactly. Just what you want is your spouse to be there nagging you. I’m not getting it.
Patches
Right. Right. I’m not sure that supports healing, maybe in the way that we intended.
Terri
Exactly. Your career history is a great picture of role expansion. And I bet you had no idea of all of the possible ways that a nurse could get involved in things, right? I mean, I don’t think. You think of the non traditional.
Patches
Yeah, no, that’s 100% true. And especially the pivot to healthcare it and what technology looks like in the clinical environment, that those were probably not the same conversations, you know, 20 years before my career. And so I’m happy to, I would say arisen at the time of the real healthcare it boom, so to speak, in the industry, and have really loved the evolution of that. And I’ve had long time partnerships with pharmacists, but it was nice to pivot to working even with pharmacy, clinical informaticists, or, you know, business systems analysts, architects, people who are building and designing software or augmenting what we had. And so, yeah, lots of good partnerships that come from pivoting your career to different areas.
Terri
Yeah, love that. Yeah. The increase in technology really gave a lot of different disciplines the opportunity to go into that it side.
Patches
Absolutely. Absolutely.
Terri
Yeah. Okay, well, you mentioned diversion. Let’s talk about that. The impaired healthcare professional throughout your career, then most likely as your bedside and management, nurse management, did you encounter impairment or diversion on the job?
Patches
I did. The two cases that come to mind are, unfortunately, the two that I had in that five year clinical management career were the only cases that I had. I wasn’t in any situations where I recognized impairment whenever I was in clinical delivery. But as a clinical manager, I did, in fact, experience two cases of registered nurses who were diverting drugs. And it can be a shocking, jolting experience. And if your career looked like mine, which many nursing clinical managers start at the bedside and then work their way into the same unit. Clinical manager. So these were peers that I had worked side by side with and then moved into the management role, and they were my direct reports. So, yeah, pretty significant. I would say, imprints on my professional experience, those particular cases. So, yes.
Terri
Did you identify it yourself? Were you suspicious? How. Let’s start with one of the cases. How did that come to your attention?
Patches
Kind of, you know, going back to the conversation around technology and data management, we had implemented a system, or I would say, upgraded the reporting capability of our medication management system and had been given training on the reports and how to manipulate the reports and manage them in such a way. But I dare say we didn’t really have the good critical thinking that we might have needed around those reports. It’s one thing to be able to filter rows and columns. It’s a whole other thing to really be a smart data analyst, using what you see to put information together. So I did not see either impairment in the clinicians or, I would say, a slippage in work from either of the clinicians. Both were, and this, the first case that I’ll describe, was two nurses actually working together to divert drugs.
Patches
So the complexity of that case was there and I would say, made the event for me even more shocking and disturbing, but for me, so no actual physical signs of impairment. One of the nurses was considered top performer in the unit, could really manage any type of patient that came through the door, was considered a trusted professional, and, you know, to the point of precepting and being able to give it additional responsibility. The other nurse was, I would say, a solid performer, not anyone that kind of stood out as a, you know, exceeding, you know, exceeding expectations, but definitely could manage any patient that came through the door as well. So it was shocking because it was two colleagues working together.
Patches
It was shocking because, you know, these were folks that I had practiced side by side and would trust and monitor my patients if I had stepped away, maybe, you know, for a break or something. But I did not discover it through visualization or observation of impairment or performance. And it was actually the pharmacy team that were also evaluating the reports who caught trends and what the data was showing in the various reporting systems. And so at the time, we didn’t have what I would call an interface with the EHR. So you couldn’t necessarily see, you know, trends with one patient for, you know, by nursing assignment, for example, but you could certainly, you know, view reports.
Patches
So the pharmacist, the pharmacy team is actually who noticed a trend that caused a raised eyebrow, and they brought that to my attention, and we began to work up a case. I, at the time, I was, you know, say, not a novice clinical manager, but, you know, certainly, sure. Yeah, I was. I didn’t fully appreciate all of the eyes that were on drug diversion, but I’m so grateful. I’m so grateful that there were multiple vantage points on these reports, not just mine. And, yeah, that was. That was the first. My first experience with that.
Terri
Yeah. I can imagine the complexity with two people. Yeah. Because unless they both come into your purview and you can kind of match it up, that’s not what you normally think. Oh, let me see what a different person is doing at the same time.
Patches
Yeah.
Terri
Imagine that complexity. Yeah. And then that took out two of your employees at the same time, which I’m sure was not appreciated.
Patches
Yeah, that’s, I mean, really tough. The, you know, and dependable, you know, like, and these were night shift staff, which, you know, I’ve read is a trend and, you know, maybe more common to see in night shift staff and oversight. Yes, less oversight. And, you know, night shift is tougher to cover. Right. So you do, in fact, you know, lose two, in this case, two team members, same shift, and then how do you manage, you know, your patient population effectively whenever that happens? And if you haven’t been through a case before, you may not understand the processes associated with that. So I had to very quickly educate myself on what next. So even though. Even though I knew how to manage holes in the schedule. Right. That’s not a uncommon task in clinical management. But what next? What is my participation in this?
Patches
How much time is this going to take away from my unit? I’m hurt I’m angry. I’m scared. I’m, you know, what if something happened to a patient in this or had a negative outcome that maybe hasn’t revealed itself? So it’s a pretty, you know, emotion ridden experience and just believe.
Terri
I mean, I imagine you had some disbelief to begin with as well.
Patches
Yeah, I mean, shock and disbelief is. Right. I’m fortunately realistic enough to know, and my first degree is in psychology. We didn’t really talk about that at the outset, but I worked in a chemical dependency unit. It was called chemical dependency. I actually think it’s called substance use disorder. That may tell you how much time has elapsed, but since I worked in that environment, but I had enough consciousness and enough knowledge on the disease processes associated with addiction that I wasn’t so naive that even these two strong nurses, that they may be in the midst of a serious addictive situation and willing to go to near any limit. So although I was.
Patches
I was shocked and had disbelief, I was wide open in my objectivity and working with the pharmacy team in compliance and those who had really studied those because I had an n of one. Right, right. And those teams had layers of experience and expertise in this. And so I’m a big fan of high reliability, and one of those is deference to expertise. And so I was definitely deferring to the expertise of my colleagues and pharmacy and compliance. So it was a quick, unfortunate learning curve to have to go through.
Terri
Yeah. They brought you the data, and then you did what needed to be done, which is great, because I will tell you, it doesn’t always happen that way. You know, even with the data and the questions, it’s often so biased that. No. And they find excuses, and it. Depending on what the process is and the facility, it can sometimes just die right there. Yeah. And so then you continue monitoring and hope that nothing happens in the meantime. Right. That’s great that you. You move forward and, oh, I wish I could be a fly on the wall. Those two nurses.
Patches
Yeah.
Terri
Coming up with, you know, I mean, they must have really known each other very well, because how do you like. Hey, you want to bring ropes with me?
Patches
I mean, bring that up.
Terri
Yeah.
Patches
How does that come to that?
Terri
Just kidding.
Patches
Yeah. The. Whenever I. Whenever I was made aware of the fact that they were working together, I began to reflect on, well, what is the relationship between these two individuals? And I knew that there was an off after hours relationship, that they were friends, and so perhaps some addictive behavior developed inside that friendship and then kind of made its way into their professional life at the time, I did not, you know, your natural response, you know, you talked about, you know, just disbelief, and it really kind of stops right there with the clinical manager. I wanted to believe that this was all wrong, and I feared that when the nurses were addressed by.
Patches
In the interview process that, you know, they would become so upset, hurt, shamed that they would no longer want to work in the organization, no longer want to work with me, and it would have damaged my relationship as a leader. But those are calculated and worthy risks. And if you put the patient first and if they were in a situation where they understood that were really trying to put the patient first, that there was a need to investigate, then that’s really kind of what guided my thinking is, let’s put the patient first here. It’s worth asking the hard questions. It’s worth interviewing and digging into on the patient’s behalf. So that made it a lot easier to bear.
Terri
Yeah. Yeah. Good point.
Patches
Yeah.
Terri
Okay, so you had a second case.
Patches
Yeah, I did. This one was a single, a singular nurse, but also complex. Very similar story. This is a nurse that I hired as a graduate nurse. So there’s something that a clinical manager experiences when they hire a GN, a graduate nurse, because you invite them in for their first job. There’s a sense of our unit, or my unit grew this nurse into this great practitioner. And so there is a little bit of kinship that you feel with a nurse that you hire as their very first nursing role. This is a very strong performing nurse.
Patches
Came out of the gate from school into our unit, into a critical care environment, and really excelled very early in her orientation and then on into the first few years of her nursing practice and beginning to see her as a leader in the unit, beginning to see her as the possibility of being a charge nurse, preceptor, and so forth. And, you know, often your employees, your teams, your associates will share personal information with you. And she had shared with me that she was going through a divorce. She had two small children, and, you know, that’s, you know, stress in those areas of your life can. Can be debilitating in some cases.
Patches
So I knew there were some things going on in her life, and, you know, she felt empowered to share those things with me as she was kind of looking to change shifts that she was working, but also night shift. And this case was, you know, same story brought forth by the pharmacy teams and the reports that they were viewing at the time, the organization I was working for, there were, I would say, advantage points of reports that I could see. And then there was a higher degree of access to adjunct systems that our pharmacy and compliance teams had. And so, again, they brought this case to me, and if I was in shock and belief, disbelief with the first one, I was nearly on the ground with this one because of this, you know, the performance of this nurse, I mean, just stellar.
Patches
And, you know, I hate to say, kind of didn’t seem the type. Right. I knew her lifestyle to be, you know, very focused on her children and. And her family, and so it was. It was shocking. But, you know, after having gone through the experience, you know, with the. The first case, I knew it was possible. I understood the processes this time. I felt more confident in my approach to it, didn’t feel any less hurt and betrayed, which is an interesting to feel thing to feel in a professional environment. Right. Like, we don’t usually use those emotion words, but that is, to some degree, how I felt. And so, same interview process. You know, organization handled it the same way, and she went immediately into recovery.
Patches
And what made this a little different than the first is that she was interested in returning, you know, to the organization after her recovery program. And in the state of Texas, our Texas nurses association manages the. Manages return to licensure, return to work, and any type of licensure restriction that might be. And so there was. She did desire to return to work. And the policies and procedures at that time of both the Texas Nurses association and the organization was that there were only certain environments and certain shifts that she could return on. So for me, as the nursing clinical manager, that was a whole other process policy procedure that I needed to learn and manage against. So that was another unexpected learning curve.
Terri
Yeah. How did that go? Was she able to come back into critical care?
Patches
This was a critical care unit that she wanted to return to, but she needed to return to a less acute environment. So, you know, the standards, I believe, and this is really, you know, I’m deferring to your expertise here, Terri, but, you know, the medication types that you can be exposed to in a med surg or acute care area, telemetry area are, you know, less invasive, perhaps, and they’re less access to some of the more high powered drugs that you can access in a critical care unit. So they allowed her to start and a med surgeon or return there. She couldn’t work a night shift. It needed to be during the day. There were certain drugs that she would need dual sign off for or certain drugs that she couldn’t administer to a certain point.
Patches
And then after her recovery, process had reached, I would say, certain criteria, then she was able to maybe administer drugs and then eventually move back into critical care, but not without, you know, not without having to rewire some operation, you know, inside the unit.
Terri
Yeah. Were you still managing the unit when she came back?
Patches
I was. I was managing the unit at that time.
Terri
Okay, so you worked with her when she returned to critical care?
Patches
Yeah, I did. And that was, you know, a little less than a year, if memory serves, and. Which seemed fast. I knew enough about substance use disorders, I think, even in, you know, some of the twelve step programs, they say, you know, don’t even buy a plant until you’ve been sober for a year. Like, really, you know, your sobriety. Your sobriety. The criticality of that and the sensitivity of that is such that, you know, handling a drug of choice, you know, seems a little bit risky, but, you know, those were the policies and procedures at the time. And so when she returned, there’s a delicate balance between keeping confidentiality about, you know, an associate’s background there, you know, regulations around that. There are sensitivities to that.
Patches
But then how do you know, how do you have the nursing staff work differently when they have to suddenly do sign offs for a particular drug that, you know, which is outside of normal, standard operating procedures?
Terri
It’s kind of a giveaway.
Patches
Yeah, it is. It is. And, you know, of course, the associate, you know, she, you know, could share her story in whatever, you know, way that she would want to. But, you know, I’m responsible for the operation of the unit. Right. I’m responsible for making sure that these standards are met and that these procedures are disciplined and to the letter of the law. And I had a lot of sensitivity to getting that right. So, yeah, it was a bit of a change for the unit. Indeed.
Terri
I can imagine. I mean, as a manager who felt that betrayal and disappointment and all those feelings you had when it happened and then to have them come back and then, as you said, a change of workflows and, you know, extra work and your feelings don’t go away. I mean, I’m sure that you were pleased that she went through recovery and you’re happy to, you know, see that it seems that she is doing well, but there must have been a lot of mixed emotions now.
Patches
Yeah.
Terri
Back on the unit, and you’re now supervising her again.
Patches
Yeah, the. So, yes, to all of that as a human being, which is, you know, you signed up. You sign up for empathy as a clinician. Right. This doesn’t, you know, it’s very similar with, you know, other disciplines. So the, you know, my empathic self is grateful that this nurse has been through recovery. You know, I’d say catching this behavior was probably one of the best things that ever happened to her, even though, like, a disaster, you know, for her. But in the moment, you know, that this is the right direction for this individual and definitely the right direction for their career if they intend to, you know, continuing practice. And so I had gratitude that she was returned. I was pleased for her.
Patches
You know, quite frankly, if we have a nurse in recovery who was a great nurse before, we’re going to have a great recovered nurse whenever she returns. And so, you know, great to have her talent back on the unit. But the additional emotion that I had was, wow, how am I going to manage these intricacies? And I felt, you know, a sense of overwhelm, and I felt a sense of irritation that I had to be in overwhelm, you know, when I had all of these great team members, there are other performance improvements that I could have been working on when I was spending my time doing that. And, you know, that’s a hard feeling to wrestle with.
Terri
Yeah.
Patches
You know, I want to be. You want to be as a clinical leader, empathic to your associates. You want to create an environment that people can grow, but you also struggle with how your time is spent. It’s limited, and you really want to spend it on the things that will get the best outcomes for the patient. And I grappled with that, and I would not say resentment is how I felt, but maybe some frustration that I was having to manage this nuance. And then, wow, what if I do it wrong? Then what is my accountability? And that, you know, what if something goes wrong? Am I accountable? So, yeah, all of those, all at.
Terri
Once, and probably a little bit of, is she gonna let me down again? Which wasn’t really you she was letting down, but yet I’m sure it felt like it. I mean, you gave her opportunity.
Patches
You know, unfortunately, I, you know, because of that experience and substance use, you know, prior to my nursing career, I knew that relapse, you know, was very possible, and, you know, I knew that all the. All the challenges for her life had not been solved.
Terri
Right.
Patches
You know, in less than one year, you know, that she would probably be fighting, you know, for her recovery, sobriety, you know, for a long period of time. And here we are with. With drugs right in her hands, you know, so you’re right. You know, there is the fear of, wow, this could happen all over again. And where are we from there? So. And were given choice. You’re given a choice to allow return to the unit to function. And so I chose. I chose that, you know, and when you’re in the thicket, you’re like, wow, this is really tougher than I thought it was going to be to manage this. But. So, yeah, all the feelings you shared.
Terri
Yeah, you wanted the best for her and once again, you wanted to give her the opportunity that you gave her originally. Right. But, yeah, it came with a lot of other things that surfaced. Yeah.
Patches
Well, you know, in healthcare, we try to, you know, create a non punitive environment. I mean, we have medication errors, we have surgical errors, we have, you know, we have those types of errors that we investigate and we really are looking for system failures, you, not necessarily individual failures. So, you know, I tried really hard to, you know, see this as a not, you know, I don’t want to be the environment, the leader that creates a punitive environment. An accountable environment, yes, but not a punitive environment.
Terri
Kudos to you. Not every manager gets that right. That’s kudos to you.
Patches
Thank you.
Terri
In your, in your experience in hospitals, did you find that, I mean, it sounds like this hospital was very proactive with their diversion risk monitoring. Do you find that to be the case with other experiences that you have or do you find that most facilities are more reactive?
Patches
Yeah, I mean, with this particular organization. Well, I guess if it’s landed on a report. Right. It’s automatically somewhat reactive.
Terri
No, it’s not because, you know, well, okay, it depends on what they did up front. You know, if you have to mitigate as much as you can, but you’re never going to prevent. So then you have to have effective monitoring.
Patches
Yeah.
Terri
To find what has gotten through your mitigation efforts. So if they did a good job up front and then kudos to them, they were monitoring and they found it. They found it before, you know, there was harm. And I mean, I don’t know how long it went on before they found it, but they were clearly monitoring. So I would call that proactive.
Patches
Proactive. Okay. I appreciate that context, but. So, yes, this organization was very proactive. And the facilities I went in after that point, I was not a clinical manager, but certainly was around implementation of software and processes and procedures. And my experience was there was a pretty well oiled machine between the technical and the technical outputs and reports, the pharmacy team, the compliance team and HR, because this can be. HR is often involved. Nursing practice, there was almost like a SWAT team approach that was taken in the environment that I, which for a young clinical manager, and I mean both young and years and young in experience, I really needed that team wrapped around me during that time. So I would qualify that as a.
Patches
As a pretty proactive approach, you know, in the way that this organization and what I’ve seen in most now, you know, I work for a large health system, so I’m going to call that pretty good, you know, pretty good, you know, series and good facilities.
Terri
Yeah, that’s great.
Patches
That’s good to hear.
Terri
Not all places are like that. And you bring up a good point, actually, is that for the young nurse manager, it’s important to have that team to support you, because can you imagine what it would have been like if, you know, that support had not been there for you? That is just. It’s a mess.
Patches
Well, definitely. And I would say fraught with risk.
Terri
Yes.
Patches
If the diversion itself is a risk alone, managing the diversion is a risk for the organization, is a risk for our ability to keep the doors open and in good standing with regulators. And so the risk expands, you know, from the patient, you know, to the rest of the organization and in some cases to the clinicians themselves.
Terri
Who knows how that would have ended if, you know, the reports hadn’t picked it up and the process hadn’t taken over.
Patches
That’s exactly right. So a novice clinical manager without that support around them, you know, stands to be a risk in that.
Terri
Right? Yeah, absolutely. Do you think that the modern day meaning, you know, not a couple of decades ago when you and I were both practicing, the modern day nurse manager has some challenges that maybe a decade or two ago, the challenges were different? Or do you think that they’re the same?
Patches
Yeah, so I think they’re slightly different, but no less or more, if that makes sense. I think there are nursing managers in a modern environment are naturally, because they, I would say, maybe native to ehrs, native to reports, native to managing multiple technical systems, I would say better, enables them to be data driven leaders, being better analysts of data that they find. So I think that equips clinical managers more effectively than perhaps my early years of clinical management, so that equips them more effectively. There is also a greater, just a greater awareness of the mental health of professionals in the healthcare environment. You cannot any day of the week not see an article that talks about moral distress, which talks about burnout, which talks about familial stress.
Patches
And so I think there’s a greater consciousness today of the risk of substance use disorder inside of a clinical unit and the risk of impairment inside a unit. So I think those two phenomena equip nursing managers a little more effectively than perhaps I did, I had. But the additional challenge is that, you know, we are in a shortage and such that staffing and scheduling is, it can dominate a clinical nursing manager’s time. The complexities of the demands of the nursing staff, the complexities of the patients have increased. Most hospital case mix indices, which tells you the sickness level of the patient, most have a higher CMI than before. And so for all of those reasons, they’re managing in a more high risk and critical environment without any new distribution of their work.
Patches
So they’re managing all the same things that I did in a more complex environment, I think, with greater risk than before. So I really, it makes me fearful. And the AONL and other nursing organizations really are beginning to wrap their arms around the clinical nursing manager and making sure that mid level manager has the right support to transition from practice to leadership. It’s a different use of critical thinking skills. It’s a different, I would say, you know, interpersonal acumen. And so I’m really glad to see the additional support. But clinical managers are really, the demands are really not sustainable.
Terri
Yeah, it’s not an easy job, that’s for sure. Any words of wisdom that you would give to a new nurse manager, or perhaps one that has been asked to be promoted to nurse manager, other than don’t do it?
Patches
Yep. No, I would definitely say do it. But if there is a, if any big words of wisdom, especially around diversion, is ask what your organization’s, make sure that you have access to your organization’s policy and procedures and make your way right into the office of the Pharmacy Clinical leader and make sure that you are locked arms with that professional and that the two of you can work together to identify diversion, that you leverage their expertise and that you partner on, you know, the needs of your patients inside the unit, beyond, you know, med delivery, you know, pharmacists do so much more than that, and they can be a really critical partner in identifying impairment, identifying drug diversion, and then any follow up if you should have to go through it.
Terri
Thank you for those words of wisdom, patches and listeners. I did not pay her to say that.
Patches
Not at all. Yay, pharmacists.
Terri
All right, thank you very much. You bet. Congratulations to you. I hear that you are going to your child’s graduation, so that is big milestones. But congratulations and thank you for taking time to record this, and we’ll get a lot out of it. So thank you.
Patches
Looking forward to seeing it live and have a great rest of your week.
Terri
Absolutely. You, too. Thank you.
