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Julie Carter:  Hi. My name is Julie Carter and I serve as Vice President of Mission Services with Trinity Health at St. Mary's Healthcare System in Athens, Georgia. And today, I am joined by my colleague and friend, Dr. Titus Gambrell. Titus, would you like to introduce yourself?

Titus Gambrell: Good afternoon. My name is Titus Gambrell. And I'm blessed to serve as the Chief Nursing Officer and Vice President for St. Mary's Healthcare System based out of Athens, Georgia. And we have our services throughout the Northeast Georgia area.

Julie Carter: Thanks. So first, why don't you share a little bit with us about how you landed here at St Mary's and what your trajectory has been?

Titus Gambrell: believe I was actually led to St. Mary's. When I considered where I wanted to go next in my career, it was really kind of a no-brainer. And so there was a position open at the time and everything just kind of lined up and it worked out.

And one of my favorite stories to tell about my entry into St. Mary's was, as I was walking in, there was scrolling messages on a TV in the lobby. And the message really was pretty much spot on. And that was, "Where you are is where you're supposed to be." And it just really touched me, and then through the interview processes and all, it just really felt like this was where, it really led to be in my next spot in my career. It's been a wonderful experience.

Julie Carter: Yeah, thank you. And what a spot to be in this past year or so. I think it's kind of fitting that you and I are talking today, as we conclude a week of recognizing National Hospital and Healthcare Week. And last week, we also paid special tribute to our nurses during the National Nurses Day. So sitting here with these landmarks, I was wondering if you would share with us kind of your reflections as leading the nurses throughout our healthcare system, through a global pandemic.

Titus Gambrell: I would be amiss if I didn't really talk about some of the fundamental emotions that most all of us, no matter whether we were in a leadership position or in the front giving care, there was a lot of fear that we had to face, right? And we had to really kind of, grapple with that at the same time showing confidence to our patients and to the public that we serve.

So reflecting back some of the earliest memories, the quiet raw, there was still such a strong faith that you had to dig down deep and to tap into. And so I heard that, you know, throughout our ministry where individuals that, as we were trying to make decisions as to, how do we treat this particular condition? How do we protect our colleagues, our patients, et cetera.

So found myself along side of the nurses, really having conversations and dialogue about, what really is important here, what steps do we need to take to, take care of ourselves, but with the patient centered.

Julie Carter: Yes, it's hard now that we've all become kind of maybe used to COVID in a way, used to the, mask-wearing and the protocols and, of course, this sense of relief with the vaccines. It's almost hard to remember how frightening it was at the very beginning. But I agree with you that it did come back to "Well, let's figure out what's most important in terms of serving the patients" and how that really drove all the decisions. Were there any particular incidences in which there was a decision point that you can think of in which that was a particularly important factor, thinking about the patients first?

Titus Gambrell: Really the first call I got from our director of lab services, alerting me that we re having our first testings and then it was our first positives. So there were so many firsts that come along. with each one of those, it seemed that though we had measures in place, we had written protocols, we had put a great deal of energy and time into focusing on what our plan would be in response more of a, incident command center, plus our patient care plan.

With each one, when you really took yourself from the macro down to the micro, with that patient-centered focus, it really was about the patient in the bed, about a particular patient

And so with each one of those, really going back to the clinicians at the bedside and our nurses, our respiratory therapists, who we really had to kind of pull in and then talk about processes and procedures and had a lot great guidance from our, parent company, Trinity Health.

So I thought it was really nice in the sense that we really honored the sacredness of each one of our patients and each individual nurse, but then collectively we were able to make movement if that makes sense.

Julie Carter: Yes. And I saw that too. I saw all the effort coming from Trinity to provide us guidance and well thought out, clinically based protocols. But when it came down to it, it was at the bedside, that it was still all patient focused.

And I think that my observation is that, as you touched on the sanctity of each precious patient, the reverence we owed to each of them at the end of the day was that driving factor. I know that you were incredibly supportive of the nurses who were working in very uncomfortable conditions for long hours, and yet really were committed to being a presence for a patient when no family could be at the bedside at that time. I think for me, that was one of the harder things. And I don't know if you had an opportunity to coach the nurses on that and talk about how important that was, not just from a clinical perspective, but from the kind of emotional and spiritual support that that offered to patients and their families.

Titus Gambrell: We didn't know that it immediately struck any of us that we would become surrogates, our chaplains the same way,   had to be bridge to bridge that communication. was really neat to kind of see how we embrace technology and began to, utilize that as best we could. But not all of our patients or families tech savvy, if you will, so we still had quite void there.

would say, the toughest conversations, but they were some of the sweetest, really were related to thinking specifically with the nurses to their struggle of having to be that proxy, if you will, to not make decisions of course, but just to kind of be there, to hold a hand, to listen to a family member on the other line crying.

When we look back, that will be one of the most difficult things that we've experienced with COVID and that was lack of family or significant other to be present in person with our patients.

And that happened a lot. well, he'd probably prayed more in the past 16 months we have been many more years prior. So, there was a lot of rays of sunshine through the midst of the clouds, just from that human compassion that I   the relationships that were built within the interprofessional team was amazing as well.

Julie Carter: yes. I think that each of us has been deeply impacted by this experience. But perhaps, these nurses with really the privilege, but also a little bit of the burden of accompanying these patients, through transitions from life and death, I think is probably one of the most profound.

As we hopefully are looking forward with COVID vaccines being thankfully effective and now readily available, what are some of the remaining challenges that you see for us as we continue to cope with the virus?

Titus Gambrell: finished a call with the Trinity work group that asked to co-lead and it's a clinical care and infectious disease provider work group. And so it's been most interesting to be on the front end of this.

So, how do we get familiar, with our routine types of patients in this midst of ongoing infections.

So I think that's going to present ongoing challenge. But again, the lessons that we learned that were progressive in healthcare delivery, we'll be able to employ those strategies, those modalities, and it will actually, I do believe, have a positive impact on our care of the community at large.

Julie Carter: Right. lots of lessons learned, unfortunately the hard way. But it strikes me that it's almost impossible to separate out some of these decisions that are on the horizon from our commitments to stewardship. And in terms of how do we continue to balance resources with continuing to address COVID-19 while also, as you were saying, adequately care for all these other healthcare issues, many of which have been postponed.

And unfortunately, we're all learning that in many cases, those who are perhaps traditionally underserved and less connected to healthcare access suffered more than others as a result of the pandemic. So balancing all those commitments, justice stewardship, and ultimately integrity. that we continue to be the ministry we say we are with that continued commitment to caring for all these people in a way that honors their dignity.

So thank you for touching on so many of those aspects. I am grateful to have you as a partner in this because you really embrace and promote what I think of as St. Mary's being a place of family and a place that genuinely cares for every person that walks through the doors. So thank you so much. I appreciate your time. This is Julie Carter.

Thanks everyone for listening. Peace and all good blessings.