The Concierge Doc Podcast with Dr. Jason Littleton, M.D.
The Concierge Doc Podcast is hosted by Dr Jason Littleton, M.D., where he features medical content to make smart lifestyle choices for optimal health, wellness, energy, youthfulness, longevity, balance, and happiness.
The Concierge Doc Podcast with Dr. Jason Littleton, M.D.
Beyond Hospital Walls: How Concierge Nursing Transforms Patient Care W/Jeannemarie Bozza
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Disclaimer:
Access to the Information and materials contained in this podcast is at your own risk. The information contained is presented for the purpose of educating the consumer on a variety of wellness and health care topics (the “Information”). Nothing contained is intended to be instructional for medical diagnosis or treatment. The Information contained is compiled from a variety of sources. The Information should not be considered complete and not exhaustive and should not be in place of a visit or consultation with your own primary care doctor.
The views, opinions and statements expressed by our guests are solely their own and do not necessarily reflect those of Dr Jason Littleton or the Concierge Doc Podcast. We do not endorse or take responsibility for any statements, claims or perspectives shared in this content. Viewers are encouraged to conduct their own research and form their own conclusions.
Dr Jason Littleton:Access to the information and materials contained in this podcast is at your own risk. The information contained is presented for the purpose of educating the consumer on a variety of wellness and healthcare topics. The information nothing contained is intended to be instructional for medical diagnosis or treatment. The information contained is compiled from a variety of sources. The information should not be considered complete and exhaustive and should not be in place of a visit or consultation with your own primary care doctor. Welcome to the Concierge Doc Podcast. I'm your host, CEO and founder of Littleton Concierge Medicine, Dr Jace Littleton. Welcome to the podcast.
Dr Jason Littleton:Now, today's guest. I'm really excited about Jeannie Baza. She's the CEO and founder of Commodore Concierge Nurse Management, a premier provider of specialized home nursing care. With more than 25 years of experience as a registered nurse, Jeannie has dedicated her career to empowering people with the knowledge and confidence to make informed healthcare decisions. Her company is built on the philosophy of providing advanced, tailored home care with expertise, discretion and compassion, ensuring patients receive the highest level of medical care and the comfort of their own homes. Jeannie, welcome to the Concierge Doctor podcast.
Jeannemarie Bozza :Thank you so much for having me, Jason. I'm really excited to be here today.
Dr Jason Littleton:I'm excited to have you on. I think your company is fascinating in what you're doing in terms of concierge nursing care helping people to feel connected, giving them point of care when they leave the hospital, helping them feel like you know what the care continues. Nothing's disjointed. They can feel confident and ensured that they're getting the right care. Please tell us more about your company. I think it's fascinating.
Jeannemarie Bozza :Thank you. I think that's a great description of what we do. A lot of the times we find, when people come home from a hospital or some kind of traumatic event, the care kind of stops where they were last helped and they feel like they're at a loss. So really at that point is where we step in. We bring you home and we continue the care. We continue to have the physicians be involved, let them know what's going on on a daily basis. To have the physicians be involved to let them know what's going on on a daily basis. We get medical orders in real time. Essentially, what we do is hospital at home and so the care just continues to go in an upward trajectory and people reach their optimal level of functioning. And that's really the goal at all times to treat our patients as we would want our family members treated.
Dr Jason Littleton:I love it. I mean, you know you work with concierge doctors and other doctors and I think that makes a huge difference. I know as a concierge doctor how important having connected care is. And then teaming up with a company of yours, I mean that's just a wonderful duo and I just think that's really the ultimate way to go if people want great healthcare. Because so many times people leave the hospital they don't know where to turn, they don't know what to do next. Maybe they didn't understand the doctor's instructions in the hospital, or maybe there's long wait times in between the next time that they can get in to see a specialist. And then you step in and your company and you really you know banish all of that away and you help them to understand what it is. The next steps are You're making sure that you know the medicines are right. You're making sure that their specialty appointments and everything else is, you know, connected. I mean that's gotta be just a wonderful thing. Your patients must love this.
Jeannemarie Bozza :I mean, that's got to be just a wonderful thing. Your patients must love this. I think they really truly value it, and I think one of the things that really gets missed when you go home is the level of anxiety that people have, right. So now, if you have an ICU nurse in your home who's able to say that's actually supposed to be like that, you don't have to worry about it, that's what we expect, the level of anxiety goes down considerably. This lowers the amount of phone calls going into the physician's offices that really aren't needed to happen.
Jeannemarie Bozza :And so now, when they are caring for other patients, they have more time to be able to care for someone who actually needs the help in that real moment. And then, when we call, we're able to give data from nurse to doctor on what's really going and they're able to make decisions in real time. So so it makes a big difference, I think in patient care. You know, now you don't have a patient who's ill having to get in the car, travel to the doc and and be seen. Rather, we're able to give vitals, full head to toe assessment. Give our our thoughts, head-to-toe assessment, give our thoughts. Draw blood in the home, draw, you know, do urine hang, IVs, chest x-rays, lab work, whatever needs to be done, and all be done in the home setting which elevates the level of care and decreases the level of anxiety that these patients are going through.
Dr Jason Littleton:Yeah, this, I mean what you do, you know it's really like the glue. I mean I see like you're really putting the whole picture together, connecting the dots, so to speak. You know, patients spend a minimal amount of time with specialists and doctors. They spend the majority of the time usually with their nurse in the hospital. And now this is an extension of that and it's really connecting the dots hospital. And now this is an extension of that and it's really connecting to that.
Jeannemarie Bozza :You know what age groups do you see your company mostly working with. So I have a hard stop with peds. I don't do children, so you have to be 18 and older to work with us. But really we see, from 18 to I, a 104 year old. You know so and we've been with the 104 year old since he was 98. So, fully, fully functioning. You know, playing golf twice a week goes to Costco. Really highly functioning, 104 year old.
Dr Jason Littleton:Now is most of the care that you're giving, you know, with sick patients, or are some of them with well patients? It's please break that down.
Jeannemarie Bozza :So we have a because of the skillset of our nurses. We have a team of over 200 ICU nurses, over 60 aides Um, and then we have a clinical component to our company Um. So I would say that our, our, our specialty very much vary because we're capable of handling anything. So I can, if somebody has the flu, they can absolutely call me and we can take care of that. But we do a tremendous amount of um surgical patients Um, and we do a lot of rehab Um. I would say twice a week we take patients from the hospital AMA against medical advice for those who don't know what that means. So we will see a situation where the patient's just failing to thrive. Things have gone really haywire and we will take them home from there and involve physicians and do all the care at home in a hospital, at home setting, and we've been really successful at this.
Dr Jason Littleton:So back up. So, like even the people who leave the hospital against medical advice, they'll contact a service like yours and say, okay, you know what Things didn't go well in the hospital. I need you to take it from here.
Jeannemarie Bozza :Yeah, and I would say I don't know that there's that many other services that do what we do because of the level of expertise of the nurses. These are ICU nurses, so there's very little they can't handle. We've run vents at home. We do really complex things at home and my only goal is not to end up back in the hospital. I was a hospital nurse for many, many years, but what I will say about hospital settings is the care is very disjointed and it happens in silos, and so when we are in the hospital we are advocating for that patient and pulling all those pieces together, but sometimes it's just not. It's just not getting where it needs to go. And you know when we get called in, if we're not at the bedside already, we're usually driving care and things will work out just fine. But if we're getting called in last minute and it's like, a perfect example is I had a patient last Christmas. I got a phone call in the beginning, beginning of December and there was a patient there in a hospital in Manhattan that had just sold his business and was a fully functioning 82 year old man and got COVID for the first time. So he'd made it all the way through COVID and never gotten COVID. And now he got it. He had been. People had been seeing the beginning signs of cognitive decline, but as soon as he got COVID he ended up having he had it affect his brain. You know, it finds the weakest part of you and and goes after it. So he went from agitated to paranoid to aggressively running down the hallway with a butcher knife at his nursing staff not my nursing staff, another nursing company, wow. And so, thank goodness, the doorman came upstairs to deliver his newspaper, heard the commotion, came inside, saw this happening, called 911. But unfortunately for this patient, if someone had noticed the signs, they could have gotten in front of us, they could have medicated for this paranoia and prevented the aggression. But the nursing staff wasn't educated enough to get in front of that and the physicians weren't necessarily be giving the data they needed to do that. And so it escalated to this situation.
Jeannemarie Bozza :He was now in the hospital for 10 days and the family called me and said they're going to kill him. Can you please help us? And I said, well, I can come and evaluate tomorrow. So I went. I went to see the patient in the hospital and it's you know, it's a tremendous hospital, and as soon as I'm going to sign in the, the security guard says to me how is Mr So-and-so today? And I said, you know him, he's like we all know him. Every night we hold him down while they give him IM Zyprexa, an antipsychotic. So I was like, oh goodness, so I get up there and I can't even evaluate him because he's so drugged up from the last night when he had gotten gotten his IM Zyprexa, wow. So I had called for yeah, like terrible.
Jeannemarie Bozza :But you can also understand from the hospital setting. They don't have the ability to be running after this patient all night long and when it escalates, multiple people come into the room. As more people come into the room, the patient escalates further and it's just a cycle you can't break, right, right. So when I went in there, I called for the medical attending and he came down and he was a great guy and I said to him listen, I just need to know if there's a medical need for him to be here. Do I have COVID lung? Do I have, you know, another infection I need to worry about? Like, is there a medical need? And he said no. I said okay. So what I see is this ending in a locked unit and he's like you're not wrong. I was like and that's not your fault, it's just the system we're working in.
Jeannemarie Bozza :I said so I'm going to take him home. And he goes you're going to do what I said I'm going to take him home, he goes. You know what happened, right? I said, yeah, I'm aware. I said, but at the end of the day, I can do everything you do here, but I can do it in his home setting where he's used to it. And if I get really lucky, you know we'll be okay. And I said so are we going to do this the easy way or the hard way? And easy way or the hard way? And he goes, what do you mean? I said am I going to AMA? Are you going to help me? And he goes, I'll help you. I said okay, I need an ambulance.
Jeannemarie Bozza :Two days from now, at 9am, which was Christmas Eve morning, wow. And he and he says to me um, all right, but can I ask one question? And I said sure, and he says why 9am? I said because I'd bet good money, you're going to IM Zyprexa him the night before and when I leave at 9 am, he's not even going to know. And he laughed and I said if I don't get lucky, I guess I'll see you in the ER, but let's like at least give him a chance, right? So I left there and I called my COO and I said listen, I think I have to come out of retirement. I'm going to have to take this case.
Jeannemarie Bozza :And she said what do you mean? I said well, I don't feel comfortable putting any of my nurses in this position, because I wasn't even able to truly evaluate this patient and I don't really know what his baseline was before. I only know what the family's saying, and they may have a different version of who he was, you know, than necessarily what medical staff might say. And she's like well, you just can't, so you need to come up with a better thing. You have to be here, here and here. And she said well, what would make you comfortable if, if you were there? And I said honestly, and she said yeah, I said your husband. And she says my husband. I said yeah, he's New York city SWAT. Swat officers are the highest trained in de-escalation. That's why they're the ones that pull you off bridges and buildings and things like that. But they're also all trained EMTs, so they all have a medical background.
Dr Jason Littleton:I didn't know that.
Jeannemarie Bozza :So she said, okay, yeah, so this is the kind of out of the box thinking that we do at our company. So I said to her that that would be that would make me most comfortable. She said, okay, consider it done. I said what do you mean? She goes, I will get you a team of de-escalation aids. She called them and I said okay, I was like, if you could do that, then I will pick from our team the best suited nurse for this. And so we we picked our dementia whisperer from Georgia as we call her Cause she's like the best with our cognitive decline.
Jeannemarie Bozza :Patients.
Dr Jason Littleton:Wow.
Jeannemarie Bozza :And we set up for her to come in for seven days and be there 24. Seven. And my COO interviewed 40 retired SWAT cops. She interviewed them all in under 24 hours and she chose from the group and chose five men and then those five guys would rotate on a 24 hour basis. That way my nurse would get to sleep every night, so she would never be too tired that she could escalate a situation, and the aid would leave every 24 hours, so they'd never be tired. And if the aid needed the nurse during the night, all he had to do was push the bell and she'd come running in. And so that was our plan.
Jeannemarie Bozza :Well, so I found enough IMs. I prex that I put down a horse. I had a psychiatrist 24-7 available to me, who also lived a couple of buildings down. I had a concierge physician who was available to me 24-7 as well, and Christmas Eve morning we roll in at nine o'clock. Ambulance is on time. We go home. He wakes up in his home at 11 am and says to my nurse he'd never met before. Can I have breakfast?
Dr Jason Littleton:And we never gave him IMs. I practice it again. Wow, that is a wonderful story, a wonderful experience that, I think, really exemplifies what your company does. It's really the glue to healthcare. I mean, look, you can have doctors, you can have specialists, and even me, myself, as a concierge doctor, I believe in connected care but, like I said, teaming up with a company like yours, it's really that extra layer that makes all the difference. Had he not had your services, this guy could have been. It could have been a very morbid case.
Dr Jason Littleton:It could have been a very morbid case it would have been very difficult. I mean I I just don't see him getting through that without what your team did.
Jeannemarie Bozza :Yeah, I think the physicians involved and even the family was like this would have ended in a very different way if we hadn't given him a chance, you know.
Jeannemarie Bozza :Yeah, and the amazing thing was, everybody who knows him knows him to be the kindest human, and he truly, truly is. He's a very giving man and it was so out of character, you know. So it wasn't him, it was infection, and we see that all the time. Right, our elderly who get UTI, you almost instantly know they have it because they're, you know, a little um crotchety. You know they're not usually, you know that difficult. And as soon as you see that, you're like, ooh, let's test the urine. Yeah, I have one gentleman that every time his sodium is a little low he becomes a curmudgeon and I'm like, all right, soy sauce stat and let's draw some labs.
Jeannemarie Bozza :You just know that that's what it is. You know, and when you do this kind of one-on-one care, you know, you know you're a patient and you, you can very easily prevent problems, and I think that's what we do really well. We almost always, yeah, I think what what concierge medicine really is is. We almost always end up coming in after a traumatic event, something's happened right, but then we get you to your optimal level and we keep you there forever because we're just constantly getting ahead of the problems before their problems.
Dr Jason Littleton:And that's true monitoring People say all the times, well, we're watching this, we're watching that, but most people aren't really watching anything but your service, along with good, kind, serious doctors, they're really on it, really watching it, really doing the surveillance that's needed to keep people connected and keep them healthy and to keep them out of the hospital. Are all your practitioners RNs or do you have LPNs or what? What are the credentials?
Jeannemarie Bozza :I will tell you that I went to nursing school when I was in high school, so I got my NA and my LPN and then I tested out of nurse, out of RN school and so I became a nurse very, very early on. What I will tell you from my experience as an LPN is that most LPNs are not utilized like nurses. They're utilized like nurse assistants. So because I have the experience in all of that and I understand that I only have five LPNs on my team and the reason is I would put them up against my R and they have true skill sets because they had the opportunity to actually utilize and use what they learned. But I won't charge a family to use an LPN sets because they had the opportunity to actually utilize and use what they learned. But I won't charge a family to use an LPN just because they have the degree, because I don't feel they have the skill set that backs that degree. Does that make sense? It does, and I think that's really important for people to know.
Jeannemarie Bozza :It's not that LPNs I learned. I'll tell you, I learned everything that I know about nursing in LPN school but I didn't get to utilize it until I had my RN, because when I was in hospital setting, they didn't use me that way. They used me in a nurse assistant setting, yeah, so that's really important to me when I, when I interview people and I talk to them like what is truly the work that you've done, because we do really complex things. So I need to know that you have the ability to give me a head to toe assessment and be able to tell me what's really going on, or use your gut, you know, on what's going on here so we can get in front of the problem.
Dr Jason Littleton:Oh, that makes perfect sense. When should a family contact you? Like, what's the type of family? That's like you know what I need Commodore services and I need to contact them now. What? What does that look like?
Jeannemarie Bozza :So I think for the most part, um, like I said, we do a lot of trauma. We do a lot of like you know, somebody just got hit by a car, somebody just had a surgery, somebody has cancer, you know things like that. But then we also have families that have elderly that want to age in place, not go to a home, and you know they could use a little extra help in there. So sometimes we'll we'll start with a family several years before the need is really really needed, and maybe we only do three days a week just because that gets the family used to them. We'll do doctor's appointments on those days, we'll take the patients out to the stores and things like that, or PT. What my company does is very different than other companies, I think, because we very much feel that our care doesn't stop and end with medicine. It's a whole person and so like we'll do cooking and cleaning and laundry and driving and coordinating appointments and keeping.
Jeannemarie Bozza :Yeah, or or even like in your elderly population, a lot of them can't work their phones or their tablets to do FaceTime with their family. That's out of state. So we'll arrange those things. So, almost like Sunday dinner, there's a Sunday night Zoom that every family member wants to get on. It can get on it, and they get to see grandma and grandpa, you know stuff like that.
Jeannemarie Bozza :We really feel it's important to keep all our patients, any age group, doing what they've always done, because the moment you take away what they've always done and what they love, you're taking away their desire to live or to be who they were before. So for me, like it's a hard stop. You know we are not sitting in front of a TV. So you love to play cards, so do I? Let's play cards, you know. Or you love to go fishing. You're never going to believe us. Let me show you the pictures of my, my family that you know. You had to see the big tuna they got. And let's go to the store, let's get some fishing poles, let's do this, let's do that, you know. So our patients are constantly moving and constantly thinking and having a reason to to continue, and I think that makes a big difference for our younger generation. We really try to be in the background and I call my nurses nursing ninjas, because they're there as soon as you need them. But you didn't even know they were there you know love it Nursing ninjas yeah.
Jeannemarie Bozza :Yeah, like our younger generation might be having a knee surgery or a hip surgery or something like that, but they also have a booming business that they're running. So we'll ask them in the morning like I need to do PT three times a day, I want to get four massages in, and you know we need to walk X amount of feet in the entire day. What's your schedule look like? Let's work it out and then we we do it based around them, but we get everything we need to get it done so that we can advance them quicker, so they can get rid of me faster, and that's really the key.
Dr Jason Littleton:I love that. Now, how do you get reimbursed? Are people buying a membership in the practice, or how does that work? What does that look like?
Jeannemarie Bozza :Right. So we are not. We're not membership based. We are almost episodic in nature. I guess we have long-term cases that go forever. Pricing is exactly the same for long-term or episodic, it does not make a difference to us.
Jeannemarie Bozza :Our nurses get paid the same amount of money, maryland, which actually works out really well too, because most of our families have three homes. So we will send them to all these different places and their team stays consistent. Wow, yeah, and I think that's a really special part of us too, and I think, because we're nurse owned, that's one of the things that was really important to me. When you have consistent care, it's it just makes such a tremendous difference. And since our families do have different places that they go, we don't charge for travel time or travel expenses, and so I don't pick my nursing staff based on who's closest to you, I pick them on who's best suited for you, and this is not just in skill set, but in their personality, because it's very difficult to be with somebody 24, seven or 12 hours a day, so you want that person to be a good fit in your home, on top of having the skills for what you need.
Dr Jason Littleton:I love it. It's got to be a good cultural fit. I love that and I know behind the camera on a phone call we talked about cultural fit and having the right team and things like that. Before I get into some other questions, I wanted you to talk a little bit about that, you know, because I think that's a great segue when we talk about the culture of your company and the nurses that you have and the people that fit your company. How did you decide that? How did you come about that?
Jeannemarie Bozza :So, like anything good, I think I fell into this. This is not something that I jumped up and was smart enough to figure all the way out at all. It just started with one really great patient and opportunity, and so when I had that one patient and then I got five referrals from them, and then those five patients gave me three to five referrals each. It just kept getting bigger and bigger.
Jeannemarie Bozza :And so it snowballed in such a beautiful way and at that time I couldn't handle all the business that came in on my own and so I brought in my girlfriends. So the company has been built on friendship and I think that is something that's so special. You think about all the nurses or doctors you've worked with over your lifetime and you've probably been in hospital settings and doctor's offices where you worked with people, and some people you work with and you're just like, wow, how did you end up here? Like you don't love this, why are you doing it? And other people, you're just like, wow, you were made for this. You were such a great physician or nurse or person, and so when I brought in my girlfriends, I literally had built a team of the nicest, smartest people I'd ever worked with, and then from there, we needed more people. So I said to them, who would you, who would you want to work with or who?
Intro:was sick.
Jeannemarie Bozza :Yeah, if, if your mom was sick and you couldn't be there, who would you call? And so everybody, like everybody, had a smile on their face. Everybody's eyes lit up, everybody knew the person I was talking about and I said and if you send me each of you, just send me one we'll double our team. But most people sent me two.
Dr Jason Littleton:And in three months time we tripled our team. I love that question because it really implicates cultural fit. You know again, because you're bringing someone on that resonates with your team already same philosophy, so you can give the same type of care. That's incredible. Most of your team are they employees or are they independent contractors?
Jeannemarie Bozza :No, so that's the other thing. Remember, I started this with my girlfriends. I never wanted to be in a better place than my girlfriends. I wanted them all to have the same opportunities that I had. They all thought I was crazy. Everybody's like, jeannie, we're nurses, we're not business owners, and I was like but you could be, and I can teach you how to do it. Pllcs I got a finance team together to help them open 401ks and 529s for their kids. I situated an accountant who could do all. 50 states understood how our business was built and what I really needed him to focus on so that they could work smarter, not harder. And so it became a really beautiful culture. Everybody here is you can't interview with me if you don't have someone who works here who's willing to put their name on the line for you. So just imagine the group that I get to work with. Like, I started with a couple of my best friends and now I have over 200 best friends. It's just such a really amazing group of people.
Dr Jason Littleton:Oh, I love it. I love it. I love how you laid that out. That was awesome. Incredible company. Incredible company. Now, you know, with you being the founder and CEO, when I think about how busy you are going to meetings, checking on your team you know when it comes to taking care of your own health and the things that you do so you can stay on top and be at your best. You know, we talked behind the camera and I talked to you about my acronym Move, eat, drink, sleep and I want you to share how you move, eat, drink, sleep so that you can stay on top of your game. Do everything that you're doing Because, look, as a CEO myself, I understand how busy we can be. I understand how you know it can feel like you're just giving all the time and you really want to be in a great place where you're feeling great, you're feeling your best, so you can put your best foot forward. How do you do that? How do you move your drink, sleep?
Jeannemarie Bozza :So I think that for me one of the most important pieces is move. I get up every morning, I have a trainer at 7 am, and so from 7 to 8, that's kind of my time, because at 7 am is shift change, so by 8 am the phone starts ringing. So I had I originally had an 8 am slot and it's just the phone the whole time. So I get up a little earlier and from seven to eight I can really just, you know, work out that excess energy and it puts me in such a great mental place when I get home for eight o'clock when I start fighting fire after fire, you know, um. And then I would say, five days a week, I, I, I do four and a half to five miles on top of that, and that in itself really just keeps me level set. That's what I need to do, and I, I had foot surgery about a year ago and I lost, I lost the four and a half to five miles, and that was a game changer for me. I didn't realize how important that was in my life until it was gone, and so I would tell anybody who's struggling. That wasn't my life until it was gone, and so I would tell anybody who's struggling.
Jeannemarie Bozza :If nothing else, just get up and go for a walk, because it's just such a great mental break because you can't do anything else. You can't do laundry, you can't write that paper. You need to write or you're in it in that moment and I think that's really important. It's almost my version of meditation. Because I can't meditate. I don't's really important, like it's almost my version of meditation. So, cause I can't meditate, I don't know about you, I can't do it. I've tried a thousand times. My mind just goes everywhere. But if I'm moving, then I can get to that kind of, you know Zen spot.
Dr Jason Littleton:So you're saying you know exercising when we talk about you know how you eat and diet, keep up with your busy schedule and diet to keep up with your busy schedule.
Jeannemarie Bozza :What kind of tips can you give us there? I would say water is a huge piece for me. I don't know about you, but hydration, hydration, hydration. So I constantly have water. I probably do about a hundred ounces a day, a lot of water. And then the food. I should be better about it. The food choices are great, but what I do and I don't know about you but I forget to eat. Sometimes I get so busy and so I can go from. You know, I'll have a really healthy breakfast right after I work out. I might, I might have a protein shake or something midday, but it could get to dinnertime at seven o'clock and you know there wasn't really a lot of times. There isn't even a protein shake in between because I've just gotten too busy. So I am really trying to be better about that. If I could just make sure at least it's three solid meals a day and I really focus on protein.
Dr Jason Littleton:Yeah, that's good.
Jeannemarie Bozza :Building blocks of the body right.
Dr Jason Littleton:Protein, protein, protein, yep, yep, absolutely. And you know again the hydration. I want to go back to that, what you were saying. That's key because, you know again, 75% of Americans are dehydrated and one of the things that can help people just stay fluid, avoid headaches, you know, to a limited degree is staying hydrated. And it helps with your focus, mentation, cognition. So, yeah, I mean that's. I agree with you. I definitely hydrate with electrolytes. That makes a huge difference. Now let's talk about sleep. You know emergencies happen. You know we try to plan our sleep schedules, but sometimes we're not able to always get this kind of sandwiched in or packaged type of sleep and it's going to vary. What's your sleep schedule? What time do you go to bed, what time do you wake up and how many hours do you get?
Jeannemarie Bozza :So I do. I take call all night. So if there is an emergency, if there's a problem with event, if something happens or someone's concerned about something, I am the first call for all things because for the most part we can usually work through them without having to involve our physician overnight. If I do have to involve a physician overnight, they always answer because I don't, I don't bother them with silly things and we have a lot of PRN orders in place for me to be able to do those things throughout the night, um, and so I would say I probably am woken up once or twice a night, um, probably four times a week. I wouldn't say that it happens every single night, but maybe four times a week that that happens, um, but I typically will. Will um be in bed some somewhere between 10, 30 and 12. Okay, and then I wake up 15 minutes before I got to go to the gym.
Jeannemarie Bozza :Okay, okay, it's like you live this. You live this.
Dr Jason Littleton:I hear you and you live this on the call type of life where you're used to being ready for anything. So buffering and having that margin as far as your movie drink, sleep regimen is important because you have to be ready to be on the go, take a call, like I love what you said fight fires. You know, because I understand that, I know what that's like. You know a lot of times, even though we're on call 24, seven, a lot of times when eight o'clock happens, you know here comes the firefight and you got to be at your best and you got to be ready. And I get that and I understand that and I know with me when it comes to how I move eat, drink, sleep you know I try to prioritize sleep.
Dr Jason Littleton:You know, in residency we had this saying eat when you can sleep, when you can use the bathroom when you can. You just don't know when the next fire you have to put out comes. You always have to be ready. So I get that, I understand that, um, but that's that's so refreshing to hear. I think one of the things that I loved what you said is that you know, in general, nursing schedules usually are well, they vary but they can start at 7 AM and go to 7 PM, kind of a 12 hour schedule, and you, you start working out at 7am right With your trainer, and then you get ready for the firefight at 8am, so to speak. And I love how you, you know, you kind of let that fit in with, like you know, prior work patterns and things like that. So that's that's really, really important.
Dr Jason Littleton:I have enjoyed talking to you like so much and I just think everything that you said is so helpful and so many patients need your services. Who doesn't need your service? Everyone needs someone who's doing surveillance, watching, having that point of care type of technician always around or on call for them. I think that's huge. I love learning about your company, commodore, and I just think you know my listeners, and even beyond you know, really need your services, so I really thank you for coming on. You know I'm going to. I know I'm going to be reaching out to you soon when I think about just how global your company is and how impactful it is. Again, jeannie, thank you for joining us.
Jeannemarie Bozza :Thank you.
Dr Jason Littleton:Listen, you guys. I want you to really take note of this podcast. I think this is a wonderful service. I thank you guys for always coming on and listening to me and joining me. Make sure you check out Amazon, apple, spotify, and also Instagram, facebook and YouTube. Make sure you subscribe. I'll see you next time. Thank you so much.
