Meet Lori, TBD Health clinician
Interview and editing by Adrienne Ton, NP
Lori Grant is a nurse, midwife, women’s health NP, mother, and cosmetologist among many other roles - learn a little more about our Arizona-based clinician here.
Hi Lori! Welcome and thanks so much for doing this interview with us! Can you tell us a little about yourself?
I am Lori Grant, I’ve been in healthcare since 2004. I practiced as a bedside nurse for 10 years and went onto getting my advanced practice certifications
I hold two certifications in midwifery and as a woman’s health practitioner. They overlap but they’re unique as well. I describe this as saying the women’s health is the gynecology component and the midwifery part is the obstetrics (pregnancy care) component.
Have you always wanted to be a nurse?
Originally, I wanted to become a WestPoint graduate. It was a plan to have a career and schooling paid for, so I could travel and do other stuff. I put all my eggs in that basket. I got endorsed by my local senator. That’s what I wanted. That’s what the yearbook said. I missed it by one person. I was distraught and I didn’t know what I wanted to do.
So, I ended up going to beauty school
Wow! I had no idea you were in beauty school. How long were you in beauty school for?
You have to do 1600 clinical hours which is more than some have to do to become a nurse or nurse practitioner. I’m a licensed cosmetologist, I put myself through nursing school doing hair.
That is so impressive! Do you miss cosmetology?
No, but it’s funny because so much of what you do is the same. It’s what you do with your hands that’s different.
You’re in someone’s bubble, you have to be able to communicate, you have to be able to read people well and carry on conversations. The skills that you pick up are the same no matter what you do if you’re in that kind of close proximity type of job.
How has that experience impacted your role now in health care?
These skills help me connect with patients. Daphne [TBD Health’s co-founder] has asked me, “how do you get someone’s whole life story when you’re drawing blood?”
Everybody has that story and it’s important to get that story. If you give patients an expectation that doesn’t align with their goals, then you’re going to end up with non-compliance and you’re going to lose that patient because they’re going to feel like you didn’t hear them.
How did you eventually get into nursing then?
My uncle got sick and ended up in the hospital, looked around, and was like “huh, this doesn’t look like that hard.” [I later learned it is hard]
I was in school - I went and changed my degree from business to nursing. And that’s how that started for me.
What does your role as a midwife look like? How does this differ from other kinds of nurse practitioner training?
I have training and have worked as both a midwife and women’s health NP. In midwifery, they believe that you are involved from puberty to death, it’s much more involved than just the delivery.
As a women’s health nurse practitioner, we cover general sexual health and the expectation that everyone should be able to enjoy very positive and active sex lives, which includes men and women.
In my training in midwifery school, you graduate based on your competence and skills, not just the number of clinical hours that you have. Training was hard. It was not unheard of to double or triple or quadruple your midwifery clinical experience to meet the competencies.
In the hospital now, midwives are doing a lot more with pregnancy management. You’re managing tears, doing first assist in surgeries. It’s a very hands-on advanced practice role with a lot of skill components attached.
What kind of practice have you done as a nurse practitioner/midwife?
When I first graduated, I felt like in my community, there was a saturation of OB/GYNs that were doing a good job managing OB patients. But there was nothing before and after, so I managed a lot of different things, such as pre-pregnancy, infertility, couples counseling, and postpartum. At 6 weeks [postpartum], our OB group pretty much turned them back to their original providers. A lot of providers didn’t know how to screen for postpartum depression, thyroiditis, breastfeeding support, etc.
There needed to be someone there for that support. I just found where they needed help and just did it with my practice.
My practice was primary care for women and couples, not excluding pregnancy, but I wasn’t the primary provider for the pregnancy.
We definitely need better support for women and couples as they go through pregnancy and after.
Now that you have transitioned out of that practice, what brought you to TBD?
[I was attracted to] the lead in the vision that you want to have non-judgmental screening with education. I also like the concept of having complete follow-up and being able to manage their labs and disease state. It was important to help make patients less anxious, by providing results and a plan, instead of just giving them results.
[I also like] being able to reach a broader population and give access to people who would have not sought care otherwise.
Since a significant portion of TBD Health services are via telemedicine, what do you see as the future of telehealth and medicine?
We are walking a fine balance between improving access to care but not decreasing quality of care. It’s a pretty slippery slope with a lot of potential to “not do a good job”. It’s important to do a good job.
I think it needs to be a blend. There are certain things that can be managed in person and some can be managed via telehealth.
I understand that TBD recently opened up a clinic in Las Vegas that you’ve been instrumental in helping create. What has your experience with the in-person clinic been like?
It has been a rollercoaster. Every week there’s a new challenge and we fix that challenge and the next week, there’s a new one. We are learning things and building the foundation here, from scheduling to deciding the best plan in person. We are developing protocol-based order sets so that individuals get appropriate screening, not just the things they think they need. We want to make sure that people get the types of screening that makes them feel comfortable and confident that they have had adequate screening.
Is there anything surprising you’ve noticed about the Las Vegas TBD clinic?
One of the things that’s been really interesting with the Las Vegas clinic is how many guys we are seeing as compared to women. I really feel like a lot of them don’t have access to care. A lot of our 20s, 30s, 40-somethings don’t have a primary care provider. A lot of women have access to a gynecology provider. When you talk to people, some of the gals will be like, “I had an appointment with my OBGYN”. I didn’t realize how big of a lack of access to care these folks have.
If a guy has a sexual complaint, they go to urgent care or emergency room or maybe start at primary care and often end up going to a urologist. Having a sexual health clinic that is not based off of gender or sex has been really neat, because we’re bringing in couples, a lot of our LGBTQ community, because they don’t feel like they’re locked into a role. We have a lot of guys coming in and asking questions like “hey, what do I need?”.
That’s who I feel like we’re servicing the most and who need that clinic the most.
I think people feel safe to come here.
It seems like the team (including you) has create a safe, welcoming environment, which is so important.
How would you describe your philosophy of medicine?
I think that everybody wants to be healthy. They want to do good. But there are certain barriers that prevent them from being able to.
So sometimes meeting them where they’re at and working towards those goals makes all the difference and makes you feel happy. It helps patients feel like they're doing a good job. And it makes them feel happy because they’re trying to improve or maintain their health.
I also believe that a lot of prevention makes a huge difference in the treatment of chronic disease and if we were to work on a lot of education to prevent that disease from occurring, and if we are able to make that change and make it stick, then in the long term that affects the whole family unit.
On that note, what is your life like outside of work and the clinic? What is your family unit like?
I spend a ton of time with my family and we do a ton of things together like hiking and camping.
We know that a lot of healthcare providers are experiencing burnout recently. How do you take care of yourself? What do you do for yourself outside of work?
So I internalized this concept of “self-care so that you can care for others”. We all know it’s important. But rarely do we practice what we preach. So I made a formal decision to modify that. I tend to exercise every day. I try to get out in nature. I do a lot of hiking and kayaking and playing with the kids and getting out camping and avoiding electronics. I try to get 8 hours of sleep and eat my vegetables every day. I try to drink water. I try to do all the things we know I’m supposed to do
The other thing I am learning is how to say no by and getting comfortable with that.
Thank you so much for sharing your experience and insight with us, Lori!
This article provides information about sexual health, healthcare and/or related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of TBD HEALTH INC.