True Resilience in the Pandemic with Sarah Bergakker

Sarah Bergakker is a certified registered nurse anesthetist (CRNA) and the founder of Mooxli, a company dedicated to providing self-care resources and continuing education for healthcare workers. 

Mooxli is an acronym for 'MOve your mindset, OXygenate your soul, and LIve life differently'. It was born out of Sarah’s personal experience in the healthcare industry for the last quarter century, navigating through emotional, mental and physical challenges that her professional training didn’t at all prepare her for.

We talk about the prevalence of burnout, substance abuse and suicide among nurses and physicians and uncover the hidden feelings that many in this field keep bottled up for fear of going against the industry’s “There’s no crying in the ER” culture.

Inspired by her personal and professional contemplation, Sarah has created a safe and supportive community where healthcare professionals can learn how to care for themselves first, because it’s impossible to pour from an empty cup--even when running on empty has been historically rewarded.

Her team helps people process emotions, release the stories that they carry and navigate the moral dilemma of being asked to constantly choose the wellbeing of others over your own. Mooxli provides the tools of yoga, purpose practices and true resilience training through its online community, book clubs, retreats and continuing education workshops.

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Transcript

Andy Vantrease  00:17
Welcome to The Dandelion Effect podcast, a space for organic conversation about the magic of living a connected life. Just like the natural world around us, we are all linked through an intricate web, a never-ending ripple that spans across the globe. Here, we explore the ideas that our guests carry through the world, remember who and what inspired them along the way, and uncover the seeds that help them blossom into their unique version of this human experience.

Andy Vantrease  00:43
This podcast is in partnership with the Feather Pipe Foundation, whose mission is to help people find their direction through access to programs and experiences that support healing, education, community, and empowerment.

Andy Vantrease  01:00
Hello, everyone. Welcome back to another episode of The Dandelion Effect podcast. Today's guest is Sarah Bergakker. Sarah is a certified nurse anesthetist and the founder of Mooxli, a company dedicated to providing self-care resources and continuing education for healthcare workers. Mooxli stands for MOve your mind, OXygenate your soul and LIve life differently. And it was born out of Sarah's personal experience in the healthcare industry for the last quarter century. She navigated through emotional, mental and physical challenges that her professional training didn't at all prepare her for.

Andy Vantrease  01:34
This conversation really is an important one. We talk about the prevalence of burnout, substance abuse and suicide among nurses and physicians. And these statistics absolutely blew my mind. we uncover the hidden feelings that many in this field keep bottled up for fear of going against the industry's "there's no crying in the ER culture." Sarah lets us in on a secret - there is in fact a lot of crying among staff but most of it happens behind closed doors and in isolation. Through Mooxli, Sarah has created a safe and supportive community where these healthcare professionals can learn how to care for themselves first, because it's impossible to pour from an empty cup, even when running on empty has been historically rewarded in their line of work. Her team helps people process emotions, release the stories that they carry from their patients, and navigate the moral dilemma of being asked to constantly choose the well-being of others over their own. Mooxli provides the tools of yoga, purpose practices, and true resilience training through its online community, through book clubs, retreats and continuing education workshops. I really hope you find this conversation eye opening and helpful I know I really did, and if not for you personally, then please share with someone you know whether they are in the field or they are experiencing some of the things that we'll talk about today. Without further ado, please welcome Sarah Bergakker.

Andy Vantrease  03:02
You talk very openly about your personal experience as a nurse, and I have loved getting to know you as a new teacher at the Feather Pipe Ranch. So introduce us to who you are, from that angle. And just the ways that you find yourself in the place that you're in today with the work you're doing.

Sarah Bergakker  03:24
My personal journey started in health care when I was quite young. I took my first nursing boards when I was 18 years old. I knew very early on that I wanted to end up in health care, and started the prerequisites for nursing school while I was in high school. That meant that I found myself standing as a nurse in the trauma room in the emergency department when I was 19 years old, very typical of people in health care, very type A, very goal-oriented. And so, I had done the didactic, the book work to be there. But I found myself standing in the trauma room without having the tools to process emotionally what I was seeing so early in my career and at a fairly young age. Now, I'm at a point in my life where I can bring that awareness to it and bring those words to it, but I didn't know that that's what I was going through. The saying, "There's no crying in baseball," we would say, "Well, there's no crying in the emergency department." And the reality is there's plenty of crying. It's just behind the doors.

Andy Vantrease  04:40
Yeah.

Sarah Bergakker  04:41
And so I came up through health care and then also was in a formative time of my life where the tougher you appeared, the more rewarded you were. And I started in emergency medicine and then transferred to an even busier trauma center. So then I was in my young 20s, working, you know, weekend, night shifts, seeing some pretty intense things. And I figured out that if I would hum "Mary had a little lamb," like under my breath during super intense traumas when they would first come into the trauma bay, and it's all hands on deck, and it's kind of this flurry of activity, that somehow that helped me. And now, looking back, I was doing this very, like primitive form of just trying to ground myself, right? But I didn't, I didn't know that at the time.

Sarah Bergakker  05:32
I still remember the night I was working in the ER, they had pulled me out of the pediatric ER to cover the adult ER, and they were like, there's, you know, yet another trauma coming in. I believe it was violent in nature. And I just felt so angry towards that person, this person that was coming in, in this very compromised state in desperate need of help. And that experience is not foreign to ER nurses. There's some pretty dark, sarcastic, coping humor that actually comes out of that. And for me, I remember feeling afraid and, and feeling like, I can't be here anymore. That's not who I want to be. And at the time, I didn't have the tools to know that if I had wanted to, I could have stayed there, giving that type of care, but changed who I was as a person.

Sarah Bergakker  06:26
So I'm an Enneagram "three," like we love trophies, we love goals, we love rewards. So I'm like, okay, new goal, things. So I considered by the different paths that I could take, and did some shadowing, ended up getting into graduate school for nursing anesthesiology, and it's so all-consuming, but it's a great way to numb yourself. It's essentially like you're doing an intense residency. Mine was 28 months long. And I did well for that, like it was well suited to my personality. I was very successful. But during that 28 months, pretty early on, my husband had always been someone who was so strong in my life, and was always pulling us forward together and was such a source of help and love. He had some very unexpected physical problems happen when I was in graduate school, and ended up having to have surgery. And then there were complications from that surgery. And that started him on a path from the 12 months when he had his first surgery to when I graduated, he had over 80 appointments and surgeries and therapy. And so the graduate program for nursing anesthesia is, is known to be very intense. It's has a very high rate of divorce associated with it. So we were already in this really difficult time. And then we started going through something that was, if it was just stand alone would have been incredibly difficult. And the culture in medicine, and medical training and nursery training is very, don't let them see you sweat, you don't need to eat, you don't need to sleep, the better and bigger machine you are the more successful you'll need to be here.

Andy Vantrease  08:22
I am just seeing so many mirrors in many other fields and many other parts of our culture as a whole.

Sarah Bergakker  08:31
Yeah, and I appreciate that pause, right, because it's it's anti to what we need as humans to succeed in the long term.

Andy Vantrease  08:42
Mm hmm. And not only succeed, survive, maybe even survive is is the bare minimum of what that culture promotes.

Sarah Bergakker  08:53
The crystal clear awareness you have about the toxicity of that is only starting to creep in to healthcare systems and cultures. In the middle of my graduate program, I would not have even been able to put words to it. But with everything that I was going through, and my husband was going through, I had just overwhelming anxiety, because it was so much. And so I met with my program director. And I just said this is what's going on with my husband. And this is you know, the surgeries he needs to have. And we were almost ready to head into, like the one and only very short holiday break that you get in that program. And she said, You know, I think that, that needs to start today for you. And that was the first time somebody in the healthcare training system showed that awareness and compassion and held some space for me. And I see looking back that she planted a seed.

Sarah Bergakker  09:58
So I finished my graduate program and kind of dove headlong into the profession, like I had the rest of my life, and looked to be very successful by the metrics that are set in healthcare, and, and was teaching and learning, and I was published, and was practicing at a high level of my license. And I found myself about six years in, in a work environment that was toxic and getting more and more toxic. And the area, I was practicing in is a small rural town. And an operating room nurse I was working with was like, "Hey, I have this friend. And she's starting yoga in her sister's basement." And like being physically fit goes super well with being type A and achievement-oriented. So I was like, yeah, I'll go for the fitness. Because I didn't know that there was anything more to it than that, honestly. I went to Joan's first class, it was very obvious that she took a whole person and mind spirit body approach to yoga. And coming from a science background, I was super skeptical of my friend calls it "crystal sucking woowoo" stuff. And so I was like, "Huh, I don't know about that. But I'm here for the fitness." And in a small town, it's not like there's three yoga studios. This was the only yoga game in town.

Sarah Bergakker  11:37
And so I stuck with it, but I was very skeptical and very, like, I'm fine, I'm fine. Clearly, I'm still learning to honor my journey and where I've been in, in where I'm going and, our, my mom raised me that you can learn anything. And so, there was a wondering of is this really the way we have to do this because it's getting more and more emotionally painful. And when I started to really open myself up to the mind body work that Joan was sharing with the yoga community, was we were still practicing in her sister's basement at that point. And she assisted me going into plow, which is like a very surrendering pose. And I felt the strongest internal fight. It was overwhelming for me. And I just remember thinking, whoa, what was that. And that was one of my first experiences of sometimes, when you start by moving the body, you can start to move your mind. And that's...Mooxli is actually like an acronym for move your mindset, oxygenate your soul and live differently. And that's the beauty of yoga, being a part of what we do at Mooxli is in moving your body, you can start to move your mind.

Sarah Bergakker  13:17
And shortly after I had that experience with plow pose, I did, we did camel pose, which is it's very, in yoga, we call it heart opening, but it's putting yourself in a vulnerable position. And it's putting yourself in a place of what I feel is like honesty. And I went home that night, it was in a season of my husband's physical problems getting worse and worse and my work environment getting more and more toxic. And again, I didn't know why, but I just cried, and cried, and cried. And it felt so freeing. That coincided with me trying every fix I knew to get through my toxic work environment. And that situation wasn't improving. It reached the point where I knew for my own emotional safety, I had to transfer out of that environment. And that transition was incredible. I've never gone through anything like it in my life. And that is when I felt like I really just kind of got, I sat down with myself and was like, okay, it's hard as I studied in graduate school, I was like, I'm gonna figure this out. And so I started looking around for resources in our immediate health community, and I just wasn't finding what I needed. And out of that was born Mooxli. And if I'm being transparent, I thought, well, if I build this company, maybe it won't be so obvious that like, I need all this helped too.

Andy Vantrease  15:02
I'm really wanting to talk more about just the mess that that is, of the shame to show your actual emotions at your job when, when you're dealing with incredibly intense trauma all the time. I mean, just even going back to the first part of your career at 19, and 20, and young 20s, in the, in the ER, there's no mention of how this, these experiences are affecting you all on a personal level.

Sarah Bergakker  15:40
So there is starting to be some awareness in the training. There are some health systems that are really starting to pay attention to this. Duke has some great research surrounding gratitude and practitioner well-being, and looking at burnout. University of Michigan has done some studies that look at time of day as it relates to anesthesia and how that affects patient outcomes and safety, which that's a form of mindfulness, right?

Andy Vantrease  16:12
Mm hmm.

Sarah Bergakker  16:13
Just being aware of how we move through the day and how the circadian rhythms of that do impact us. And we can't look at that, and study that without acknowledging our humanity. And then, at the end of the day, healthcare systems, the majority of them are not for profit, but it's kind of a misnomer. They are profit driven. And at the end of the day, what is really starting to force awareness by healthcare systems, to this need to foster resilience and self-care, and mindfulness, is studies show that we're burnout is high, it costs the system money in the form of turnover, patient safety decreases. It's getting tied to negative outcomes that cost the system's money, which is slowly forcing a light to be shown on this.

Sarah Bergakker  17:07
I connected with Dr. [Tese] Stephens, before any of this new the pandemic was coming. And her and I had this conversation. At that point, before the pandemic, that things were at a tipping point for the individual healthcare provider and systems that were willing to raise their awareness and build resilient systems, were going to start to be the premier providers of health care and places to work in health care in the country. And that is going to be part of what drives them being competitive, which in the past systems that fostered a lot of those negative things I talked about, were the big, prestigious academic centers to be associated with. There's studies done again, before anybody knew that a pandemic was going to be part of our professional experience, that over 50% of healthcare workers were burned out. And so we don't have studies yet that reflect our current rate of burnout. But it's going to be staggering.

Andy Vantrease  18:07
Yeah, absolutely. You know, when we were talking before this, you mentioned burnout doesn't mean you've had a hard day, or you know, two hard days. It is like a deep, emotional, physical, mental exhaustion that is creating this cascade of effects in your entire being. So for those listening, I'm really wanting to educate on what burnout actually is, how does it present, and what are some of the signs that someone may be headed in that direction, or maybe smack in the middle of it and, and are in denial?

Sarah Bergakker  18:45
That's a great question. Burnout…that term gets thrown around. Burnout is consistent stress that is experienced over time that it's not processed, it doesn't have an outlet. And in the short term stress can be good for us, right? Because it drives that fight or flight system, part of our, you know, the autonomic nervous system. And so in the short term, it's it can be helpful. But in the long term, it can express itself in a lot of ways, of frequent headaches...Having heart arrhythmias is, unfortunately fairly common among healthcare professionals. If you talk to people that have gone through nurse anesthesia training, the number of them that came out on either blood pressure controlling medicine or heart rate controlling medicine, or both, is concerningly high. And for a lot of them, that's for the rest of their life. A term that is commonly used and actually measured surrounding burnout is emotional exhaustion. And then detachment. Detachment is what I was experiencing when I felt anger towards the victim of trauma coming in, you know, at midnight on that Saturday shift in the ER. And I felt that detachment, because I was emotionally exhausted. So we start to detach from our connection with other people. And studies have looked at this, that the more burnt out and emotionally exhausted you are again, those patient, safety goes down, because you start to dehumanize the person in front of you. And then you start to become detached from yourself. And depression, anxiety and hopelessness are all the things associated with that.

Andy Vantrease  20:29
Mm hmm. It was important to paint a picture of what that experience is because, you know, I feel like a lot of times when we're trying to measure these things, even you know, I've I've had health challenges and experiences where I've gone into the doctor, and they've said, "Are you experiencing a depression? Are you..." "Well, what does that mean?" "Well, are you having suicidal thoughts?" "No, not particularly." "Are you, you know, having trouble sleeping?" "Yes, a lot." And there's all these different markers and measures for what depression means, what anxiety means. And unfortunately, I feel like we live in such a culture where unless you are hitting rock bottom, everything should be okay, everything's fine. You know, even when I look at things like substance use, there's this idea that it has to hit a certain point for it to be something to pay attention to. But a lot of people are just saying, "Yeah, I can handle it, I'm good. I'm fine." And then that bar just continues to, to rise to the detriment of anybody who's experiencing this.

Sarah Bergakker  21:45
And speaking to the culture that you're describing, administrators are saying to their healthcare staff, you know, during the pandemic, thank you for your resilience. And unfortunately, what resilience means for a lot of administrators is that you show up no matter what, and you get it done no matter what, and you come back the next day, and you do it again. And the point that you're making is in anesthesia, we have immediate and kind of private access to really strong medications. So the rate of substance use disorders with anesthesia drugs, where the providers who get caught, is one in 10. It's reasonable that it's even higher than that for the ones that are using. And that one in 10 doesn't speak to alcoholism.

Sarah Bergakker  22:38
And so what does true resilience look like? We are certified for continuing education credits, which means most healthcare advanced practice professionals and physicians receive a stipend from the hospital to get annual continuing education. So it means that they can now take that annual continuing education money. Most people are given a week of time to accomplish that every year. They can come to Mooxli, and they can raise their awareness before they become one of those one in 10 anesthesia providers that gets caught abusing anesthesia drugs, or before they become the 10 to 15% of healthcare providers that abused drug and alcohol in other ways. And so shifting that, bringing awareness, and then...I use the word, the term true resilience often when I'm speaking to people, because resilience is so misused, that some of us have a bristling response to it when we hear it from administrators. Because the truth is, sometimes being resilient means that you say enough. And in a constructive way, you don't show up. And you pause, and you regroup, and you figure out what you need to do so that when you do return to work, you could do it in a mindful and healthful way. And it's very, very slow. But nationally, our healthcare systems are starting to shift and recognize that there is financial benefit to holding space for that type of resilience.

Andy Vantrease  24:19
Sarah, where did you find the courage to begin to admit to some of the feelings that you were having and the experiences that you were having with a lot of the, just the emotional weight and, and the trauma that you had experienced throughout your career? So many people are afraid to come forward. And, and it seems to me like there's a lot of suffering in silence happening. And people perhaps feeling like they are the only ones, or if they speak up, they're not, you know, resilient and or strong enough, or they can't handle what's been given to them. Where did that courage to come forward come from? What were the steps leading up to starting a company that is focusing on this?

Sarah Bergakker  25:15
So I've referred to some of what my husband has gone through. And four and a half years ago, that led to him being full-time physically disabled and not able to work as an emergency room nurse after doing that for 20 years. And we sat down as a couple and said, "We have no construct for this. We have no mentors in our lives that have gone through this. And we're not going to get through this, if we aren't brave enough to go find the right resources to support us." So what he was walking through, and what we were walking through as a couple was definitely a huge motivator. And then one of my big mentors in my life, I'll be like, this, this work is so hard. It's it's it, the feelings feel so big. And she gently reminds me, "Well, it, it beats the alternative, right?" And I got to the point professionally, that if I didn't stop and figure out a new path forward, my alternative was, I couldn't continue to professionally do what I had been doing for 22 years. And I had such a strong sense of identity tied to it, that there was great fear associated with the incredibly negative feelings I was having towards the profession, and with leaving it.

Sarah Bergakker  26:47
And I went through a period of transitioning out of my toxic work environment, you asked how Mooxli was born. I just I took a solid year. And I had transitioned to a different job as a nurse anesthetist. I had gone from, the previous job was frequent call, very long hours, nights and weekends, to, it was kind of very set hours and part time. And I just took a year to get comfortable with being with myself long enough to hear myself. And ask what do you really want? And what is this really about? And what's really happening here? And now I have the clarity to see that part of the fear that I was experiencing at that time is heart and soul I'm a caregiver. It was so confusing to have such negative emotion about who I'm hardwired to be.

Sarah Bergakker  27:50
But out of that came these incredible gifts of learning about self-compassion. I read Kristin Neff's book pretty early on. And that was such a foreign concept to me. And then, even this summer, is when I was first introduced to Dr. Dan Libby through Feathered Pipe. Dr. Libby and I talked on the phone for a while because we, there's some very mutual parallel missions we have in our organizations and...But hearing him speak to compassion fatigue in a way that just resonated with me, I had never even understood even with all the work I had done up to that point. And so going back to who I am heart and soul is a caregiver, right? And I thought, I know, I'm not the only one who's walking through what feels like a life crisis related to this. Because as I started to shift and change, then it starts to attract people, right? And I started to get phone calls and text messages. So the caregiver in me was like, you got to get this. And out of that was born Mooxli.

Andy Vantrease  29:01
That's amazing. And I do always love how when you make a decision and as you're on your journey and your path of transformation, others show up and, and that sense of community is so important. So important. I mean, it really is such a balm for the, the wounds of feeling isolated. I mean, community and the people who just understand you right off the bat, you don't even have to explain what you're going through, it's that feeling of I see you and I hear you and I have gone through similar things. There's nothing that really compares to that, in my opinion.

Sarah Bergakker  29:49
Well, it, community is so powerful and it's, it's vital to our survival. And in healthcare, needing help and hurting and needing support is so stigmatized that if as a healthcare provider, you're willing to take the smallest step forward and break down that stigmatism in the smallest way, and, and hold space to say, it's okay to not be okay, I just I feel like it was that small hole in the dike that just burst the dam open. Because there's such a desperate need. And the community that has shown up, it's so powerful and my life is so full. And I'm so grateful to walk through a different type of support. And I started Mooxli, I think I launched the website nine months before the pandemic hit. And being able to walk through the pandemic with the Mooxli community has been so powerful.

Andy Vantrease  30:58
Yeah, and the timing of that, my goodness, of already needing it so strongly before the pandemic. And of course, having no foresight that this is what we would be facing in 2020. How have you shifted into serving people in the times that we're facing versus before the pandemic?

Sarah Bergakker  31:19
It has been, you know, that peeling the onion process for me to continue to be vulnerable and step forward and share with the community. This is what's coming up for me, and then allowing that to kind of hold space, so other people feel free to share as well. And the pandemic challenged me to do that in a much deeper way, because it was so difficult, for all of us. That is a fair generalization. It is so difficult for all of us. I would suggest that anybody who is practicing in health care right now is burned out. It is such a challenging practice environment. And so it went from, as a business leader, deciding we were supposed to be in Santa Barbara on retreat in April of 2020...So as a business leader having to make big decisions about cancelling, and then what it looked like to cancel. And then I felt like as a team, the Mooxli facilitator team, we kind of went into crisis intervention mode. And Aly McLean is a fantastic nurse anesthetist, who practices at Boston Children's, and she did a YouTube video for mindfulness while wearing an N95. And that kind of went viral in the anesthesia community because the pandemic brought an awareness to people that had none, or were skeptics of this body of work. It forced them to kind of get to that same point I was at - if I'm going to have a way forward in this pandemic, in this difficult environment, I have to start paying attention to these things that I've never acknowledged before.

Sarah Bergakker  33:07
So Aly did the N95 video. And then, so that starts with a place of, of mindfulness. And as you're putting on this, PPE, it becomes a very emotional experience. So just to create a safe space for yourself to notice what you notice. And like, for my own self, it was fairly early in the pandemic, and I had had a string of shifts where I was doing a lot of COVID positive care. And the PPE you sweat in it in a way like, my calves would sweat, I was like, I just didn't even know these parts of my body could sweat. So it's physically exhausting. It's emotionally exhausting. And I had worked on off shift and so I was going to put a sleep mask on to go to sleep. And it put my sleep mask on. And the double straps of my sleep mask felt like the double straps of my N95. And I emotionally felt panicked. Thankfully, with this work I've been doing and I was able to be mindful and notice what I noticed and pause and hold space for what was coming up for me. But bringing mindfulness to our community to say these new experiences...Here's ways that you can constructively walk through them. You're not alone in your experience that you're having.

Sarah Bergakker  34:31
And then a big challenge early on was that there wasn't PPE, there was an adequate PPE. People were being asked to reuse PPE, personal protective equipment, in a way that wasn't consistent with safety standards. And healthcare workers struggle greatly for asking for what we need. And we can't be aware of what we need, if we can't first be mindful, right? So practicing mindfulness to check in with ourselves and, and see like, what are my values here. A common saying that was being thrown at us early on was you signed up for this. And that caused a lot of emotional confusion for care providers. Like, did I sign up for this? But it doesn't feel right, it doesn't feel right to be, you know, marching headlong into this experience without adequate protection. So using mindfulness and bringing that to our community as a foundation for checking in with yourself listening to yourself. And then mindfulness and resilience are so interdependent. And based on what's coming up for you, using that to process through. What is my big purpose? For me, my big purpose is to move through life in a way that glorifies God. What's my small purpose? My small purpose today is to keep myself safe, and to get the best care I can to the patients in front of me.

Sarah Bergakker  36:00
So then we help the community. We did a kind of emergency interview with Dr. Theresa Stephens, of what does resilience look like in this moment, and she gave us some great tools. But another huge struggle we have, unfortunately, is that asking for what we need, as I said. So then we brought in Fotini Iconomopolous, who is just a powerhouse of a woman. And her leadership skills in negotiation are just incredible. So then, we sat down with her, kind of in this emergency interview, so that in real time, she gave us the tools of, we identified what we needed, through being mindful, we identified how that translated to our values to maintain our own resilience, and then Fotini gave us the tools to ask for that in a way that was constructive for us as individuals and for health systems. And so that was kind of our crisis intervention early on, in addition to that, you know, a lot of private messaging, what was coming up for people and, and supporting people uniquely in those ways.

Andy Vantrease  37:12
Mm hmm. Those are both videos, right? The one that you do and then negotiations and the one that you did on resilience, just free videos that...Can people find those through your website?

Sarah Berkagger  37:24
Yeah, or the Mooxli channel on YouTube?

Andy Vantrease  37:28
Okay. Yeah, I watched those as well. And I even not being in the healthcare field, I found so much benefit from hearing Dr. Stephens' talk about resilience and talk about your values and really holding strong to that bigger picture. And then breaking it down into, "Okay, here's my 'big why'. What are my 'little whys'?" Which could be, you know, the job, the role that you have at your employer, and then, you know, all of these different things. It was very interesting to hear you to talk about the ways that many healthcare professionals think or believe that their "big why" is their job. And I think a lot of people can resonate with that even outside of health care, of just getting very attached to the identity and the responsibility of the job as your purpose or as your why, when really taking a step back, and when you were just speaking about the different tools that you use, what I was hearing was, was creating space.

Sarah Berkagger  38:41
Absolutely. And at that point, in the pandemic, I had healthcare professionals contacting me via phone saying, "This is what's being asked of me." And you know, on the phone, they're actively tearful, because what was being asked was so inconsistent with their values. They would say over and over again, "I have no choice." And lovingly reminding them and holding space for them that there is choice. But for many people, this was the first time that they had awareness brought to these values that are so central to what we do at Mooxli. And so to stand up and say, "This is what I need, if I'm going to continue to work here," feels like a threat to self, right? Because without clarity, just our training teaches us...Like, why would you sacrifice your health? That's ultimately what we do. Why would we sacrifice our emotional and physical health for something that isn't our purpose with a big P? And so we kind of get socialized to the notion that this is all there is. And so giving people the freedom and holding space for...Absolutely, it's not all there is, and absolutely you always have a choice, and Dr. T. Stephens in the interview talks about the book, The Choice. And it's written by Dr. Edith Eger. We have a monthly book club for healthcare professionals. And that was the first book that we did. And Dr. Eger talks about how even being a survivor of the Holocaust in the concentration camp, she had a choice. And that is such a new notion to healthcare providers, but it is so freeing and it is so powerful.

Andy Vantrease  40:27
Mm hmm. I even am thinking about the people during this pandemic, who have become caregivers, you know, mothers who are homeschooling now and people who find themselves in positions due to the the conditions of the pandemic and the regulations and just what we're facing. I'm really grateful to even be introducing people to these ideas in a wider sphere than specifically just health care and nursing. So I really appreciate that. And, Sarah, perhaps, can you speak a little bit about what it looks like to get in touch with you? And to find some of the resources and maybe even talk about the retreat that's happening at the Feathered Pipe? Yeah, how can people start to get involved?

Sarah Bergakker  41:25
Yes, so there's a lot of different ways to contact me. A lot of people like Instagram, Mooxli has a Facebook page. If you're interested in joining your healthcare professional, and you want to join the monthly book club, you can find the book club link, the group to that on our Facebook page to join as well. You can head to Mooxli.com, which is our website. And it's pretty easy if you want to be part of the community that receives our ongoing emails and resources that we share. And then you're always welcome to just email me directly. It's sarah@muesli.com. And the whole point of this is community. So please reach out. Please share your stories. When we show up for ourselves, it's so empowering to others. And it's astounding to me, the community that we have formed to this point, and I'm just so excited to see the community we're going to form going forward.

Sarah Bergakker  42:32
Related to the fall retreat, my mantra since March of this year has been, "Everything is exactly as it's supposed to be." So if we are supposed to be at Feathered Pipe, September 19 through the 23rd, 2021, that's where we'll be. It's 22 continuing education units. So a lot of people, like I said, their employers will, you know, pay for it. And we are recognized as a provider of continuing education for the American Association of Nurse Anesthetist, but they're recognized as a certifier of continuing education credits nationally. And so if you work in a different specialty, you can just manually on your own, take the credits you earn that are certified through us and then apply through your professional organization to have them honor through reciprocity. And if you're curious what that looks like, you could just contact your professional organization. But I love what Joan Mudget says, she says, "At the end of the day, people who are for this will be here, whether they're getting the credits or not." That's definitely the point that I was at in my life when I started this journey. So...

Andy Vantrease  43:48
I imagine it is a combination of learning tools, you'll be together, you will be sharing stories. Is it part continuing education, part rest?

Sarah Bergakker  44:00
Yeah, so our traditional continuing education experience is you go to a beach or mountain destination anywhere USA, and then you spend six hours a day and a pretty sterile conference room with a lot of PowerPoint slides. And you do that every day for four or five days in a row and then you go home. And all of that talk for the most part, those lectures are all patient-care focused. So if you come to a Mooxli retreat, there is not a single clinical lecture. Everything we do at Mooxli is care for the caregiver focused. So we're turning where we're looking to give care to on its head. And operating rooms start very early in the morning. So every mostly retreat starts with an early morning practice, and then we break for breakfast. We really try to avoid kind of the death by PowerPoint approach. And all of our monthly team members are called facilitators. They're not lecturers. They're not instructors. They're to come alongside and facilitate. So essentially from the process you go through from morning to night each day is to start with mindfulness, to bring awareness, and then in the sessions where we're, you know, sitting roundtable and having talking, facilitating sessions, it's tools to bring to what's coming up through this mindfulness and awareness. And then we have an evening practice each night that is very specifically tailored to healthcare providers. Insomnia, and disrupted sleep patterns are huge struggle for healthcare providers, so we do a yoga practice called Yoga Nidra that facilitates restful sleep. We have powerful practice of guided meditation by Joan Mudget, to release those we carry. Because if you practice for any length of time, in health care, you carry so many stories with you. And so creating a space to carry those stories in a loving and meaningful way, rather than in a harmful and potentially toxic way. And then we move through every day that way, and then the last day is really kind of a top down approach of how do I move forward in my personal and professional life with these new tools?

Andy Vantrease  46:27
Hmm. That sounds wonderful. I really enjoyed this conversation and just found so much benefit and so many gems for me and my life. So I greatly appreciate you in this conversation today.

Sarah Bergakker  46:43
Andy, thank you to you and Feathered Pipe, and the beautiful space that you're holding for us as healthcare providers in so many ways. From my first point of contact with the Ranch, it has been nothing less than restorative. So thank you.

Andy Vantrease  47:15
Wow...Once again, another amazing conversation. I'm so impressed by Sarah, her courage for being brave enough to change the ways that she worked and lived and functioned within her relationship with her husband and her coworkers. Really loved the chance to dig in and talk to her about her purpose and her "big why." And just think about that idea of what my purpose is, what my 'big why" is and, and where all the pieces of the puzzle fit into that. So I found that incredibly inspiring. And of course a needed reminder that we and I can't help anyone without getting real about identifying and asking what I need first. That truly...I can never hear that enough. For more information about Sarah and the Mooxli community you can visit mooxli.com. That's mooxli.com where you'll find free resources, retreat signups, social media links, and newsletters to help you on your path to self-care.

Andy Vantrease  48:23
A special thank you to Matthew Marsolek and the Drum Brothers whose music you hear at the beginning and end of this podcast, as well as our dear friend Jean Shinoda Bolen, who first turned us on to the phenomenon of "The Dandelion Effect" and how ideas are carried through the world.

Andy Vantrease  48:38
This podcast is brought to you by the Feathered Pipe Foundation, a 501 (c)3 dedicated to healing, education, community and empowerment. If you'd like to help support this project, please visit featherpipe.com/gratitude, or leave a review wherever you listen to this episode, and share with friends. Be sure to tune in to our next conversation in two weeks. We cannot wait to share another amazing episode with you. We'll see you then. Have a beautiful day.

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