From Nursing at Sea to Dogs with Diabetes – a Conversation with Denise Gruzensky
Nursing at Sea
Her adventures started when she took a job as nurse on a Carnival Cruise at the turn of the century. The travel was a selling point, but Denise Gruzensky loved nursing in this unique environment. She worked as a nurse practitioner but could also work as a nurse when needed. Gruzensky’s taken advantage of the world of online consulting and sees a lot of good in this shift. When she found out her dog had diabetes, she used that as a teaching opportunity to write a children’s book that lets kids with diabetes know that they’re not alone. Beth has a wonderful conversation in this episode with Denise about all of this.
Learn more about supporting the Don’t Eat Your Young Podcast with a membership — visit Don’t Eat Your Young’s membership page!
About Denise
I am a certified family Nurse Practitioner with my master’s degree in Nursing from the University of San Diego. I’ve worked in Emergency Medicine, Carnival Cruise Lines, Indian Health Services, Family Practice, Internal Medicine, and a concurrent career for the last six years as a Legal Nurse Consultant. I love continuing education, career development and I’m passionate about patient education and preventative care. My practice philosophy: “I believe in treating the whole patient. They are best equipped to partner in their care and wellness when they understand why we make recommendations and are empowered to participate in their healthcare decisions.”
In 2021, when our family moved, I remained with my practice and transitioned to a primarily virtual practice.
I assisted with Adventist Health’s AHEAD (Adventist Health Early All-Around Detection) program, piloting remote cancer risk evaluation screenings. I am a graduate of the 2022 IC.
I am a wife, a mother to four littles and a fur kid (dog). We love being outdoors hiking, biking swimming, camping and more.
I grew up loving all animals. As an adult, I developed a passion for rescues. In addition to writing, I volunteer for local animal shelters, work as a Family Nurse Practitioner, and I’m a mom to four humans-and a dog. We are a forever family through adoption which all started when I rescued Harley.
In “Not Like the Others” you are introduced to Harley, my rescued Yorkshire terrier. He will learn the meaning of a forever family and unconditional love.
How do you talk to your child about their newly diagnosed illness? How do you tell your child their pet has an illness like diabetes? What can you do to explain loving unconditionally? The answer is “Harley’s Story”.
I believe pets teach us important life lessons. “Not Like the Others” is the first book in my series “Life Lessons from Fur Friends”.
Links
-
Intro/Outro:
Welcome to Donate Your Young, a nursing podcast with your host Beth Quaas. Before we get started, we have a few quick notes. Donate Your Young is a listener supported podcast to learn more about becoming a member and the perks available to you for becoming a patron yourself, visit patreon.com/donateyouryoung. You can learn more about the show, share your story to join Beth as a guest or connect with our wonderful community in our Facebook group. You can find all those links and more at donateyouryoung.com, and now on with the show.
Beth Quaas:
Hello everyone and welcome to Donate Your Young. I'm your host Beth Quaas. Today we have Denise Gruzensky on the show. She's an RN. She's worked in many capacities throughout her years, including a stint on a Carnival Cruise Line, which I think we're all interested in hearing a little bit more about. She's also written a children's book, so we're going to hear Denise's story today. Welcome, Denise.
Denise Gruzensky:
Hi Beth. Thank you so much for having me. It's such an honor to be here. Oh,
Beth Quaas:
Well, I know you have some interesting things to share, so let's get into it. Why don't you tell us a little bit about yourself?
Denise Gruzensky:
All right. Well, first of all, thank you so much for having a podcast like this because any of us that have worked in nursing know how important this topic is. I have been a nurse since 1994. I spent a lot of my nursing career in cardiac step down and then also in the emergency room. I graduated my nurse practitioner in 1999. I did a two year nursing degree so when I went to the University of San Diego, I did an accelerated program, bachelor's to Master's within the three year period, and then found out was difficult to find a job as a nurse practitioner. I was really struggling. I had sent out resumes, literally I was living in San Diego at the time, sending out resumes to absolutely every primary care provider's office I could get ahold of. And I got an interesting phone call. I had a friend that had graduated a year before me and she said, I've got a full-time job now and Carnival Cruise Lines is looking for a nurse to come out over the millennium new year. Are you interested in doing it?
Beth Quaas:
That's amazing.
Denise Gruzensky:
And I said, yes.
Beth Quaas:
What a cool thing to do.
Denise Gruzensky:
And it ended up being... So it transitioned. I did the millennium new year's stent with them and then later on that next summer, I still didn't have a full-time job. Thank goodness we have our nursing careers as well because I was still working. It wasn't that I wasn't working, but I wasn't using my full degree. So I was feeling a little bit like, oh man, I paid all this money for an education and I'm not using it. They called me back and asked if I wanted to go to Alaska. So I went ahead and went to Alaska and loved Alaska.
Beth Quaas:
What did you do there in Alaska?
Denise Gruzensky:
So the cruise ship actually goes from Vancouver Canada and it's a seven day cruise up through the inside passage and then you pick up new guests and turn around and come back to the inside passage.
Beth Quaas:
Okay. So you were still on the cruise ship in Alaska?
Denise Gruzensky:
Oh yes, yes, cruise ship in Alaska. So good question, clarifying question, and I loved it up there. I had an amazing time. I love hiking, I love mountains, I love the outdoors and we work hard and we played hard. That's what I used to say about Carnival. And it was an interesting transition because about the exact same time that I finished, in fact, I did three weeks and then the nurse I was working for said that I was not working for, but that I was substituting for, another one of the nurses said, well, if you want to stay here for three more weeks, I could use a vacation. And so we talked to the head office and they let me stay. So I got to spend six weeks there and about the same time that was kind of winding down for those six weeks two really big events happened.
Number one I got called by head office. They were having a brand new cruise ship, that size class that was being launched that would have about 1500 guests and a thousand crew members. And they were trying to figure out how to staff them. So the larger cruise ships at the time had two docks and four nurses and the smaller cruise ships had one dock and three nurses, and they were having this middle class ship coming out. And so they were trying to figure out how to do that and the person in the head office at the time said, I've been trying to talk about nurse practitioners. You're already a nurse practitioner. Would you be interested in being our first nurse practitioner so that we could have a nurse practitioner and three RNs? And the idea really was that you would, as a nurse practitioner, I have my nursing background and so if things got really, really critical out at sea, I could work as a nurse when needed, but be hired as a nurse practitioner.
So say we had an inpatient, you're cruising from Vancouver to Hawaii because that's part of that crossing, relatively 20, maybe not even 24 hours into it, but a short period of time into it, it's the point of no return. You can't get a helicopter out to get a patient off, whatever comes in is all yours. And so then you have to use a nurse 24... You've got a staff for 24 hour shifts instead of just the clinic shifts. So I could rotate in and help out with those hours and the doc could just take over the clinics for us. So that was kind of the idea of that role.
Beth Quaas:
What a unique job for a nurse because I haven't talked to anybody, I've known it was out there, but I haven't talked to anybody. So what was your experience? Did you love it?
Denise Gruzensky:
I did. I ended up doing it for five years. I had a great time doing it, but there were ups and downs as there are with any job. Number one, as an emergency room nurse, the patients are packaged by EMS to bring them to you. So the same thing happened at the same time they were asking me whether and want I wanted to do this role they also we had a patient that we ran a code on from their cabin and myself and the other Canadian nurse at the time and then there was a British nurse on at the time, it was the three of us because I was working at the time as a nurse, we really struggled. The two of us that were pretty new to working the job and felt pretty awful about the code itself. And we always, as they do in the emergency room or hopefully for any nurse, they did kind of a debriefing afterwards.
And I remember the Canadian nurse telling me that I had done everything wrong. And so I remember sitting down and talking with our lead nurse that was the girl from England, and her and saying, I can't do this nurse practitioner job on here. I can't even function as a nurse. I was just told how awful I did in this role so how can I possibly step up my role to being in an even greater responsibility job? And she said, well, first of all Denise, both of you don't realize that you both did just fine.
Beth Quaas:
That's nice to hear.
Denise Gruzensky:
And remember, she's dealing with her own set of emotions from what just happened because the patient did expire. She's dealing with her own set of emotions and she's taking those and she's putting them on you and both of you actually did the best job you can possibly do. You are not used to going to the scene and handling the scene.
Beth Quaas:
Right, right. Absolutely. And even the most experienced person, that patient may have had the same outcome.
Denise Gruzensky:
I will never forget her as a lead nurse because it was just so amazing how she was able to manage all those emotions. And I remember her saying to me, remember, if you come out and you don't really like the job, you don't have to keep doing it. But what does it hurt to come out and try? I think you'd be great at this.
Beth Quaas:
And what a fantastic experience for you. I'm sure you learned just from that situation that you were in, how you felt to be told you didn't know what you're doing, and then to have somebody experience tell you yeah, did just fine. And to have the insight to say you're both dealing with emotions and you know do know what you're doing and you did the best you could. I'm sure it changed the way you treated people moving forward.
Denise Gruzensky:
Very much so. And I had come from a background where I worked in medical records to start off with when I was 16 and then I worked as a ward clerk and then when I started nursing school, that same hospital used me during the summers as a CNA. So I've worked in multiple roles and I remember always thinking even when I was working in all those roles, I am going to always be cautious in how I treat absolutely everyone working with me. We are all an integral part of this and we need to make sure we have respect for each other.
Beth Quaas:
Absolutely. Imagine if that experience nurse didn't say the things that she did to you, you may have just left.
Denise Gruzensky:
Oh, I don't think I would've stayed working for Carnival Cruise Lines.
Beth Quaas:
Right. So one person's actions and kind words can go a long way. I hope people get that message from what the story that you're telling because it's very important.
Denise Gruzensky:
It's huge and it makes all the difference. I ended up with a five year career with Carnival Cruise Lines that I loved and enjoyed. And yes, it had ups and downs, but I would always come back to what she had told me.
Beth Quaas:
Yeah, that's a fantastic story and that's what this is about. If we can just lift each other up instead of dragging each other down, even if our emotions are running high, it goes a long way to help everyone else. Especially today, we see people leaving and getting burnt out and it takes one person to say the right thing or the wrong thing really and it can change the trajectory of someone's career.
Denise Gruzensky:
Very much so.
Beth Quaas:
What did you do after Carnival?
Denise Gruzensky:
So after Carnival, I had learned, I loved to travel, so I lived in Miami Beach for a couple years and worked there. And then I moved to Rhode Island and ended up working in several different roles in Rhode Island. I worked in a nurse practitioner in an emergency room. I worked as a nurse still doing travel nursing contracts. I taught for community colleges at Rhode Island and I worked for the [inaudible 00:11:05] and Indian Health Tribe kind of all at the same time to try to help my finances. I was struggling because as every position was just a little bit in... Anyway, so I was trying to make up finances.
Beth Quaas:
That leads me... Sorry to go backwards to the question, for anyone interested in being a cruise line nurse, which I just think is amazing, was the pay comparable? Could you live off of that wage?
Denise Gruzensky:
Well, so what I found was because the pay was considerably less than when I worked in the US or when I worked in the US here, I was in California at the time and I don't know what the pay is now. I left in 2005 so it's been a hot minute. I'm not even sure how many nurse practitioners still exist on cruise ships anymore. I should go back and look and Google and see if the physician still exists.
Beth Quaas:
I bet you it's blown up. I bet you there's a lot more.
Denise Gruzensky:
You would think so. But there was also a problem a little bit because not every nurse practitioner was as open to fulfilling as many roles as Carnival needed them to.
Beth Quaas:
Yeah, I get that. I can understand that.
Denise Gruzensky:
So it kind of goes back into that same, I don't know, that same kind of trajectory where I remember hearing from another cruise ship when I went out to do some training for them because I ended up doing some training for staff as well. I put together a crew education program for what healthcare was available to them on the ships because they didn't really know. And I remember hearing that they had had a nurse practitioner work on their ships on their ship that didn't think they needed to show up to a code.
Beth Quaas:
Yeah. When you have only a small number of providers, you need everyone there, it's something like that, a crisis like that, you need everyone to show up.
Denise Gruzensky:
You do. And part of that is a clarification I feel of roles too. So it was a brand new role. It was being developed and so there probably wasn't great set forth expectations maybe of what that role should be, which is also really important from anybody in an administrative standpoint that we have very, very clearly defined roles. But I know that Carnival was trying, they were creating a role and so it didn't necessarily had to be the exact same way I did it, but then there should have been certain expectations that were definitely laid out.
Beth Quaas:
And we're talking about Carnival because that is your experience, there are many cruise lines and we're not saying one is better than the other, we're just talking because that was your experience as a crew Carnival.
Denise Gruzensky:
No, and I enjoyed working for them too. Yeah, I mean, yeah and whenever there's a brand new role I think that's important no matter cruise ship, not cruise ship, whatever. And yes, I enjoyed working for them, so I didn't have a bad experience.
Beth Quaas:
I just love this conversation because I guess maybe because I always thought it was a really neat thing that somebody could do. And there's nurses that are ready to leave the regular hospital care and look for new things. And this may be something that they hadn't thought about, especially if you like to travel and maybe the pay is less because you get lodging and food, I assume.
Denise Gruzensky:
Well, and that's it. You get lodging food. I sold my car for the five years that I was out there and yeah, I didn't pay rent, I mean it was all cash coming into pocket and I paid some taxes because I lived in the US. But yeah, so if you look at benefits, and I think that's how we have to look at salaries as well because I was traveling, I was scuba diving wherever I wanted to. I was hiking in different locations. And so there were a lot of benefits that for me outweighed the pay at the time. And I actually got bills paid off while I was out there.
Beth Quaas:
That's fantastic. So what have you been doing recently?
Denise Gruzensky:
So I now work as a nurse practitioner for a large company in California. I've been working with the same supervising physician in an internal medicine practice for approximately the last seven years. About two years ago, two and a half years ago, my husband's job moved us away, and it was the one thing that COVID did was give us the ability to work remotely as providers because companies could see reimbursement for remote visits where that didn't happen before. So I have stayed with my practice. I mostly do a virtual practice. I work three days a week. I have a very busy family.
I have four very young children and I'm able to see patients remotely about every four months I go back and see patients in office. Part of why that works though is if I need somebody seen in person. There are two other people in our office, there's another nurse practitioner and a physician. And so if I want somebody seen in person, I can have somebody go to a Rapid care, the ER, or they can come in if it doesn't need either one of those things, they can come in and see one of the other providers.
Beth Quaas:
Compared to me how you think the care is the way it used to be before COVID when you saw every patient in person to now when you're seeing them virtually? I have no concept of that because I do anesthesia. I can't do that remotely. So tell me if you see any differences are some good and some bad?
Denise Gruzensky:
I think there's a lot of good. I think the only caveat to that is the inability to put a stethoscope on a patient. And so there are instances where that's necessary, but I see a lot more positive. I am able to keep up all of my patients with their quality care, like their management of their diabetes, their management of making sure all their... I'm all about preventative medicine. That's what I love to do. In fact, I'm certified in cancer risk assessment now as well through the City of Hope and so that we can bring that to our patients too. And I'm able to do all of that remotely and patients love it. One of the things that has been really tough is my wait times have always been kind of long as a nurse practitioner. Now patients will say, oh, it's not nearly as long.
I sat in an office for two hours and waited for somebody, or I sat for an hour and waited for somebody. My wait times are not usually that long, but you do wait for me a bit. It takes time to do all of the things that I do and ask you all the questions and let you ask all the questions back. Patients are very grateful for that. They've always liked that. Most of my patients will say, it's worth the wait for you because I know I'm going to get my full amount of time. I always make it real clear upfront. I do my best to be as on time as I can. Your time is valuable. I don't negate the fact that your time is very valuable, but patient education was my favorite part of being a nurse and it's what I like to do as a nurse practitioner.
And that may or may not be the right fit for you, but just be aware. So when they're establishing, I'm actually studying that expectation at the front. And where virtual comes in is they're not waiting in my office. They're at home. I've had somebody in the grocery store and she's get on and they'll say, give me just a minute. I'm going to get out to my car or I'll say, okay, I've seen you now I know you're not in any distress, which is the main part of my virtual visit for an exam. And I'll say, so I'll call you on the phone if you would like a little more privacy just to give them that HIPAA expectation as well.
Beth Quaas:
Oh, that is a bonus. That is fantastic. Well, I grew up in rural Minnesota and you had to drive a couple hours if you wanted to see a specialist of any kind. And that's a hard thing. I watched my parents go through it and to have that virtual aspect available now would've been fantastic back then too. I do see that as a plus for patients, especially sick patients, elderly patients. You don't need them coming into a building if it's not, like you said, some critical that they had to be seen in person. I think that is a huge bonus. So I'm glad that you think that as well. And as far as the stethoscope or lung sounds, whatever you're listening for, do they make anything or are they working on some kind of thing where you could have a medical assistant in there placing the stethoscope and you can hear over speakers?
Denise Gruzensky:
I'm sure it's coming down the pipeline. I will tell you that I already do in-office virtuals to get my diabetic foot exam done. I'll have my nurse come in, I've taught the MAs how to do them, and so I watch it and they can tell me what they're... Yes, I've got a peal pulse. This is what the cap refill is. So I've taught them how to do it and then I watch it and I'm able to document that.
Beth Quaas:
Oh, that's fantastic.
Denise Gruzensky:
That's also a way I get vital signs because I can get an actual, if I have a patient who's struggling with their blood pressure, I'm having them do it at home. I'm encouraging them to go get their machines, which that's the other thing. I treat a lot of COVID patients virtually, they're not going to come in the office. They're in isolation as well. And one of the things that we've tried to step up is people getting their own home oxygen saturation little machines, they're like $20 and then I get a heart rate and I get your oxygen level so that helps with that. So we've really been able to see people get more done in their homes. But again, if I want an actual blood pressure on you, well, okay, so let's see each other in two weeks for follow up. Come in with your documented blood pressures, bring your machine that you're using at home with you, come into the office, let's get a comparison while you're in the office and I'll get an actual blood pressure done by my MA in the office.
Beth Quaas:
I think telehealth is only going to continue becoming more of our lives as we go away from COVID because I think it forced something that probably should have happened long ago for patients, for some patients, not all patients, I would say for most though, wouldn't you?
Denise Gruzensky:
Yeah, a good majority of my patients can be seen virtually and then be seen every four months in office or once a year in office. I can get my diabetic patients, I'll say, do you want to come in for an in-office visit for your three month follow up, or do you want me to order your hemoglobin A1C or any other labs and have you get those lab orders and get those done prior to our visit in three months? So it just opens up so many options and I hope that it doesn't go anywhere because I love doing it.
Beth Quaas:
I can only see it becoming more of our lives and not less.
Denise Gruzensky:
I agree.
Beth Quaas:
Like I said, people don't want to travel. In Minnesota we have winter for about 11 months out of the year it seems. And when roads are bad, if that's an option, I think it's an excellent thing. And like you said, your wait times can be less, which means you can potentially see more patients. And we know, especially with mental health and things, how important that is to be able to see as many patients as we can. So talk to me a little bit, you wrote a children's book and I want you to talk a little bit about that because we both love dogs and I've read your book and I think it's amazing. So talk to me a little bit about that.
Denise Gruzensky:
Well, it was really surprising. Let's see, and I may get my dates a little bit off right now, I should have reviewed my dates. But I adopted a Yorkshire Terrier when I was living in Rhode Island, so just before I moved to Rhode Island. So around 2006 as a rescue, I wasn't married, no kids, no nothing. It was just the dog and I. And in around 2008 he got diagnosed with diabetes. It was such an eye-opener to me. I was already a nurse practitioner. In fact, I had called up my vet and said, my dog is peeing more often. He's having accidents in the house, which he wasn't doing before. He's drinking more and he's eating more. And for my patients, that's diabetes. What is that in a dog? And the vet said, possibly diabetes, please bring him in right away. And sure enough, his blood sugars were like over 600 and dogs blood sugars are supposed to be about the same as humans.
So around 70 to 120, 130, you tend to have them run a little bit higher because they can't tell you when they're not feeling good. So if they're starting to drop low, it's a lot harder to see it in a dog. But I remember the vet telling me, I was bawling my eyes out because I thought, what does this mean? No, no, no, no, we can treat them the same way you treat a human. They can live for a very long time with diabetes. And you caught it early. And one of the things that they see as a vet oftentimes is that people don't know what symptoms to watch for and so by the time they bring their pet in, they're multi-system failure from the disease. And then they do have to be put it down or put to sleep or I try to not use that with my kids because then my kids think when they fall asleep, they could go to the rainbow bridge when they fall asleep.
But anyway, so it actually happened after Harley lived for another four or five years with the diabetes, he ended up going blind from while we were trying to get it under control. He did really, really well with that as well. And in the book, he tells his own story to kids, but also adults. I really meant it for both about being rescued, finding out he had diabetes and learning about other pets with special needs and what unconditional love really means.
Beth Quaas:
It does all of that. It is a fantastic book and it really does say, just because you have a disease, there's nothing wrong with you. We still love you and you're still part of this family. So it was very well done.
Denise Gruzensky:
Thank you. I really appreciate that. I'm glad you enjoyed it. It means the world to me because he gets to be still kind of, you're an animal lover too, so he still gets to have a little piece of me. I get to talk about him. So it kind of gets to still be with me some when I get to talk about him too. And then he gets to educate. I don't want another person to have an animal that has to be put down because they didn't know what symptoms to watch for. That was a huge thing for me. And then children with diabetes, I've gone to multiple diabetic walks and juvenile diabetic walks and they'll be like, really, a dog can have the same thing I do. And to see a child who's going to be living with this for the rest of their lives realize that I'm not alone.
That's huge. We know for adults as well as kids, but especially kids that are wanting to be like everyone else. And so it really gives them something to connect with that an animal can have it as well. And then a little piece of it that I wasn't expecting because we adopted a sibling set, so my four children are siblings. They've moved in when they were 1, 2, 3, and 4. They're now just about 6, 7, 8, and 9 given some birthdays. But it didn't occur to me, which sounds crazy about the adoption piece of Harley's story and the rescue piece and how my kids have connected with it. They just love it.
Beth Quaas:
Well, there's your next book, right?
Denise Gruzensky:
Well, my next book has got to be about the Rainbow Bridge. Because kids asked to see Harley. And I got to have the next piece... He's been gone since 2013. And so I'm like, okay, we got to talk about the Rainbow Bridge. So I actually have written the Rainbow Bridge. It's going through editing processes and I'm looking for an illustrator since Harley's story has mostly pictures as you've seen, some illustrations for pictures that weren't as great equality. But the Rainbow Bridge is not something I feel like I can take a picture of. So I need an illustrator for the book.
Beth Quaas:
Oh, that is fantastic. And then like you said, maybe we'll see one on adoption as well.
Denise Gruzensky:
And I definitely have one on the works on inclusionary stuff as well, because you see animals are way more accepting of other animals that are unlike themselves than sometimes we are as humans. And so that's on the docket for it's life lessons from Fur Friends, is the series planned.
Beth Quaas:
Oh, I love it. I'm glad you're continuing on that because I think you have good messages to share in relatable stories. So tell us some tips or advice or inspiration for nurses that you'd like them to know.
Denise Gruzensky:
I really, really feel like your podcast and the theme behind your podcast says it all because we all have a place in healthcare, you don't function as well as a nurse practitioner or a physician without your nurse. Your nurses don't function... We don't function as well without our MAs and our LVNs and our CNAs, and we all don't function as well without our ward clerks at the front desk and the people... Like every single person has a place and deserves respect.
Beth Quaas:
Absolutely. You couldn't have said it better. And in my world, I would say it's of course the nurses and the anesthesia team, the surgeon, but the surgical technologist and the aids that run for us and help clean our rooms and those people, you can't do it without everyone. So you're right. I'm so glad you said that. And we can all learn from each other. There are things that I learned from students because I teach now too. I learned so much from students now, they're coming out of ICUs that are so much busier than any ICU I worked in way back 25 years ago. They are very bright people. So we can all, if we listen, we can all learn from someone.
Denise Gruzensky:
Exactly. I feel exactly the same way.
Beth Quaas:
Thank you. I am so glad you came on to share your story, Denise, and what an inspiration. Please go out and look for her book and the books to come in her series. Tell us one more time, Denise, what's the name of your series?
Denise Gruzensky:
Life Lessons from Fur Friends and it is available on Amazon.
Beth Quaas:
And we'll have that in the show notes as well. So anyone wanting to find out more information can go there to get that information on where to find those books. Thank you so much, Denise.
Denise Gruzensky:
Thank you for having me. It's been a pleasure chatting with you, and thank you for doing this podcast. Thank you for putting this out there.
Beth Quaas:
Thank you. It is my passion and I really appreciate to hear that people that is helping people because that is the whole intent of this podcast, so I appreciate it. Thank you very much.
Intro/Outro:
Donate Your Young was produced in partnership with True Story FM Engineering by Andy Nelson. Music by the Light Hearts. Find the show notes and transcripts at donateyouryoung.com. If your podcast app allows ratings and reviews, please consider doing that for our show, but the best thing you could do to support the show is to share it with a friend or colleague. Thank you for listening.
