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0:00 Put your aces in the right places and don't focus on your weaknesses, but strengthen your strengths. 0:08 By strengthening your strengths, you're incorporating your life lessons, your schooling, your profession, the people that God surrounds you with, and you take the good from that, 0:18 and then you just keep pushing through. 0:26 you 0:33 Hello and welcome to the Degrees of Success podcast. I'm your host, Freda Richards. 0:38 And today we have an incredible guest, Elma Arellano She is the director of clinical respiratory therapy and she's using her personal challenges to motivate and educate 0:50 others. Help me in welcoming Elma Arellano. I want to start off by talking about your decision to get into healthcare. 1:00 Where did that drive in passion? to jump on that journey come from. A Journey into Healthcare 1:05 I know that there's a great reason that you jumped on your journey and I'd love to hear more about it. 1:11 Okay, let me get my... Every time I talk about her, I feel this... um presence. 1:20 um Every time, it never fails. I feel like she's right here. 1:25 um Guadalupe. 1:32 Guadalupe. Yes. And so I became a respiratory therapist for her. 1:40 And she was born with, it's called congenital diaphragmatic hernia. 1:50 And the outcome is very poor. And not knowing anything, I... 1:59 I don't know if you call it denial. um 2:08 holding onto a face, but I don't believe it. 2:14 I don't know. And I would say the doctors don't know what they're talking about, you know? 2:22 You get angry. Um, but... 2:28 My... in my heart I thought she would be okay. 2:34 So we had, God for my husband, had such good insurance and um it took us to Phoenix, Arizona. 2:45 And we could pick between Philadelphia or Phoenix and we went through Phoenix. 2:52 I think being closer to home, because we're from Tucson and knowing that we're so young, you know, so young, I was only 23 and 3:04 and um just needing that family. And um they said, we gotta fly you over. 3:13 They said, we gotta fly you over to um Good Sam. So from Tucson Medical Center, they flew us to, me and her to Good Sam before I delivered. 3:24 And I was on bed rest for two weeks and I got to meet a lot of staff and the respiratory therapist would always come and talk to me. 3:33 The nurses were too. I don't want to feel like they didn't, but for some reason, the respiratory therapists would always tell me, this is what's going to be expected. 3:42 I don't want you to be fearful in the delivery room where you're going to see us there and the whole team. 3:50 And then she was born and right away she required life support like this. 3:57 We really didn't get to hear her cry because they were ready to put the breathing tube in. 4:03 because she needed it. And again, I was still like, she's strong, she's gonna show you, you know, just not knowing. 4:12 so for eight days, we got to stay at the hospital. 4:17 We rented a room at Good Sam, me and my husband, and we were there with her 24 seven. 4:23 And it was time for her to go. You know, she fought, oh my gosh, she fought so hard. 4:35 I'm so sorry for your loss. How old was she? m 4:42 eight days, eight days. And she was so smart. my God. So smart. 4:48 I mean, she was my first so I didn't really know but now that I have my voice I'm like, what happened? 4:54 So funny. Because she was just so smart. 4:59 And, and so the respiratory therapist would explain everything, oh everything, every step. 5:08 And my husband was the one that got familiar with that terminology. It's so interesting. 5:13 He knew everything. He was making the decisions because I just wasn't there. And, you know, to comprehend that. 5:20 So he was just going and making decisions. And I'm right there listening, but not really. 5:25 And and then, you know, was her condition got worse. 5:30 She got a blood clot in her brain because she was on the last machine, which is called ECMO. 5:37 And ECMO is the last resort, it's more intense than life support, which we think is horrible, but ECMO is the last resort. 5:49 And um just to give the viewers and everybody an understanding that life support we think is the last resort and either live or unfortunately you pass away, but when life support 6:03 can't do it, then ECMO comes in and it's a bypass outside the body. 6:09 and it allows the lungs to heal. And she didn't really have lungs because of her condition, her lungs didn't get to grow. 6:18 So imagine not being able to breathe. And that's why unfortunately she passed away. 6:24 So when she got the blood clot, because ECMO, you have to thin the blood. And to thin the blood, you're more at risk for developing blood clots. 6:33 And she got it in her brain stem. So. The neonatologist told us at this point, there's nothing more you can do because if we push to get to surgery, because we weren't even at surgery, she wasn't stable enough to 6:49 get to surgery. said if he said if we get to surgery, you know, and she's neurologically not there, what was the whole purpose of this long fight? 7:00 You know, and then it made sense to our brain. You know, it's 7:06 she would be a vegetable pretty much. we said, and that's when he said, um let her go with dignity. 7:17 So we did. And then that's when we prepared. 7:26 And again, there was a respiratory therapist and put her in my arms and I got to rock her for the first time. 7:32 And then I promised her. 7:39 then I would live my life for her, which I'm glad I did. 7:45 She deserved that. She was nothing but love. 7:51 She was nothing but love. That little girl loved so much. Gosh. 7:57 And she fought so, so hard. So hard. So how could I not do this for her? Living for a Lost Child 8:06 My goodness. The fact that you can... 8:13 live through that period. is astonishing to me. 8:20 Your strength, even in telling the story, 8:26 What a blessing. Eight days of love and and redirection for mom, right? 8:35 Because you promised her that from that day forth that everything that you did would be living for her. 8:48 Mm-hmm. So, what tell me... what that looks like for you. So you're 24. 8:57 huh. you're 24, you've gone through a horrific tragedy. 9:03 Your very first child, you and your husband. Mm-hmm. 9:09 Your first child since you on a journey to where you now need to live for her. What does that mean at 24? 9:17 I was so scared. I remember being so scared and thinking, I'm not smart. 9:25 I literally, um I struggled a lot in school. um And I said, I don't know how I'm gonna do this. 9:34 And my husband, he said, you can do it. She's gonna help you do this. 9:42 And I just got that fear and I got angry with the fear. And I actually felt I was being a coward. 9:50 And I said, I shouldn't be. She was so strong. was like, I'm such a coward. 9:57 um And my husband said, you're just, you don't have confidence in yourself, but she's going to give it to you. 10:04 um I remember again, like you said yourself, I was grieving and a commercial played. 10:15 And it was Pima Medical Institute. And I saw the ventilator and I recognized it from, you know, being at the hospital with her. 10:25 And I just called and I said, I need a register. um And I forgot the profession, the name. 10:33 I forgot respiratory therapist. And I remember I told the representative that admissions, I'm sorry, I said, I need to become what works with ventilators. 10:45 and I didn't even call it life so far, just said ventilators. And she's like, yeah, that's a respiratory therapist. 10:51 And I said, do you have that program? Yeah, and it starts in three months. And I started in three months. 10:58 And yeah, I was so scared, my God. And then I was not doing good. 11:04 The first exam, I bombed it. I didn't know how to study. 11:10 I don't know, there was a lot going on. um You know, I was not getting it. 11:16 I was making flashcards. My husband's helping me study. And then my husband had to have like a heart to heart. 11:22 was lot going on. I mean, yes. Okay. You bombed your first test. 11:27 You're six months at this point, possibly out. No, three months because Pima Medical Institute, it's a fast pace. 11:36 So one course is done like in two to three weeks. 11:41 I was literally, yeah, I was bombing my first class and I was like, my God, I can't do this. 11:50 And I was still working with my dad. So then my husband said, you need to stop working. Overcoming Fear and Building Confidence 11:57 And we had all these medical bills. Oh my God, it was just insane. And I said, I can't. 12:04 And he said, you need to because I'm not, not going to be able to finish. So we did. We went down to one income. 12:09 It was hard, but he's never complained. And, and it helped me because then I was able to invest more time in studying. 12:18 And thank God I finished. I knew you would. And so did your dad and it sounds like absolutely so did your husband. 12:27 Oh yeah, he's a rock. And you weren't gonna quit for her. 12:32 No, I think I was just having like a pity party and my husband was like, okay, that's enough talking. 12:38 Cause I was like, I can't do this. You you're having this moment. I was circling down that moment and he said, you have to do it. 12:46 What are you gonna, you're not going to fulfill your promise that you made to her. He's like, that's, that doesn't even sound right. 12:53 You would tell me. And I was like, you're right. It doesn't sound right. How important is the support from family when you are in a situation such as yourself? 13:06 Your husband literally encouraged you to quit your job with your father, which I definitely want to talk about, uh to stay focused on school. 13:14 How important is it to have someone to help you balance that all? If you don't have it, like I tell my students, I always tell them the first day, do you have family support? 13:24 And a lot of them say yes, no. And the ones that don't, I tell them, I'll be your support. 13:30 I'll be your, you know, your cheerleader because I needed it. If I didn't have my husband, oof, there's no way. 13:40 You need somebody that is motivating you, encouraging you, excited for you when you pass exams, when you pass competencies. 13:48 when you had an amazing day at clinical, you just, need to have somebody to share that excitement with you because the journey is not, it shouldn't be alone. 13:58 It should be with your surroundings, you know? So no, you need it. If not, I don't think you'll be successful. 14:05 There's no way. I know how important it is to have community and family and people who support you. The Importance of Family Support 14:12 I also know that your drive and your push and vision for hard work has come from your past. 14:19 You started with that in construction. Tell me about that. Yes. 14:25 My dad, has a construction company. My dad only went to fourth grade in Mexico and yet he's able to run this business and he's, how does he know? 14:38 70, I he's gonna be 70. Oh my God, he's gonna kill me if I have it wrong. 78, think. 14:44 Oh my God, he will kill me. But he's still working because of that work ethic. 14:51 He does not need to work. But very young, he just molded us. 14:58 So I have two sisters, two older sisters, and I have a younger brother. And he just really molded us to work hard. 15:07 And there's no such thing as, not so much handy downs, but I'm not gonna give you everything in a silver platter. 15:15 You need to work hard, you need to make your own destiny. And he did, he pushed us to just, 15:22 build that work ethic because you have to be taught that you know have to know how to work. 15:28 I remember he would when I started working with my dad um he showed me how to talk to people because I was talking to contractors and I you know was working before that at 15:41 Dairy Queen you know I'm going to school but when I worked with him he said okay I need to get you to how to communicate with um contractors how to move 15:52 your guys, would call me, he would tell me, this is your team. So I would build, um I'm sorry, I would bid a building. 16:02 My first one that I got was called Cellular One. And it was, again, all we did was um block. 16:08 So that's our specialty. And we would just bid on the block, the rebar, the cement, and I would have to count how much masonry material I would need. 16:18 And then I would have to include how many minutes it would take. And then my dad would say, okay, I want you to come to the site. 16:24 So I would have my little hard hat and I thought it was all cool. And I would go and I would see the guys work and I would see their loyalty to my dad. 16:35 And the reason I saw the loyalty to my dad was because you could never tell he was a business owner. 16:41 He dressed like the guys. He moved. He got his hands dirty. 16:47 And he would tell me, when you lead people, that's what you got to do. You don't sit behind the desk, you got to move. Work Ethic and Early Lessons 16:53 You got to see what your people are doing. And then he just showed me how to talk to contractors because communication he's shown me is very important. 17:02 So he was showing me these little life skills. And again, I'm only 18, 19, 20. 17:07 I left once I started school, but those carried me to where I'm at now. 17:14 Let's talk about that now because you go to Pima. 17:21 How did you get to ������Ƶ? What's that in between? And do we have, and you have three incredible boys. 17:27 So before you get here, tell us the in-between between Prima and ������Ƶ. 17:34 Okay, so I'm at Pima Medical Institute, and then I start working at uh University Medical Center, now known as Banner. 17:44 You I started in 2002, I left in 2014. My supervisor knew my dream to become a neonatal uh respiratory therapist. 17:53 That was my goal. So you have to get to certain levels. You have to do what's called adult general floor, adult ICU, and then neonatal. 18:03 And she saw my drive, she saw my urgency, and um she said, all right, it's time. 18:10 They put me in the NICU, the neonatal intensive care unit, and I was there for like 10 years, and that was my specialty. 18:17 And that was the completion of my promise. Like that was big because that was my goal. 18:24 Right? That was my promise. And I got really good at the ventilators because I saw it do magic for her. 18:34 And I wanted to make sure that I could move those knobs just to keep that baby alive. 18:40 just, it was just so important. And then I started to have students shadow me, you know, cause they have to do neonatal rotations. 18:49 And I enjoyed having students. I, I enjoyed showing them. 18:55 my experience. And I was like, teach me knowledge because I lost some of that textbook. 19:01 I was like, let's do a trade off. Let's do something. Give me something. Don't be a taker. 19:06 So, you know, I give you give and, and it was I enjoyed it so much. 19:14 And, and then Pima Medical Institute where I graduated, they said you want to be an instructor for us. 19:20 So in 2009, I signed up with them and I still worked at Banner, now known as Banner, and I continued to instruct. 19:30 So I was doing two jobs and I enjoyed it so much. 19:35 And then in 2014, Pima Medical Institute said, do you want to come full time? 19:40 And I was like, no, I do not want to leave the babies. No. I was like, that's not going to happen. 19:46 And I turned them down and I appreciated it, but I was like, I'm not ready. And then it just kept... 19:53 in my circling in my brain and I was like, my God, am I not being obedient anymore? Transitioning to Education 19:59 I was thinking, God, why are you opening this door? My brain doesn't want to go there, but my heart does. 20:04 It was just, it was a lot of internal conflict. My husband's like, I think it's time. 20:10 And I was like, you don't know what you're talking about. I was like, no, it's not time. 20:16 I need to get babies home. I was like, no, that's my job. I want to make sure every baby gets to go home. 20:22 and um... Just that was my drive, you know? 20:30 because she didn't get to come home. 20:36 But with every baby you sent home, a piece of hers. 20:41 because you're fulfilling that promise. Yeah, and I didn't want families to go empty handed. 20:49 It's so ugly. 20:56 So my husband said, but guess what? You can build soldiers. 21:03 And I'm like, what? What are you talking about soldiers? And he's like, instead of two hands, you can help mold so many hands. 21:12 And I was like, okay, now you're talking and it makes sense again. I was like, I'm ready to listen again. 21:17 And I really took that with me and I was like, soldiers. was like, my God, I was like, you're right. 21:25 And got excited and I took the job and I left the hospital. And then the program director said, but now you need your bachelors. 21:35 To teach in the classroom, you need your bachelors. And I was like, oh God, that means I have to go back to school. 21:41 I was like, no. And I was like, and then I have my boys, you know, and then I have two on the autism spectrum, the older ones. 21:51 But you know, it's. They're such good boys. And I was like, my God, but it's still busy, you know, so I was like, Okay, okay, I can do it. 22:00 My husband's like, I'm on board. And, and then again, I talked to my boys, because thank God, they, you know, obviously, they understand everything. 22:07 And I said, Mom, to go back to school. And, you know, as a mom, you do it on their downtime. 22:13 So they're like, chilling, kicking back when you should be chilling, and you're not because you're doing homework. 22:19 Right? Like they're napping and you're not gonna nap. At all. 22:25 No, at all. So I balanced it like that and got my bachelor's and then uh Pima Community College starts reaching out to me and saying, and it was a team, some of the team members that were 22:42 working in that area, in that college. And then I got a hold of the program director. 22:48 He just started to pick his brain and I was like, do you think I'll be a good fit there? And the reason I was thinking of leaving the school that gave me so much was for a career advancement in the director clinical role. 23:01 I felt I could do so much more in the clinical setting that I love. um, and he said, I want you to change it all, change everything. 23:11 If you come here and you work for us, cause the position was open. You make it to how you want it. 23:17 And I was like, what? So when he said that, I was like, let's do it. And yeah, so I applied and when I got into the parking lot, I smelled my daughter. 23:30 So when she comes to me, it's through sed. And it just hit me and I was like, okay, this is good. 23:37 You want me here, you want me here. And I was like, okay, babes, I'm gonna do it. And I just felt so happy because again, I was nervous to leave the school that gave me so much to go to the competitive school, right? 23:50 But it's been good. And then again, Russell, he said, we need to change our associate's degree for our students into a bachelor degree. 24:02 And he goes, you know what that's gonna mean? And then I said, no, what's the plan? 24:08 You need to get your master's. And I was like, my God, what? And again, it was that, huh? 24:15 Okay, back to the grind, right? Back to no real downtime and pushing through. 24:22 And at the same time, I was already getting these um urgencies that I wanted to focus, not just in the neonatal population, but in the asthma pediatric, because it's the number one 24:35 mortality in children. And like your grandma. COPD, because that's the third leading cause of death in the adult population. 24:44 And I was like, but I didn't know how to do it. I had all these ideas. And I remember I wrote them down, but I didn't know how to do it. 24:52 And I knew that I needed more school. I knew it. was like, obviously, I'm lacking education. 24:59 And then um I was going to start at ������Ƶ in, I believe, 2020. 25:04 But with the pandemic, I put it on hold because I had to convert everything to online for my students. Applying Education to Real-World Challenges 25:10 That was way too much. And then again, it was like, you know what? It's time. 25:16 Let's do it. And I'm glad I did because that's helped me to do all these projects. 25:23 You You go and get your degree from ������Ƶ. You get your master's in healthcare administration. 25:31 Tell me, how do you currently use your degree in which you've learned in your current position? 25:39 And tell me about what you're most proud of in regards to your accomplishments. 25:45 Well, with the ������Ƶ, you know how the curriculum, you start your first class and then the second class, it's the knowledge keeps building, right? 25:55 It keeps carrying over. um I want to say it was already in the first class and I was thinking, oh, I could, I can start something now. The Power of Lifelong Learning 26:05 I don't have to wait to graduate. And I did. I started the pediatric asthma team with my students. 26:13 And we started to educate Cochise County because that was the high need and because there's also a shortage in respiratory therapists there. 26:23 lack of education. And I learned how to research that from all the proposals that the ������Ƶ had me do part of my assignments. 26:33 And it was for other projects, the assignments, but I also then applied it to my work. 26:43 So I was able to do that and I'm really happy because it's still continuing on. 26:48 The other thing that um I really learned how to do was called the gemba walk and it stays with me because for my dad, he instilled in me, be out with your guys, be out with your 27:00 team, watch to see what your team is doing because that's how you know what they need. 27:06 And what your request is, you'll know if it's valid or not. And when I learned at the ������Ƶ, I had to do a gemba walk. 27:15 And um I realized that I was only doing maybe 25 % of it because again, I didn't have the knowledge to get know how to get that information, go bigger and then implement bigger. 27:30 And that's what I've been doing with my team. So I have a team about it kind of varies per clinical, but it can be up to like 13 to maybe eight. 27:40 clinical instructors and they're out in all the hospitals. And what I do is I go out with them and I'm just observing and that's part of the gemba walk. 27:53 I observe and then I get creative to see can this objective be fulfilled at this facility? 28:00 Does my staff have what they need to be successful to achieve the student learning outcomes for my students? 28:07 um And I wasn't doing that. I wasn't going to that extreme and collecting the data. 28:13 There's just not happening. And now it's more also welcoming that feedback. 28:21 And I actually asked my team and I remember asking, but not asking, asking like now. 28:29 And that has really been successful. Those are really high on my list because the community, the Tucson community reaches out to me, the managers. 28:41 my colleagues and they say that there's been a big shift at Pima College since I've been there and I feel good about that because they say it keeps getting better and better and I 28:51 really feel like it's getting better and better because I started using the knowledge before I graduated. 28:56 I just couldn't wait. I was too excited. As you should not. I was like, yes, implement. 29:02 I yeah, I was like, I'm messing up. I need to, I'm not even finishing the whole cycle here. 29:09 So it's been good. The floor is yours. If there's anything you want to say or ensure that our listeners or viewers take away from today, what would that be? 29:20 I had a student and she was 65 years old and she wanted to become a respiratory therapist. 29:27 And I just want individuals out there to know that there's no age gap to enhance your learning, to grow, em to change careers. 29:39 I don't want people to think, I'm too old or I'm too young or I'm not ready, because you'll never be ready. 29:46 But if you do have the support like I received from the ������Ƶ, even with my, can I do this? 29:53 They're like, yes, yes, you got this, you got this. um I just want the listeners to know education is so important and if there's an opportunity and a will, there's always a way. 30:05 And I'm grateful that I did it. I'm so happy that I did it. And most importantly, don't take um a breath for granted. 30:15 I'm going thank you so much for joining us, for sharing your incredible knowledge and your overwhelmingly triumphant story. 30:23 Somehow that brings us to the end of this episode of the Degrees of Success podcast. 30:28 I'm your host, Freda Richards, reminding you that your next chapter might just be your best one yet. 30:34 See you soon.