The MICNP Podcast: Inspiring, Informing, and Advocating for Nurse Practitioners

Episode 8: From First Day to Legacy: Lessons in NP Leadership Across the Journey (Taped Live at the MICNP 2025 Conference!)

• Season 1 • Episode 8

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TAPED LIVE FROM THE MICNP 2025 CONFERENCE IN SOUTHFIELD, MICHIGAN!

In this episode of the MICNP podcast, hosts Rachel Hetzner and Jen McConnell engage with guests Lisa Golker, Ilana San Souci, and Louis Davis to discuss their experiences as nurse practitioners. They share insights on early career lessons, the importance of mentorship, navigating imposter syndrome, and the evolving role of nurse practitioners in healthcare. The conversation emphasizes advocacy, leadership, and the unique contributions of NPs in various settings, highlighting the need for confidence and continuous professional growth.

Takeaways

  • Create your own job if the one you want isn't available.
  • Trust your gut; you're more capable than you think.
  • Nurses are held in high regard outside of healthcare.
  • Independence is a significant change when transitioning to NP.
  • Imposter syndrome is common among new NPs.
  • Know your limitations, but trust what you know.
  • Nurse practitioners need to be involved in health policy.
  • Show up with confidence in every interaction.
  • There are no limits to what you can do as an NP.
  • Advocacy and professional growth are essential for NPs.

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Michigan Council of Nurse Practitioners (MICNP): Website

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Rachel Hetzner (00:07)
Welcome to the MICNP podcast. I'm Rachel Hetzner, your president-elect. Join us as we bring you the latest insights, discussions, and expert perspectives on the evolving role of nurse practitioners in Michigan and beyond.

Jen McConnell (00:21)
Hosted by the Michigan Council of Nurse Practitioners, MICNP this podcast is your go-to resource for advocacy, education, and professional growth. Whether you're a student, a seasoned NP, or a healthcare leader, we're here to keep you informed, inspired, and connected. Each episode will explore critical topics in clinical practice, healthcare policy, legislative updates, and professional development, all tailored to the unique needs of Michigan NPs.

Tune in as we amplify the voice of nurse practitioners and work together to shape the future of healthcare. Subscribe now and stay tuned for expert conversations, legislative updates, and the latest in NP practice in Michigan.

Justin Hooks (00:56)

This material is provided for entertainment, general information, and educational purposes only, and is not intended to provide medical, legal, or professional advice. Nothing in this presentation, discussion, or material should be interpreted as establishing a client, provider, attorney, client, or other professional relationship. The views expressed by the speakers, guests, participants, and vendors are their own and do not necessarily reflect those of MICNP Additionally, references to any specific products, services, organizations, or third-party entities do not constitute an endorsement or recommendation by MICNP. No representation or warranty is made regarding the accuracy, completeness, or reliability of the information provided. MICNP expressly disclaims any liability for any direct, indirect, incidental, or consequential damages arising from the use of or reliance on the information provided. Participants and members of the audience should always consult their own healthcare providers, legal counsel, financial advisors, or professional advisors and qualified professionals for questions and advice. Any reliance on the information presented is solely at your own risk.

Rachel Hetzner (01:41)
Welcome to the MICNP podcast live from the 2025 annual conference where we have Lisa Golker, Ilana San Souci and Louis Davis with us today. Welcome to our show.

Hello, I am Rachel Hetzinger, president-elect for Michigan Council of Nurse Practitioners and co-host of the MICNP Podcast.

Justin Hooks (02:07)
And hello everyone. My name is Justin. I'm the other co-host of the MICNP Podcast and the chair of the Education Committee. Today I will be the stand-in producer and mute host.

Jen McConnell (02:22)
Hello, I'm Jen McConnell, PR and Marketing Chair for MICNP and Producer and now Stand-In Co-host for the MICNP Podcast.

Rachel Hetzner (02:30)
Before we jump into our topic, can each of you quickly introduce yourself to our listeners and our live audience?

Louis Davis (02:39)
Hi, I'm Dr. Louis Davis. I am a nurse practitioner and associate professor of nursing. I practice as a hospitalist and previous chair of the education committee for MICNP

Ilana San Souci (02:51)
My name's Ilana San Souci I am a DNP with focus in family practice. I'm also a certified pediatric nurse and I currently work for Trinity Health IHA Urgent Care and I've been in practice about one and a half years. I am also the president-elect for the Ann Arbor chapter of MICNP

Lisa Gulker (03:08)
Hi everyone, my name is Lisa Golker. I have a DNP in adult acute care from Wayne State University and I work in health information technology and was recently named the chief nurse for Oracle in their health information technology practice.

Rachel Hetzner (03:28)
Before we get started, we ask all of our guests the same question on each episode. If there was something that you know now that you wish you knew when you started your practice in healthcare, what would you tell that person? I know this is a tough one, so Louis, what's something that you wish you knew when you had first started?

Louis Davis (03:44)
When I began, actually when I was in school to be a nurse practitioner, I didn't know for sure what I would do or what I even wanted to do. So this is something I share with my students often that if you don't know what you want to do or if the job that you want isn't available, you create one for yourself. And I'm still doing the job that I created for myself.

Ilana San Souci (04:09)
I would have to say to trust your gut. This has been very key for me in practice. You know a lot more and you're more capable than you think you are. I've had some once in a lifetime experiences in my short career, but the outcomes were a lot better because I did trust my gut in those situations.

Lisa Gulker (04:27)
And what I would tell everyone is, especially if you sort of widen your aperture and think about other things to do than what are traditionally thought of as nursing roles, is do not underestimate the value and the trust that's placed in nurses and what they know in the world generally. it's interesting. We know what's expected of us when we care for patients and families, but outside of healthcare, nurses enjoy enormous respect and are held in extremely high regard. And so that's a really important attribute to remember the place that nurses hold in society.

Rachel Hetzner (05:07)
Yeah, I think that the things that that we contribute can have a lot of impact because of that respect that we have as nurses. So I agree with you all there.

Jen McConnell (05:20)
So question for Ilana, can you take us back to your very first day as a nurse practitioner? What were you feeling?

Ilana San Souci (05:28)
Anxious, excited, and ready. I took my boards a year before I started practicing, so I was able to take them as soon as I finished clinical practice, but I couldn't practice as a nurse practitioner until 2024 when I had my diploma. So I was very ready to kind of get started, you know, the last four years in clinicals and all that work were finally amounting to something. I was anxious because I was going to see things that I'd never seen before, but also excited to finally see what I could really do now that I was on my own.

Rachel Hetzner (06:04)
What surprised you the most about your transition from being an RN to an NP?

Ilana San Souci (06:28)
The big thing was the independence. I work in a lot of solo sites, so the clinical decisions are mine and mine alone. I do have support from a team, but

I do not have to really answer to anybody necessarily. Another big thing is I felt or I still feel like, you know, nurses are the most trusted profession, ⁓ but a lot of people, especially older people coming into the clinic are still not sure what a nurse practitioner is and they still want to see the doctor. And then I have to have the conversation with them that I am your provider. I am able to do this. I am able to take care of you.

So that was a little bit surprising. I knew it would happen, but not to the degree that it has. And also the amount of growth that happens in a short time frame. I could tell you I was very nervous on day one, and I've been in my space about a year and a half, and I am a much more confident provider now. And so the growth, think, from nursing school to nursing is a little bit more slow.

But as soon as you are done with NP school, you have to hit the ground running. So I feel like the growth was expedited.

Rachel Hetzner (07:26)
It's funny that you said this--how a lot of the patients are asking when they can see the physician or something like that. And now that you've been practicing for a while, now they probably, they get confused and think that you're the physician and you have to educate them. No, I'm a nurse practitioner. This is what I do. Sometimes they'll even say, when are you going go back to med school? And I'm going to finish that up--there's always that education.

Jen McConnell (07:55)
What kind of support or mentorship did you wish you had when you first started, if any?

Louis Davis (08:01)
I was the first APP in my role in the hospital where I started as a nurse practitioner. We did have one other APP in the hospital, but I didn't have an actual real mentor to look up to. So I sought support for and mentorship for my NP friends that are in other roles. I don't think I would change anything because it really helped me be much more independent and self-sufficient.

Ilana San Souci (08:23)
So I also did not have a lot of mentorship in my career. I was made to be pretty independent for my first day. I shadowed a few providers and then I didn't count on the schedule, but I still seeing patients independently. And then after about four to five months, I was on my own in a solo clinic. So we don't have a true mentorship program.

But we are actually starting that now in our group. We're doing a new graduate program. So I am one of the test drivers for that as a peer mentor. we do have a provider chat during working hours. So there is always somebody to help you even if they are on the west side of the state, which has been helpful, but not a ton of mentorship in my role.

Lisa Gulker (09:07)
Yeah, my response is going to be a little bit different again, because the roles I've been taking on are quite different. as I continue to take on more leadership roles in the place where I tend to work, which is where we're putting forward technology for use in practice, there aren't many APPs in my field. And so at first, I look to other clinicians, often pharmacists or physicians, to collaborate with and that has worked and they still continue to be important mentors and frankly now colleagues in what I do. But I still had to search pretty hard to find people who I work with who had the heart and the minds of direct clinical practice providers so that they understood who we were designing for and how they were going to use these technology tools--those continue to be important factors. 

What I will say though is I'll encourage everybody to not just find mentors, but find promoters of your career. So mentors are great. I've loved the mentors I've had. But where I really started to advance in my roles is when I had someone who promoted me in the places where I wasn't at the table. So that's also important to look for. And sometimes it's the same person, but sometimes those are different people. And it's important to look for those promoters as well.

Jen McConnell (10:25)
Yeah, I think there's a lot of opportunities for a lot of us as nurse practitioners to kind of be trailblazers because there's a lot of confusion about what we do. So that can be harmful to what we're trying to do, but also it can open a lot of doors for us. I really feel like that is something that we should take advantage of.

So Louis what do you remember about your first day as an NP and how did it shape your journey?

Louis Davis (10:46)
So I still remember that. It's been nearly 10 years and I remember it like it was yesterday. Really, I was the only NP in my role. as a nurse, you have long orientations when you're going into an area where you haven't had experience in clinical practice. So I built my own orientation with the APPs that were in the ER with physicians and then the one nurse practitioner we had in the hospital. But I definitely had butterflies. I was nervous that I was going to do something wrong and imposter syndrome. But my orientation lasted about five days and then I was on my own. I think it really just shaped who I am and I worked really independently in my role.

Rachel Hetzner (11:29)
I like I still struggle with imposter syndrome with so many different aspects of my life right now. If you could offer one piece of advice to yourself on that first day, what would it be?

Louis Davis (11:38)
I think it would be to not doubt my own abilities I knew that I was licensed and prepared to do the job that I was in. And I think that that was helpful.

Lisa Gulker (11:48)
Yeah, for me, what was important and what I would advise is, I think what's a gift for us is a unique way we've been educated. I think most clinicians are trained to look for evidence. think the scope of the kinds of evidence we look for as nurses is much broader than most professions. so trust that education that you've received.

Trust your ability to use those best practice resources that include the wisdom of your colleagues and wisdom you've gained as a bedside clinician in various roles. And no clinician in any practice specialty knows everything all at once. And I feel like nurses are uniquely positioned to be open to the feelings that they have of, don't know the answer, but because my primary responsibility is to my patient.

I'm going to do my very best to find the best answer for them as the human as opposed to what an evidence search necessarily would show. So we do that, but we also think about that human being and what might be best for them in each situation. So never forget how we were educated and that we learned to do that as part of our education. That'd be my advice.

Rachel Hetzner (13:03)
I think it's important to know your limitations, know what you don't know, but then alternatively know what you do know, you know, trust what you know and know your resources for the things that you don't. So I absolutely agree with you there. What have you learned about advocacy and professional leadership that took time and experience to understand?

Lisa Gulker (13:24)
Here's what I would say as an answer to that question. People from other industries, again, because so much of my experience is outside of direct clinical practice, have preconceived notions that are different than what we experience if we're a provider in a clinical setting about what nurses are, what we do, especially when you work in an international field like I do. And nursing across the globe is very different in different places.

And so advocacy for nursing for me means I'm approaching colleagues with a willingness to educate them about what nurses do, the roles that they play in healthcare broadly, and that they have things to offer in many different workplaces. And so that's been an important part of advocacy for me. And then we do have a unique brand of leadership qualities that

I don't necessarily see in my colleagues, but universally in nurses, some of the same things that I learned as a US educated nurse, I see in colleagues across the world, Saudi Arabia, Africa, the EU, et cetera. that is that we, and we actually, it's a sort of a fellowship that we have and embrace with each other, but that willingness to bring together different people and value their opinions and pull it together for the best possible outcome. That's sort of a unique quality I see in nurses broadly. and then make sure that that in a corporate setting really is part of your leadership brand. So that's been really important for me.

Jen McConnell (14:56)
So Lisa, tell me what does legacy mean to you at this stage in your career?

Lisa Gulker (15:01)
I was thinking about that. For me, I hope it means that there are more roles for nurses in settings like mine and work settings like mine. even though I'm the first chief nurse that Oracle or my company has had, I do not want to be the last. I've already started to look to be a promoter for somebody else and think about what that would mean.

It's important for me to prove, again, that unique value that nurses bring in a role like mine, in a company like mine. So I was thinking about this the other, actually, I got this data a couple of days ago. When I looked at all of our users who use our technologies, and I looked at the different practice disciplines, not surprisingly, nurses are by, about four or five times the largest number of users we have in our technology systems in multiple roles. And so knowing that, it's really important that we continue to propagate this role in these companies where we're designing and producing tools for nurses to use that our largest user group is represented at a high level in the company. So to me, that's what legacy means here.

Rachel Hetzner (16:07)
Ilana and Louis, what would you say your legacy is at this stage? What does it mean to you at this stage in your career?

Louis Davis (16:14)
I've watching for the last decade as states gain independent practice and allowing nurse practitioners to practice at the fullest extent of their education and training and every year hoping that it's happening here. I'm looking forward to the day when we are all able to treat and manage our patients at the height of our education and training.

And I think we need to ensure that all nurse practitioners get involved in health policy to ensure that happens.

Ilana San Souci (16:52)
I echo that sentiment. I want us to be seen as equal and competitive in the healthcare market. I get asked every day, well, what's the difference between you and a physician assistant or what's the difference between you and a registered nurse? And I think making nurse practitioners in terms of clinical practice leadership, I just think that it's very important that any role that we can play in and do play in. we have a chief nurse here, hospitalist, clinic provider. I think it's important that people are educated and aware of every role that we can play and that it's not just in healthcare, at the bedside.

Rachel Hetzner (17:32)
That's awesome. Everything that you guys said, I definitely agree with. How do you see the role of the NP evolving and how can NPs shape that evolution?

Louis Davis (17:45)
For me, I think it really is getting nurse practitioners, as I mentioned, involved in the legislative process and being at the table where health policy is made.

Ilana San Souci (17:56)
I agree with that. I think it's also important that we are a part of organizations that support and promote our practice like MICNP. So to be in your state's organization that does do that, as well as, like I said before, be on an equal playing field with other providers. Have that full practice authority. Let us work at the top of our license.

Lisa Gulker (18:16)
Yeah, from my perspective, again, supporting exactly what my colleagues are saying on the panel. Again, it's just having a voice in many different places and collaborating with the other practice disciplines to continue to make sure that they understand our unique role and why it's important.

Jen McConnell (18:38)
So in what ways can NPs step into leadership without, say, a formal title?

Louis Davis (18:45)
I think it really depends kind of what you're doing for work and what resources you have available to you and what access to other people in your same field. I'm lucky to be in the face of students, NP students, nursing students all the time in my role as a professor and as well as through my role as an academic practice partner coordinator, where I not only help students see the value in getting involved in their practice organizations, but also contributing to the scholarly output of our field to show that nurses are out there generating new evidence and ⁓ helping to disseminate it so that the rest of the world can see the value that we have.

Ilana San Souci (19:23)
I think offering to be a sounding board, a listening ear, a support system for new graduates. My experience is only in clinical practice right now, but even in our MICNP chapter, I give my card with my personal email and phone number to students just to say, hey, if you have any questions, if you need somebody to bounce ideas off of, if you want application for job advice, I'm here for you. Like no question is off limits. And as Lisa said, be a promoter for those people. Just have everyone's back and really be there for each other. And I think that's a good way to be in leadership.

Lisa Gulker (20:01)
Yeah, from my perspective, it's show up to every interaction with confidence and what you have to offer. then as we do, and again, this is what we just do by the nature of nursing practices, show up with the evidence with the receipts. So it's not unusual for me to be in a design session with engineers and product managers and they present a concept or the even the user experience teams will say, yeah, this is the way we think this workflow should go in the technology.

And I will say, I encourage you to go walk out into a few settings of care. And this is the way it happens, not the way you're envisioning it. So get off the whiteboard and go out and be with the end users. And you'll see that that's not the way that nurses generally work. And almost always, that's the truth. So again, we show up with that confidence and we know our expertise.

Rachel Hetzner (20:53)
Yeah, we have a lot to offer and knowing our worth and that our thoughts and perspective, it matters, it really does. What's one thing that you're working on now to grow as a leader?

Louis Davis (21:07)
For me, it's something that I think I've had to continue to work on my whole life. And I still have to make a conscious effort to be an active listener to the person that's talking to me, to actually stop and hear what they're saying, and sometimes even repeat it back to make sure that I'm hearing what the message that they're intending to convey. ensuring that that active listening is helping the person that you're working with feel that you value them and their time and what they have to say. And I feel like it just doesn't come naturally to do that. So we have to make an effort to do that.

Ilana San Souci (21:40)
I'm just really trying to step up and show up for the nurse practitioner community. I'm the president-elect for the Ann Arbor chapter, and I'll be stepping into that role in May. So really trying to advocate for the community and for nurse practitioners and for the full practice authority. And then at work, also just being visible and being a resource for people is very important to me because I did not have that. So I am working one-on-one with a new graduate and just supporting them, promoting them, and being there for them. And I think things like that are pushing me forward in my roles for leadership.

Lisa Gulker (22:17)
I'm still working on time management. It's a lifelong pursuit and priority setting. there are some times when, and I know there's a few of my colleagues listening that are going to laugh at this, which is I have to go back to my training as a critical care nurse and take care of the primary and secondary surveys first. Is there an airway? Things like that. And I do have to take some time to reset and make sure that I'm focusing on the right things. So that time management and priority setting is something I can continue to work on.

Jen McConnell (22:49)
I love it. think a lot of NPs are probably laughing right now going, time management, that's always a problem for us, whether it's getting to work on time, getting our charts done, all of that great stuff. So if you haven't already mentioned these, what's one leadership skill you believe every NP should master no matter where they are in their journey?

Louis Davis (23:10)
I think I wasn't ready for that one. You kind of just answered it. I think the active listening time management, I think we've kind of covered that. I think assess what you're deficient in and then make a conscious effort to improve that.

Ilana San Souci (23:24)
Know what resources are available to you and know how to use them appropriately. Like things like up-to-date open evidence. Just know what you have and be willing to learn and take feedback from patients, from co-workers and everybody else. You have the chance to learn and grow in your profession every day. And I think that that's one of the best things for us in our careers in any field. So just know what you have to work with and trust yourself also.

Lisa Gulker (23:53)
I already mentioned the time management and priority setting. the other thing that I would say is learning how to work with a team better is something that when I listened to our first speaker at our conference today about leadership, thought, gosh, there's still a lot. As long as I've been doing this, there's a lot for me to work on. I would say that skill set, it sort of holds up what my colleagues are saying, which is understand what your limitations are and be willing and open to know what those are and continue to try and work on them.

Rachel Hetzner (24:24)
You know, one of the reasons that I love these conferences is that we can all come together and realize that at all stages of our career, we often have the same concerns, the same questions and things about different topics. It's cool we can bounce ideas off of each other and really get the perspective of everyone in different stages of their career, where they're coming from. So everyone, it really has been an honor. Is there anything else that we've missed that you feel is important for nurse practitioners and our audience or listening to this podcast to know?

Louis Davis (25:00)
Yeah, I think maybe just going back to that feeling of imposter syndrome, though, for those of you who might be new in your role, know that you are the expert in the field when you walk into the room. Even if you're not the most seasoned person, you're ready to practice and that you have colleagues that surround you. We have, many nurse practitioners in Michigan. So there are always people willing to support you. You already took a big step by joining this organization. So use these people that are around you as your resource and building blocks to help you get to where you want to be.

Ilana San Souci (25:34)
I would say don't be afraid to take chances. I think that that's one of the biggest things that's helped me so far. I have some pretty once in a lifetime stories in my very short career. So if anyone has a minute and they want to hear some crazy stories like delivering a baby in an urgent care, come find me. But just trust your gut, like I said earlier. Know that you have the knowledge and the skill set to do your job. And don't be afraid to take those chances dig deep into figuring out things.

Lisa Gulker (26:02)
What I would say is there are no limits to what you can do as an NP. It's the kind of education you realize very quickly as you work with all different kinds of people that you've got a really truly unique education and way of thinking about the world. Don't hesitate to push the boundaries about the roles outside the roles we traditionally take. And that wisdom that you've gained as an NP can really be brought to the world in new and exciting ways. there are really no limitations to what we can do as nurses in the world is what I would say.

Jen McConnell (26:35)
I love this. I think this is great. So I'd like to thank our guests for being here. We're doing amazing. And I'd also like to thank our audience who cannot be heard for good reason. I'm on the other side of this watching us tape this live. like we say, all good things must come to an end. So that's a wrap. Stay tuned for more engaging topics and educational opportunities, whether you're a student, a seasoned NP, or a health care leader.

We're here to keep you informed, inspired, and connected. So tune in as we amplify the voice of nurse practitioners and work together to shape the future of healthcare. Subscribe now and stay tuned for expert conversations, legislative updates, and the latest in NP practice in Michigan. We can't wait for our next podcast, so you better tune in. It's coming soon. See you next time.


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Justin Hooks

Co-host
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Rachel Hetzner

Co-host
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Jen McConnell

Producer