This is part of a monthly series about side gigs—nurses with interesting side jobs or hobbies. This month, we spotlightJax Nurses Buy Houses (JNBH).
More than 10 years ago, when they were still in nursing school, Chris McDermott, MSN, APRN, AGNP-C and Joshua Rodenborn, BSN, were discussing the idea of starting Jax Nurses Buy Houses (JNBH). They founded the company in 2019 with friend Sunny Kapadia, as a way to build a portfolio of rentals for retirement as well as a chance for them to give back to their community. As life-long natives of Jacksonville and seeing multiple areas for improvement there, they made it their social mission to donate a portion of our proceeds to medical care and research.
McDermott works full-time in private practice in Jacksonville Beach, Florida. Kapadia, although not a nurse, is a specialist in the health care field, coordinating physician groups within the greater Jacksonville area. Finally, Joshua Rodenborn is an Intensive Care and Post-Anesthesia nurse in a major hospital in Jacksonville, Florida as well as a managing member of Jax Nurses Buy Houses.
McDermott and Rodenborn told us all about their business.
Explain what Jax Nurses Buy Houses is—what do you do?
JNBH acquires residential properties through traditional or distressed sale. Often, we help sellers who perhaps inherited a property or just want to sell fast to someone reputable and honest. Distressed sales include properties we acquire at foreclosure or tax deed auctions. We will analyze a property and determine if it is a good fit for our rental portfolio, renovate and retail, or wholesale. Do you personally rehab houses or do you subcontract out?
When first starting out, it was “all hands on deck.” As we have continued to scale our operations, we have subcontracted work to skilled contractors. DIY sounds romantic and lets you keep more profit; however, it is near-impossible to scale up a business this way. And your results may not be a professional-level quality. We learned early on that building a team is the key to success (and much less stress).
What do you like most about your business?
It is rewarding to take a home that is the biggest eyesore in a neighborhood and bring it back to life, turning it into affordable housing. It’s one thing to talk about transforming a neighborhood; it is a whole other thing to literally do it yourself through your own will from start to finish.
There is a double pay-off: the satisfaction of being your own boss in a well-run business and the satisfaction of improving a piece of this city, one brick at a time.
What would readers be surprised to know about your side gig?
Joshua, while working as a nurse, actually cared for the wife of a rental applicant months before he applied. It’s surprising how small the world is sometimes.
What have been some of your most challenging experiences with your side gig?
There is a saying, you can have a job good, fast, or cheap, but you can only pick two. For example: If you want a job done good and fast it won’t be cheap. Another example, if you want a job done cheap and fast it won’t be good.
Challenging experiences include dealing with and selecting contractors, while staying on schedule. We’ve had contractors not show or even do something incorrectly—once damaging our air conditioner in our newly renovated home.
Spend your time vetting and getting to know your contractors and vendors of materials.
What have been some of your best experiences/greatest rewards with your side gig?
The relationship the founding members have built with each other is one of the most unexpected and rewarding things that have come. Early morning breakfast—where we divvy up the tasks and plan our next move—have become a welcome staple in our COVID-restricted social world.
Another experience: We were able to help a prospective tenant move from a crime-ridden area (shooting occurred outside/bullets struck her headboard) into a newly renovated home in a matter of days.
What have you learned from having this business?
Formulate a plan and have multiple exit options. It may sound trite, but not having a plan is a plan to fail. With all of us working full-time jobs and having full-time families, it has been imperative that we all stay on the same page through the acquisition, renovation, and disposition process. We each rely on one another to complete our roles through each step of the process.
Jumping into real estate is like a very complex ICU patient with multiple variables that are interdependent on each other. If you are starting down this journey (“I wanna be a real estate investor!”) you need to build a team to be successful. Think of needing to call a consult at midnight, and you know they will respond. Now think of this as plumber for a pipe that just burst. Additionally, you need to be organized and know your cost and expenses for each project.
Is there anything else that is important for our readers to know?
Stay positive and remain adaptable to your conditions. With COVID-19, we have suffered delays with acquisitions of new properties and our local county courts. There will always be a hiccup along the way, and you never know what’s going to happen. Don’t take it too personally, never kick yourself when you’re down, and get back up and keep trying. You have to feel success in your bones.
While COVID-19 continues to infect people throughout the United States, stress levels seem to be increasing as well, especially for minorities. Unfortunately, people of color (POC) don’t often get the mental health care that they need.
Aiyana Ma’at, MSW, LICSW is CEO and founder of Perspective, an online counseling platform prioritizing the mental health needs of the Black community. She took time to answer some questions for us about minorities and mental health.
You’ve stated that Black adults experience 20% more psychological stress than whites. Why is this? Why has anxiety and depression been so much higher in the Black community?
To be a Black person in America means that on some level you are dealing with trauma, discrimination, or trials of some kind just because you exist. Black people need a safe space to release this pressure and buildup of pain in our hearts and minds. Historically, African Americans have dealt with a tremendous number of disparities in areas such as mental health care access, health care and treatment, socio-economic status, and conscious and unconscious provider bias, just to name a few. African Americans have not always trusted many of the health care systems that are here to serve. These realities easily make a Black person more susceptible to mental health issues such as anxiety and depression.
What are the most important things that minority nurses can do right now to help protect their own mental health?
It’s important for POC health care professionals to make sure that they are making time for self-care and setting boundaries personally and professionally around how they show up to support patients and colleagues and how they are expected to show up. Health care providers especially cannot give from an empty cup so they must make sure that they nourish and fill themselves up every single day. Self-care is a must.
Why did you start Perspective? What do you hope it will accomplish?
I started Perspective for a few reasons, but the first comes out of personal experience. I struggled during my childhood and struggled even more during adolescence. I experienced intense loneliness as a child and have dealt with deep issues of abandonment and rejection much of my life. My saving grace came when my mom started me in therapy as a teenager. It was literally life changing for me.
I want other people—particularly Black people and people of color—to have access to being seen, heard, and healed too. Our community can often get stuck in thinking that getting support means we’re weak; we don’t have enough faith or that something is wrong with us. We also have to deal with potential conscious or unconscious bias from non-POC therapists and potential disconnects in professionals not really understanding the context in which we come—our realities, our way of thinking, our unique experiences. There are so many barriers that can get in the way of our getting help before we even get started and this motivates and moves me deeply to do my part in dismantling these barriers.
Explain what Perspective is, how it works, what it offers, and when it will launch.
Culturally Competent Counseling for the African-American Community. It’s 100% Online in all 50 States.
Perspective is the only destination of its kind online whose mission is to prioritize the African American community by providing culturally competent professional counseling via text, audio, or video, anytime from anywhere.
It’s convenient and affordable. Unlimited counseling is available at a significantly reduced cost as compared with in-person therapy. Accessibility will be from any device—computer, laptop, tablet, or smartphone, with bank-level secure encryption, via text, live chat and video sessions. We launch in Summer 2020.
Getting started entails a pretty simple process. Each person needs to answer some questions so we can learn more about the prospective client’s needs, preferences, and what they’re looking for. They will get matched with a culturally competent therapist who is selected specifically for their professional background and life experience to ensure they are a good fit.
What can Black nurses expect to get from Perspective that they couldn’t get from any other type of therapy?
Culturally competent counseling. Cultural competence includes a therapist’s ability to recognize and understand the role culture (both the client’s and therapist’s) plays in a client’s ability to feel genuinely understood, supported, and helped. When a therapist is culturally competent, it increases the well-being and outcomes for the client being served.
Is there any other information that I haven’t asked you about that is important for our readers to know?
If readers themselves or others they know are interested in learning more about our services they can go to www.therapyforblackfolks.org. They can also complete this brief 5 question survey if they (or someone they know) are interested in having someone follow up with them about exploring therapy: https://forms.gle/96csQ1rV9ctN8W2x5
As COVID-19 continues to sweep through the nation, researchers are realizing what groups of people are especially affected by it and are more susceptible to it, such as dialysis patients.
Maya N. Clark-Cutaia, PhD, ACNP-BC, RN, Assistant Professor of Nursing and Medicine at the NYU Meyers College of Nursing, spoke to us about the patients she works with in her research studies to shine a light on exactly what is happening to certain marginalized populations.
The dialysis patients whom you care for/track, are they at high risk for getting COVID-19? Please explain.
The majority of the patients I work with on my research studies are African American, aged 50-60 years, disabled, living off of federal subsidies, with low health literacy and educational attainment. They tend to live in crowded, multi-generational homes, in neighborhoods that are under-resourced. This population of patients is at increased risk for COVID-19 because of the disproportionate incidence of the underlying conditions most associated with COVID-19: heart disease, diabetes, kidney disease, and lung conditions, such as asthma.
According to Medicare COVID-19 data, hypertension and diabetes are the first and fifth most common comorbid conditions for COVID-19 and the top causes for chronic kidney disease (CKD). CKD is the third most common comorbid condition, among Medicare recipients, with COVID-19.
They are also at increased risk because of their way of life. My patients or their family members are essential workers. They are the bus drivers, security guards, grocery clerks, and sanitation workers that keep our cities running. They often have to go to work to be paid and thus are at great risk for exposure. Living conditions are ripe for spread of disease and little, if any, was invested in these communities in regards to prevention, testing, and contact tracing.
What are the greatest needs of people with kidney disease who require dialysis?
TRANSPLANTS! While it remains true that the majority of transplants are cadaveric, 40% of transplants result from living donors. Similarly, conversations with your patients about palliative care and transplantation are vital. Ask your patients about what they know about transplants. Are they on the transplant list (why or why not)? How long do they expect to live on dialysis? Do they have a living will and advanced directives? The fact of the matter is that these patients are critically ill and their multimorbidity makes them highly complex. They need to understand their prognosis and have a say in how they live and how they die.
What are their socioeconomic challenges? What about getting the right foods to eat? Transportation to dialysis, etc.? Please explain.
Many of our patients are supported by federal subsidies. Due to the complexity of their disease and treatment regimens, many are unemployed. Treatments last 3-4 hours, three times a week, and that does not include transportation time, and getting on and off of the dialysis machine.
Patients often describe choosing between purchasing meals, paying for prescriptions, and transportation to and from dialysis sessions.
Basic necessities are often hard to come by, and the current federal programs, while they provide support, it does not mean that the support is ideal. For example, gas stations and convenience stores accept SNAP, and while this translates into food accessibility, they are not healthful food options. True groceries are limited in the neighborhoods my patients live in or require transportation to and from.
Patients often do not feel well enough on their days “off” or non-dialysis days to meal prep and typically do not have the resources to do so. The inability to maintain dietary and fluid restrictions result in patients often not feeling well, having unpleasant dialysis sessions, and can lead patients to skip sessions on account that they do not feel well enough to complete them, or dread the symptoms they will experience as a result of their need for increased filtration related to “non-adherence.” It becomes a viscous cycle that often results in hospitalization.
What can nurses do to help make sure that these patients have what they require—both to stay healthy while keeping their risk for COVID-19 down.
We all need to recognize that wearing masks and other COVID-19 precautions are not about us as individuals, but as a community. We are protecting our seniors, the immunocompromised, and those with underlying conditions, like my dialysis patients.
Educate yourselves, your friends, your family, your neighbors. If you have not been directly impacted by COVID, you will be. Stay informed about the risks to the general patient population and advocate for them. I am reminded of a news bit of a part of our administration touring a dialysis center without a mask or other personal protective equipment. It was unacceptable then, and it is unacceptable now.
No one spends as much time with patients as we do. No one is going into COVID and ICU rooms more than we do. And while I hate to make any of this political…it is. We need to not only advocate for our patients in the hospital, we also need to advocate for them in society. Advocacy groups are not for everyone, but every single vote counts, and we need to make informed decisions as medical professionals about the type of care we want to deliver to our patients and who is going to advocate for them. Vote. Vote often. Vote informed.
How else can nurses support these patients? Is there anything that they should not do?
Most nurses are well informed regarding standard precautions and contact precautions. Dialysis nurses in particular, have been donning and doffing PPE long before COVID. Those of us who do not know this patient population well need to ensure that we take the time to look up hospital policies and abide by them.
Anything else about COVID-19 and dialysis patients?
It is not over. In fact, it is far from over. COVID-19 is surging in states all over the country and as states continue to open, we need to remain vigilant and adhere to COVID precautions. Wear your masks, wash your hands, and limit exposures. Protect yourselves and protect those not capable of protecting themselves. Remain up-to-date with your local statistics and protocols. It will inform the care you provide.
I would also like each of you to know just how proud I am to call you colleagues. We have been redeployed to areas foreign to us. We have worked with limited PPE and limited information. We have traveled across country to work because we felt compelled to do so. We have left our families and cried in our coffee. We have hurt and felt a sense of guilt because we cannot contribute the way we would like to, but the constant is that we show up. We show up, and we have shown up big. Our profession is powerful and invaluable, and my chest swells with pride each passing day.
This is part of a monthly series about side gigs—nurses with interesting side jobs or hobbies. This month, we spotlight a photographer.
By day, Shannon Lynn Boxter, RN, works as a travel nurse at Duke University Medical Center, in the COVID ICU and at the University of North Carolina in their Cardiothoracic ICU. But in her spare time, she captures beautiful images of clients through her side gig—a photography business.
Boxter got started with photography when she was in nursing school and needing a creative outlet. Armed with a small digital camera, she began experimenting on shooting at different angles. “I guess the bug bit me then,” she admits.
At the time, she offered tons of free shoots. When she graduated from nursing school, she purchased her first semi-professional DSLR camera.
Her photography business, Shannon Lynn Photography, was started as a passion project. “I wanted to document my friends and family. However, I was so intrigued with how other photographers captured beautiful images that I wanted to know more,” says Boxter. “I taught myself everything I could about lighting and shooting. I offered my services for free and was a second shooter for photographer friends. I learned so much! Most of all, I have been perfecting my style and who I want to be as a photographer for the last six years.”
As for the type of photography she does, Boxter says she identifies most with photographing families and couples. “Anything that has a promise of an adventure is something I’m interested in documenting. I think the process of finding your style is very complex and directly tied to who you are as an individual,” she explains.
While she’s mostly self-taught, Boxter enjoys learning and continuing her photography education. She says that she still gets excited at each shoot because she knows that she’ll be providing her clients with lasting memories.
“It renews my faith to see a baby being born or a couple so in love during an engagement shoot,” she says. And even a young family member seems to be following in her footsteps. “My little boy, who’s almost four, has developed an interest in taking pictures and he now has his own little digital camera. It’s adorable to watch his eyes light up when he captures something new.”
“I love the creative freedom photography allows. I feel free when it’s just me and my camera. I find it a challenge to capture the in-between moments and identify as a lifestyle photographer; I give prompts and let the moment be what it is,” says Boxter.
There’s another reason that Boxter loves photography. She also fosters dogs through Cause for Paws. “A good photo of a rescue dog is so important for future adopters to see,” she says. “I really enjoy being able to use my photography to help these dogs find forever homes.”
Social media can be a fantastic way of keeping in touch or sharing information, but it can also be a hotbed of controversy. Elizabeth Hanes, an RN who now works as a journalist, unexpectedly experienced this herself, when Dr. Sandra Lee, also known as “Dr. Pimple Popper,” recently commented on a story Hanes had written.
Hanes took the time to talk with us about her experience.
Exactly what happened? Please explain.
On Saturday, June 20 (I believe), Dr. Lee tweeted a link to my WebMD article (from the WebMD Twitter account). The social media people at WebMD had written social sharing text that said, “What’s the difference between sunburn and sun poisoning? A registered nurse explains.” Above this, Dr. Lee wrote, “Why would a registered nurse explain this? Why not a dermatologist?” and included an eyeroll emoji.
The nurses of Twitter did not respond well to that. The thread had, I believe, thousands of comments. I never saw the original post; I only saw the “apology” post, which also has been deleted.
Were you surprised at what Dr. Lee, aka Dr. Pimple Popper, posted? Why or why not?
I was taken a bit aback. My first thought was, “Why wouldn’t a registered nurse explain this?” This is well within the scope of what nurses do on a daily basis. My second reaction was pure amusement. I guess I will have to say I thought it sounded petty.
Many nurses responded—some were angry and even called for the cancellation of her show. Do you think that a lot of health care professionals don’t understand the nurse’s scope of practice? What about people who don’t work in health care?
I think there were two issues here. First, that many people don’t understand nurses’ scope of practice. Second, that people don’t understand how journalism works. It feels strange to have to write out that a nurse’s scope of practice includes patient education. Our entire profession is built, in fact, on the foundation of teaching patients about their bodies, about wellness, about disease, etc. To me, patient education is the essence of nursing practice. So for someone to sort of call that into question felt baffling.
But people also seemed very unclear on how journalism works. They seemed to believe that only subject matter experts should be reporters. But journalists aren’t required to be subject matter experts, themselves, because journalists know how to conduct research to find the facts they need to write a story. Sometimes that research involves interviewing subject matter experts—like a dermatologist. In this case, the process did not include interviews. That’s just how it goes in journalism.
Do all nurses educate their patients as a part of their routine care?
Yes, absolutely. All nurses engage in patient education on a daily basis. Or family education. In fact, nurses are the health educators of the world. That’s not to say physicians don’t also educate. Of course they do. But physicians often provide patient education at a high, over-arching level. For instance, an oncologist may explain to a patient what chemotherapy does, but the oncology nurse will be the one educating the patient and his or her family members about the effects of chemotherapy, how to cope with those effects, how to set up the home environment to best care for a person receiving chemotherapy—and on and on. Doctors don’t do that. Nurses do.
Why do you think it’s important for the masses to understand that nurses are fully qualified to provide health education?
I think most people turn to nurses first for health education on an interpersonal level. They do this without even thinking about it because nursing is the most trusted profession. My experience has been that people, in general, highly value nurses and their knowledge.
I think there’s a bit of a disconnect when it comes to media and reporting. For instance, during the kerfuffle with Dr. Lee, some people on social media directly questioned my background and credentials—was I really qualified to write this article. When members of the public do this, it does not offend me. In fact, I wish more people would engage in this sort of critical questioning of stories in the media. When they see a celebrity offering an opinion on some topic—let’s say it’s how COVID-19 spreads—I wish more people would ask themselves, “But what do actual epidemiologists say?”
It’s a different story when a doctor or fellow nurse or another health care professional questions my credentials—and in public, no less. These people should know that patient education of all kinds—including articles on WebMD—falls well within the scope of nursing practice. It’s disrespectful to question that or to imply that it does not.
What can nurses do to get the word out about this? Or does it need to come from higher up, like health care and/or nursing organizations? Or both?
I would like to see two things happen:
I would like to see more journalists requesting nurses as sources for their health reporting.
I would like to see more nurses become health reporters.
To the first point, I wish that more health journalists would understand that nurses play a different role in patient care than doctors do, and that their stories would be much enriched if they included the nursing perspective along with the physician’s.
Imagine a news story about a new cancer treatment that not only includes quotes from the researcher about the chemistry involved and quotes from a physician about how this treatment will provide more options for patients—but also includes quotes from an oncology nurse about how this treatment might affect a patient on an everyday level, when they’re at home after receiving it. Currently, we typically get the first story: the one that only includes quotes from the researcher and physician. But the second story gives a much deeper perspective that would benefit readers. For this type of reporting to happen, health system media relations people need to cultivate and support nurses as sources for the press and then suggest and offer those nurses as sources when appropriate.
To the second point, as a nurse reporter myself, I’ve adopted a mission through my RN2writer project “to transform health care communications by making nurse-created content the industry standard for excellence.” Toward that end, I train other nurses in basic journalism skills to start them on a path toward a reporting career. You know, there’s a lot of inaccurate health information on the web. I think one way to combat that is by having nurses produce more health content. I think, subsequently, that publishing more nurse-created health content will reinforce the understanding that patient education is the essence of what we do as nurses.