DNP Ep. 79: Creating a Big ‘Why’ Before Starting Your Side Hustle with Melissa Pauline MSN, AGACNP-BC, AGPCNP-C

Dr. Sandra Pagenta: Dr. Nurse Podcast fam. Welcome to another episode of The Doctor Nurse Podcast. Today on the podcast we have Melissa Pauline. She graduated from nursing school with her associate’s degree in 2003. She worked in emergency medicine for 10 years before going back to get her B S N, which that just goes to show you you don’t need to B s N to get working as a nurse.

And then she went back, finished your B S N in 2013. And then she got her first master’s

degree in adult geriatric primary care. And then she went back in 2017 and got her acute care post-masters. So she is working as a I C U intensivist or an I C U nurse practitioner. And then on the side, she has her own Rejuvenate You Wellness Clinic where she’s doing IV hydration drains, weight loss aesthetics.

She works part-time at that and she works full-time, I don’t know how, as an I C U N P. Welcome,

Melissa Pauline: Melissa to the podcast. Hey Sandra. Thank you for having me.

Dr. Sandra Pagenta: I am so glad to chat with you. And again, we were talking before the podcast. She is just, she’s crushing it. She’s literally just moving from space to space.

She’s got goals, she’s got vision, and she’s knocking them down. So I can’t wait to hear. So Melissa, tell me a little bit about how you kind of see your role. I’ve briefly introduced you kind of what you’re doing, but really explain what you’re doing in the ICU U setting and then what you’re doing in your, in your side hustle business.

Okay.

Melissa Pauline: So in the ICU U setting, I am considered ICU nurse practitioner or ICU U intensivist. And what we do is we a group of us as nurse Practi. We run a 10 bed medical icu unit. So that means we go from emitting the patients to providing some. As far as putting in lines, so arterial lines, central lines, intubation, chest tube, lumbar puncture, you name it, we do it.

And we also with multidisciplinary rounds, we also manage the patients. Putting in, ordering medications, figuring out what course we want to take when it comes to antibiotic. Figuring out the social aspects of our clients cuz we, cuz I do work in a level one trauma center in an urban area, so we have a lot of social issues in regards to our patient population.

So we do a lot of that with the help of our attending. We switch out attendings once a week, but pretty much we run the icu. Wow. Wow. So I’ve

Dr. Sandra Pagenta: had one other acute care nurse practitioner on, and that’s pretty much what she said, because the residents cycle through, the attendings cycle through, but the NPS are there Monday through Friday and they know what’s going on.

And so the docs really rely on them heavily to carry the unit and let the, you know, kind of let the boss know what’s going on. Tell me what I need to do, tell me how to. Problem solve, think through things. But you guys are the ones running, running the show, right? Is that, is that kind of

Melissa Pauline: what you’re describing?

Yes, we’re a constant on the unit. I would say that we’re like an island of our own. So we’re not registered nurses, which means we’re not following orders, but we’re also not physicians. So, you know, we’re not an MD so we’re like on a little nurse practitioner island on our own. So it’s really hard when it comes to celebrating us.

Right. So do we fit into nurses week, but we’re not. Do we fit into Dr. Day? We’re not physicians. So it’s kind of like, you know, we’re, we’re kind of like the, in between, between the two, the two islands we are what links we link the nursing bedside aspect and the MD aspect to it. Cuz you know, in order for us to be nurse practitioners, we have to be bedside nurses to begin with so we can, we can get acclimated and know what roles need to be play.

Yeah.

Dr. Sandra Pagenta: What I like too is I’m kind of seeing this word picture. You guys are like a bridge, right? And unfortunately, the bridge never gets recognized. You just walk across the bridge, right? And so the people on the one side are just like the people on their side are like and you’re like, listen, you guys can’t talk and get things done if it wasn’t for us.

Unfortunately, I agree. There isn’t a great way to celebrate nurse practitioners and what we do in the different areas that we work in. So definitely can understand the, the, the. Disappointment. That can be for sure. So tell me a little bit about your side hustle as well, because again, in the middle of rocking the I C U and keeping patients alive in the acute care setting, doing incredible procedures that again, nurse practitioners can do with appropriate scope.

Tell me a little bit about what you decided

Melissa Pauline: to build on the side. So, because I am double board certified so I can be in the office versus also be in the. I decided to open up Virginia U Wellness Clinic. This was in May of 2020, so right in the heart of Covid. We realized that, you know, we need right of the hospital because there’s actually no room for them.

So what other way to help them is through a wellness clinic. So we provide IV vitamin. So highs vitamin C Myers cocktail weight loss drips athletic performance drips. So it’s just a way of keeping clients hydrated without actually having to go to the emergency room. We also do like aesthetics, so we do zm n for the fine line wrinkles.

We do lip fillers. And then on the post-op side, Do like seroma drainages for clients that have had hypo suction and have like the fluid collection and can’t get that massaged out. We remove drains for clients that are coming from out of the country that have like tummy tucks and stuff, and they come back with the drain.

Normally you can’t just go to an urgent care or your doctor’s office to get those taken out because, you know, if they don’t put it, they don’t want to take it out. And then to the removal. So I do a little bit of a lot of things. Clinic so that I can be able to help keep my client out of the hospital.

Dr. Sandra Pagenta: Yeah. So tell me a bit, a little bit about your time split between the two for someone that’s like, okay, wait, how is she managing all this in, in the day? How do you kind of work out your schedule so you can keep up with

Melissa Pauline: both of these? Well, in my, in my office right now we, I did have a medical assistant working with me who just recently quit.

So right now I’ve juggled the two, so I do 36 hours. The icu, I’m also the team lead, so I’m in charge over there. So I do three days. So I normally do like Sunday, Monday, another day during the week. And then in my office, I’m normally here two or three days a week, but it’s by appointment only. I can’t just like walk in and think somebody.

Here. So it’s just everything is by appointment only. And I try to kind of gauge it where I kind of front load everybody. So like I’ll have like my busy two days, Tuesdays and Thursdays, where I put everybody in that, on the, on the schedule for those two days. And then that way, you know, I still have, I’m a wife, I’m a mom of two.

Like I still have, you know, my responsibilities at home. So I still have to give ’em at least a day if

Yeah,

Dr. Sandra Pagenta: exactly. That’s crazy. So how did you, so we know that you learned all your skills for your I C U work through EX working as an rn, but then also going back for your, your master’s degree. Now these other things that you’re doing at your clinic, at your personal, you know, part-time job.

How did you learn these skills? Like is this something that you went to school for, you took a course,

Melissa Pauline: like how’d you learn? Well, you take courses. So my best friend, she also does what I do, but she’s like an hour. Away from where I’m located. So she started doing it first and then we took courses and learned how to do it.

I was very interested in the IV vitamin therapy because June of 2020, I had weight loss surgery. I had the gas. We’ve done, and you know that when you have that done, like you don’t process and digest your foods and your vitamins. I’m supposed to take, you know, calcium and magnesium and all that every day, but I realized when I took the class that I just can do a drink once a month, and it’s the same amount of vitamins and fluids that I can get every single day versus taking every single day.

I do an IV every month to keep my vitamin levels. So we just take classes. You can take any type of course as long as you’re, depending on your the state that you’re in. Some states are completely independent. In the state of Georgia, we’re not independent. So I have a collaborate in MD that I, that I work, I don’t work alongside, but he checks my charts every quarter to make sure that I’m doing everything that I need to do.

Yeah.

Dr. Sandra Pagenta: So interesting. As you were, as you were talking about, you know, learning about the different courses, taking the different things, and then doing it, what was the turnaround time between learning and then starting to implement these things in your own practice? How long did you give yourself?

Melissa Pauline: I would say I started taking the course maybe March.

So March of 2020, I took a, I took the IV vi, it’s called IV Therapy Academy. I took their online course and it was like a self-paid type of course. And after everything that I needed to learn how to open up the business, how to do everything, and then I registered the business name May of 2020, and then I opened up the door September, 2020.

Dr. Sandra Pagenta: Okay. So that wasn’t long at all, like six months from taking the course to starting opening your house?

Melissa Pauline: Pretty much, yeah. Yeah, if you’re, if you’re passionate about something and you really wanna get it done, like there should be no barriers. Just be able to see. Yeah.

Dr. Sandra Pagenta: Yeah. One of the things too, I love about what you’re describing and how you kind of got started with the idea.

Is you solved your own problem. Do you know what I’m saying? So like a lot of entrepreneurs come on here and they’re like, I noticed that this wasn’t being solved. And so I just went and solved it. And so you had to kind of assess where to put your business, how, what would be the great location, what would be the structure of it?

And one you just get started, you’ll figure it out as you go, but how did you kind of assess where to put the business when you were looking for a spot for someone that’s like, okay, maybe I could do. Where, where do I even start with a business? Where do I even put it? So, I

Melissa Pauline: mean, the right answer to that question is market research.

Right? But as a nurse, we, they don’t teach us any of that stuff. They don’t, they, what I learned as a nurse when I graduate in 2003 was you need to start in med search and you need to turn your patient every two hours and. Right. They don’t teach you about being business minded. They don’t, they don’t let you know that you can be an entrepreneur and, you know, these are the things that you can do to make that happen.

So I just kind of had to figure it out myself. Of course, you know, it wasn’t losses, it was lessons learned throughout this process, but I just know my area. I know what area. I know what kind of business I have, so I have a cash based business, right? So they don’t take insurance. So I, where do I need to settle myself?

I need to be in a place where I know that their, like the household income is at a certain price point, because then I know that, you know, this is not a, some people would say it’s a necessity, but it’s really not a necessity. Preventative care is something that you wanna do, so it has to be with people that have disposable income to be able to pay for this type of treatment out of pocket.

Yeah. Yeah,

Dr. Sandra Pagenta: for exactly. So again, ma kind of looking. The area around where you’re thinking about putting your business is a great way to start because it allows you to kind of go like, I’m gonna be able to, to make money here. People have that disposable income, and I’ll be able to, to.

Have the clientele to meet when I’m, when I’m servicing and what I’m offering. So tell me, what was one aspect of starting a business that was challenging because of your background as a nurse? Kind of like what you said. I just, I, they don’t teach us the stuff in school. And then one thing that you’re like, this is easy because I was a nurse and this is an easy part

Melissa Pauline: of owning a business.

Let me see. The hardest part is all of it. All of it, because first we’re we, you know, you apply, they hire you, they give you all the paperwork, osha, hipaa, privacy, you do all of it. You sign for days, you do the classes, right? You don’t care if the electricity is paid or not. Like it’s a hospital, so it’s gonna, every time it flick the light, it’s gonna turn on.

Right? So all of it was really I just had to like really do my research and really learn the ins and out of the business. I mean, I’m sure three years, there’s still things that I need, I’m still working on that I need to like, perfect. But I think a lot of it was hard. The one thing, the, when you asked me like what was not hard,

client relations, customer service. Right. Taking care people. Yeah, taking care of people is like second. I’ve been doing it for so long that that’s not the problem. Marketing network, I mean, not marketing, but networking and talking to clients and telling ’em about your business. That is not hard. That’s the easy part.

Thanks for listening to the episode. I hope you’re enjoying the conversation. I wanted to take this time and remind you to check out the success. NP Etsy shop. It’s a shop that I design with my best girlfriend, cute nurse practitioner gear hats. Bags, anything you could think of as well as adorable digital products.

Mom life stuff. So resources for nurses to come. We’re just excited about our shop. It’s another way to support the podcast and to get really cool gear. Check it out and be sure to tell your friends about the podcast as well as the se shop if you’d like and what i’m building here, any promotion any sharing helps build my audience and i greatly appreciate it now let’s get back to the episode

Melissa Pauline: Running the business marketing is not as easy as people make it seem. Just like the financial back office, a lot of that stuff is just, it’s just a lot. But you learn as you go. Yeah. Yeah. And

Dr. Sandra Pagenta: with hiring your ma, I know you said you lost your ma. Are you looking to hire or have you been thinking of ways of making this more passive so that you can kind of step away from the business and let the business kind of run itself?

Let that be a passive source of income, which again, Nothing’s ever really passive. That’s one thing that I’ve been noticing as well through different conversations is that, yes, money might be coming in, but you have to manage it. Anything that doesn’t get managed, you can’t measure. You can’t determine is it growing.

You have to measure and you have to manage passive income, period. But is there an attempt that you’re trying to make to keep, to make this business more

Melissa Pauline: fast? The attempt is What I’ve learned is that people are like fickle. They’ll start off and you’ll hire them, teach ’em everything, and they’re like, ah, this is not my thing.

So I’ve dealt with that. So what I’ve learned is to ta kind of take a step back reassess and reevaluate and see really where I’m trying to go and where I’m trying to go is to have to be, to manage the back office and not let’s necessarily be in the front office all the. So I’m, I will be looking to hire like an to be able to do the things that I can do and then I could be in the back office and just manage it that way.

Dr. Sandra Pagenta: Yeah. Yeah, that’s a really good thought. Cuz if you can get someone to do a certain amount of it, even if you offload a portion of it, certain amount of visits that are ongoing, you’ve got visits in between that you can then get in the back, do that work, come out, do a patient, she’s done two or three, you’re gonna be making more money.

And you are not doing all the work necessarily by yourself, of course, offsetting her salary. But the more productive she is, the more money she makes. I mean, make that an incentive if you, you, if you hire someone. So yeah, that’s really, really good. So for an inspire, like an aspiring entrepreneur that’s like, I really wanna, I really wanna get into this.

What is something that you would tell her that she needs to do to get started? Him or her? You need to do this, and if you wanna get started with a business idea.

Melissa Pauline: I think what I would tell her would be just to figure out what your goals are in life. Because I’m like, if you’re, if you can, anybody can take a class, anybody can take a course, you can teach anybody anything.

Right. But like, they, like the good olds saying, said, you can take, you can take a horse to water, but you can’t make ’em drink it. And that’s what I’ve learned. Everybody, you know, they’ll get on social media, oh, this looks so cool and I wanna do this and I wanna do that, and then it course it, but don’t execute.

But what I would tell people to do is like, if you’re gonna put your money out there, put your money where your mouth is. If you’re gonna put your money out there and take a course, then you need to at least execute because you can never say that you never accomplished anything without trying. You have to try, you know, this is not a hard bill to get into.

IV vitamin therapy won’t make you like a millionaire, but you just have to know in your surrounding area what you can add onto that. To build and expand. So like for me, in my area, I started with IV vitamin therapy and then quickly realized that my area, they have fine line and wrinkles and they like fillers and Xeomin and Botox and all that.

So then I add, I took a class and I added that to the business to start scaling. And then, you know,

To be able to kinda get revenue. So you just have to know what is in your area to be able to scale and build.

Dr. Sandra Pagenta: Yeah. So that’s kind of going back to that market research and just kind of listening to what the clients need when they come in. Right. And they’ll start to tell you like, Hey, do you do this?

And you’re like, no, but I could. Right. Why, why not? Right? Like, so that again, is something that. You know, as I’ve been building my Etsy business and we’ve been kind of creating content, digital content shirts, things like that, I’ve been pushing more towards like, I need to ask people what they need, what they want, like what is it that you guys want?

What is it that you need so that I can then fill those gaps. Because if you, again, get in that mindset of I’m here as a gap. Like to fill gaps to create solutions, then those solutions can end up turning into profitable side hustles, businesses, business ideas and things that you can end up scaling, which is really, really great.

And so working in the I C u, doing the part-time side hustle business what would you, what would you be, what would be one thing you would tell your younger self if you could go back and tell, you know, Melissa, hey, you’re starting off your career. This is something that you need. To remember at the start of your career and carry it throughout your, the rest of your career,

Melissa Pauline: anything is possible.

Anything you put your mind to is possible. Had I known in 2003 that there’s a possibility that I can leverage my nursing license to open up my own business, I would’ve done it a long time ago. I think you get as a nurse, especially a young nurse, you get caught up. You get caught up with the income and you don’t realize that you need to leverage the income in order to do bigger things.

Because I mean, I was young, I was 20 years old, I had just turned 20 when I became a registered nurse. So I was just like, I was all about working in the er, making some money and going on vacation. That’s what I really, and you see, it took me 10 years just to get my bachelor’s. And the reason why I got my bachelor, cuz I was getting passed up on.

Opportunities in because of the fact that I didn’t have my bachelor’s. So that’s really why I went back and then quickly realized that when I was working as a house supervisor in the, in the C-suite as a, you know, administrator, that I’m like, okay, this is not what I want. I, I wanna open up my own business.

I wanna still take care of clients, but actually make an impact. Hmm.

Dr. Sandra Pagenta: How did you change your mindset? What’s something that you did to kind of get yourself out of that mindset of employee to now business owner? Because that’s sometimes really hard for people to make that switch from, like, I’m working for the man to, I am the man.

How do you make that, how did you make that

Melissa Pauline: switch in your career? I’d say. Everybody’s different. My personal switch was when I realized that I was nothing but a number when you’re there, but then when you’re not there, I mean, you can, they’ll forget about you in a second. Personally, in 2018, I had lost my son.

And I was pregnant at the same time. So when he was sick in the hospital it was, when are you coming back? Not that, oh, how son doing? Is he okay? It was like, Hey, we’re short and we need you to come back to work. And you know, from then I started thinking about it. I was just like, you know, I’m just not gonna number something were to happen to me.

I could have, they would send my family a fruit basket. Then by the time the fruit basket was delivered my job would’ve been on the newspaper or online to fill a spot. Right. So I think since then I was thinking about a way to get away from the bedside or get away from working for the man and solely, and it’s not even, there’s nothing wrong with working in a hospital system or working for the man, right?

Yeah. Just like now I know that when I go to, It’s an, it’s an, it’s an option because I know that, you know, if I didn’t feel like going to work, if I wanted to be a full-time entrepreneur, I can just be like, okay, well here’s my notice and I’m gone. You know what I mean? I love what I do in the hospital and that’s why I’m there.

But I realized during those trials and tribulations with my family, I realized that I was nothing but a number and that I needed to find a way to give myself that option and opportunity to do something

Dr. Sandra Pagenta: bigger. Oh, Melissa, I’m so sorry for your loss of your son. That is being a mom like that is the hardest thing I can ever imagine going through.

Period. And your why is big and that I think people need to take home right now is Melissa’s why, for why she is an entrepreneur. Why she hustles like she does is your why is huge. Your your why. And again, I talk about this all the time on my podcast is what are your, what are you chasing after? Right. And you’re chasing after.

And not just the coin. That’s, I mean, whatever. You can always make more money. And that’s one thing we learned as nurses, you can go make money, right? But the freedom, the security, the n you know, trusting in your skills. Those things like that stuff, that’s, that’s the, that’s the real meat and the potatoes of life is being able to, I don’t need to do this anymore.

I’m not happy. I get to go do something else. And that was what, again, that I talk about on my podcast, that my son was the thing for me too, that made me go like, wait a minute, like. I’ve been spending all this time at this place, which is fine. There’s nothing wrong with that job, but you are right. You are replaceable and you are irreplaceable in your home.

You, your people around you that you love are irreplaceable. So, yeah, I think that’s incredibly emotional and thank you for sharing that with me. Because. It is it’s the truth. It’s really what we need to be chasing. And I want more nurses to have that same sense of like, I go here because I want to, not because I have to,

Melissa Pauline: and I think everybody needs a why.

And that’s, that’s one thing I would tell people. If you wanna be an entrepreneur, you have to have a why. You can’t just do it because it’s a fad. It. It’s cool. You have to have a why, because you know it’s not easy when you have to do things on your own. When you work in a hospital, you clock in and clock out, right?

No call, no show. You lose your job. But here in as an entrepreneur like you, it’s, it’s a struggle. You have to force yourself every day to come in, whether you have people on the books or you don’t have anybody here, you still have to. Come and make things happen on your own. There’s nobody that’s gonna be like, well, you’re supposed to clock in at 7:00 AM where are you?

Nobody’s gonna ask you. It’s your business. If I don’t show up today, I’m not going, I’m not showing up for myself. You know, I’m not, not anybody. I’m not showing up for myself if I don’t come in today. So I, so you have to be able to be, you have to be able to have a. And you also have to be structured enough to show up for yourself.

If you can’t show up for anybody else, you need to show up for yourself.

Dr. Sandra Pagenta: Yeah. Yeah. That’s incredible. Incredible. I love that. And I think that’s the take home message is showing up for yourself and have a really big why as to why you’re doing it. Because you won’t keep going. And it’s the same for working out eating well.

All the different things, motherhood, parenting, these are all the same concepts. They’re just, they’re all the same theme. They’re just that same work of, both are hard. Both are hard. Right. So choose your hard, what’s your hard gonna be? Yeah. Working at a hospital is hard and whenever you, whenever you have, you know, something tragic happen, they’re like, when you coming back?

Melissa Pauline: That’s hard.

Dr. Sandra Pagenta: But so same thing is hard showing up for your, choose your hard. And I think that’s what I hear you saying, which I love. I love that. Give me a shameless plug for your business for people to find you on. And if anybody wants to reach out, say, Hey, I wanna know how you did it. I wanna know how you became a double board certified nurse practitioner.

I wanna know how you started your business. Give a shameless plug for you and your side and your side household girl. So

Melissa Pauline: we do I have a Instagram page, Missy, the ICU np, which name’s gonna change sooner rather than later. It’s gonna be m r p Wellness Consulting. So what I’ve decided to do is take all the knowledge that I have in the business that I have and start teaching other nurses how to find their whys, help them start their own wellness clinic.

So that’s coming soon. So you guys can follow me on Instagram and my page is at Rejuvenate You, wellness Clinic. And that

Dr. Sandra Pagenta: Gotcha. Perfect. And guys, check her out. Thanks for listening to the podcast. As always, enjoy the journey of your career and if you have any questions, reach out to me, reach out to her.

And we’d love to just feel them. And yeah, thanks for listening.