Mallory Buxton, BSN, RN
Founder, CEO of Solos- Concierge Nurse Patient Advocates
I was talking to a fellow nurse entrepreneur in the D.C. area today and I told her about the events leading up to my decision to start Solos. I got done and she said "Wow. I thought this was going to just be a Meet & Greet phone call, but I need to process all this. I have so many questions. You just dropped some bombs." It was the first time that I felt I had eloquently articulated my "story" of how Solos came to be and how it is still evolving today. I wish I would have recorded that phone call. I'll do my best to recount the story here:
How I Chose Nursing as My Profession:
In high school I decided I wanted to be a Physician Assistant, PA. I chose biology as my undergrad at South Dakota State University. Sometime between my high school graduation and the start of my freshmen year of college a seed of doubt was planted, "What if I don't get into PA school?" I decided to change my major to nursing/pre-PA so that if I didn't get into PA school I would still have a nursing career to fall back on. While in nursing school I discovered what a Certified Registered Nurse Anesthetist, CRNA, was. I thought this sounded pretty rad, so I decided that was going to be my goal. Before applying for CRNA graduate school, you need at least 1-2 years of ICU nursing experience. I worked in the cardiac ICU in Sioux Falls, SD for 3 years and continued in the medical surgical ICU in Phoenix for another year after moving to Arizona in 2014. As a nurse, I got bored easily and was never 100% fulfilled or happy with any area of nursing I pursued. Besides working in the ICU, I also got my chemotherapy certification and worked at 2 different outpatient chemotherapy centers, I taught nursing clinicals for my alma mater, and did float pool for one of Phoenix's largest hospital. My plan after moving to Arizona was to apply to CRNA school after getting settled in. In August 2015 I read Rich Dad, Poor Dad by Robert Kiyosaki. After reading that book I knew I wouldn't be fulfilled no matter what area of nursing I went into or how many advanced degrees I accumulated. I had an innate drive to do something bigger than myself and I knew that to be truly happy I had to pursue it.
The Straw that Broke the Camel's Back:
While working in the medical surgical ICU in Phoenix in September of 2015 I received an admission from the ER of a patient with incredibly low blood pressure. He needed life saving vassopressor medication via an IV infusion. This is a basic standard of care and something ICU nurses do often. I was ready to administer the life saving medication when I realized I did not have an IV pump to give it. This is like asking a chef to make an omelette without a frying pan. You can't do it. I had the drug but did not have the necessary equipment to give it. This infuriated me, how can we give exceptional patient care if we don't even have an IV PUMP in the ICU of all places. Like, what the hell?! The supervisor on that day seemed to think that eating yogurt was more important than calling around and trying to help me find an IV pump for my patient. I was able to convince my comrades to help me find one and the patient was stable when I finished my shift that night. I was so pissed off though. Since when does snack time come before patient care? Not okay in Mal's book. The supervisor continued to think this wasn't a big deal after the patient was stabilized. So, I did what any irritated nurse would do: I went straight to the Chief Nursing Officer, CNO, to voice my opinion and recount the afternoon's events. The CNO was very understanding and seemed genuinely concerned and grateful that I brought the situation to her attention. I felt better that this major issue was brought to light with someone who had the power to do something about it.
The next week the head supervisor from the ICU (she was not working the day the incident happened) called me at home to revisit the situation and find out more about what happened. I dove into the details and gave a passionate recount. She was very polite and empathetic but it was clear that she had a separate agenda for the phone call. After I had told her what had happened with the patient, she gently reminded me that next time I had an issue I should follow the proper chain of command. It was inappropriate to jump directly to calling the Chief Nursing Officer that day; I should have spoken to the supervisor. I explained that the supervisor was well aware of the situation, but continued to eat her snack at the nurses station while I was scrambling to find an IV pump. And after we had found one, she did not make any attempt to notify the manager or director. That was why I took it upon myself to alert the CNO who had distinctly told us at the last unit meeting to call her "with anything." I thought this more than qualified as anything. The head supervisor continued to stress that it was inappropriate for me to make that call and that only a manager should report to the CNO. They have these chains of command set up for a reason and I was to follow them. I think I had steam coming out of my ears after she said. I was surprised that I was being reprimanded for trying to improve patient care. I started crying and raising my voice, "Since when does the chain of command matter when a patient's life is in danger? That was the last thing on my mind. And further more the supervisor on call was not taking any proactive steps to make sure this situation wouldn't happen again." I was so angry I was having trouble forming sentences. It just blew me away that we were even discussing this.
After I got off the phone I decided that I could not work at this hospital anymore because our values did not align. I had a new job within a month, October 2015, and I was fully committed to "starting something." My new job was a significant pay cut and it negatively affected the interest rate and terms on my home mortgage at time. I didn't care though, I just had to get out of that toxic environment. I didn't know what I was going to start, I just knew I had to do something more. I continued to listen to podcasts and read personal development material and in April of 2016 I got my idea to start a concierge nursing service from a podcast on my way to work. I said "YEP! That's what I'm going to do." I launched Solos in September of 2016.
Almost 2 years later, the universe has connected me with an amazing group of nurses and our goal is to end loneliness and help 1B people. We believe that no one should ever feel alone or afraid when having a medical procedure. I am so grateful for where this journey has taken me and I cannot wait to see what the future holds. In the words of Steve Jobs, "You can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something - your gut, destiny, life, karma, whatever.Because believing that the dots will connect down the road will give you the confidence to follow your heart even when it leads you off the well worn path; and that will make all the difference.”
Author: Mallory Buxton, BSN, RN
You just spent this chunk of change on surgery, you want to get the most bang for your buck right? Well, what if someone told you that your results will greatly be determined by how closely you follow discharge instructions and aftercare?
Many patients do not want to bother friends and family after surgery to help them. Particularly, plastic surgery because it's often elective and there is a stigma around it in America that it's unnecessary. This leads patients to seek privacy and not ask friends and family for help. Case in point from a Solos patient in 2017:
"My son lives in Phoenix, but I didn't want to ask him for help after my tummy tuck. I wanted to maintain my modesty and also didn't want him to have to take off work for me. I was embarrassed to tell the surgeon and staff this and was so thankful that the Solos brochure was inside my pre-op packet. The patient coordinator had nothing but positive things to say about Mallory and her team. I felt totally comfortable calling and inquiring about their services. I'm so glad I did. It was a total relief having Mallory and Lisa help me after surgery."
After surgery there are activity & weight lifting restrictions. The general anesthesia you received makes you groggy and puts you in a "haze" for sometimes 48 hours after receiving it. There are medications such as narcotics, muscle relaxants, antibiotics, antivirals and anti-anxiety pills to keep track of. As one former client very candidly pointed in a text after Mommy Makeover surgery, "And there are like 4 different medications that I have here. When do I take them? And how much and how often should I take them? Should I eat with them? What should I eat? And oh crap, I haven't crapped in 5 days." Yikes! A Concierge Nurse Patient Advocate can help you understand your medications and make sure you're taking them correctly. They'll make sure you're not lifting more than you should be after surgery (Solos Nurses will carry your grocery bags and do your laundry for you) and think of things you would not have thought of to ask the doctor. And if you get constipated? No worries, they have a few tricks up their sleeve to help even the most stubborn colons. Certain surgical procedures, like an abdominalplasty (aka tummy tuck) require patients to wear abdominal binder afterwards. This can be very difficult to reposition by yourself and friend & family often don’t feel like they are putting them on correctly. Correct application and positioning of surgical binders, bras and garments is another thing Concierge Nurse Patient Advocates can help with.
In my experience, many patients forget that even though it's an elective surgery, it's still SURGERY. And it's scary. A Concierge Nurse Patient Advocate is someone you can call or text just to ask a quick question. Patients feel totally supported both physically and emotionally knowing they have that option. It's important to have that teammate to help cheer you on after surgery (and all areas of life) and provide affirmation that what you're experiencing is normal, others have felt this way, and you are doing amazing. Keep going! This support is critical to phenomenal patient results. If you do not feel emotionally, mentally and physically supported, you will have increased anxiety and pain which releases stress hormones that in turn hamper the healing process in the body. (Reference to scientific study done to support this statement coming soon.)
Many patients fly in from out of state or out of country to have plastic surgery in sunny Scottsdale, AZ. Some bring family to stay with them and some come alone. Both groups benefit greatly from having a Concierge Nurse Patient Advocate. It can be mentally and physically exhausting for family members to care for patients after surgery. The bigger your tribe of support, the better and having a Concierge Nurse Patient Advocate there can bring relief to the patient AND family member. The family member needs to remember to take time for themselves and can take a nap or catch a movie when the Concierge Nurse Patient Advocate is there to help. Having a nurse's insight, someone who has worked with postoperative facelift, tummy tuck, breast augmentation, and rhinoplasty patients before is comforting for everyone involved. And if you're coming alone to Scottsdale to have surgery? All the more reason to have a Concierge Nurse Patient Advocate assist you. They will bring immense peace of mind to you before surgery and during your recovery period.
It's important to remember the Concierge Nurse Patient Advocate does not replace a doctor & his ancillary staff. They are an addition to the team. Your Concierge Nurse Patient Advocate can ask all the questions you have flying through your head and write down all the little details that doctors are famous for adding in at the last minute. And the best part about this teammate is that they can come home with you! A Concierge Nurse Patient Advocate will make sure you’re following the doctor’s orders exactly as prescribed and know what warning signs to watch for, such as infections or allergic reactions, after surgery. No more anxiety or wondering if you’re going to “mess anything up,” your Concierge Nurse Patient Advocate will dismiss that worry in two shakes of a lamb’s tail. Sounds kind of nice, right? And not only for patients, but doctors as well. Having a Concierge Nurse Patient Advocate at consults and follow-ups, helps the appointment run more smoothly and saves time for doctors and staff. Concierge Nurse Patient Advocates can advocate for patients from inpatient hospital stays to follow up appointments and everything in between.
So, let’s say you have surgery coming up and you have some friends lined up to help you. But now you just read this article and you’re starting to think, “Maybe I should have more help. My neighbor said she’d come check on me, but she always was a little flaky. I don’t want to go through this surgery and then not get optimal results because I tried to lift something too heavy or wasn’t sleeping in the correct position.” Call us!! It’s that simple. Find out your options. Or just go for it and book us for a half day drop in on the SolosNurse app. We’re here for you and we’re happy to help. Because as our mission statement says, “No one should would wake up from surgery and feel scared. No one should go home from the hospital and feel alone. Everyone deserves to feel beautiful.” Don’t go solo, think Solos.
Author; Mallory Buxton, BSN, RN
Lots and lots of pillows. Whether you're having a facelift, tummy tuck or brachioplasty (arm lift) odds are that the surgeon is going to want you to sleep ELEVATED and propped up on pillows. So start hoarding the pillows, because you'll want to sleep with them behind you, under your bent knees to take the strain off of your back and under yours arms for comfort depending on the type of surgery you had.
2. Stool Softener
I don't care how regular you are, 99.9% of post surgical patients become constipated from anesthesia and/or narcotic pain medications. Until you have had your first post operative bowel movement, please, please, PLEASE take a stool softener every day starting the day of surgery. Narcotics are very effective for relieving pain but also very constipating. Combined with a decrease in activity and appetite and the odds are stacked against your colon.
Hydration is key after plastic surgery (Well, let's be honest it's always important!) In order to make it easier to drinks fluids, have straws on hand. Even better, have a tumbler with a lid and plastic straw so that if it tips whilst you're trying to drink lying in bed, you have less of a chance of spilling.
4. Plastic Snack Baggies
If you're having any type of facial surgery (rhytidectomy, blepharoplasty, brow lift) many surgeons will want you to ice with frozen peas after surgery. If so, the small little rectangular bags meant for snack baggies (I always picture pretzel sticks in these when thinking of them) are ideal for icing any part of your face.
The #5 thing you may want after plastic surgery
5.) A Concierge Nurse Patient Advocate
100% of the clients we've helped have given us 5 star reviews on Facebook. From giving you a ride home after surgery to staying overnight and bringing you to your follow up appointment, Solos Nurses provide peace of mind and convenience to your and your family. Although you may have friends or family that are available to you, there is no substitute for the comfort and privacy a Concierge Nurse Patient Advocate can bring, especially in the first 48 hours after surgery.
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Mallory Buxton, BSN, RN
An entrepreneur & believer