Dani:

Welcome back to the Handoff from Trusted Health. I'm Dr. Dani Bowie, Chief Nursing Officer of Trusted Health. This season, we're covering all things healthcare, innovation and the importance of fearless leadership for change. In this episode, I have the pleasure of speaking with Dr. Angela DiDonato, Associate Program Director of the Nurse Anesthesia Program at the University of Pennsylvania School of Nursing. Today, we discuss her career highlights and the creative approaches she's taking to prepare advanced practice nurses. We also cover nurse legislation and advocacy as well as the importance of planning for and supporting career mobility for nurses. Here's my conversation with Dr. Angela DiDonato.

Welcome to the Handoff. I am so excited to have Dr. Angela DiDonato with us here today. Angela, welcome.

Angela:

Thank you, Dani. Thank you so much for having me.

Dani:

My pleasure. Well, let's get going. I like to start the show off by centering us back to our purpose and keeping the patients the forefront of what we do and why we're having our discussions today. Angela, is there a particular patient experience or story that has had a profound impact on you that you could share with our listeners today?

Angela:

I'm a CRNA by training, so I tend to spend a lot of time in obstetrics, and I, in the last couple of months, had a patient who was going to have a C-section and was not real happy about it. She was being sort of standoffish, and as I talked to her about it, she told me that she had had an emergency C-section the first time, and it was a really, really difficult experience for both her and her husband. I said to her, why don't you tell me about that experience and we can talk about the things that are going to be different this time, or all of the things that she talked about, the pain that she had, the anxiety that she had, the lack of control that she had. I kind of countered with, well, this is what we're going to do differently this time, and there were some things that she was really nauseous, which is sometimes common norm, a C-section.

Sometimes you can't get around it no matter what kind of antiemetics you give. And I said, that may still happen because we're going to be manipulating your uterus, but this is only going to last for so long. You know what I mean? Within 90 minutes of this procedure, you're going to be in the recovery area holding your baby with your husband, and this is all going to be wearing off. And she was a little reluctant to kind of buy into that. But after, once we got in and we got settled and she was comfortable, and baby came, the baby was fine, everything was good. By the end of it all, she was like, thank you so much for walking through all of that with me because, and not only did she have a better experience, which I was happy for, fortunately, you don't want to be the one who's given them a terrible experience.

But later, when I went back to check on her in the PACU, she said that going through everything that happened the last time, she has a different perspective because not only did I say to her, this is what's going to be different, but I explained to her why some of those things happened, which no one had ever done before, and I think that's something that we can sometimes forget about. When you're doing something day in and day out, it becomes very rote for you, and it's not rote for the people who are in there having that experience. You know what I mean? And even just women coming back, having babies a second time where, oh, you've done this before, what's happening? And they don't always know what's happening. So I feel like it's something that as nurses, we tend to forget. It's such a small thing that we can do to listen to their experience, acknowledge their experience, and show how we can do it differently this time.

Dani:

Absolutely. It's kind of like a debrief. You're like, Hey, walk me through what happened and here's why, and here's how it's going to be different, which is a really profound way to approach with your patient, their experience, because oftentimes it isn't set up as like, well, what happened last time and let's move forward into the future and how you should expect to be treated. And not everything's going to be a hundred percent as you say it will, but I know listening to that story, I would really appreciate that experience. Even as a healthcare clinician with experiences, someone's still saying, let's walk you through these experiences and what they mean to you. How much time did that take you to do that?

Angela:

Yeah, it didn't take very long. I mean, the conversation we had before we went back to the operating room was less than 10 minutes. And then obviously while we were in the operating room, we were kind of discussing things as they came up. But yeah, it really didn't take very much.

Dani:

That's the other, I think, important piece to consider is this upfront conversation and expectation can actually save you time on the backend because if there is lack of knowledge or understanding going into something and you go through it and then you have a reaction to that and you're trying to peel back, why is my reaction a certain way? What happened? That can be two hours worth of time of conversation with patients. And so I think that this is a really important call out, Angela, of taking time to listen to our patients and investing in them upfront, educating and walking them through their experiences and listening. It's fundamental to how we should be approaching our care and our patients, and even like I said, a debrief like we do sometimes with our colleagues.

Angela, you mentioned that you're a CRNA, but I also know that you have some other career jobs that you're doing. You're the Associate Director, Program Director for the nurse anesthesia program at University of Pennsylvania. You are also doing some advocacy work. Can you provide some career highlights for our listeners and some leadership principles that have helped guide you in this unique career that you have today?

Angela:

As I said, I'm a CRNA by training. My full-time job is the associate program director for the nurse anesthesia program. So I train other nurse anesthetists, and I do that because I really had an amazing experience going through the nurse anesthesia program. It was an opportunity that was given to me that I am forever grateful for. I absolutely love taking care of patients in the operating room, and I absolutely love showing that to other people and encouraging them to also do the same thing. So my program director Maria Van Pelt, who is now at Northeastern, was a huge influence on how I approach nurse anesthesia and how I approach my students. So I had an amazing example of what it means to really lead and be really, really good at it. Nurse anesthesia was not always where I thought I was going to go.

It's funny how things pop up. I was working in a PACU in a smaller hospital many years ago. I'm dating myself. There was no electronic anything for how we saw patients. So when you were in charge in the pacu, you had to go back into the operating room and poke your head into all of the rooms and figure out what was happening. And I poked my head into a room and one of the CRNAs that I was friendly with was in there, and she said to me, what are you doing out there? And I said, oh, we're just waiting for these last couple patients to come back. And she goes, no, no. I mean, what are you doing out there? You should be in here with us. You would be really good at this job. And it had never occurred to me to do anything like it.

So I segued from there into the trauma ICU at HUP because I wanted to get a really good critical care experience and figure out if this is really what I wanted to do. So I spent three years as a trauma nurse at HUP, and I really liked the idea of taking care of one patient at a time, which is I think one of the great things about anesthesia is you have nothing else to focus on. You have all of your attention is on this one person, and as many people who work in healthcare are very type A personalities and they want it all to be just right when you only have one person in front of you, you have so much more opportunity to get it just right instead of running back and forth from room to room to room and things like that.

So that part really, really appealed to me. So I practiced as a CRNA for 10 years and I taught part-time all along the way. I did simulation. We built a SIM program for the University of Pennsylvania's nurse anesthesia program, and then we had some leadership changes and I was asked to come on board as the Associate Program Director, and I continue in that role. Today I work with an amazing program director, Dr. Don Bent, who is phenomenal. We work together as colleagues in the nurse anesthesia program for a long time. So we already had a really nice working relationship. We already had relationships with the students, so it was kind of a seamless transition and it's been a dream for the two of us to work together. We have great ideas about how we want to build the program, and a big part of that is building the profession and the workforce.

There is a huge shortage of anesthesia personnel. There are pockets of the country where there's a real dearth of anesthesia providers, especially when you're talking about rural communities. And CRNAs fit that bill perfectly because they're working in the communities that they're living in. So it's a great opportunity to fill those gaps and provide access to care for people who wouldn't normally otherwise have it. And I'm still one day a week in the operating room. And then in terms of advocacy, I am the incoming President for the Pennsylvania Association of Nurse Anesthetists. I've been affiliated with the organization since I graduated from school. Again, I had a great example in my program leadership, Maria Van Pelt and Russ Lynn. They always talk to us about being a steward of your profession. And if you are not involved with the issues at hand, then you really can't complain about what's happening to you because there are decisions that are being made and you can either be a part of those decisions or you can be really sorry with the outcomes.

So I started volunteering with the organization, and actually that's how I ended up doing the podcast for Penn. After visiting legislators and having conversations, nobody really knows what nurses do. Nobody really understands the breadth and depth of nursing. And I thought to myself, if we had a medium where I could say to people, oh, this is what nurses are doing, this is an example of what nurses are doing. Nurses are senators, nurses are congresswomen, nurses are in tech, nurses are doing startups, nurses are entrepreneurs, nurses are also leaders, nurses are also clinicians, all these different things. So if we had that, it'd be a really nice thing to be able to point in people's directions so that they understand what nurses really do because we're not represented really well in the media. You know what I mean? We're usually just following doctors around and saying, yes, sir, of course, what can I do?

Which is silly. And then I was told that I was the one who was going to have to do it because no one else had their bandwidth to do it all by themselves. So then I found another great partner, Maryanne Leary, who's the Director of Innovation at Penn, who was all in, and she was like, I think this is a great idea, but we need to do it together because I don't have the bandwidth for all of it. And we've been doing it together ever since, and it's been great. It's one of the things that I really find a lot of joy in is reaching out and talking to nurses about the things that they do and the impact that they're making.

Dani:

That's something that I really enjoy in the podcast is hearing the stories and getting this broader global perspective, as you mentioned around nurses and healthcare professionals in general and how they're operating and thinking about the community. I really liked how you mentioned you recognize you're calling your passion, building up the workforce and moving into the teaching space and things falling aligned in partnership to really elevate that with the right individuals and then also care for the patients. You like that singular care, and you knew that, so you were like, Hey, I'm going to pursue and be able to deliver on that. What aligned with your desires there? And then lastly, as you were talking about legislation advocacy, you said you can't really complain unless you're doing something about it. You may have to just sit back and take what's happening unless you're active and involved, which reminds me of some great quotes.

It's like the man in their arena or the woman in their arena. It's a hundred percent true. And I think that's a call and a takeaway for those listening is, Hey, we can have opinions and ideas about it, but let's not be super critical unless you are the one in the arena fighting the good fight and looking for the change, advocating for the change, doing the work. And if you're not, that's okay, but support those that are So if you are saying some things, you're passionate about it, we would encourage you to get into it. And Angela's going to talk a little bit more about how to do that in this episode.

Let's talk about workforce, Angela, and again, you're the associate program director of Penn. I'm definitely hearing the theme of you're a leader, but you're a teacher, you help build up this next generation. What are some creative approaches that you are using to prepare advanced practice nurses?

Angela:

So one of the things that Dawn and I think are really, really important is instilling a sense of teamwork that seems very mundane, that of course that makes sense. But in anesthesia it's not because we work very singular. Everyone's kind of in their own thing doing their own thing, and we definitely attract personalities that maybe, I don't want to say don't work well with others, but everyone's a leader kind of a thing. And that can be a little bit challenging. So we really want to encourage in our students this philosophy of we're all in this together, and it's really important to try in and garner other people's perspectives and figure out why they're doing what they're doing. And in my doctoral work, I kind of looked at communication during emergency C-sections. So you have an absolute emergency that's happening with two people when you're talking about C-sections, and you have surgeons who have a priority, you have anesthesia, people that have a priority.

You have the nurses that have a priority, and all of those priorities are competing at the same time, and everyone wants to do what's best for the patient. But you have to understand that at certain times during that emergency, those things are going to shift. So there's the point in time where my priorities are going to supersede everyone else's because if we don't get the patient to sleep, you can't do anything else. So my priorities are going to supersede everyone. And if you can't let that go or even understand that person's perspective, that's when you start to have jam ups and you start to have people arguing over, this needs to happen first versus that needs to happen and you need to hurry up and all these different things. Whereas when you take this perspective of what is it that you're trying to do, because this is what I'm trying to do when that's something that we're trying to instill in our students really, really early, is this team approach to things of relying on your colleagues.

One of the other things that we're really very, very invested in is encouraging a very diverse cohort, which is not something that's typically seen in anesthesia. Anesthesia is very much like nursing. It's mostly white women. I feel like there are definitely more men that move into anesthesia than nursing in general. So our population looks a little bit different there because it's a very technical field, so it tends to draw a lot of men into it. But that's pretty much where we are. I think it's really important when you consider the diversity of the patient population that we have. It's important for people when they're going to have an anesthesia and they're scared, they're having this big surgical procedure, they don't know what's going on, and then the person who walks in the room looks just like them, and it's from a neighborhood that they're like, and you know what I mean?

There's a connection there. And it's not to say that you can't provide anesthesia to somebody who doesn't come from the same background, but we all look for a connection. I mean people all the time when I walk in to introduce myself and they see my name as DiDonato, they're like, oh, paan right away. They're comfortable with that because they're Italian too. So as people, we all look for some sort of commonality, and I think it's really important to have that representation. So it's something that we're really trying to foster in people. We work really, really hard to make sure that the students that we bring in, that we really invest in them specifically and what they need. So we also have a lot of mentorship throughout the program as well.

Dani:

Wow. I love the concept of mentorship, and you touched on it at the beginning, you said it sounds kind of mundane, but the concept of teamwork, communication, building that collegial relationship so that you're able to better serve those patients, the one, the two, the patients that you're serving in those scenarios and giving the workforce not only the technical skill that you learned through your education, but the soft skill of how to be able to communicate, have those crucial conversations, share with your colleagues, learn from your colleagues. And grow is something that I think is a lack in a lot of programs. Honestly, you're recruiting top talent. So they have the technical ability, it's learning the soft skills. It's going to make them a great clinician and practitioner and delivering care. And you're right. Finally, the diversity aspect. We do look like those that look like us or a connector right away, especially when you're so vulnerable and uncomfortable, it's like you're grasping for any straw.

It's like, oh, hey, I grew up there. Or I like your shoes. I wear the same type. I mean anything just to kind of like, I'm so uncomfortable. I don't know what I'm going to go through. I still do that, and we've been in healthcare a while and I still get uncomfortable and look for that. So valid call outs and points that I think is imperative for building the next generation. Now, as you think about the profession as a whole, you are very passionate about your advanced practice group and the nurse anesthesia, but I know that you're also holistically passionate about the workforce. What are your thoughts on the current state of nursing and what are your hopes for the future as you're training this subset of individuals? But I know you have broad dreams for the whole profession.

Angela:

Yeah, because we work with nurses all throughout the continuum of care for the patient, the labor and delivery nurses, we're all working together with them. And healthcare, as you know, we tend to work in these silos where we don't really see ourselves necessarily as a team. By having these conversations about communication and really connecting with the people that we're working with on a daily basis is really, really important. I think that this is a really, really interesting time for nurses. We're seeing a lot of big change socially. It's a great opportunity for nurses to step forward. As leaders, we are the largest contingent of the healthcare workforce. If nurses didn't show up for work today, people would die. And not to disparage any of our other colleagues, but that wouldn't necessarily be the same. There will be things that couldn't be done. You need really good nurses to take care of your patients. You could have the best surgeon in the world who does the absolutely most pristine surgery. And if you don't have good nurses taking care of that patient postoperatively, all that good work gets flushed down the toilet.

Dani:

If

Angela:

You don't have good nurses taking care of that patient preoperatively and making sure that everything is set the way it's supposed to do, you're not getting set up for success. And that's just looking at it from the surgical realm. You could take that whole concept and put it into any realm where nurses are, there's such an integral part of the whole continuum. So we're at this really interesting time where we're just coming out of this crazy pandemic. We're having massive movement out of the bedside and everyone's burned out. Everyone's kind of crotchety and cranky. Covid hass been weird. It's still hanging over in the zeitgeist. You know what I mean? It's all still a little wonky. We're not really sure what's going to happen or how this is going to change. And I think we have such a great opportunity in nursing to start to look at how are we doing it before and how are we going to do it moving forward?

And I think a big part of that is that nursing was never set up to be anything more than a nurse. Any other job you get into, there's an entry level job and then you move up to this position and this position, this position, you don't ever expect to stay in that entry level position for the entirety of your career. However, in nursing, we kind of do that. We're like, oh, you're going to be a bedside nurse and then you're going to stay there forever. I know how much work you've done in workforce and staffing and things like that. And I don't want to make you start to twitch by saying people should be allowed to move out, but we should be planning for that because there are going to be people who are going to move out. There are going to be people who are going to move out and to do different things, and we need them to do those different things because we need nurse practitioners.

We need CNSs, we need midwives. We need all these different people. We need leaders. We need nurses who know what they're doing to move into leadership positions so that decisions that are being made actually make sense and they're not being made by people who don't understand what's happening. And we've never really done that before. We've never taken that perspective of we're bringing these nurses into the bedside and we're going to train them to be really good, and then they're going to start to move into other positions, and many of them are going to just be leaders at the bedside. And that's incredibly important because when you invest in people at the bedside and you give them an opportunity to have utility and autonomy and they have purpose in their job, they stay at the bedside and that's what we need. And instead of everybody getting burnout and shifting and you have all brand new people all the time who aren't learning from the experiences from the people who've been there forever, I think that's a really exciting piece. And it's one of the things that I teach a policy course, and it's one of the courses that undergrads are allowed to take. They take it as a graduate course, and there's only a handful of courses that they're allowed to take that are graduate courses as undergrads to be able to use for later credit. And I love having the undergrads in there with my graduate students. They're learning from the nurses that are there that are already in the workforce.

Dani:

I actually think that the education cross mingling education undergrad and grad is a brilliant strategy because it does give you perspective beyond entering at the bedside and seeing someone advance in their career growth development. You mentioned the autonomy utility is so important. I wasn't twitching when you said we should be looking at the workforce from you enter in the way you enter is probably not how you're going to end your career. And by no means is it how your career is going to play out And keeping that mindset and perspective I do think will set us up for better success. So I'm in alignment with you, Angela, and we're in the day of data, and so we should be able to segment out pieces of our workforce that are moving on and advancing and plan for that and prepare for it and be okay with it as leaders to create programs, ways to catch 'em, help support them in their growth, and be able to also actively backfill.

I recently wrote an article and the quote I use is, you let up on the reins, people will use their brain. So if we can give people freedom, I have so much delight in knowing and seeing what the workforce will do. And as a new manager, I had to give people freedom and like, Hey, help me manage this unit. And I'll say that was one of the best experiences of my career in giving a lot of great nurses the freedom to help me manage this unit. And we had wonderful outcomes. I'm with you and I am challenging our listeners. As you think about the workforce, let's think about their growth, autonomy, freedom, utility as promoters in who they want to be and how we can support them. Now, I mentioned we were going to talk a little bit more about advocacy and I would like to do that. And you've already hit on some highlights as you're like, yeah, I'm talking to legislators, I'm looking at policy, and I'm like, you go girl. I need to get more involved in how you're doing that. And so I would love to have you share with our listeners as the incoming president of the Pennsylvania Association of Nurse Anesthetists, how are you approaching advocacy?

Angela:

The thing that's really challenging in the US is that all of the nursing legislation is down at the state level. There's no national anything, so it gets really challenging. Any state that you go to, the rules are different everywhere you go, which makes it really difficult for nurses to be facile and move from place to place and work because in certain states, practice is very restricted. People don't want to work there, and then they have a shortage of people. And then there are other states where there's much more people are allowed to practice their full scope, which is the other challenge. If you take a look, everyone always talks about the Institute of Medicine report on the future of nursing that Donna Shila was so important in putting out such a long time ago, and yet we still haven't done the main recommendation, which is allow everyone to practice to the full scope of their training.

And there's so many challenges to that. So in Pennsylvania, what we're really focusing on is having the opportunity for CRNAs to practice to the full scope of their practice and to be recognized for that. So until fairly recently, we weren't recognized as anything other than RNs in the state. So our certification wasn't recognized at all. So it was really difficult to even say how many CRNAs are practicing. We knew because we know for the people that are part of our organization, but the state couldn't tell you because we're only listed as RNs. So we were able to get a title designation, which is phenomenal, but we still don't have full scope of practice. There still is our barriers to practice in the state that we're trying to navigate around CMS came up with rules with how you can bill for nurse anesthetists and their supervision language in the rules. However, the Clinton administration passed a law saying that if the governors wanted to opt out of that, they could. So each state could then say, our CRNAs can practice without the supervisory requirement. And at this stage of the game, I think 21 states have opted out. So almost half the country, there's no state supervisory regulation in terms of billing.

And that's what we're talking about. We're talking about supervision. It's all about billing. Nobody wants to supervise anybody they can't bill for. So during COVID, governors, pretty much across the board, I think every state opted out. There was an emergency opt out. President Trump put it forward and said, anyone who wants to opt out for this emergency time so that everyone can do whatever they need to do in order to take care of these patients, then let's do it. The governor in Pennsylvania also opted out so that we had plenty of opportunity to use people the way we needed to use them. And then that expires. Why are we now going to go back to a restrictive practice when it worked? There wasn't a line of dead bodies coming out of anywhere because of this relax in the practice.

Dani:

You did mention in one of your statements, your hope the time that we're in is a time. It's an amazing time that we're in, and that is a good example that you brought up of how the crisis lifted restriction to create the right type of practice opportunity. We are in a workforce crisis and the restriction is not helping in the capacity of scope of practice. And you're right, what's driving that billing and being able to generate revenue money, like you follow the money trail there. The other issue that you mentioned too is liquidity of the workforce across our entire nation is limited based off of states. And that's unfortunate too because again, we're in a major crisis, but we may not be as in a big of a crisis if we had more liquidity. And as you mentioned, even the utility of how we move our workforce and use them. What would you give as a piece of advice to our listeners? How did you start getting involved and having these conversations? It can be kind of intimidating. You don't want to show up and just start talking and you're like, should I be reading something? How did you approach your legislators? How did you involve your professional organization? How did you start? You are a master teacher, you teach a lot of students, so teach me how to do this.

Angela:

So honestly, I think it starts with leaders encouraging people to come forward and really making people understand how important their ideas are. When I graduated and I started practicing as a C N A, I knew people who were involved in the organization and I reached out to them and said, Hey, I'd like to help. What can I do? And actually the first thing that I did was plan the symposium, which was great. Anyway, so I started there and then I was nominated to the board and then got on the board. And we work really hard to work with anyone who wants to go see their legislators. For example, we just very recently had a lobby day where we were calling CRNAs to go visit their legislators and talk about the legislation that's coming up, get some co-sponsors for our bills, et cetera, et cetera. And as board members, we make ourselves available to go with people so that they have an example like this is how you talk to people.

We have a list of talking points. We explain strategy and why we want to do things the way we want to do it. And I think that encouraging people and giving them the confidence to share their voice and share their opinions and go and meet with their legislators, they work for you. You voted them in. You know what I mean? You shouldn't be afraid to talk about those things. And we offer all different kinds of support. So I work really, really hard to engage that in my students and all of my students, no matter what their role, even the undergrads, I even tell them, you're going to be a leader at the bedside. So you need to be able to formulate an opinion on these things and have some good reasons as to why you have that opinion. People expect that of you. The first thing that you want to do as a leader is encourage people to come and talk to you, even if we're not talking about legislation, but a leader in an organization like talk to the clinicians about what they need or how changes are impacting them.

So many organizations are restructuring right now and they're trying to figure out how to do things differently post pandemic. So how is that affecting the people at the bedside on the day-to-day? And we're almost pulling nurses further away from actual patient care and adding in all of these technicians or mean or nurse interns or all these different things to actually physically take care of the patient because the nurse is busy up to her eyeballs and paperwork. How do we document the things that we need that are really important and do it in a really, really efficient and streamlined way so that the nurses actually have time to physically take care of the patients and they're not up to their eyeballs and paperwork. So that's just an example of things. It's not just about advocating for the profession isn't necessarily just about going to legislators and changing policy that's out there. It's changing policy on your unit. It's changing policy in the division that you work for. It's changing policy in the organization, and I think as leaders, it's our job to encourage that to happen.

Dani:

I just recently did a couple other podcasts with different leaders and that some of the topics you touched on, one of 'em was like, Hey, the documentation burden is so real. How can we simplify and streamline that? Another leader I spoke to, she was like, Hey, if you've got a problem, go to the front line because I'm confident they know how to fix it for less money with more innovation because they're in doing it. But most importantly, what I was hearing you say is creating the psychological safety and space to voice your opinion and have an opinion and bring solutions and be okay with what is brought up. And as a new nurse, it can be uncomfortable learning how to do that. And so being able to create that environment of curiosity, innovation, let's try some things and see how it works, is a key call out, I think, to solving some of the challenges we face in the days ahead and having that fearing less or fearless approach to leadership. Angela, this has been a lovely conversation and inspiring as always, and I love your perspectives. Where can our listeners find you? So if they want to reach out, hear more about your podcast, want to send you a message, where would you direct 'em to reach out to you?

Angela:

So I'm on LinkedIn, Angelarosa DiDonato. It's spelled phonetically, so it's not that hard. Also, anyone can email me. It's angelaro@upenn.edu. And the podcast is Amplify Nursing, and you can find that on the University of Pennsylvania School of Nursing Research their site. You'll see it on there.

Dani:

Fantastic. As our final question today, what would you like to hand off to our listeners?

Angela:

I would really like to say thanks for your time and attention. I think any opportunity to talk about how we can make the entire nursing landscape better for nurses in general is a wonderful opportunity. So anybody who's listening clearly cares and they really want to make a difference. So I want to say thank you there and if anybody has anything that they think I can help with, I'd be happy to have any more discussions, they can reach out.

Dani:

Well, as always, it's a delight talking with you. I like the perspectives and the ways that you are approaching the work that you're doing, and it does create in me a desire to be a better leader and a better nurse in general. So thank you Angela. Really appreciate your time and love the conversation today.

Angela:

Thanks, Dani.

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