Brooke Faught, NP on sexual health, trauma-informed care, and the perks of meeting in-person

MK: Hi, I'm Dr. Michael Krychman. I'm here at the North American Menopause Society Annual Meeting in Washington, D.C.,and I'm so excited to be joined by Dr. Brooke Faught. She is a nurse practitioner and Director of the WISH Institute. Can you tell us a little bit about what that is? I know you're in Nashville.

The Women's Institute for Sexual Health

BF: I am in Nashville and started the practice back in 2005. It's the Women's Institute for Sexual Health, [and] it's a division of Urology Associates. And a lot of people say, "Why would you start a women's clinic in a urology practice?" And the reason is, when we think about urology, we oftentimes think about erectile dysfunction, we think about premature ejaculation. But there are also bladder problems, kidney stones, hormone issues.

And it's not just for men, women experienced all of these same issues, too. So I was brought on, essentially, to start this practice and to better expand women's services. What we know is that more women in the United States complain about sexual health matters, and certainly, urogynecologic issues, than we see in the male population, so that's what I do in my practice.

In-person conferences

MK: So I'm really excited to see you in person. I haven't seen you in a long time, and it's really nice to be here at a conference in person. I think you gain a little bit more. Tell me what your thoughts are about these virtual conferences. Why travel? You know, travel is challenging, but what are the benefits to being here in person besides catching up with me?

BF: Well, that's the number one benefit. You know, it's funny, I used to gripe about traveling, and now I'm like, "Oh, thank God, I get to wait at an airport." For me, I've noticed that with the virtual conferences, while I'm so grateful to have a backup opportunity [...] to gain our continuing education and just keep up with the latest research, it's so easy during a virtual session or a virtual conference [...] at home, and you're surrounded by all these things that you have to do, [...] to get distracted, and to say, "Oh, I'll watch that later." Do we ever watch it later? No. [...]

For me, the biggest thing is collaboration. Just networking with my colleagues. And oftentimes, those of us that are in kind of sub-specialties, there's so few of us that do this, that it's nice to be able to see each other a couple times a year. And you just don't get that same interpersonal connection when you are through a computer or over the phone.

02:28

MK: Yeah, and sometimes having those sidebar conversations with your colleague, walking from one session to the next, are the best, and the pearls that you don't really get when at home. You turn off your camera and you're checking email, you're tending to the kids, or doing other things at the same time.

I think that we're kind of here to stay. There's going to be in-person [meetings], maybe a little bit less in terms of number and virtual and it'll kind of be a hybrid, kind of like how telemedicine is developing.

NAMS Planning Committee Highlights

I know recently, you were involved in a session here at NAMS. You were moderating. Any highlights or take-home messages? Tell us a little bit about that.

BF: I was involved in the Conference Planning Committee, which is really exciting. I was really excited to bring in more holistic perspective on the COVID impact on women. You know, I'm a women's health nurse practitioner, and the nurse practitioner training incorporates this mind-body-spirit approach. So when we think about seeing patients in the clinical setting, I'm constantly thinking about piecing all of these components together.

I have this wonderful colleague that I used to work with her name is Vikki Pedigo. She's also a women's health nurse practitioner. She's also, I think, a certified health coach, and she has a couple of integrative health coaching degrees and certifications. So she gave a really good lecture that I was lucky enough to moderate, in addition to Dr. Gloria Bachmann, who you also interviewed.

Vikki's lecture was moreso on the overall psychosocial impacts of COVID, and the experience on women. [...] Then when we break down the impact on different ethnic groups and subsets of women, it really [showed] the different aspects of how this has impacted women's emotional health and psychological health, our habits and our actions, and our ability to function and work.

It was really profound. Then she gave some really good tidbits as healthcare providers that may seem super simplistic, but they were actionable we can implement them within our own clinical practice. [...]

Having conversations about trauma with patients

One of the take homes for me was [that] sometimes if a patient has been through significant trauma, and trauma can be very small or it can be big, we oftentimes think about trauma as getting hit by a truck or a horrible history of child molestation, but it could also be as simple as painful sex or you lost your job or, things that are profound, but they're not necessarily life-threatening.

And any type of trauma. If you begin a conversation with somebody and start pulling out the experience of that trauma, and you're not equipped to deal with it at that time, you can actually do more harm. So her advice was to make sure that you recognize the conversations that you're having with people.

If you feel like you're getting into a realm where that patient is bringing up some traumatic events, and you're not in a realm to either deal with it at that point or refer out properly, acknowledge but also divert the conversation and figure out a way to better manage it in the future, and let them know that this is not necessarily the best location.

MK: Right. And, we're seeing a lot of changes in sexual health. We're seeing changes in desire mismatch, we're seeing even COVID-related erectile dysfunction, low libido, [and] concerning increased domestic violence. I think when you think of trauma, you think of negative issues.

I know, and you know, that we traveled a lot, and then, all of a sudden went to nothing. It's really impactful. These are life changes that really impact us and [have] far-reaching implications, sometimes too much of a good thing. It's not a good thing, being home all the time doesn't give you that buffer.

It's really important because I really think we're moving from a pandemic to an endemic. Unfortunately, COVID is here. We're learning as we go. We're kind of building the runway as the plane is landing. I think it's really important how it affects individuals and what have you.

Brooke, I really want to thank you for the time that you've had. I know you're really busy and there are other things going on, but I really appreciate you taking the time to spend a few moments with us and give us some highlights and your insight. Thank you.