Before You Clock-In, Check In

No matter what kind of nursing you provide, or what clinical rotations you enter as a student, conflicts arise. Here's what I learned abroad about walking into a stressful environment, and walking out with a sense of peace. Nurses Announcements Archive Article

Before You Clock-In, Check In

I walk into my residential yoga school, 9000 miles away from home after four flights, 2 days of travel, and 3 hours of sleep. South India, monsoon season. 90 plus degrees and my room-mate refuses to use air conditioning. My ego is reduced to that of a tight fisted, red-faced toddler, insistent on some creature comforts. After all, I am the one with reasonable demands, right?

The first thing India teaches you is that demands, by their very nature, are not reasonable.

When we have expectations of any sort, our minds close, barriers form to possibilities that could be positive outside of our limited habits. This is true in nursing. We have colleagues with whom we would rather not work. Patients we reserve special code names for like 'frequent flier,' or 'train wreck.' Often we talk about how these behind-closed-doors habits are wrong or unfair to the patient, but do we realize that such practices are also unfair to ourselves?

Here's an example: When you see you will be working with nurse X, a person who you feels undermines you, or bullies you, chances are you experience an inward [if not outward!] groan. Immediately you feel tension, literally - the muscles tighten and you mentally prepare for 8 or 12 hours of going head-to-head. But what would happen if you saw yourself as a 'first responder' to this discomfort, and consciously took steps to disarm yourself, and by default, the milieu? You might actually be open to enjoying the shift, working together, and going home with peace.

Back to India. For my teaching certificate, I needed to practice 'Karma Yoga,' something charitable toward the world. My first Karma Yoga was to help feed and attend to injured stray dogs [there are hundreds, if not thousands of them everywhere.] Next, I went to an orphanage.

Immediately, my muscles tensed, I felt dread and resistance, similar to the feelings I have had when encountering someone or something at work for which I expect to have an emotional struggle. The 45 minute ride to the home for girls I prepared myself to feel depressed for these children, some of whom had been exposed to HIV/AIDS, who had been trafficked across the country, who were phycially young but minds were aged well beyond what they should. My guard was up, because I had no idea how to protect *myself* from seeing their pain.

The second thing India teaches you is that nothing is about you.

All that tension I created was my own mental burden. The orphanage was one of the highlights of my stay. The girls were bright, smiling, smart, and in their dire circumstances, simply thrilled that they had visitors. They were not alone, and they wanted to share everything, simply because someone cared to know about them. The girls cooked chapati bread, interrupted each other with great enthusiasm to tell their stories, laughing all afternoon.

When we make judgments about co-workers or patients, allow ourselves to grit our teeth in frustration, talk behind their backs [or even think negatively!] we often don't have the whole picture, just as I made assumptions about the orphanage being depressing. We cheat ourselves out of the opportunity to see that nurse or patient as a human, just as flawed as we are, with just as many mechanisms of self-preservation flying up for reasons unknown. If there were a way to connect, would you try it? What do you have to lose?

The third thing India teaches you is that we are all connected, universally.

We all have the potential for kindness or cruelty, and it is up to us to make a positive impact that echoes from the one person to the next. With that in mind, I offer a short and sweet written guided 'meditation' for your next dreaded encounter at work. As you read, feel free to practice these thoughts now, and check in with them next time you clock in.

As you read, your breathing is gentle, but deep. Any sounds around you, whether it's children or cars or dogs barking just become a part of background noise. If you have to get up to attend to something, simply take a breath, feel peace and patience and return when you are ready.

Adjust to a comfortable position, so that yo can fully relax and read without circulation being compromised.

Two small spheres float over you. One is warm and golden, over your chest. The other is light blue and cool, over your forehead. You think about anxieties and people or patients at work and take a survey of what happens with these thoughts. Does your heart quicken? Muscles twitch or tighten? Pressure rise? Feelings of anger or mistrust? Let these feelings come without judgment. They will pass. Your heart remains open and glowing with compassion, even for those who do not seem to *need* it.

Now focus on the small golden sphere over your chest. It glows with warmth. As you think about these people or situations, the globe warms, and you become aware that you only know part of their story. The warmth spills into an open heart that is free of judgment and full of forgiveness. You are willing and able to confidently bring feelings of compassion, love, and unity into your workspace.

The small blue globe over your head is cooling reactive tendencies. If you feel wronged, you know that you need only to do the right work, and not focus on others' influence on you. The cooling globe calms and reinforces your ability to stay positive in the face of adversity. You think of co-workers or patients who you allow to disrupt your sense of self-control and positivity, and immediately you are able to cool down any raised blood pressure or tense muscles. You think of the people around you, and truly wish them well, and wish yourself well, too.

With that, I close this article with the Indian tradition:

The light in me honors the light in you.

1 Votes
SunnyPupRN

About SunnyPupRN

RN,CYT

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Specializes in PMH.

What a great article. Thank you for sharing and teaching.

Specializes in Psych.

Thank you!

Specializes in Oncology.

Years ago I was a counselor at a residential summer camp. It was toward the end of the summer and all of our nerves were getting frazzled as we grew weary and tired. We had just been given our cabin lists for the upcoming week; in an hour or two campers would be arriving. Several counselors sat at picnic tables comparing lists:

"I had that girl last summer, she's whiny."

"That girl was here earlier in the summer. She refuses to get along with any body. I can't believe she's coming back."

I looked at my list and felt fairly optimistic until someone read over my shoulder:

"Tempest? You have a camper whose name literally means 'storm?' Good luck with that."

At that point in time a mid level director who had been listening in came over and said to us, "I think you're all going to have horrible weeks. You're all expecting to, so how could you not? And you're making first impressions of these poor campers before they even get here." We all felt pretty sheepish.

Working now as an oncology nurse where we often see the same patients on the same unit for several admissions, or the leukemia unit nurses will try and give the bone marrow transplant unit nurses a heads up on patients, I have found that to be a good lesson. As an adult, I have tweaked it a bit to realize if a patient has something like a psychiatric history, I do want to be aware of that before seeing them, but mostly I try to keep an open mind about people.

Great share. Thanks!

Specializes in Psych.

@ blondy What a wonderful story, blondy! Thank you for sharing. We just never know where our life lessons come from do we? :) I once heard a story about a pt being admitted to the ER and the staff [not sure if it was nurses or medics] giving report. They were saying 'another borderline girl for you, put your running shoes on.' The ER doctor said, 'We need to remember those symptoms that you find so tedious are her way of coping with something incredibly painful, and it's how she has survived. We don't know what she has been through, or if you or I would be any different in her shoes." Compassion lives.

Specializes in Psych.

Thank you! So appreciative of everyone's thoughts [good or bad] and the time you took out of your day to read.

Thank you so much for this! I have lurked on this site for years but as soon as I read your article I finally made an account so I could comment. I have a bit of a yoga practice but I've had a really hard time transferring the calmness and positivity that I feel after I practice to work. I'll try to keep this advice in mind during my next shift.

Heres a somewhat relevant story: I got report that a pt was a jerk. Later he told me a joke and I didn't get it at all. So he says "that was a joke." I laughed and apologized for it going over my head. I paid more attention for the rest of the day and he was funny, very dry like most HCP's. We had a great relationship!

Specializes in Psych.

Thank you so much for this very moving account of your 'lurking' and history with your patient. I'm so glad that you found this relevant to your practice! Best wishes for peace in your yoga practice and work. Namasté!

What a wonderful article! Thanks for including the meditation. I'm a new grad and haven't found a home unit at work; it's not so much the individual patients, but some units that have the same stressful effect on me, so any tool for getting a handle on those feelings is much appreciated. My preshift routine should get a lot calmer!

Specializes in Adult MICU/SICU.

I remember my first job as a new grad we had a pt on the unit no one wanted because she was "whiny" and "clingy" and caring for her took a huge psychological toll. She was very sick, and had been on the unit for months.

Eventually I got her on my list of pt's - "Oh no!" I thought.

Paula turned out to be awesome, and I grew to adore her. Quickly I began to ask for her, and no one cared to argue with me about it. She became the first pt to be special in my heart, and 22 years later I fondly my recall her as a wonderful person.

It just goes to show how making your mind up ahead of time about someone is not only unfair, but can deprive you of something wonderful if you let it.

Specializes in Psych.
What a wonderful article! Thanks for including the meditation. I'm a new grad and haven't found a home unit at work; it's not so much the individual patients, but some units that have the same stressful effect on me, so any tool for getting a handle on those feelings is much appreciated. My preshift routine should get a lot calmer!

Thank you for the kind words! It can be difficult, I agree to get ahead of emotions when you are 'in the moment.' Try to remember that there are people with whom you won't click, and that's ok. You can't control anyone else or how they behave. You can control how you respond to situations that are stressful. Sometimes it takes practice, but accepting people and their flaws can make for a more settled, peaceful environment. May your light shine on!