Maureen Bonatch MSN

Thank you!

My twin daughters were born two weeks before 9/11. Although they entered the world before this tragedy, they grew up not knowing any different when it comes to travel and life before we suffered such shock and uncertainty. My daughters started college last fall and had a semester and a half of college life before COVID-19 caused them to virtually finish the rest of the semester. Although they had that small taste of college life, it seems as if college, and everything, may eventually have a new normal due to COVID-19. Featured in the allnurses® Fall 2020 issue... allnurses® Magazine Library College Then and Now Last year as my daughters prepared for school, we shopped for the usual things for new first-year college students. Like a mattress pad, a fan, blankets, and other necessities. This fall, their school supplies include face masks, cleaning supplies, anti-bacterial hand sanitizer, and a no-touch forehead infrared thermometer. My daughters had spent the year before they graduated high school researching colleges to determine the one that suited their needs best. Albeit it’s a smaller campus, but it provides the college community life and traditions they'd anticipated enjoying—which may all come to change. College is more than the academic experience if you’re living on the campus and offers the sense of community that accompanies this transition in life. One that will now need to be much smaller. Instead of encouraging growing a social network, students will be encouraged to nurture the college experience virtually. College Housing While 9/11 brought many of us together, unfortunately, COVID-19 has put many of us at odds. A nurse raised them, so hand hygiene, promoting wellness, and sanitizing aren’t anything new to my daughters, but applying these practices to everyday life, and wearing a mask for most of the day, is. I want my daughters to have the college experience and also understand the mixed feelings many communities may have of the risks that accompany an influx of individuals from all over the country. Last fall, we arrived at the fun chaos of parents dropping off students, welcoming committees, assemblies, and a lengthy move-in time throughout the day. This year our time is scheduled and limited, and interactions are discouraged. My daughters can’t share the same room anymore and had fewer housing options with efforts to maintain social distancing, decrease contact and reserve housing for those that might need quarantining. Class Structure The school, like many, has made many preparations for the return of students. However this fall will be a learning experience for all of us, as this year has been. Many students, who have grown up in the virtual era, were looking forward to college’s in-person experience. The student’s opportunity to collaborate with peers, and marinate in the academic environment, was changed significantly. Many schools present a robust, virtual classroom, although other classes or professors are not equipped, or prepared, to offer this learning environment. After being thrust into the virtual classroom this Spring, many professors rallied to the challenge, but others were left unprepared for this type of learning experience and scrambled to create remote learning options, move materials online, and design learning experiences in alternative ways. Classes this fall provided more options since they will be virtual, hybrid, or in-person. The restructure to smaller in-person courses was accompanied by an expansion of days and times available, and may have resulted in challenges to get into the desired class. Most likely, this type of change in classrooms will continue. Professors will have to become better prepared, and more creative, to meet these challenges. Altering Expectations Daily routines have evolved from just concerns on setting the alarm to get to class on time to monitoring contact tracing, daily temperatures, and testing for COVID-19 is at the forefront of most minds more than academic testing. Students canceled internships, studying abroad, or Spring break trips and others graduated to find the job they’d expected was no longer available. Family time has become more cherished, and independence more necessary than ever. Communications last year included chatting via FaceTime with our daughters, we didn’t realize that would be the new normal for this semester. Parents or any visitors outside of campus are discouraged from dropping in. Although we are hours away, the option to visit was always there. For a parent aware of today’s circumstances, it leaves the fear that if someone gets sick, whether a student or parent, you might not be there. Last year my daughters worked in the dining hall, and most of their work consisted of filling the buffet and salad bar and other food items. As Spring wound down while COVID-19 wound up, the buffet availability reduced to no longer self-serve, takeout was encouraged, and precautions were taken around handling cards with a no-touch system. This year, take out is the only option. College Life Tomorrow COVID-19 has caused some students to change their plans. They may have decided to take a gap year to wait it out until we gain a better hold on the virus, or consider options outside of traditional college. They may remain at home to rethink plans and take a pause to think if the cost of college—both financially, physically, and emotionally—is what they want now, or maybe ever. For some, this is a pause or inconvenience while. In contrast, others may pause their plans and may follow a different path other than college or choose a different educational system. These college admissions reductions may result in increased costs and prompt colleges to consider redesign with a multi-faceted approach. Increased virtual classrooms, and a focus on increasing relevance to local students Providing short-term educational experiences for laid off workers Additional on-line resources to make the most of in-person education Embracing creative educational techniques Shifting college socialization and traditions toward new virtual norms Emphasis on promoting health & wellness and smaller classes Market to those who are considering the nursing profession, or have grown to appreciate health care workers, as many now have a better understanding and appreciation of these essential roles Rallying Amongst Uncertainty Uncertainty remains not just for college but for all of us. As we struggle to find a new normal, we remain apprehensive that we may have to backtrack the baby steps we’ve made. We may hesitate to make plans that we don’t know if we can keep as we’re more aware of our vulnerabilities. These are small hardships and just a glimpse into the domino effect this virus has had on our lives. Many have faced much more difficult challenges and tragedies due to COVID-19. Amidst all these uncertainties, one thing remains certain: the resiliency of the human spirit. The ability to adapt and evolve has gotten us this far, and hopefully, one day we'll look back at this transition from today to see how far we have come tomorrow References Reopening Colleges During the Coronavirus Disease (COVID-19) Pandemic - One Size Does Not Fit All Universities Will Never Be The Same After the Coronavirus Crisis 7 Ways the Coronavirus Pandemic Could Change Colleges This Fall and Forever How Coronavirus Affects Nursing School Admissions

Technology has become immersed in most areas of our life, and that of our patients. This can make some tasks easier, but it can also have negative implications when you can’t, or don’t want to, step away from the screen. Although there are many positive benefits to the use of technology, ongoing use, and spending an extended time staring at a computer or phone screen, can have negative effects. Often it may be difficult, if not impossible, to eliminate the extent of use of technology since many daily tasks, and more positions, require the use of technology. Increasing awareness of how ongoing use of technology can impact our lives, and our patients, can assist in reducing exacerbation of some ailments, or offer a chance to suggest modifications, or provide preventative education. Physical EffectsVision Extended time spent staring at a computer or phone screen can result in eye strain, blurred vision, or dry eyes. Some methods to alleviate discomfort include: Keep eye drops on hand, rest your eyes for brief intervals—and don’t forget to blink Ensure that lighting is adequate and intermittently change the distance you’re focusing on Increase the text size on your screenPain and StrainIf you’re working on a laptop, be sure to put it at the correct height. Avoid looking down at the screen and putting additional strain on your neck or shoulders or this may contribute to discomfort, or tension headaches. Other things to consider include: Try not to hold your cell phone in an awkward angle between head and neck Evaluate your workspace and desk for proper ergonomicsBe mindful of the risk of repetitive strain injury from typing, clicking the mouse, or staring at the computer screenInactivityThe risks associated with too much sitting has prompted more people to invest in standing desks. Most nurses encourage patients to exercise more to decrease risks of obesity, diabetes, and heart problems, so this can support patient education. A few ways to reduce the time sitting, and increase exercise, include: Set a timer, fitness app, or watch, as a reminder to take a break, or to stand and walk around Park farther away from your destination, or take the stairs when you canStand when you have the opportunity, or walk around your office while taking a phone call HearingHeadphones and ear buds provide a convenient way to listen to music or audiobooks, catch up on podcasts, or have a private conversation. Ongoing exposure to loud volumes can result in hearing loss or tinnitus, so a few ways to protect your hearing include: Turn down the volumeLimit the length of time of usePut it on speakerphoneSocial EffectsSome people’s fear of missing out has left them unable to unplug, or tune out the need to constantly check their screen for updates. It may also lead to feelings of inferiority, or social isolation from relying on cyber friendships. Technology has made it possible to stay connected with distant family, provide telehealth for patients in rural areas, and offer convenient access to information. It’s also made us become more impatient, desire immediate gratification, and become more easily distracted. Too much multitasking has left many unable to focus, or it may reduce our productivity instead of improving upon it. A few ways to practice, and educate, on creating better technology habits include: Reduce overall screen time by prioritizing notifications, or set designated times to check emails, and social mediaSet automatic messages to discourage distracted driving, or interrupting sleepTurn off reminders for incoming messages to increase the ability to focus Set parental controls on phones, and check them periodically, for cyber bullying, inappropriate content, or other risksRemember that the social media presence others create isn’t always accurate to reduce feelings of jealousy or inadequacy, or create a gratitude journal to outline positive aspects in lifeCreating a BalanceTechnology has many positive benefits. It’s provided us with methods to provide less invasive healthcare, expand treatment options, and increase opportunities for long-term health. It’s also offered convenience in our personal and professional life for scheduling appointments, gaining information, and reducing tedious tasks. Most of us aren’t going to eliminate the use of technology. The key is to develop a balance of technology use with our life, and increase awareness of the potential negative effects for ourselves, and our patients, and then work to reduce them. How Do You Balance Your Technology Use?

Thank you! Hoosier- It is such a careful balance to provide realistic, practical advice, even if doesn't always want to be heard.

The news is often overflowing with articles about nurse burnout, bullying, staff shortages, and questionable compensation. You may have experienced some, or all, of these issues yourself during your nursing career. Maybe enough to make you wonder why you went into nursing in the first place. This may make it difficult to come up with a positive response when someone asks you, "Do you think I should go into nursing?” The issues of inadequate staffing and the significant number of nurses reaching retirement age are a common concern of the nurses today. A continuing influx of nurses into the profession is required to help reduce these staffing issues. Although with a significant number of nurses leaving the profession, it can be helpful to provide advice that is more practical, rather than personal, for someone considering a career in nursing. Don't Be a Dream Crusher Complaining comes as a natural response to most people, some so much that it's become a habit. We might not think twice about unburdening all the unsavory things about being a nurse on a willing listener to feel validated. Even if your complaints are justified, this can paint a negative image of the nursing profession. It may potentially deter future nurses before they determine if nursing is a good career choice. Even if it feels like the bad aspects of the job are outweighing the good, consider that the positive benefits of nursing are probably what led you to the profession, and made you stay. Provide Practical Advice The profession of nursing continues to be an attractive, growing, career option. One that's held in high regard and respect by many who consider it the most honest and ethical profession. With an awareness of the challenges that can accompany a nursing career, explain what you feel might be a few key characteristics of a good nurse. That way they can determine if a nursing career would work well for them based on their career goals, personal strengths, weaknesses and their personal life. What Are Some Characteristics of a Good Nurse? Flexibility: Nurses work holidays, weekends and with varying schedules. Sometimes there may be several different shifts in one week or extended hours during one day. Empathy: Nurses must draw upon empathy when caring for patients at their most vulnerable times, or dealing with the challenges of patients that have different views, beliefs or are just difficult to care for. Compassion- Providing compassionate care is at the heart of nursing, no matter what the specialty. Physical endurance- Long shifts spent on your feet providing physical care for patients can take a physical toll, so recommend that they consider their personal tolerance and physical limitations. Attention to detail- Accurate documentation and having a discerning eye to notice changes in patient conditions is essential to provide quality patient care. Excellent Communicator- Nurses work with an increasing variety of disciplines, cultures, and in diverse environments. This requires strong verbal and nonverbal communication skills. Lifelong learner- Healthcare is continuously changing through the use of technology. This increases demands on nurses to continue learning to keep their skills relevant. Emotional stability- The demands of nursing can be stressful, so positive coping mechanisms, prioritizing self-care, and the ability to recognize and address signs of burnout are important. Organized- Stellar organization skills are helpful to juggle the varied demands of a nurse's usual day and provide quality patient care. See for Themselves These key characteristics are shared by many nurses, although each specialty, and different nursing environments, can come with their own positive and negative attributes. It may be challenging to adequately describe a day in the life of a nurse to ensure a future nurse is entering the profession without blinders. A deeper look into the reality of nursing could be achieved for someone who is uncertain if nursing is the right career choice. What are Some Ways We Can Encourage a Future Nurse? Take an online course Shadow a nurse to observe a usual day Become a certified nursing assistant (CNA) to experience providing direct patient care Obtain work in an entry-level job in a healthcare environment Share Your Wisdom The nursing profession isn't for everyone, and ultimately the decision is an individual one, but you can help a potential nurse to make the best decision about their career. Instead of chipping away at the fresh face full of idealistic hopes and dreams, allow their enthusiasm. It just might help you remember why you chose nursing in the first place. What Advice Would You Give to a Future Nurse? References 1. https://www.verywellmind.com/complaining-why-do-we-do-it-3144857 2. https://www.BLS.gov/ooh/healthcare/registered-nurses.htm 3. https://news.gallup.com/poll/245597/nurses-again-outpace-professions-honesty-ethics.aspx 4. https://www.beckershospitalreview.com/workforce/49-of-nurses-have-considered-leaving-the-profession-in-the-last-2-years-study-finds.html

At the beginning of our nursing career, we might’ve thought the biggest challenge to overcome was passing the NCLEX. We may have envisioned passing this test as if it were the biggest, and last, obstacle standing between us and caring for our patients the way we want to. When in reality, it was just the beginning. Much of the time the issues that challenge nursing career plans are out of our control, and the NCLEX is just the first of many tests nurses face most days. Even if challenges are out of our control, building an awareness of the source of frustration, and focusing on ways to address it, are the first steps to feeling more in control to overcome career challenges. Time Isn’t On Our SideNurses generally go into the profession because they want to care for people, but often much of their time is spent doing paperwork. Patients may not always understand that these additional tasks are a necessity, and it can result in frustration for them, and also for nurses. This, and ongoing staffing shortages can limit the hands-on time nurses get to spend with their patients. The struggles for nurses to accomplish all that they’d like in a workday that might include frequent overtime can lead to a work-life imbalance, stress, and potentially burnout. When time challenges your best intentions for managing all your tasks so that you still have adequate time for your patients, try to organize and prioritize time commitments as well as you’re able to. Understand that some things may be out of your control. Explain to patients that the paperwork is part of your job, and inform them of when you plan to return when you’re leaving their room. Sometimes a little transparency, and helping patients understand what to expect when they’re feeling vulnerable or at a loss of control, may help reduce their frustration. If you continue to feel overwhelmed, and like you’re running yourself thin with no reprieve, be sure to look for, and address, any signs of burnout. Unexpected Injuries and Health IssuesDespite the best intentions for a long career on the floor, nurses often suffer from back or other physical injuries. This can result from long hours standing, lifting and transferring patients, and the overall physical nature of providing nursing care. This may be combined with working with staff shortages, which can result in inadequate assistance that may result in an injury. Nurses may also be exposed to violence in the workplace due to working with angry patients, or if illness contributes to violent behaviors. Always keep safety in the forefront of your mind when caring for patients. If your body is starting to protest about long hours working on the floor, consider continuing your education to increase career options, or look into other opportunities to utilize your nursing degree without as much physical strain. Don’t forget to practice self-care. Taking the time to care for yourself and get adequate rest is not an indulgence, but a necessity. You can’t care for others if you don’t take care of yourself. Continuous Changes in HealthcareStriving to never stop learning is especially important for a career in healthcare. With rapid, ongoing changes, working in healthcare is continuously presenting us with new technology. This can affect the way care is provided, improve documentation methods, and offer varied options for scheduling. Some of these changes are beneficial and can make the job easier, but often the trial and error of learning new technology can be difficult or frustrating. The Affordable Care Act (ACA) brought changes to healthcare delivery, including offering more patients access to healthcare than before, an increased focus on preventative care and chronic conditions, and the need to improve cultural awareness. Even if a change is for the better, it can still be stressful when you’re trying to keep up with the new while continuing to provide the personalized patient care that is at the heart of nursing. Nursing usually isn’t a career that allows you to bask in keeping things the same way that we’ve always done for very long. Try to stay relevant by reading healthcare journals, reviewing online educational material, network with peers, and explore other methods to keep your mind sharp. Rise to the ChallengeMost of this information isn’t new to us, and there are probably many more nursing challenges that you can identify. We may have been dealing with some of these issues, or have been aware of them for some time, but nurses are known for their resiliency and resourcefulness. The test is determining how we will rise to face these challenges to make the most of our nursing career. Have You Overcome Any Challenges in Your Nursing Career?

Where there are people, there’s conflict. Unfortunately, as much as we try, we can’t always leave our differences at the door before starting work. Varying opinions, miscommunication, misunderstandings, values, and priorities can lead to tension and stress. Employee conflicts can create an uncomfortable work environment. As a nursing supervisor, you can’t ignore a volatile situation between employees once you’re aware of it. Often it’s not the conflict that’s the problem, but how we deal with it. That’s Not In The Job DescriptionWhen you started as a nursing supervisor, you may not have considered the challenges of dealing with the conflicting personalities of the employees you supervise. Most employees are hired based upon their knowledge and skill, which doesn’t mean they’ll get along with everyone they work with. It can become an even more unpleasant part of your job if you try to ignore the issue. You might end up spending a lot of your time, thought, and emotional energy dealing with the consequences of the conflict. It’s best to intervene early to help ease the tension. If you ignore the problem, it may nurture feelings of ineffectiveness and frustration with your position. This may evolve into unresolved resentment for the employees that have made the work environment uncomfortable. Step Into the RingYou may be the supervisor, but that doesn’t mean you haven’t formed friendships with some employees and developed your own assumptions of others. This can make it more difficult when dealing with a situation. You’ll have to leave your biases and preconceived opinions behind to approach the situation objectively. It may be your instinct to try to fix the conflict, but you should try to determine the source of the discord before acting. Just as if it were a patient presenting with a conflicting diagnosis, it’s best to seek the true cause of the symptoms before starting to treat them. Put Away the GlovesYou might only know part, or one side, of the story. Take the time to listen and try to understand the situation before acting. Sometimes when employees feel as if they’re heard it might be enough to start mending fences. Ask questions to prompt them to think about the situation from a different perspective. If possible, encourage the employees to work it out themselves. Discord could stem from a variety of reasons such as conflicting personalities, gossip, unequal pay, jealousy, feeling as if a coworker isn’t pulling their weight, perceptions, internal or external stressors, believing there’s favoritism—or they just don’t get along. A few ways to work to resolve the discord include to: Allow each employee to privately verbalize their concernsSeek to identify and how to best address the problemRule out bullying and incivilityGive clear, behavioral feedback regarding what could be done differently, with specific information on how to improveBe consistent with standards and set consequences, so employees know what to expectFollow-through to ensure that the problem is resolvingDocument the situation, steps taken, and resolution for referenceApologize if you’ve played a role in creating the discordSeek another perspective, such as someone from human resources, or another manager, if necessaryRing the BellIt can be challenging to be around the same people every day, and even more so when you work in a stressful environment. The healthcare environment requires teamwork to provide safe, quality care. It’s in your best interest, and the interest of your patients, to work to resolve the situation. Draw on your communication skills to help employees develop a professional, or tolerable, relationship. A nurse leader’s work often involves leading by example and providing guidance and coaching to help employees work through discord. It may be an unsavory part, but it’s a necessary one. Try to be alert for signs of animosity before a situation becomes volatile or uncomfortable. Although sometimes, despite your best efforts, there are situations that disciplinary action may become necessary. Be sure to be consistent with following the steps and guidelines from your facility. There’s No Winner or LoserA nurse leader has to be involved with their employees to know a problem exists. Dealing with employee conflicts may not be the most enjoyable part of the job as a nursing supervisor, but it can help you gain the respect of your employees, and grow as a leader. Although there’s no formula that will work for any, and all, employees, sometimes just taking the time to listen and seek a satisfactory solution can be beneficial for your employees. How Have You Dealt With Employee Conflicts? Article Sources 7 Strategies to Manage Conflict 9 Ways to Deal With Difficult Employees Can’t Nurses Just Get Along? How to Deal With Lateral Violence in Nursing Dealing With Difficult People

Maybe you’ve been preparing for years for a leadership position through education and promotions, or perhaps the opportunity was thrust upon you. Regardless of the path you took to get here, you’re now in a nursing leadership position. Even if this position is within the organization you’ve worked within for years, your priorities have changed. In addition to being responsible to your patients, you’re now responsible for your employees, as well. Even if you know all the employees, and have worked beside them, they’ll have different expectations of you in your new role. Most leadership positions have tasks that require the skills of either a manager, a leader, or both. Only you can determine how to balance the key aspects of both roles and carve a successful path as a nurse leader. Manager versus LeaderIt’s not necessary to be assigned a leadership position to be a leader, and all nurse leaders aren’t successful in leading their employees. You can lead from wherever you are in the organization if you know how to project qualities and characteristics that inspire and influence others. Organizations need both managers and leaders. Both roles have different priorities, and sometimes you might need to combine the skills of each. You might be required to manage budgets, inventory, staffing, and quality improvement efforts, while a leader’s duties extend beyond required tasks. Leaders must consider their employees emotions, and recognize and respect them as individuals. To gain their trust and respect, leaders must ensure their employees feel appreciated, and that they believe their efforts make a difference in the organization. Qualities of a Good LeaderOften nurses are promoted into leadership positions because they’re good clinicians, critical thinkers, or since they have the most experience. But perseverance doesn’t procure leadership skills, although that doesn’t mean you can’t work to acquire or enhance these skills. Consider what qualities you’ve sought, or admire, in a leader, and how you might work to develop, or model, those behaviors. A few desired qualities in a leader might include: Presenting as a role model in a professional, and ethical mannerBeing fair and consistentTaking responsibility, and being accountable for their own performanceKeeping the bigger picture within viewDisplaying passion, vision, and focusA commitment to the organization, and their employeesAn empathetic and caring natureExcellent communication skillsSeek a nurse mentor who will provide you with honest feedback to help you determine where you fall within this spectrum, and what skills you should strive to improve. Listen to their feedback with the understanding that acquiring a nurse leadership position is only the beginning, to succeed it’s important to continue with professional development and keep abreast on potential organizational challenges. Initial Efforts Reap RewardsWithout the heart and soul of a leader, you can be in a leadership role but not be successful in leading. Inspired and motivated followers who support their leader are essential to accomplishing organizational goals. Whether you’re new to the organization or adjusting to a role in which you’re now supervising your coworkers and friends, taking the time to listen, rather than making assumptions on what you believe needs done, can assist in achieving success. Initially, most new leaders can benefit from spending more time listening, than delegating tasks and acting. Take advantage of the knowledge and expertise at your fingertips, and share your expectations, as well as clarify what your employees expect from you in this new role. A leader is one person, it requires communicating and collaborating with your team, and addressing individual concerns, to earn the respect and support essential to achieving success. Find Your PeersIt can be lonely at the top when you realize that although you can still be friendly, and even friends with your employees, you have a new level of responsibility and often have access to confidential information that you can’t share. It’s helpful to develop a social network, and professional relationships, with other nurse leaders to reduce feelings of isolation. Broadening your network can allow you to establish mutually beneficial relationships in which you can share best practices, knowledge, and validate that you may face the same challenges. If you’re concerned about asking for advice, or sharing experiences, with local competitors, there may be opportunities to establish trustworthy relationships online where you’re not in direct competition. These can be acquired through professional networks, or on social networks such as LinkedIn. New Challenges and RewardsA new nurse leader can be presented with many challenges. But there are also opportunities to reap rewards and gain professional satisfaction from having the chance to make a difference in your organization, and for your employees.

Download allnurses Magazine Nurses work at the frontline of patient care. We collaborate and work with other healthcare professionals, but usually provide the most direct patient care. This extra time spent serving as an advocate, resource, and educator, while helping patients facilitate their healthcare journey has prompted the nursing profession to sometimes be thought of as the heart of healthcare. It’s also contributed to nurses earning the honor of being voted the most trusted profession for the 16th consecutive year in the Gallup honesty and ethics polls. Although, the nursing profession isn’t without its challenges. The shift toward quality, value-based patient care with a heightened emphasis on population care that focuses on increased health promotion and holistic patient-centered care, requires a larger, more diverse, and highly educated nursing workforce. To continue to support patients, and manage their care, nurses must resolve to seek solutions for current issues within the nursing profession. Nurses are rising to the challenge, and efforts have already begun to tackle current issues and implement positive changes for the future of the nursing profession. Issue - Nurse Staffing and RecruitmentNurse staffing shortages are not a new issue. The challenge of maintaining adequate staffing to meet the increased demand for nurses remains ongoing. Insufficient staffing can contribute to additional issues that affect job satisfaction and the provision of quality care. As one of the fastest growing healthcare fields, nursing is anticipated to grow by 15 percent from 2016 through 2026. This is faster than average according to the Bureau of Labor and Statistics. This age-old staffing problem, and present nursing shortage, challenges us to meet this need due to a combination of factors that are increasing the demand for nursing staff. These include: The Affordable Care Act (ACA) has enabled more patients to acquire access to healthcare. Some patients may have never had healthcare before, and many patients may be more diverse or have complex healthcare needs. The nursing shortage is aggravated by several. With an aging nursing workforce, and the pending retirement of baby boomers combined with an inadequate nursing faculty to educate future nurses, recruiting and retaining an adequate supply of nurses is even more challenging. A shortage of nursing faculty. The wide gap between clinical and academic salaries, and the need for additional experience and education may have contributed to the lack of adequate nursing faculty. The nursing faculty shortage has forced some universities to limit the student capacity for their nursing programs. Make a Resolution to Seek a Staffing SolutionNurses are unique in that they can choose multiple education pathways. Although it’s felt that additional education can help nurses successfully navigate increasingly complex patient needs. Advanced education can also allow nurses to take on additional roles and responsibilities within the nursing profession. The Affordable Care Act (ACA) was one of the prompts to inspire The Robert Wood Johnson Foundation and the Institute of Medicine (IOM) to begin working toward making nursing education a seamless academic progression with a goal of having 80% of nurses obtain a Bachelor of Science (BSN) by 2020. They recognized the need to rethink some of the roles of the nursing profession and increase their education, to meet the needs of an aging, more diverse, patient population. This progress to transform the nursing profession continues, with the intent to improve effective care for the changing patient population. Having more BSN prepared nurses can also result in shorter hospital stays, lower healthcare costs, reduced patient mortality rates, and improved patient outcomes. Issue - Struggling with Nurse RetentionAlthough once nurses obtain a position, the environment and culture of the organization must provide positive benefits to encourage them to stay. Organizations that focus more on recruiting nurses, and then not making efforts to make positive changes to retain them, often endure ongoing struggles to retain nurses and maintain adequate staffing levels. Retention issues that may occur due to the facility environment and culture can include: Excessive overtimeInadequate staffing levelsNurse burnoutHigh staff turnoverScheduling dissatisfactionA wage or benefit package that isn’t competitiveInadequate time to provide patient careNurse bullying or incivilityFear of workplace violenceInability to achieve a satisfactory work and life balanceLack of opportunities for advancementResolve to Work to Retain the Nursing Staff GainedPoor retention affects more than the organization. Inadequate staffing can disrupt productivity, impact patient care, and decrease job satisfaction. Patient satisfaction is often linked to the quality and contentment of the nursing staff, so neglecting issues within the nursing environment can spur a vicious cycle of patient dissatisfaction and nurse turnover. Issue - Overwhelming Stressors in the Workplace The healthcare environment may be fast paced and ever changing, but it’s not normal for nurses to be constantly overwhelmed and exhausted. Passion isn’t always enough to sustain nurses through the physical and mental demands of the job, yet many neglect their own mental health and wellness. Some may even feel as if it’s a sign of weakness to admit to these feelings, or as if they should be able to handle everything on their own, get over it, or that it’s part of the job. But long shifts, working extended days in a row along with conflicting demands can lead to fatigue and burnout. Many nurses overlook the signs to slow down, implement personal preventative care measures, or seek treatment. A negative or toxic work environment may be related to some of these issues. This can result in other mental or physical issues overlooked or unnoticed such as: Burnout- The cause and the way the symptoms of burnout manifest can vary. This can lead to an increased risk of medical errors, may affect patient care, impact job satisfaction, and increase turnover.Post-Traumatic Stress Disorder (PTSD)–Intense, ongoing stressors combined with staffing issues may leave little to no time to process a distressing event at work.Bullying, harassment, and incivility- The RNnetwork survey indicates that 45 percent of nurses report being harassed or bullied by peers. Repeated, unwanted harmful actions intended to humiliate or offend the recipient can infect staff with fear and humiliation, decrease productivity, increase absenteeism and increase turnover.Alarm fatigue- The multitude of devices meant to assist and alert staff to patient needs can result in sensory overload and desensitization. Their purpose is defeated when nurses ignore, overlook, or are unable to differentiate critical or routine alarms. Alarm fatigue can become counteractive to enhancing patient safety.Resolve to Commit to a Supportive EnvironmentThe way we treat each other is as important as the care provided. Nurses should respectfully support each other as professionals and encourage others to adhere to the advice they give to their patients and realize that mental health can be just as important as physical health to provide safe care. Nurses are less likely to encourage others to enter the nursing field if they aren’t engaged, or don’t feel supported, or appreciated, in the workforce. Promote a professional environment that realizes value and shares goals and success to attract and maintain the best employees by: Recognize and hold people accountable by rejecting negative behavior and reinforcing what behaviors are unacceptable and detrimentalAlign a positive atmosphere to patient outcomes to attract and retain staff who support each other and the organizationEncourage and model clear, calm communication that’s mindful of volume and body languageNurture a culture of mental and physical wellness and invest in individual health needsSeek evidenced-based practice to develop an approach for alarms to perform appropriately and reduce false alarms and risks accompanying alarm fatigueIssue - Increased Risks of Workplace Violence & Job HazardsPerforming procedures which can cause discomfort or pain for patients that may be fearful or confused can put nurses at risk for workplace violence. The risk of physical or verbal abuse from patients, or family members, can be exacerbated by inadequate staffing and can contribute to an undesirable, unsafe, work environment. The Occupational Safety and Health Administration (OSHA) states that from 2002-2013 the rate of serious workplace violence was 4 times greater in healthcare than private industry. This may be even higher since many may not report because they don’t want to lose time, think reporting won’t make a difference, or that violence is part of the job. The highest rates of violence usually occur in the emergency room and psychiatric units due to substance abuse, cognitive impairment, waking from anesthesia, fear or frustration. This risk for violence for nurses is in addition to the environmental and physical risks associated with the job due to injuries from patient care, exposure to bloodborne pathogens or needle sticks. The increased age of much of the nursing workforce, inadequate staffing hectic pace, fatigue and long hours, can result in decreased alertness and awareness and increase the risk of injury. Resolve to Reduce the RiskEducation and awareness of situations with increased risk and incorporating a zero tolerance for violence can assist with proactively addressing these issues. Other methods to work to decrease the risk of violence and injury include: Emphasize the importance of reporting and documentingReport and gather data regarding incidents and risksSet a zero-tolerance policy standardDevelop an expected code of conductBuild awareness of the importance of ergonomics to reduce injuriesEducate on awareness and how to identify and address if there is a risk for performing safe careRemove items in the patient care areas that could be used as a weaponEnsure there is adequate lighting and an awareness of available exits in a crisisEncourage clear patient communication on what to expect for their treatment, and wait timesAlert staff if patients have a history of violenceIssue - Meeting the Needs of Diverse Patient PopulationsThe patient population is becoming increasingly diverse. Striving to increase diversity in nursing staff, and education on cultural awareness can assist with improving cultural competency. Knowledge of cultural differences, expectations and how to identify personal assumptions, can assist nurses to reduce communication and cultural barriers to care. This could potentially lead to better patient compliance and outcomes. Many patients are reassured to have a caregiver from the same ethnic or racial background. They may be able to better understand cultural preferences, communicate more effectively and appreciate the patient’s perspective. This can help in gaining patient trust and confidence in the care and increase patient satisfaction. Resolve to Educate and Incorporate Cultural Awareness Patients depend on nurses to adhere to their professional obligation to make healthcare decisions that balance treatment options and patient wishes. The nurse may not agree with the patient’s beliefs, or may struggle with conflicting personal values, but should still strive to provide care in the client’s best interest. Cultural awareness can help the nurse understand and support the patient’s unique care needs even if they conflict with the nurse’s personal beliefs. Education and understanding on cultural diversity can increase awareness of personal attitudes, and beliefs, and allow nurses to provide fair treatment to patients regardless of their economic status, race, religion, ethnicity or gender identification.Factors such as the changes in the economic environment, stable employment options, and the variety of settings and opportunities for advancement have played a role in increasing diversity in nursing: This has also influenced males and other minority groups to pursue nursing. This may help ensure the nursing profession can be sensitive to cultural specific needs while providing care for diverse populations.Developing and supporting a more diverse, culturally aware, ethical environment may increase the nurse’s comfort in speaking up to act as a patient advocate and provide culturally appropriate care.Issue - Blending Generations in the WorkforceNurses delaying retirement, and an influx of new nurses, has resulted in blended nursing generations in the workforce. Generational differences and efforts to work coordinately can result in conflict and job dissatisfaction. Although individuals can’t be classified by their generation, since each person may have their own unique characteristics and expectations, most are influenced by the period they grew up in and experiences they’ve encountered. Generational differences can affect thoughts and perspectives and impact the ability to work coordinately. The generation we grew up in can also influence: How we interactPreferred work and life balanceMethods of communicationValues and beliefsSignificance of education and trainingDesire, and preferred method, to be recognized for work performancePreferred management styleDon’t Overlook Technological ChallengesToday’s nursing workforce must be both clinically skilled and technologically perceptive by balancing hands-on patient care with technology. This can prove challenging with blended workforce generations. Each generation, and individual may have varied comfort levels, and views, regarding technology. Some may be challenged to learn new processes, while others harbor fear and uncertainty. Resolve to Work to Embrace Generational DifferencesIncorporating technology into the workplace can provide opportunities for education and reverse mentoring between generations. If effective methods of learning are considered, opportunities can be created to develop leadership skills for new nurses. New generations may be more accustomed to utilizing technology, while other generations may be accustomed to relying heavily on touch, sight and smell to gauge the patient’s medical condition. Both methods of patient care have positive benefits. The challenge is to create a balance that doesn’t completely rely on technology while maintaining the human element in nursing care. Ways to strive to embrace generational differences include: Recognize the unique characteristics and expectations of each generationIdentify traits shared between nurses of all generations to foster teamwork and collaborationWork toward a sense of purpose and overall goalsFocus on expectations, rather than outcomes, when approaching tasksTechnology and scheduling software can be beneficial to reduce paperwork and to work toward a better work-life balance, reduce overtime and the risk of short staffing. But quality, knowledgeable nursing staff must be available for technology to be effective. Issue - Striving for Safe Staffing LevelsStaffing is one common element that can affect multiple nursing issues. Inadequate staffing contributes to more than nursing retention. As patients shift out of hospitals for better reimbursement, it can mean shorter stays with patients with more complex needs. Mandatory overtime, long shifts, or extended workday stretches can affect the ability to provide safe patient care. It can also contribute to: Increased fatigue and rate of injuryMedication errorsLength of patient stayPatient mortalityNurse burnoutPatient dissatisfactionResolve to Seek and Support Staffing Solutions Staffing issues have not gone unrecognized. The American Nurses Association (ANA)recognizes the significance of safe staffing and has implemented surveys, incorporated research and data collection to work toward positive legislative changes. This exploration of optimal staffing levels hopes to emphasize the importance of nurse and patio ratios and the effect on patient outcomes. Hospital patient levels are constantly fluctuating. Staffing levels are dependent on patient acuity, complexity of care, the number of admissions, discharges, transfers, and the skill level and expertise required. Nurses have the best judgement on staffing levels and how to best manage flexible staffing while supporting each other. Working toward mandated staffing levels may help reduce the risk of patient harm and improve nurse job satisfaction. Find Our Voice for Ourselves and Our PatientsThe role of the nurse continues to grow to meet the complex demands of the healthcare system. Nurses need to become change agents and have a voice for themselves, and their patients, to work toward being full partners in redesigning healthcare. Nurse’s voices are important and can contribute the expertise acquired from education and experience across many healthcare settings and specialties. Nurses Can Get Involved by:Volunteering and participating in committeesContinuing with personal and professional growth and educationBecoming a mentor to:Appreciate, and explain, the history of why tasks are done the way they are, and to take a critical look for areas for improvementShare expertise, guide and educateInspire and empower future nurses and nurse leadersGain a feeling of ownership in the success of the organizationBridge generational gaps by comprehending the strengths of different generationsContribute toward a positive workplace cultureDisplay a willingness to embrace changeAcquire a fresh perspective on the newest and latest trendsNurses Voices CarryNurses can make a difference by taking ownership of the nursing profession and committing to change the culture and status quo by getting involved within their organization, their community and contributing their voice to public policy. Nurses are generally underrepresented when major healthcare decisions occur. The Nurses on Boards Coalition is making strides to correct that with a goal of having 10,000 nurses on boards by 2020. To begin acquiring a broader strategic mindset nurses can: Start prepping mid-career to prepareWork with a mentor, or other members of the boardTake courses on presentation skills and public speaking to build confidenceRecognize that nurses have valuable contributionsServing on a board can be personally and professionally rewarding. It may also provide opportunities to enhance professional networks, impact public and community health, and be on the forefront of strategic planning. If nurses become a voting member in decision-making roles in healthcare they can: Have a seat in decision makingLead conversationsHold other board members accountable for decisionsBe the voice for nurses and patientsBring the patient perspectiveResolutions for Future ChangeThe Robert Wood Johnson Foundation(RWJF) initiative, The Future of Nursing: Campaign for Action, emphasized improving access to care, collaboration, diversity, healthier communities, nurse leadership and education. We’ve made great strides toward these goals, but continue to have more work to do. Many of the issues in nursing are interrelated and ongoing. But by making small steps, and increasing involvement within, and outside, organizations, nurses can work to find their voice to make a better future for our patients and ourselves. The public continues to place their trust in the nursing profession to provide compassionate, honest and ethical care, and nurses are honored to provide it. Recognizing the contributions and impact of nurses can help us realize that together we can lead positive changes for the nursing profession and lift each other up for future success. Sources 5 of the Biggest Issues Nurses Face Today Current Issues in Nursing and Healthcare Focus on Self-Care Could Help Prevent Nurse Burnout HealthLeaders Top 10 Nursing Stories of 2018 Low Nurse Staffing Increases Risk for Inpatient Death Our Nation Needs More Nurses on Boards Ready to Serve The Case for a Nurse Trustee Update on Future of Nursing Report: Are We There Yet?

Daisy, I hope this helps make your holiday season more joyful.

Months before the holidays arrive we start getting bombarded with advertisements and movies depicting the perfect holiday scene. These fictional people are happy, and stressors are wrapped up while everyone exchanges beautiful gifts complete with a handmade bow. Most of us enjoy indulging in these scenes, and envision trying to recreate the perfect holiday depicted by the media and television. Even if we know it's not real, we may desperately want it to be. But instead we're scheduled to work, or the kids get sick, or we can't afford what's on their Christmas list. We're overwhelmed with too much to do with too little time, money, sleep, and patience-but with plenty of patients who need our attention. It's hard to give one-hundred percent at work when we're preoccupied, or resentful that we're working and we can end up dreading, instead of enjoying the holiday season. When You Feel Like a ScroogeAlthough most of us realize that people require healthcare every day of the year, we may not have considered how a nursing career can affect our personal life for many holidays to come. We may understand the need to work, but it can be disheartening when we end up missing out on holiday traditions and family gatherings. We can spend time being resentful because someone else got the day off, or we were called in to work, or feeling inferior because we're too exhausted to keep up with what we feel the holidays require. Or we can try to change our perspective. Attitude can make or break the holiday. Often the holidays repeat this same stressful rollercoaster year after year. Each year we think it's going to be different. That this will be the year that everything is perfect. We know the holidays are coming, yet we haven't tried to change our expectations or attitude, and the outcome remains the same. We end up bringing ourselves down, which can lead to not being present for our patients when they may need us the most. They may be spending the holiday season ill, or without their families. If we take the time to plan and prepare for more than our shopping list, we can begin taking control of holiday expectations. Sleigh Holiday ChallengesEven with holidays surprises, most of the challenges during this season are the same year after year. If we try to work the holiday around our work schedule, instead of trying to work around the holiday, we can determine priorities and let go of unnecessary obligations that leave us exhausted and overwhelmed. Unfortunately stress usually accompanies the holiday season, but if we anticipate some of these stressors, we might be better prepared to adjust our expectations and response. A Lack of GoodwillStaff, families, and patients feel the extra strain during the holidays and often nurses are on the receiving end of their frustrations. The gift of extra patience may help in working with those that are sick and increase your gratitude for the good health of family and friends.Patients who have no family may see you as a substitute, taking the time to talk about their holiday traditions can allow you to attempt to recreate a small part for them.So, So, So Many Social ObligationsGatherings can be numerous and overwhelming when you're trying to be everywhere and do everything. Make priorities early so you can declare that your schedule is already full.Crowds usually mean stress. The benefit of working different shifts, or having varied days off, means you can consider shopping alternate hours or days, or avoid it by shopping online.Consider changing the day, or time, you celebrate with family if you're working. Make new traditions that are less stressful, or ones that aren't tied to a certain day or time that may not always match your schedule.Some Might be Having a Blue ChristmasWhile many of us struggle to fit everything in, others may suffer from social isolation. The holiday season often brings feelings of sadness and grief for many who have lost loved ones. Look for signs of depression in patients and family, and if necessary, refer for treatment.Taking care of yourself is one of the best gifts. Plan for time to relax to deal with the hustle and bustle of the holiday.You Don't Have to be Santa ClausOverindulging in food, alcohol, and overspending our holiday budget can result in kicking any healthy habits to the curb. Try to recognize financial and personal triggers to be mindful of eating in moderation, and sticking to a budget to prevent January regrets.The pressure to make goals and resolutions while completely overwhelmed-as if to right all the wrongs in the past month-can be distressing. Instead plan small, monthly goals to avoid unrealistic pressures.Memories Aren't ScheduledIt's not easy working in healthcare, and especially over the holiday season when we feel like we're missing out, or not doing enough. But if we think of our favorite holiday memories, they aren't usually about specific gifts, or attached to one day. The best memories are often unexpected and priceless.

Many of us begin planning for retirement early in our career with most of our concerns evolving around financial planning. Although it's essential to plan for adequate retirement funds, it's just as important to consider the psychological adjustment that can occur with retirement. Although most of us never stop being a nurse, often we've attached some of our identity to our work.After spending years in nursing, retirement can bring feelings of loss, although many don't admit this. Society has conditioned us to believe that these are the years we've been waiting for, so it may feel wrong to express unhappiness or loneliness. You may feel as if you've lost a part of yourself, or realize you'd tied most of your social network to work. The nursing shortage has contributed to a demand for nursing staff. This may open additional opportunities for flexible, seasonal, or float positions that can allow for a gradual adjustment to retirement. Shifting into RetirementIt might become apparent that although you've prepared financially for living expenses, those travel and other expenditures that you've put off until retirement are more expensive than you've budgeted. Maintaining a little nursing work may help fund your freedom to pursue your plans. Choosing to remain, or return, to nursing in a new or reduced role can help keep your mind sharp while allowing you to cash in on your skills. Your attitude about work might change as well when you choose to go to work, instead of feeling as if you must go. Take a Turn in Your CareerYou've spent countless years advancing your career through education and acquiring new skills, but long shifts, or too many days in a row, can be draining. There may be ways to explore new roles that allow you to utilize that clinical expertise with less physical strain. This could be an opportunity to transition into other positions or try something new such: Teaching - For schools or adult learning centers, as a wellness consultant, or by providing education on First Aid, or a nurse aide instructorFreelance healthcare writer - Keep current on new technology and changes in healthcare by researching and writing healthcare articlesTravel nursing - Explore some of those retirement destinationsGo PRN - Consider opportunities that provide more flexibility such as a substitute school nurse or in a casual, or PRN position to retain, or gain, an area of nursing expertiseBack to school - If you've reduced your workload, and the kids are grown, perhaps now you have the time to pursue that extra education you've put offThis is only a fraction of the different ways you can continue to utilize your nursing skills. The important thing is to explore what motivates you, or what career goals you may have put on hold. Retirement may signify the end of one career, but it may be the beginning of a new one. Put Recruiting in ReverseMany employers have always valued the expertise of their older workers, but the desire to recruit or retain them has become more prevalent with the nursing shortage. Rather than mourning the wealth of knowledge of a nurse nearing retirement, some employers are exploring ways to be more flexible to accommodate the needs of these workers. Such as by: Finding ways to work around the nurse who is semi-retired and wants to spend the winter out of state can prove beneficial when schedules are tight during summer vacations.Developing roles in orientation, training, or mentoring are often great ways to enhance the onboarding of new employees while allowing the experienced nurse to share their wealth of knowledge.The Road to RetirementRetirement doesn't have to be an all or nothing venture. Whether financial needs inspire you to keep your foot in the workplace, or you just enjoy working, consider that there are other opportunities available rather than feeling obligated to the same old job if it's left you uninspired. That opportunity may only mean reducing your work schedule or exploring a different role. But that small change might make the difference and allow you to take advantage of the years you've invested in your career.

I'm glad this article resonates with so many people and hopeful that it helps to remind us to be kind to ourselves.

All day, every day, we analyze each thing that occurs with our inner thoughts to determine our view, which can make or break our day depending on our perception. We spend more time in the company of our thoughts than with anyone else. Isn't it time to work on a better relationship and start being nicer to ourselves? It's not always what happens that influences our self-talk, but our interpretation of it. If that inner self-talk is irrational and untrue, we can develop unrealistic expectations, damage our self-esteem, or undermine our performance. Many things are out of our control, yet that doesn't stop us from blaming or criticizing ourselves. Sometimes we say demeaning or degrading things to ourselves that we'd never say to another person. This may be over petty things such as if we didn't do something, forgot something, or made a mistake. Often, it's due to holding ourselves to unrealistic standards. This ongoing negativity can derail enjoying our successes, or it may escalate into something self-destructive. Notice Negative ThinkingWe are a product of our thinking, and eventually, we may come to believe what we tell ourselves. Negative self-talk is usually a learned behavior, but we may have practiced it for so long that we're not sure where we learned it. Negativity may have become an automatic response. Our thoughts can hurt us, but when we are caregivers, we have the potential to transmit this negative energy to others. A few examples of negative thinking include: - Unrealistic expectations that leave us feeling guilty, hopeless or overwhelmed when things don't meet what we anticipated. - Recurring negative thoughts that keep us stuck in old patterns instead of allowing us to move forward. - A method of thinking that results in us never being satisfied since we view each task with an all or nothing mentality. - Looking for problems when they don't exist instead of realizing we don't always need to solve a problem because maybe there isn't one. - We assume we know what others expect, or that they know what we desire. When we don't want to ask for help, we don't always receive it. This may leave us angry or resentful. - Any change is impossible. We cling to what we're comfortable with and avoid focusing on the positive things that may accompany change, or we choose the easiest option even if it's not the best one. - Envy poisons our thoughts and we continuously compare ourselves to others and reduce opportunities for happiness. - Overthinking every situation, which can result in unnecessary stress. Break Through the BarrierSometimes the only barrier to reducing negativity is in our mind. Recognizing that there's an opportunity to choose negative or positive thinking may help silence negative thoughts by removing their power. Our thoughts keep us stuck in patterns of negative thinking, which can lead to self-destructive thoughts or behaviors. These could include things such as making the same mistakes, continuously second-guessing ourselves, grasping for immediate gratification without considering long-term consequences, or being overly critical. Steps to Reduce Negative Thinking: Develop an awareness of negative thoughts so you can recognize them and take steps to reduce or eliminate them. Say the word, stop, or reword thoughts into something more positive.Find the silver lining, the exception, the one good thing in the situation and focus on being grateful.Fill your life with activities that you enjoy and friends that are positive influences.Focus on being in the present moment through deep breathing, affirmations, positive visualizations, or inspirational books or podcasts that assist in developing mindfulness.Make a deadline for decisions rather than dwelling on them and allowing them to control your thoughts.Fake it until you make it by acting how you want to feel.Sometimes negative or self-destructive thoughts are more than we can manage on our own, or they could lead to self-destructive behaviors. It may be necessary to seek additional help from a mental health professional if these thoughts lead to self-destructive behaviors such as excessive use of alcohol or drugs, excessive spending, getting stuck in bad relationships, intense ongoing sadness, or losing the desire for things we once enjoyed. Be Kind to OurselvesWe're usually aware of the benefits of being nice to others, and how unkind words can produce long-lasting hurt. Perhaps if we tried to treat ourselves as kind as we strive to treat others, we would be able to reduce negative thoughts and have a more positive outlook that might benefit us, as well as those we care for. How Do You Halt Negative Thoughts?

Post-traumatic stress disorder (PTSD) is usually associated with active and retired military members, and although they may consist of the majority of those suffering from PTSD, they're not the only group at risk. PTSD can develop after someone has experienced, or witnessed, a traumatic or terrifying event, or it could be from an ongoing, long-term trauma. This could include a physical or sexual assault, an accident, war, a natural disaster, or the unexpected death of a loved one. Other groups that could develop PTSD include the families of victims, children, and rescue and emergency personnel such as nurses. As nurses, and especially the nurses who work in the emergency department, we routinely deal with occupational stressors such as violence, trauma, and death that can put us at an increased risk for PTSD. While we're accustomed to screening our patients, we should remember to also assess families of victims, our peers, and ourselves for PTSD. Be Aware of PTSD Symptoms Nurses can experience intense ongoing stressors. These may be accompanied by staffing issues that leave little to no time to process a distressing event that may occur during work. Many nurses who experience PTSD think they should be able to cope with it on their own, or that they'll get over it, or believe that dealing with recurring, overwhelming stress is just part of the job. Some nurses may try to hide, deny, or not recognize the symptoms of PTSD. Or they may imagine that admitting to a need for treatment would be viewed as a weakness. This can lead to delaying, or not seeking treatment, or mistaking the symptoms for other medical conditions. PTSD rarely occurs on its own. Burnout syndrome, substance abuse, depression, or other psychiatric disorders, often coexist with PTSD. Symptoms of PTSD could be delayed in appearing and can vary. Emotionally there might be feelings of guilt, anxiety, anger, denial, grief, and fear. These emotions can display in an array of behavioral symptoms such as: Intense fear, and feelings of helplessness Flashbacks, or mentally re-experiencing the event Ongoing anxiety Self-destructive behaviors Hyperarousal, or an exaggerated startle response Withdrawal from others, or avoidance of things that remind them of the event Nightmares, insomnia, or other sleep disturbances Emotional outbursts or other cognitive or emotional symptoms, such as difficulty concentrating, feeling disoriented or having difficulty concentrating Stress vs. PTSD PTSD was once classified as an anxiety disorder, but it's now considered a trauma and stress-related disorder. It differs from common stress reactions because of the length of duration and how it may result in a disruption of daily life tasks and relationships. Nurses who have endured a prior trauma, have a preexisting psychiatric disorder, or lack a social support system could be at an increased risk. Nurses suffering from PTSD may notice symptoms: That persist for at least four weeks, instead of disappearing hours, or days, after an event Which may disrupt the ability to interact socially, or at work May occur long after an event when something occurs that triggers a memory, or a patient reminds them of a prior traumatic experience That can affect quality of life, the ability be productive at work, and to produce positive clinical outcomes for their patients It's Never Too Late for Treatment Education should be provided regarding how PTSD is related to overwhelming stress, and not a personal weakness, as this may be beneficial in encouraging nurses to seek treatment. PTSD can become a chronic condition and the treatment Is usually gradual and ongoing. Nurses, and nurse leaders should be mindful of following up after an incident. Or recommend that a co-worker, or family member, consider critical incident stress debriefing (CISD) if they've experienced, or witnessed, a traumatic event. CISD is most effective if offered within 24-72 hours after the trauma. By offering a safe place to express anger, grief or sorrow over a traumatic event, it can assist in coping with the potential physical and psychological effects associated with traumatic events. Each individual's experience is unique, and the best treatment may vary with trauma-focused psychotherapies, medications, or other methods specific to the individual's needs to assist in processing coping with the trauma. Raising Awareness of PTSD It's never too late to begin treatment. Increasing the awareness of the prevalence of PTSD, the varied populations that it can affect, and the symptoms to be aware of, may help to inspire nurses, and others, to seek treatment.