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Topics About 'Stress'.

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  1. I am ready to leave the nursing profession after 6 years. I have a bachelor's degree in biology and got my associate's in nursing. In high school, I decided that I wanted a career in nursing. By the time I entered college, I decided I wanted to become an OB/GYN. Halfway through college, I realized I didn't want to be a doctor. I wasn't sure what I wanted to do but I wasn't going to change my major and start over. Fast forward about 8 years, I considered nursing and applied to nursing school and here I am.....back at square one. I wish I had sacrificed and endured one or two more years of college by changing my major and pursued something else. I often-times cringe when I think of going to work. My attitude changes, my heart races, and anxiety sets in. My coworkers are nothing less than awesome. Most of my patients rock. Both have been unexpected blessings to me and I thank God for our paths crossing. But management, the physicians, and the facility at which I work have made nursing a profession that I wished I had not entered. I never have to wonder how devalued I am when I'm at work. Our voices are not heard, and as a matter of fact, our concerns are considered complaints. Not only am I a caregiver, but I am the business office, auditor, waitress, maid, logistics, IT, quality assurance, babysitter, personal assistant, and the list goes on. When doctors fall short, it is our job to clean the mess up.....and, no, I'm not speaking of mistakes that affect patient care. I speaking of simple documentation that they are supposed to take care of. I understand the importance of having all "I"s dotted and every "T" crossed, but when will the physicians be held accountable? I can't be chasing down physicians when they forget to check the correct box especially when it has little or nothing to do with a patient's outcome. That's not my job. We nurses are stressed, afraid, furious, and just plain depressed as a result of these added responsibilities. We already worry about our patients even after quitting time. After leaving work, many of us call back up to the floor or unit checking on our patients. We are genuinely concerned about them, but it is very obvious that management's agenda is not the patients. Whatever management's agenda is becoming our agenda, right? WRONG! I'm here to take care of patients, not physicians. There are so many nurses, YOUNG, fairly new nurses, that I know that started their nursing careers with a clean bill of health. They are now on antidepressants, benzos, blood pressure meds, and others due to the stress and unhappiness. Nursing has gotten away from patient care. It's about making money for the organization which is about making the physicians happy. If that means being stripped of our dignity, we are to do what it takes. I feel as though it is second nature to provide excellent care to our patients. WE have saved many lives anywhere from observing changes in our patients to discovering mistakes made by others (physicians) and correcting them or directing attention to the oversight. I wish they would let us do OUR jobs and provide care and management can run up behind THEIR "customers". If we can keep those two jobs separate, that would be great. We are a vital part in patient care, but yet, we are so underappreciated and taken for granted. We make a positive impact in many lives, but we are the first ones cursed out because someone is having a bad day. Not only are we unappreciated, but we are very disrespected, and in many occasions, we are unfairly belittled and we are just supposed to accept those words because "it's part of the job." I'm done accepting it. I'm reminded every day there are replacements waiting in line. I'm reminded that any fool can do my job. I don't want a pat on my back every time I do a great job, just acknowledge that I am a vital part of the team. I understand human resources has a stack of nursing applicants on their desks. I just don't have to be reminded of that everytime all my paperwork isn't on the chart (because I'm still working on it), or if I come back from lunch two minutes late. I am not cut out to take jabs and low-blows without throwing them back. I have so many responsibilities that I take on from the time I punch the clock to the time I punch out and I refuse to be disrespected by someone with a title because I happen to not move fast enough or I am having to clarify an unclear and, most of the time, an unfinished or incorrect order. I'm helping YOU out!! We genuinely worry and care about our patients that it often consumes us. When a patient codes or expires, we are crushed. I once had a patient who got stuck at least 15 times by various staff members, including physicians, to get IV access. The patient took those sticks like a champ, but I still went home and boo-hooed because I hated to see him go through that. We hurt when our patients hurt. On top of carrying out our responsibility as nurses, we are holding in so much emotion associated with our patients.....yet we get very little to no respect. Don't get me wrong, there are some physicians that I'm in contact with whom are polite and value my opinion and I do appreciate them. Of course, I'm not always right or may not make the most intelligent statements, but they acknowledged my voice. Again, I don't want a cookie. I just want to be acknowledged as a professional. I understand customer service includes dealing with angry, rude, and the dissatisfied. But when I have poured my heart, soul, and emotion into my job and my customers and I am still allowed to be mistreated and insulted, then that becomes a problem. I feel I have no rights as a nurse. Who is protecting me? Who is my voice? Who is standing in my defense? So at this point, it's time for me to bow out from the nursing profession gracefully and while in good standing with the organization, my family, and myself before I am forced out or OD on my meds(or somebody else's). My family, happiness, health, dignity, and peace of mind is worth leaving. They tell me Costco employees never leave. I'm-so-over-nursing-I-would-rather-work-at-costco.pdf
  2. Meetings A typical nursing faculty day starts an hour or more early to check emails and get organized for the first lecture or class. And bing! An email calendar reminder: a 30-minute countdown to the curriculum committee meeting. Frantic scrambling ensues – where are the previous meeting notes? A dreaded discovery – today’s report is a totally forgotten one. Off to the meeting with the embarrassment and self-torture brain tape running amuck. Not quite what the TV sitcom portrays. Teaching Two hours of teaching follows the meeting. A class break between class one and two brings student appointments. After class two is a quick lunch at the desk and phone calls. Student Appointments After lunch, three more student appointments, no break, term paper grading for the remainder of the afternoon. More Meetings Late in the day - bing! A phone alert reminder of a Nursing Department meeting and the research update presentation obligation as the (leadership requested) task force head. More frantic scrambling looking for the presentation that - sigh – was found. Following the task force meeting… oh no! today is the library trip – now closed, so much for working on the dissertation. Wearily locking the office door, juggling a tote bag full of nursing care plans to grade and leaving. Yet, until the care plans are graded for tomorrow’s 12-hour clinical day, the day is not done. There is More... A typical day? But wait there is more! In addition to teaching duties and responsibilities and serving on committees, there is completing license maintenance professional development hours. Advanced practice faculty have to complete extended hours of continuing education credits to keep working. As if that weren’t enough, common are requests for workshops or conference presentations, often outside of office hours. Peer mentoring can eat up precious time, as can additional classes due to faculty shortage. Active participation in research, self-credentialing, and community involvement are among the many other responsibilities. Northwestern University found that 60.9% of faculty at public universities and 56% at private ones find committee work stressful. Overlapping Roles Overlapping roles increases the demand for faculty time, which is already constrained with student needs and course requirements. Far from the capability of doing it all, and not being able to meet basic responsibilities causes stress. The inability to meet leadership expectations with committee or task force assignments that may impact one’s chances for promotion or tenure exponentially increases the stress. Northwestern University reported that three-quarters of their faculty suffered at least moderate to severe stress from multiple roles required for their position (Northwestern University, n.d.). So, What Can Be Done? Considerations for leadership when assigning additional roles to stressed faculty are the possible stress associated conditions: mental depression anxiety pessimism inability to concentrate Serious physiological ill that can occur: Alcohol abuse Substance abuse Chronic fatigue Sleep disorders Headache Muscle tension Gastrointestinal ailments (Better Health, 2012) Teachers who were surveyed listed several reasons for their job stress. Here are some common themes: Too little time Not being able to develop their class Not enough administrative support Changing responsibilities (Mulholland, R. et al, 2013) Consequences of nursing faculty stress on their performance include: Less efficiency Impaired student-faculty interaction Poor student outcomes Clinical errors especially medication errors Placing patients at risk due to poor supervision of clinical students Academic institutions should take advantage of opportunities to decrease the stress caused by overlapping responsibilities on nursing faculty: Provide mentoring for new faculty before assigning additional tasks Review whether current committees or task forces are necessary Offer paid time off for faculty pursuing advanced degrees Consider the course load of the instructor before recommending them to a committee Rotate responsibilities throughout the nursing faculty community Nursing Faculty can help themselves by: Speaking to the Dean or Department Head when the workload gets overwhelming Get help with prioritization and organization if necessary Reach out to a mentor or colleague for help Schedule some time for self to unwind and relax Don’t take unnecessary work home Take care of physical and mental health Consider whether the job is worth the stress Overlapping roles for the nursing faculty may never go away. It is possible, however, to prevent hating the job you used to love.
  3. spunkygirl1962

    Try A Healthy Dose of Smiling

    Let’s face it, we work in a profession where we are frequently under a lot of stress. Stress has been linked to a number of health problems, such as obesity, high blood pressure, Type 2 diabetes, heart disease along with other illnesses. We deal with patients – and their families – who are often hurting physically or emotionally or both. Add to the mix the workplace pressures that come with the territory when delivering quality medical care. As nurses on the front lines of patient advocacy, we may find ourselves frustrated if not overwhelmed. A Simple Smile But there is one thing we can always do to make it a bit better for ourselves and others, even in a small way. We can smile. "Simply using the same muscles as smiling will put you in a happier mood. That is because the use of those muscles is part of how the brain evaluates mood," as stated by Michael Lewis, a psychologist at Cardiff University. As far back as the 1800's, One of the first scientists to suggest that our expressions may actually heighten our feelings was Charles Darwin. Charles Darwin labeled this theory as the "feedback loop." Mother Teresa, who brought compassionate care to some of the world’s most impoverished people once said, “We shall never know the good that a simple smile can do.” Smiling can be beneficial for a person’s health and psyche. A smile can make a person happier and more productive at their workplace and/or in their personal life. There is Scientific Evidence to Support the Notion that Smiling is Beneficial Endorphins First, a smile can release endorphins that relieve stress and pain. University of Kansas scientists who are experts in the field of psychology report that a smile can help humans cope with various life stressors by lowering of the heart rate and blood pressure significantly. Immune System Furthermore, a smile may strengthen the immune system, according to research conducted by the National Institutes of Health. The study linked pleasurable stimuli and positive emotions to an increased immune response. Long Life Lastly, a smile for success and happiness adds years to your life. Dr. Laura Kubzansky, an associate professor of society, human development and health at Harvard, discovered that such factors as strong social bonds, a positive outlook, emotional happiness, and enthusiasm can extend life expectancy. Every day we walk past many people at our workplaces and we frequently do not know what is going on in their lives. We might pass an employee in another department overjoyed by the news of a promotion. Just as likely, we may walk past a wife who just learned that her spouse of 50 plus years has only a few days left on this earth. We cannot change bad news into good. But we can smile. Smiling and positive thinking have been shown to have a large number of health benefits for your psyche and physical health. So next time you walk by someone just give them a smile. It might be just what they need to help them get through their day. I read recently that the town that I live in currently in a recent poll was voted the seventh rudest city in the Country. Wow! How disappointed I was to see this. If everyone just smiled at each other, would this make our city a better place in which to live? What Do You Think? Would people be happier and healthier if they smiled more at each other? Who knows for sure, but it sure would be worth a try! Share a smile and see how it makes you feel!
  4. FALSE! We know a lot more now about the effects of lack of sleep on our health and the news is not pretty. First I have to recollect my own years of night shift nursing and the toll it took on me. Fighting to stay awake all night when my circadian rhythm was telling me to sleep, not thinking clearly enough during the night due to fatigue which could possibly lead to miscalculations, forcing me to take a sleep med daily so I could "sleep the daylight hours away", overwhelming desire to fall asleep as I drove home from work, and the disruption in my home and social life with me gone every night. When you really spell it out, working nights is not healthy, puts nurses at great risk and we don't receive full disclosure of the risks when we take the job! Did you know that there are a lot of quality of life benefits from getting a good night's rest? Cell renewal and rejuvenation Management of stress hormones Gut health Weight management Chronic disease prevention Cognitive functioning Seems like sleep is pretty important, don't you think? On the other hand, this is what happens when you don't get enough sleep. Shift Work and Long Hours Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work. Negative Impacts of Shiftwork and Long Work Hours : Rehabilitation Nursing Journal Women who worked on rotating night shifts for more than five years were up to 11% more likely to have died early compared to those who never worked these shifts. Those working more than 15 years on rotating night shifts had a 38% higher risk of dying from heart disease than nurses who only worked during the day. Rotating night shifts were linked to 25% higher risk of dying from lung cancer and 33% greater risk of colon cancer death. The increased risk of lung cancer could be attributed to a higher rate of smoking among night shift workers. The population of nurses with the longest rotating night shifts also shared risk factors that endangered their health: they were heavier on average than their day-working counterparts, more likely to smoke and have high blood pressure, and more likely to have diabetes and elevated cholesterol. Shift Work: Night Shifts Linked to Early Death | Time When I worked full-time nights it was the only job available so I did not have a choice. But I never knew how at risk I was for health issues. My mother was a full-time night supervisor for over 30 years and her life was shortened by heart disease, diabetes and obesity which fits the above profile. So how do we counter this situation? First step is to recognize we have a problem. To their credit, the ANA has a position paper with institutional recommendations. But the one that stands out for me is the recommendation that YOU have control over. Employers should encourage nurses to be proactive about managing their health and rest, including getting 7 to 9 hours of sleep per day; manage stress effectively; develop healthy nutrition and exercise habits; and use naps according to employer policy. This is where WELLNESS comes in, which is my life's work. I wonder if it is because of seeing my mother suffer from the health consequences of night nursing and I didn't want to go down that same path. How To Get Better Sleep When You Work Nights STEP 1 Assess whether you are a "night owl" or not and pursue the work hours most in line with your circadian rhythm. STEP 2 Negotiate 8 hour shifts rather than 12 hour shifts. Negative Impacts of Shiftwork and Long Work Hours STEP 3 Try to achieve uninterrupted sleep of 7-8 hours by: Darkening the room really dark Wear a mask over your eyes Turn on a white noise machine (like gentle rain) to drown out sounds that could wake you up Use Melatonin, your body's sleep hormone if you need a sleep aide Prepare for sleep by stopping caffeine 4 hours before you go to bed Indulge in a nice warm bath before you go to bed STEP 4 Set a schedule for nighttime eating where you eat every 2 hours. Bring to work 2 healthy snacks and a big salad that is loaded with fresh vegetables, some fruit and protein (chicken breast, hard boiled eggs, cheese, etc). Stay away from processed foods and follow a low-glycemic eating plan to prevent weight gain. Here's a great website. STEP 5 Enhance your nutrition with high quality supplements to give you more energy. Include multivitamin/multimineral combination, pure fish oil, vitamin D. STEP 6 Drink 8 glasses of water during the night. The exercise you get going to the bathroom several times will keep you awake. STEP 7 Create an exercise routine that you "love", energizes you, and you will do every day after you get up from sleeping. (Walking, Cardio, Stretching, etc.) STEP 8 Meditate or do a moving meditation like Yoga or Tai Chi daily to get centered and reduce stress. Check out Tapping or EFT (Emotional Freedom Technique) which you can do in the night to manage stress. STEP 9 Add fun to your day even at work to help your body release endorphins and you will feel better. STEP 10 Write down everything you are grateful for at the end of each shift to ensure that you appreciate your accomplishments and start shifting your energy from stress and negativity to a more positive outlook - and that will help you sleep better too! So what are you willing to do to get a better night's sleep? Or what are you already doing that is working? Please share.
  5. First, the World Health Organization has declared that 2020 is the Year of the Nurse and Midwife. The theme for 2020, Nurses: A Voice to Lead - Nursing the World to Health, demonstrates how nurses are central to addressing a wide range of health challenges. It will encourage nurses and the public to celebrate, but also provide information and resources that will help to raise the profile of the profession throughout the year and attract a new generation into the nursing family. 2020 is also Florence Nightingale's Bicentennial – celebrating her 200th birthday on May 12. Having the Year of the Nurse and Midwife coincide with Florence Nightingale’s bicentennial raises the exciting prospect of nurses finally being recognized for all the good they do. And the Nursing Now Nightingale Challenge will produce a new cohort of young nurse leaders who will take the profession forward over the next decade. National Nurses Week is May 6-12, 2020. Supported by the American Nurses Association, National Nurses Week celebrates nurses and their role in society. The week also helps to raise awareness about nursing as a possible career choice and also to educate the public about the kind of work nurses are involved in. And, finally, coinciding with that week is: National Student Nurses Day May 8 National School Nurse Day May 8 International Nurses Day May 12 So there is a lot happening for you to get involved in. But we also need to be aware of and address some of the challenges that might be jeopardizing the forward progress of our profession. Challenge #1 There is a NURSING SHORTAGE on the horizon due to these factors: Aging Population As the population ages, the need for health services increases. Aging Work Force One-third of the workforce could be at retirement age in the next 10 to 15 years. Nursing faculty is also experiencing a shortage, and this leads to enrollment limitations, limiting the number of nurses that a nursing school can generate. Nurse Burnout Some nurses graduate and start working and then determine the profession is not what they thought it would be. Others may work a while and experience burnout and leave the profession. Career and Family Often during childbearing years, nurses will cut back or leave the profession altogether Regions Some areas of the country struggle to fulfill the basic needs of the local population as a whole. Growth A higher need is seen in areas that have high retirement populations. Violence in the Healthcare Setting The ever-present threat of emotional or physical abuse adds to an already stressful environment. Emergency department and psychiatric nurses at a higher risk due to their patient population. Challenge #2 Unhealthy Lifestyles There is an abundance of nurses with unhealthy lifestyles. We need to give attention to the personal health of our nurses. After all, if we don’t have healthy nurses, everything else we try to do to increase our nurse population will be of no avail. So let’s look at the state of our health. A study of 2,730 hospital nurses from the American Nurses Association (ANA) Health Risk Appraisal (HRA), surveyed from October 2013 to December 2015, found serious deficits in diet, sleep, and physical activity that may jeopardize nurses’ health and negatively impact the healing strength of the profession. (And from my vantage point as a Wellness Practitioner, this data probably holds and in fact may even be worse in 2020.) For nearly every indicator, the health of America's nurses is worse than that of the average American. Nurses are more likely to be overweight, have higher levels of stress and get less than the recommended hours of sleep. Here are some key findings: (Notice how many are within your control) Nurses are Exhausted 56-57% reported often coming in early and/or staying late and working through their breaks to accomplish their work 33% said they had often been assigned a higher workload than that with which they were comfortable 59% of respondents reported that they worked 10 hours or longer daily 47% slept fewer than 7 hours per day. Nurses are Overweight 56% were overweight/obese with a body mass index > 25 kg/m2. Only 14% of the nurses were eating at least five servings of fruits and vegetables per day (2.5 cups). Just 45% of the respondents were engaged in aerobic activity of at least moderate intensity for 2.5 or more hours per week, while 47% performed muscle-strengthening activities twice a week. Nurses Do Not Prioritize Their Health Over Others 68% put their patients’ health, safety, and wellness before their own. Nurses are Stressed and Burned Out From a study by the Cleveland Clinic of their nurses, 63% suffer from burnout. If it is not addressed nurses can become disengaged and eventually leave the profession. And, severe levels of stress are not only unhealthy but can negatively affect patient care. As you know, if nurses don’t adopt and maintain healthy lifestyle behaviors they are at risk for chronic diseases and early mortality. On the other hand, nurses who make healthy lifestyle choices have a spill-over effect and will be more apt to discuss and recommend preventive behaviors such as smoking cessation, more physical activity, and eating a healthier diet to the people under their care. With personal health on top of their mind, they may be better able to prevent workplace injury and avoid errors related to fatigue. So nurses who adopt healthy lifestyles may even provide better patient care. So What Does All This Mean For You? YOU can contribute by taking action on whatever you think would work for you. After all, you are the key to everything that will make The Year of the Nurse a truly important opportunity to showcase what we do and who we are. In my opinion, your best option that could be a win-win for both you and your profession is to take action on adopting a plan to get healthier. You are, after all, being watched by those around you as the expert on health, and if you embrace wellness as a lifestyle choice, you will make an impact on other’s behaviors as well. Don’t overlook the fact that you are a role model for not only your expertise but how well you model the health practices you teach to others to manage and prevent the chronic diseases they experience. And because this is the beginning of a NEW YEAR this is the perfect time to get started. What Are You Waiting For? Please share your lifestyle enhancement ideas to give other nurses ideas to draw from.
  6. If you’re a college student, you’re most likely being pelted by life stressors. The article, Spring Stressors You Can Expect, provides insight into unique sources of student stress and the related short and long-term consequences. Unfortunately, consequences can be life-threatening when high levels of stress are experienced over a long time. These include increased rates of depression, anxiety, cardiovascular disease and other conditions that significantly impact daily life. Learn How To Manage Stress Of College Life Nursing school brings its own unique set of stressors. Just thinking about the huge amount of material that nursing students must learn and retain is enough to cause cold sweats. There is also the added pressure of clinicals and applying what has been learned in “real life”. Add in the demands of coursework and your mental, physical and emotional energy can easily slip away. There are several ways to sharpen your coping skills when faced with mounting stressors. Let’s take a look at some strategies for self-care that may ease the pressures. STEP 1: Eat Well Eating healthy while in college is a challenge. Students often fall into bad eating habits due: Stress eating Skipping meals Fast food meals Vending machine “meals” Financial hardship With a healthy diet, you can feel, cope and perform better. Ready to get started? Check out these helpful tips from Clarke University. STEP 2: Get Moving Regular exercise not only improves your physical health, but also promotes: Improved memory retention Increased focus and concentration Boosts mood Relieves stress Now, you may be thinking “how am I going to fit exercise into my already time-crunched schedule?”. You can start by reading tips in the article, How to Find Time to Exercise in College. STEP 3: Don’t Depend on Caffeine For many, caffeine is necessary for the night study session or a quick boost of energy. It’s readily available in the form of coffee, tea, energy drinks, and even chocolate. But, relying on caffeine as a stimulant can actually slow you down and make studying that much harder. Consider the following: Caffeine dependence, withdrawal and toxicity do occur Withdrawal symptoms include headache, fatigue and irritability Caffeine can lead to sleep problems and prolong sleep deprivation It’s a myth that caffeine has no real side effects. STEP 4: Set Realistic Expectations It’s difficult to juggle school, work, responsibilities and a personal life without a great deal of stress. Setting realistic expectations can prevent you from having your plate too full. STEP 5: Don’t Procrastinate Have you ever put off an assignment because it wasn’t immediately due? It’s so tempting to put off coursework or studying until “a little later”. The problem is ..."later" comes sooner than you wanted and an amount of stress occurs when assignments, exams and clinicals are scheduled around the same time. Try keeping a detailed calendar of important due dates for all your classes. Seeing the big picture will help you avoid deadline anxiety. STEP 6: Have An Outlet We all need a stress outlet and a way to decompress. Your stress outlet should be something you enjoy, such as exercise, spending time with friends and family, getting a massage and hiking. STEP 7: Know When to Get Help Unfortunately, stress is unavoidable. When we experience high levels of stress for extended periods of time, it can be detrimental to our mental, emotional and physical health. If you are struggling with stress that is interfering with your daily life and studies, consider these resources: Campus counseling services Substance abuse prevention hotlines Academic advisors Suicide prevention hotline Physician or therapist You can also simply reach out to someone you trust, such as a friend, family member or faculty member. Resources A Student's Guide to Managing Stress What tips do you have to share for reducing stress while in college?
  7. Carol Ebert

    Cultivating Winter Stillness

    I have a chronic condition that has plagued me for about 2 years called Tracheal Stenosis (Idiopathic Subglottic Stenosis). Upon seeing an ENT specialist after experiencing shortness of breath when I tried to make speeches, wheezing, and having difficulty expelling mucus from my lungs, the diagnosis was obtained using a scope into the trachea. I got to see my beautiful insides, but the entry to the trachea had a narrowed opening which was causing my symptoms. And what is it caused by? Who knows. And only white women have this, and not very many I might add. Leave it to me to be a public speaker who now can’t speak publicly! Well, the good news is it can be resolved (temporarily) through a surgical procedure that makes small snips in the opening and then the opening is stretched, and I’m good as new. However, it seems to be a repeat procedure approximately every year. And here I am right now scheduled for surgery (for the 4th time) in the next 3 weeks. Yes I am frustrated because it can’t be cured no matter how healthy I am - and I am Nurse Wellness and have been a role model for wellness for over 40 years. All those wellness strategies I live my life by still couldn’t prevent this. And, so I will survive and do what I need to do to keep on my path as a wellness educator. So how does this tie into STILLNESS? I find that all I can do right now is go into stillness and the fact that it coincides with the Winter Solstice seems to be no accident. I have found that late December through January are cocooning times for my business and for life in the countryside of Minnesota – where we are usually snowbound - which lends itself to being still. Looks like the universe is giving me a reason to be still since I generally have difficulty cultivating that trait. Just to further make that point, a good friend gave me an “Energizer Bunny” stuffed animal for Christmas because that is my M.O. as I am always on the go with teaching. Now let’s go a bit deeper to better understand what surrounds the Winter Solstice. December 21 is the shortest day and longest night of the year. The winter solstice is a time of quiet energy, where you get the opportunity to look within yourself and focus on what you want and need. It's a time to set goals and intentions for the coming year, to examine and let go of our past, and to make changes within ourselves. The solstice is essentially tied to a personal awakening. What Does The Winter Solstice Mean Spiritually? It's Celebrated In Tons Of Religions And Cultures. Nature remembers what we humans have forgotten every cycle must return to stillness, silence, the dark; every out-breath requires an in-breath; every outer endeavor turns back inward to its origins, its center, and begins again; from death comes new life, and from the darkest night, the new dawn is born. A Winter Solstice Mystery: Beauty In the Belly of the Dark Great words of wisdom. But how can we apply the teachings of the Winter Solstice and capitalize on the stillness of this part of the year? Here are some strategies to consider. Solstice is an opportunity to look within yourself and focus on what you want and need Practice “doing nothing” by meditating, visualizing or just sitting in silence with your eyes closed. Just do this for very short periods of time at first to get used to being still and then extend the time. Focus on what you want to have happen this upcoming year that will be fulfilling and pleasurable. Solstice is a time to set goals and intentions for the coming year Once you decide what you want to have happen, write it down as a goal. By December 31, 2020, I will have accomplished: The steps I need to accomplish this goal are: The dates for accomplishment of each step are: Solstice is a time to examine and let go of our past Write down on paper all the past beliefs that have stood in your way from having all you were meant to have in life. Crumple up the paper into a ball and burn it. Thank the burning ball for all the lessons you have learned from those roadblocks Feel the sense of release as they disappear into ashes Solstice is a time to start making changes within ourselves Commit to one personal change you want to make during the new year Determine how you will monitor your personal progress (Journaling, marking on your calendar daily or weekly, chose the method that works for you) Solstice is essentially tied to a personal awakening and the above steps fit right into what most of us already do as we embark on a new year. We set intentions and goals and just forge ahead. This time, however, consider incorporating the STILLNESS factor into your daily life as a way to monitor your progress and keep yourself on track. And this is the perfect reminder for me as well. Once I am post-op I could jump right back in the fast lane with my voice intact and not slow down until next year when it will predictably slow me down to stillness once more. Or I can take time out for stillness along the way to monitor and appreciate my personal growth in an ongoing way. Now, how about you? How can you incorporate stillness in your day – week – month – year?
  8. Ashleigh Boyd Nurse Anxiety Coach

    3 Simple Ways To Squash Compassion Fatigue

    Ever woken up covered in sweat at 3 a.m. wondering if you forgot to chart something at work? Or, how your patient is doing? Or, the mess you left at work? There’s nothing worse than the feeling you get when you think you should have done more. You’re tachycardic. You’re diaphoretic. And, it always happens at the most inconvenient time, doesn’t it? When you’re trying to walk out the door, or five minutes after you get home or the worst ... when you are trying to fall asleep. Whether it’s your charting, a late med or leaving your patient rooms a mess, doubting your every move can be a real pain in the ... But, we get over it because we’re human beings. Sure, it’s annoying, but generally speaking, life goes on. Continued doubt, lack of support, increased daily requirements with no end in sight is daunting. Not only does having to re-live your shift, replay your actions or recreate the real life scenarios in your head, it also wastes time that you could be enjoying for yourself. At best, you come off looking unprofessional and unreliable ... so you think. At worst, you lose a job - you lose money but save your sanity. As nurses, we’re busy. And I mean, reeeeaaaalllly busy. I don’t know about you, but I’m often running around like an idiot trying to take care of my patients but also help my team out. This is when things go a little awry. It’s not uncommon for nurses to feel like they are torn in 30 directions at once. Ingrained in our heads from school is: what’s the best option of these four correct answers ... But, very rarely do we feel like we walk away a winner; charting done at bare minimum, call lights and bed alarms constantly sounding, titrating drugs and scanning later, updating white boards, informing families, arranging rides, setting up follow-up appointments, researching geriatric psych facilities because the social worker is on-call and not answering, taking patients upstairs or to OP areas, giving medications to patients, comforting patients, attempting to advocate for your patients, educating staff and families ... the list can go on and on and on and on and on ... How? You Ask How can I walk away feeling like a winner and not take all the what-ifs with me?? Real-Time Transformative Response (RTR), my dear. Now, before you roll your eyes ... let me clarify a few things. What is Real-Time Transformative Response (RTR)? RTR is a technique that can be used at the hospital, home and anytime you are needing support to get out of the vortex of doom. You don’t have to give up control of anything. RTR is all part of creating a work environment that allows you to decompress, release stressors and stop taking everything home with you. Here are my top 3 life-saving tidbits, without which ... I’m not sure where I’d be! 1 - Understanding Our Bodies I like to think of Biofield Response as a bubble around our bodies. Although it’s important to understand what is going on inside our bodies, it’s just as important to know what is going on outside of them too. A simple way to think that homeostasis occurs when both inside and outside match. Biofield Response is the inner communication highway that is literally excreted into the world from our bodies, energy and frequencies. Have you ever just felt drained being around a specific person or go home feeling wiped out?! That’s because you are. Your energy is literally clogged. Like a bad carburetor. Throughout the day we are constantly exchanging energy and sometimes we gather too much of what we do not need. This is when you begin to feel bogged down, anxious, overwhelmed, or just plain over it. Understanding this was the biggest eye-opener of my life. I can actually take on the energy of others and make me feel even worse than I already do ... ?!!? As Einstein said: So, the environment we work in at the hospital isn’t always the most pleasant: people, surroundings and situations. So this means that the energy we take on while we are there is actually changing us physically, emotionally and mentally! 2 - Celery Juice Hands up if you suffer from: brain fog, chronic illnesses, and anxiety that are taking over your life from hospital-induced compassion fatigue. Celery Juice is an absolute godsend, especially if you have multiple issues going on, or even one. I totally get how strange it sounds but it’s a miracle in a cup. I began juicing and noticed within TWO days a total change in my body. TWO. I swear by it. My family does and so do hundreds of thousands of other people. Hands down ... 16 oz of celery juice on an empty stomach has single-handedly changed my life. Thank god for Anthony William. 3 - The Power Of Our Brain Without our brain, there’s no way we’d be functioning at the level that we do, right?! But, the brain is so much more than what we give credit. I can tell you that you can change your compassion fatigue, anxiety, overwhelm and stress in seconds. But, I can feel the eye rolls and mouse moving to X out of the screen ... BUT ... It’s true. You can change your past experiences that are tainting your current ones, and allow you to empower yourself with the gift of understanding how your neural pathways work. How you can repair, change and alter your brain sequences, triggers and creates a pleasant experience out of a traumatic one. The power of our brains is endless. Discovering that in less than 10 minutes, you can go from a 10/10 anxiety level from a past experience that is causing you PTSD and hindering your job ... Down to a 2/10 by using simple but proven techniques is what made me realize that our brain is an untapped mega machine. Compassion Fatigue is here to stay but there are so many things we can do to help ourselves. Corporate is just now awakening to the idea that maybe, just maybe they have induced this nursing syndrome. And, just maybe they need to fix it before just enough people quit that their hospital won’t function anymore ... Ashleigh Boyd, R.N. Nurse Anxiety Coach & CF Expert
  9. Carol Ebert

    Holiday Stress Busters

    Sure, you might have said last year I’ve got to do things differently and yet here it is again in your face. Tips to Decrease Holiday Stress Of course, some of you have already made some great changes to simplify, slow down and put the holiday in perspective, (I know I have) and I would love to have you share your strategies at the end of this post. But for the rest of you, here are some tips that might help right now bring more peace and less stress. Step 1 – What prep needs to be done? Look over this list and select the most important things that need to be done and delegate the rest. Try to select only 5 things. I know this list is exhausting to read, but you don’t have to do everything. creating the gift list making or buying decorations decorating putting up outside decorations prep for holiday travel making family advent preparations planning family reunions getting ready for relatives holiday baking cooking for family reunions planning parties inviting friends to the party shopping for the party cleaning for the party cooking for the party cleaning up after the party buying or making cards writing notes on cards making or buying stockings buying stocking stuffers making travel plans volunteering for charity helping out at church helping out at school holiday activities at work buying or cutting down a tree decorating the tree shopping for gifts making gifts buying gift wrapping supplies wrapping gifts mailing gifts cleaning up after the holiday writing thank-yous planning holiday menus getting kids to write thank-yous putting away decorations special grocery shopping disposing of the tree taking down decorations other _______________ other _______________ Step 2 – What do you really value the most over the holidays and want to have time for it? Check those you want to have happen and decide how all the busy-ness from all the tasks above will affect them. Feel free to cross more tasks off the list above so you have more time for those below. Spend enjoyable time with my immediate family Reunite with my relatives Celebrate the birth of Christ Create a festive, beautiful home environment Show my love and generosity through gifts Remember the poor, lonely and needy Be active in my spiritual community Celebrate with friends Relax and be renewed Step 3 - How important is self-care for you over the holidays? Review this list and check the items that reflect your reality. Then decide whether you need to make some adjustments. Have less free time Get less sleep Get less exercise Eat more sweets and consume more calories in general Drink more alcohol Have more tasks and responsibilities Have less time to be alone Am more worried about money Spend less relaxed time with friends Have less relaxed time with my family Have more responsibilities at work Step 4 – Implement Stress-busting Strategies to regain valuable time for YOU! Problem: Thinking that you still have to please your long-gone relatives and bake every cookie from scratch. Having to bake 12 dozen perfect cookies for the Cookie Swap! Solution: Go to a fine baking establishment and pay for some cookies made from scratch that are probably better than yours! I’ll cost you less time and money. Problem: Thinking you are superhuman and wearing yourself out shopping for the perfect gifts for everyone when all they really want is a gift card. Solution: Make one trip out to get gift cards for everyone and they’ll love you for it, and they won’t have to stand in the return lines after the holidays. Problem: Creating a holiday blood sugar rampage by eating all those cookies, candies and cakes, and wondering why you are so exhausted and can’t fit into that holiday outfit. Solution: Load up the frig with healthy snacks that your family can graze on. Prepare healthy fun snacks to serve and give away as gifts. Problem: Driving on the roads and shopping in the stores just when everyone else decides to do the same thing. Solution: Go OUT when everyone else is IN! Get over the adrenalin rush of shopping in a frenzy with large crowds of people – your body and mind will love you for it! Problem: Having to rummage through 100 different “stuffing” recipes and then discovering they all have the same ingredients. Solution: Buy a bag of instant stuffing mix and tell everyone it is your “secret formula”. Problem: Going to everyone’s house over the holidays, including yours, and having the same holiday dinner over and over again. Solution: Try serving an old fashioned 4th of July picnic meal for your holiday celebration. Celebrate July at Christmas instead of Christmas in July. Hopefully, this holiday review is helpful and a wakeup call so you can truly enjoy the holiday season with all the peace and joy you deserve.
  10. If I was standing on stage in front of an audience of nurses and said something like this: raise your hand if you have been victim to a toxic environment, addicted to anything: i.e. alcohol, cigarettes, drugs, food, sugar, social media, gaming, or your phone, to name a few, depressed, lonely or, been fired for your lousy/threatening attitude; I would venture to say, most if not all of us would raise their hands including me. As a matter of fact, I just described the first 15 years of my nursing career. You may not all be overachievers like me but most of us have been subject to some of these things and they cause us to suffer in a myriad of ways that we are totally unaware of. If you are sick of dealing with depression, addiction, anxiety and other mental health issues, poor health, lack of sleep, chronic pain and multiple other physical ailments, relationship issues, feeling unfilled, unmotivated and or watching your dreams evaporate; that’s a list of the things I coach/write about so you are in the right place. Believe it or not, no matter where you are on that list the cause of all of those things is nearly universal for nurses and it’s called chronic stress. We must learn better ways of coping with stress or we will continue to lose ourselves in the quicksand that our lives and careers have become. I think most of us know that stress can be effective in our lives and we need a certain amount of it to live and grow happily. However, when stress becomes chronic, it’s no longer an effective tool in our lives. According to the American Psychological Association in an article titled Understanding Chronic Stress; "Chronic stress can occur in response to everyday stressors that are ignored or poorly managed, as well as to exposure to traumatic events. The consequences of chronic stress are serious, particularly as it contributes to anxiety and depression. People who suffer from depression and anxiety are at twice the risk for heart disease than people without these conditions. Additionally, research has shown that there is an association between both acute and chronic stress and a person's abuse of addictive substances." Before I get to my 5 ways to overcome chronic stress I want to give you an introduction to what we’re going to do with these 5 things. I love writing to you, my people, but I also want to coach you. This stuff saved my career and my life so I want to share it with others. Human beings learn in three ways: through our senses, by practicing it, and by repeating it to others. To put it my favorite way I learned in the military, see one, do one, teach one. Each one of these 5 solutions has a tool to help you incorporate it into your life. 1 - Habits are Magical Tools Habits are magical tools that help you get your brain on board with what you’re doing to improve your life and meet your goals. Before we start building new ones we need to find out the ones you already have by, preforming an inventory. Tool #1 Habit inventory- the best thing about habits is you don’t have to think about them but sometimes they get away from you and can be ineffective without you even being aware that you’re doing them. The inventory is a way to find out which habits you have and whether they are ineffective, effective or neutral, this is just an inventory, no judgment allowed. Part 2 Now that you know what habits you already have, you can start to make small changes a little at a time that will build up into amazing powerful routines. I like to start with the morning routine for two reasons: everything you do in the morning sets the tone for the rest of the day so if you win the morning you win the day! 2 - Control is a Natural Human Instinct Control is a natural human instinct but there are some things we have NO control over and trying to control them is contributing to your stress. This tool is an amazing way to learn to differentiate between things you can and cannot control and how to deal with both. 3 - Eating Affects You Physically and Mentally Eating affects you physically and mentally and the effects are not always positive. If you want to elevate your mood, think more clearly, be healthier or have more energy to do the things you want, upgrading your nutrition plan will move the needle in ways you never dreamed possible even if you consider yourself healthy. What you eat effects more than your weight. This tool will help you listen to what your body needs and act accordingly. Your body speaks to you in a form of biofeedback mechanisms. You can judge how to care for yourself by how you Sleep, if you’re constantly Hungry, what your Mood is, your Energy level and food Cravings. This tool is called the SHMEC scale. 4 - Movement and Exercise are Not the Same Movement and exercise are not the same things. They also do much more important things throughout your day than burn calories. We were built to move not to sit around all day except for the 1 hour you hit the gym for a workout. Consistent movement throughout the day makes us happier, clears our brains and balances our hormones. Having an active job counts as regular movement, such as floor nursing but movement is meant to be balanced, therefore you could be doing too much which can throw you off as well. I am not knocking exercise but we need to use it as a hormone balancer, not a calorie burner and that takes knowing what your body needs at all times. We will use the same tool as #3 for movement and exercise. 5 - Accountability and Integrity Accountability and integrity with the person you spend the most time with, yes, you. My hope is that now that you have read down to number five it has dawned on you that you can win over depression, fear, loneliness, not feeling good enough, your health, and anything else you feel is holding you back by making the choice to take action. This tool is one that I learned in early recovery from addiction. This is the evolved version since I have been using it for almost 20 years. It’s called the accountability mirror. It is designed to help you learn to be your own best friend, to trust yourself again, to show compassion to that amazing person in the reflection, and above all fall in love with the person in the mirror again or perhaps for the first time. Making changes in your life can be overwhelming but there is no need to do all of it at once. Small changes will help you feel better and start to pile up before you know it, creating an amazing lifestyle for a vibrant, healthy, fulfilled life. Going forward, each tool will be described and you will have daily activities available to you here.
  11. Going to work should not be dreadful. However, for many nurses, the stress, burnout, and culture can sometimes make it downright painful to get dressed and head to work. After days, weeks, months, or even years of these types of feelings, you might lose the love you once felt for the profession. If you’re going through this, you must remember that you are not alone and that these feelings are normal. If they hang around for a few days or a month, it’s probably not too concerning. But, any longer than that and you may need to start looking at strategies to help you bounce back and reignite the passion you once felt for your career. Here are a few of my favorite things you can do to get back on track. Take Time Off Americans let 768 million vacation days go unused in 2018. This equals billions of dollars in lost benefits and often means that workers aren’t getting the rest, relaxation, and restoration they need. Unfortunately feeling like you’ve lost your passion for your work can sometimes be a double-edged sword. You feel burnout, so you keep working with the hopes of finding something that will reignite the passion you once felt. Unfortunately, it often makes the situation worse. If you’re feeling disconnected from work, talk to your manager or supervisor about scheduling in a few “mental health” days. Don’t plan any major events on these days, instead book time doing something you love. Or, you may want to make an appointment to get a massage, pedicure, or other restorative treatment. Treat Symptoms of Burnout Burnout is a challenging condition. If you start feeling like every day is a bad day or you’re exhausted all the time, you might be dealing with burnout. Other symptoms to watch for include: Feeling worthless or hopeless Feeling bored or overwhelmed Feeling under-appreciated Exhaustion Frequent illness Headaches or muscle pain Change in sleep patterns Change in appetite If you are experiencing any of these symptoms of burnout, you need to get the treatment you need. Talk to those around you about how you are feeling. If you have a workplace mentor or a boss you trust, start there. They may have noticed these changes, too and can offer invaluable feedback. You should also try to increase your connection with your coworkers, but avoid interactions with negative individuals. You might also need to look for activities outside of work that can increase your feelings of meaningfulness and purpose. Look for a New Specialty Sometimes feeling overwhelmed and unhappy can be a sign that it’s time for a change. If you work in a specialty like hospice, oncology, or other high-acuity areas, you may need to consider looking for a new area of nursing to try. Not only can a change decrease your level of stress, but it can also help you find your passion through learning about new areas you never thought about before. Work With a Coach or Mentor Reaching out to another nurse who has maybe experienced these same feelings can be helpful. If you have a mentor, start there. If not, it might be a good idea to hire a career coach who is also a nurse. You can discuss your feelings with them and also ask them for ideas of other areas of nursing that could be a good fit with your background. Take Care of Yourself It seems that self-care, getting plenty of rest, and eating a well-balanced diet is a good answer to just about any problems we have in life. And, feeling burnout and drained at work isn’t any different. Carve out time to get at least 30 minutes of moderate-level activity each day. Find a diet that is low in carbohydrates, junk food, and sugary foods. You might want to consider one that is plant-based or at least has high amounts of fruits and vegetables. Finally, make sure you are getting eight hours of sleep every night. Getting Back on Track Remembering your passion for nursing can be challenging when you are in the midst of burnout and other feelings of disconnection from your work. You can use these ideas, but there are also many other ways to reconnect with your passion for the art of nursing, it just takes a little work and time. Have you ever experienced burnout or “fell out of love” with nursing? What helped you get back on track? Share your ideas with us by posting in the comments below. We would love to hear them.
  12. J.Adderton

    10 Don'ts For Less Holiday Pressure

    The pressure of the holiday season seems to begin building earlier each year. From holiday anticipation to New Year dread, a full range of emotions hits us before the first leaves fall. We barely make it through the marketing bombardment of all things pumpkin spice when the holiday displays go up in stores. Just think a minute about all the messages telling you how the holidays “should be”. A few that come immediately to my mind is commercials, social media, movies, family and long-standing traditions. It is possible to relieve the pressure and frustration of the holiday season. Here are 10 things to consider not doing this season to keep the focus on what is most important to you. Don’t Suffer From FOMO I have a serious fear of missing out (FOMO) on certain holiday activities. For example, I don’t really want to go shopping on Black Friday. But, a little voice inside my head tells me if I don’t go- I will be missing out on something I am “supposed” to do as part of the holiday “experience”. Escape the trap of FOMO by letting yourself off the hook. You may not have to decorate the perfect tree, bake cookies for your co-workers, host the neighborhood party and send 50 Christmas cards to your closest friends and family. This holiday season try letting go of what you feel you are supposed to do with a revised list of what you truly find meaningful. Don’t Stress Over the Perfect Gift Stores would love for you to believe the perfect gift can be found on their expensive shelves. But thoughtful gifts usually carry more meaning than short-lived fads that result in credit bills to start the new year. Set a budget that doesn’t stretch your resources and stick to it. Try these alternatives Donate to a charity in honor of someone Give homemade gifts Share a memory by giving a photo Give the gift of your time Don’t Eat Every Treat It’s really hard to pass on those sweets, appetizers and goodies that are a part of our holiday celebrations. But, with a little willpower, you can avoid making the annual “lose the holiday weight” resolution on New Year’s Day. Just use moderation and you can still enjoy all the delicious seasonal eats. Don’t Forget Your Rose-Colored Glasses In movies, families often reconcile, undo wrongs and heal old wounds around the Christmas table. Unfortunately, it is not this easy in the real world. We often set our expectations too high for family and friends to meet. Try setting aside grievances during the holidays and address when the timing is more appropriate. Keep in mind that others may be caught in the stress of the season too. Try cutting them a little slack when they do (and they will) fall short of your high expectations. Don’t Drink Too Much There are several reasons why we may drink more alcohol during the holidays Social gatherings and parties Depression and/or loneliness Increased stress levels Merrymaking can easily lead to regretting what you did at last night’s work party. Try keeping a “big picture” of your true alcohol intake to help you keep it in moderation. Overindulgence can lead to increased risk-taking behaviors and worsened depression. Don’t Forget Exercise Exercise is a great way to tackle holiday stress by improving mood and boosting energy levels. Research also shows regular exercise can reduce anger, tension and fatigue. Don’t Try to be Perfect Remember, perfect holidays do not exist. Even when you pour all your time, energy and money into your holiday preparations, everything will not go as expected. Be realistic and expect hiccups in even the best laid plans. Don’t Live Up to the Hype Do you live in a neighborhood where every house goes all out in decorating? If so, you may be feeling the stress of keeping up with the outdoor wreaths, lights and inflatables displayed by your neighbors. Before you spend the time and money on elaborate outdoor decorations, ask yourself “is this important to me?”. If the answer is no, let it go. Don’t Forget What is Most Important Try making a list of the people and traditions that are most important to your holiday celebration. This will help you stay focused on what matters most. Don’t Forget to Ask for Help This may be one of the hardest things to do. We don’t want to put anyone out during this busy time, even when we become overwhelmed. Likely, there are people in your life who want to help and are ready. They are likely just waiting for you to take the step to let them know what you need. If your depression or stress begins to impact your daily life, reach out for professional help. Let us hear from you. What have you found helpful in reducing holiday pressure? For more tips, check out this resourceful handout. Managing Holiday Stress Handout
  13. You’ve probably felt the effects of workplace burnout at least once in your nursing career. As of this week, burnout has officially been recognized by the World Health Organization (WHO) as a formal occupational phenomenon. Clinicians of all types have been living with the effects of short staffing, stress, and other patient barriers that seem to zap their energy and ability to provide the best care. Burnout is now defined as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It’s characterized by reduced professional efficacy, feelings of exhaustion, and increased mental distance or negative feelings about your work environment. Nurses and Burnout The concept of burnout has been around since the 1970s when psychologist Herbert Freudenberger coined the term. When you’re under high levels of stress for an extended period, it’s common to start to feel tired and unhappy. However, the phenomenon doesn’t only make you want to sleep. It can create psychosomatic issues like anxiety, depression, and insomnia, too. Nurses in burns units, critical care, pediatrics, and emergency departments are at a greater risk of developing the condition. The high levels of care and increased uncertainty of outcomes in these areas can take their toll on the mental and physical faculties of any nurse. Other causes of burnout include inadequate staffing and caring for those who are nearing death or actively dying. You might also struggle with burnout if you’re a newer nurse or have continued conflicts at work that challenge your values. How Can You Prevent Burnout Many people think that burnout is driven by the way each nurse deals with stress. However, some experts believe that burnout is a consequence of administrative processes. This means that preventative measures must be initiated on a global level if you want to see changes in the level of burnout nurses experience. Here are a few ways administrators can help to minimize the number of nurses affected by burnout. Improving Communication Methods The concept of interoperability isn’t limited to the patient’s medical record. If you must access multiple platforms to gather information and then manually synthesize the data to make care decisions, this could be adding to your level of burnout. Another factor in communication involves having to search for policies and procedures, rather than having these types of resources in one central location. Think About Scheduling Whether you work 3-12 hour shifts or 5-8 hours shifts, nursing is challenging. Many nursing units have rigid scheduling policies that make it challenging to take a day off at the last minute for “mental health” needs or family events. You might also not get your schedule more than a week or so in advance, so scheduling life outside of work can be difficult. Facilities need to learn ways to adopt flexible scheduling policies so that nurses get the time off they need. This might mean hiring more staff, so that weekend rotations are decreased or using “prn” staff to fill in during times of high acuity. Some units use self-scheduling as a way to increase satisfaction with schedules Consider Nurse-to-Patient Ratios A 2018 study conducted at Marshall University concluded that nurse-to-patient ratios are directly related to nurse productivity and overall health, including mental, emotional, and psychological factors. Not only did the researchers find that the health of the nurse was in jeopardy during times of inadequate staffing, but they also suffered from job dissatisfaction. In California, nurse-to-patient ratios are mandated, but the rest of the country is left to the individual policies of healthcare facilities. More nurses are advocating for set staffing ratios and working with lawmakers to initiate legislation. However, this can take years for it to become the norm across the nation. Does the New Recognition from WHO Help? Do you feel that recognizing burnout out as a workplace phenomenon will help support issues such as staffing ratios, long hours, and job stress? Will employers finally look for new methods to fix the problems that plague nursing units? What do you think? Share your thoughts in the comments below.
  14. tinyRN72

    How Mindfulness Saved My Career

    In a way, I really hate to tell this story, but I also feel that if it helps just one other person, then it is worth it. So, here I go! First, allow me to provide a bit of background. I have several years of nursing under my belt. I have always wanted to work for myself, and I have, just not as a nurse. My husband and I started a holistic wellness center about a year ago. For my part, I offer health education classes, meditation, and weight loss. My husband offers coaching, mindfulness living, and stress management. When we started this adventure, I really didn’t know what mindfulness was and had no experience with it, but I go to his classes every week, because it is my company and I should know what we sell. Now for the part I hate to admit to: starting about 18 months ago, I felt like my career was ending. I hated it, but I still loved it, so I didn’t give up. The day-to-day job was becoming so stressful! I felt anxious on my days off, constantly dreaded going to work, and I didn’t want to do it anymore. However, I still loved caring for patients. That part never gets old to me, I find peace in it, and it is in my heart to do this work. It was the other stuff: short staffing, near impossible patient ratios, being constantly nagged about whiteboards, being forced to attend interdisciplinary rounds that occur in the middle of med-pass on a step-down unit where we once had 4 patients, but now have 6, and so many other things. I was overwhelmed and unhappy, and I’m ashamed to say that I became very angry. I’m even more ashamed to admit that my behavior was becoming unacceptable. If I’d been my boss, I would have fired me. I was always negative; that “you’re getting a new patient” call set me off and I spoke quite disrespectfully to my charge nurse more than once; and I used the excuse of “venting” to justify it all. It was not OK and at some point, I knew that I had to get a grip on it before I got fired, or I had to find a new way to earn money. No other job seemed acceptable: I am a nurse. This is where my husband’s Mindfulness classes came in (just in time). Defining Mindfulness There are many ways to define Mindfulness, but my husband likes this definition: How Does this Apply to Life? To Nursing? I started paying attention to the thoughts that ran through my mind every day. The chatter sounded something like this: How am I supposed to have time for all of this? What do they expect me to do? I am only one person who can only do one thing at a time! When is enough enough? How can I work with my phone ringing all the time? I just want to walk out of here right now! This is ridiculous! I can’t! I just can’t! This place doesn’t care about nurses or patients – they only care about money! Why do so many nurses put up with this! (This is family-friendly website, so I left out the worse stuff and edited a lot for the sake of keeping things clean.) What Can Mindfulness Teach Us? Mindfulness taught me to look at these thoughts with acceptance, and without judgment. Just looking at them made me more aware of what my self-talk was doing to my head. The negativity, the complete self-centeredness of it was appalling to me. I didn’t want to be this angry person, stomping around like I was the only one who is busy, or getting admits before my discharges were done. What I found is that I really didn’t like me anymore, I was sort of toxic. More than that, Mindfulness taught me to be curious about these thoughts. I Began to Ask ... Is this helpful? Does it make anything better? Did I ask for these thoughts? What triggers these thoughts? How do I react to these thoughts? How do I want to react to these thoughts? Asking these questions gave me power over the mean voice in my head that was spewing vulgarities about every little inconvenience. Taming the Beast It didn’t happen overnight, but I tamed the beast that had taken up residence in my head. Mindfulness allowed me to examine my thoughts, dissect them, and cut out what was not serving me. It started by helping to see the thought and pause before reacting. This allows for time to decide how you want to react. Mindfulness is an ongoing practice, and this is just a tiny slice of it. But this little bit was life-changing for me. I feel like the scales are balanced again. Yes, I still feel frustration, I still get busy and need to juggle things, but my brain doesn’t interfere anymore. It’s been about 6 months and those nasty little thoughts that made my day hell rarely pop up these days, but when they do, I pause and I decide how I will react. No more knee-jerk fits of frustration! I feel so much less stressed. It’s nice to just take things in stride. Of course, there is a bit more to it than this. Mindfulness gave me a new mindset of being open and accepting of what comes without judgment and without wanting it to be different (ex: getting a new patient when you are already really busy.) When I mastered this, the unwanted self-talk was hushed. This also works when being stuck in traffic, with rude encounters at the grocery store, and many other situations. What I found is that my reaction of being angry about these little things that I have no control over, just kept feeding the angry beast. Over time, not getting wrapped up in these thoughts left it to starve. I’m so thankful my husband teaches this class and my only regret is that I didn’t listen to him sooner!
  15. You probably know happiness when you feel it. As a nurse, you may feel those positive emotions that come with a deeper purpose when an acutely ill patient turns the corner toward better outcomes or a patient living with cancer finds out they are in remission. You also feel happiness in everyday life when you reach goals, spend time with loved ones, or enjoy a nice dinner with friends. However, happiness isn’t something that comes easy for everyone. According to the World Happiness Report, the United States ranks nineteenth in the most satisfied countries in the world, with Finland, Denmark, and Iceland ranking in the top five. American adults have been experiencing a decrease in happiness since 2000 and reporting more thoughts of suicide, depression, and acts of self-harm since 2010. These statistics are scary. Nurses can experience high levels of stress-related to work environments, short-staffing, and the emotional aspects of working with ill and injured individuals each day. Combine your work with the statistics about happiness in the U.S., and you can see why it’s critical to take your happiness serious and plan out ways to increase your happiness quotient daily. Here are ten ways you can increase your happiness today. Create Happiness Goals Ok, you might think this sounds silly, but we live in a country where happiness is dying. So, having a goal to meet up with friends once a week for happy hour or planning a date with your partner is good practice. Find a Hobby Finding a hobby can be challenging. If you are looking for a hobby, think about what you loved to do as a child. Did you enjoy painting or crafts? If so, this might be an excellent place to start. If getting started on your own feels like a daunting task, find a class to take that can get you started with the basics. Use Your Vacation Time A recent report revealed that a record 768 million vacation days went unused in the U.S. in 2018. This is an increase of 9% from 2017 and adds up to billions of dollars lost in benefits. Dedicated nurses can sometimes feel guilty about taking vacation days and leaving their coworkers short-staffed. However, your vacation time is critical to your health and ability to refuel so that you can continue caring for others. Stay Healthy Nurses are skilled in educating patients on ways to stay healthy. You teach about diet, exercise, and chronic disease management. But how well do you keep you with your own wellness? Make your health your number one priority. Get plenty of sleep each night, eat a well-balanced diet, and get at least 30-minutes of activity daily. Practice Gratitude Each of us has many blessings in life. Expressing our gratitude can boost your mood and remind you of reasons to be thankful. Try telling the most important people in your life how you feel about them. Or, keep a gratitude journal to jot down two to three things you are thankful for each day. Ask for Help When You Need It Whether you need a little assistance with an admission or a patient who needs a PRN medication, asking for help can make your day run a little smoother. You should also ask for help outside of work when you need it too. If you feel that your happiness tank is getting dangerously low and you are struggling with symptoms of depression or suicidal thoughts, make an appointment to talk to a counselor or psychologist. Take a Walk Getting outside can boost your spirits. Feeling the sun on your skin and the wind in your hair is an excellent way to inject a little bit of happiness in the middle of a busy day. If you’re having a stressful day, take a 15-minute break to get outside and get a little sunshine. Volunteer Your Time Nothing can boost your mood quite like giving freely of your time and gifts. Find a charity organization that aligns with your purpose in life and spend some time working with others who may be less fortunate than yourself. Have a Good Laugh Did you know that laughing releases endorphins, the feel-good chemical, into your bloodstream? Laughing also relaxes muscles and can relieve built-up tension and stress. So, the next time you are looking for ways to boost your happiness, catch a comedy show, hang with your bestie who knows just how to make you laugh, or play a fun game with your family. Practice Mindfulness Life is busy. Whether you’ve received your fourth admission for the day or you’re trying to balance work and family life, taking time to connect to the present is critical to your happiness. The good news about mindfulness is that you can practice it pretty much anywhere. Find a quiet place like the breakroom at work or your bedroom at home and sit down in a comfortable position. Then, close your eyes and take ten deep breaths. As you breathe in, silently and slowly count to four, then hold your breath for a count of four, followed by a long exhale for a count of six. Do this for at least one cycle, but preferably two to three times. Happiness is a much-needed emotion. If you don’t plan ways to increase your happiness in your everyday life, you can start feeling sad, depressed, or disconnected from those around you. What other ways do you increase your happiness? Comment below to let us know what activities bring a smile to your face.
  16. Maureen Bonatch MSN

    How Technology Use Can Impact Our Health

    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 Effects Vision 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 screen Pain and Strain If 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 ergonomics Be mindful of the risk of repetitive strain injury from typing, clicking the mouse, or staring at the computer screen Inactivity The 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 can Stand when you have the opportunity, or walk around your office while taking a phone call Hearing Headphones 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 volume Limit the length of time of use Put it on speakerphone Social Effects Some 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 media Set automatic messages to discourage distracted driving, or interrupting sleep Turn 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 risks Remember 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 life Creating a Balance Technology 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?
  17. Maureen Bonatch MSN

    Make a Not to Do List

    Many of us spend the day counting the hours until our shift is done, or until we have a day off to focus on our personal To-Do List. But once this long-awaited time arrives, often it’s never enough. We may spend most of our spare time crossing off the things that we need to do, leaving little time for what we want to do. Often there’s no better feeling than accomplishing everything on your To Do List, although sometimes that list seems never-ending. What if that list was shorter, making it easier to reach those goals? What if we narrowed down our To Do List by focusing on what not to do? Then perhaps instead of being controlled by what we feel we have to do, we can spend more of our free time doing what we want to do. Reevaluate Your To Do List There’s no doubt that there are many tedious tasks that we have to do each day, but often many that populate our list, or our minds, are things that may not merit the guilt accompanying them. What might have been good a few years ago, might not meet your needs today. We may spend so much time doing what we feel we have to do that we no longer know what we want to do. The life you live today isn’t the same as the one you lived a few years ago, or even last year. Our needs and wants evolve with the passing of time, but often we don’t reevaluate if there are things we can remove from our homes, or our thoughts. Minimizing, decluttering, and organizing our material possessions has gotten a lot of focus lately. Some even say that decreasing the things in our physical space can help us find more happiness and peace in our thoughts. Make a Not To Do List There are tasks that take up our time, energy, and finances, that may begin to feel more tedious and not worthy of our time and energy. Focus on one or two tasks, or items at a time and consider, how much do I care about this? Prioritize your time for what’s important to do today, what can wait until later, and eliminate those things that may not be worth your time. I’m Not Going to ... Keep that subscription to that magazine or blog I no longer read, or pay the membership fee for an organization I no longer have the time, or the desire, to participate in. Purge your home and the guilt of things that are no longer important to your life today. Move those clothes around that I keep thinking will come back in style, or that I’ll lose 10 pounds so they’ll fit better. Reduce the time spent sorting through your closet and make it easier to find the items you love to wear. Stare at the overflowing inbox and instead start deleting or unsubscribing the unnecessary, or endless, emails vying for your attention. If you don’t want to unsubscribe, many offer the option of reducing the frequency. Check my email every five minutes. Plan certain times during the day for email and social media so it doesn’t overtake your day. Set your phone down so you can be fully present. Be distracted or annoyed by spam phone calls, or feel the need to respond immediately to texts and social media. Instead block spam numbers, let them leave a message, or change the settings for times you don’t want disturbed. Say yes to get-togethers, meetings, and clubs that I really don’t have the time, or desire to participate in. Decline early, and politely, so guilt doesn’t weigh on you or result in you backing out at the last minute. Neglect to ask for help. Someone in your family, or professional life, might be willing to assist with, or do some tasks more efficiently. The Gift of Time Most nurses realize the value of each minute. Whether we’ve learned that from the demands on our time, or our patients who say they wish they’d spent their time in a different way. Make the space and time for what’s most important in life. Don’t let the tedious tasks on your To Do List take up all your time and prevent you from getting to the things you really want to do because there’s too much you have to do. What we don’t do might just provide more time for what we want to do.
  18. J.Adderton

    Nurses Experience Empty Nests Too

    Recently, I mulled over a nursing diagnosis for myself based on Erickson’s stages of psychosocial development. What led me to revisit generativity versus stagnation? My daughter, an only child, spread her inexperienced wings and flew my protective coop. I think I have experienced every human emotion while trying to adapt to this next phase of my life...the empty nest (cue tear drops). I have become increasingly aware that the stress of nursing does not ease up just because I am working through something difficult. Nursing also doesn’t take it “easy on me” just because the risk of depression is already heightened by the work demands of our chosen profession. In my daily routine of taking care of others, I came to realize nurses experience the highs and lows of empty nests too. Challenges of the Empty Nest A huge part of our identity is wrapped up in the role of “mother” or “father” when raising our children. So, when the last child leaves home we are often left with a profound sense of loss. Yes, our homes do feel emptier but it is our identities that are greatly impacted. Relief and Grief When my daughter left home, I felt a sense of relief that I had done my job. We want our children to be able to confidently go into the world and build independent lives of their own. However, our experience is bittersweet because we may be left with a sense of loss, loneliness and sadness. Grief is a natural, and sometimes unexpected, response to this life transition. Empty Nest Syndrome Empty nest syndrome isn’t a clinical diagnosis. Instead, it is the phenomenon of experiencing these feelings of sadness and loss when the last child leaves home. Let’s look at other associated feelings. Frustrating Lack of Control I admit it. I liked having a say in my child’s day to day activities. Where she went, who she went with, how she went and how much she spent was somewhat under my guiding and watchful eye. Now, I often feel frustration because I am having to relinquish control. I don’t have the “inside scoop” on the details of her daily life and have to learn how to let go so she can be in control. Self-Identity and Loss of Purpose When children leave or move out, we sometimes feel as if our primary purpose in life left with the child. The last 20 years or more have been spent raising children and our self-identity may be tied into the role of parent. Since personal goals, hobbies and friendships may have been put aside while parenting, it is not uncommon to experience a loss in our sense of purpose. Strategies for Redefining Ourselves Adjusting to an empty nest is not as easy as “just getting used to it”. It is important to replace the loss in a meaningful way. Here are a few basic strategies for redefining ourselves when experiencing an empty nest. Identify ways your life roles and self-identity has been changed by a child leaving home. Also, consider how your day-to-day life and relationships have been altered. Make a list of the roles you play in life outside of your parenting role. Think about roles that require a significant investment of your time and energy, for example: spouse, sister or brother, daughter or son, friend, member (association, community or team), employee or profession and any other life roles you may have. Think about how you would like to build your other relationships. Create a list of new interests or hobbies you would like to explore or renew. This may be difficult at first because your children’s activities may have been your primary interests. It may not seem natural at first, but go ahead and get some things down on the calendar. Getting involved in other activities will help ease feelings of loss and emptiness. When to Seek Help Empty nest syndrome is not a clinical diagnosis, but it is a real condition and may require outside help. Common symptoms that may be experienced include: Increased sadness Feeling stressed and easily aggravated Crying easily Sleeping too much or too little Excessive worrying Changes in weight Avoiding social activities Any of these symptoms can be overwhelming and lead to depression. If these issues are preventing you from being active or coping with daily life, it is time to seek professional help. Therapists and counselors can evaluate you for depression and provide coping strategies Epilogue My daughter left for college three years ago and returned home. Oh, how easily I slipped back into “mom role” and it felt comfortable- like a big comfy sweatshirt. After a few months, she traveled across the country 2,586 miles to be exact, to start her life. Sometimes, the empty nest is a revolving door but finding yourself again is a little easier each time. Have you or are you experiencing an empty nest? Share your story and tips for coping. Resources: Empty Nest Syndrome: Pros, Cons and Solutions Is Empty Nest a Myth? An Empty Nest Opens New Doors
  19. J.Adderton

    Heat, Humidity and Protecting the Heart

    The hot and humid “dog days of summer” can cause heat stress in healthy people. For those with existing heart disease, typical summer weather can be downright dangerous. Studies have shown heat and humidity are hard on the heart. Heart disease, especially heart failure and ventricular dysfunction, make it harder for the body to cool in summer weather. According to the American Heart Association, a heat wave lasting just 2 days increases the likelihood of a premature heart-associated death. Heat and Heart Stress The body sheds extra heat through the involuntary process of radiation and evaporation. This process cools the body but adds some stress to the heart. In individuals with heart disease, the stress can be significant. Radiation (Circulation) Heat naturally moves from warm to cooler areas. If the air around us is cooler, our bodies use radiation to release heat into the air. This transfer will stop when air temperature reaches body temperature. The heart has to pump harder and faster to reroute blood flow to the skin for heat release. Evaporation (Heat) Sweat cools the body through evaporation. Just one teaspoon of sweat can cool the body by 2 degrees a day with low humidity. Evaporation is less effective on humid days when the air is heavy with water vapor. This process of cooling places additional strain on the heart. Sweat pulls sodium, potassium and other minerals needed for water balance out of the body. To counter this loss, the body holds onto water by retaining fluid. Heart Problems and Problems Coping Healthy people most likely adjust to hot summer days without missing a beat. However, those with heart disease may have difficulty coping with the added physical stress. The following factors may further contribute: Heart muscle damage can decrease the heart’s ability to circulate enough blood to adjust to hot weather. Narrowed arteries can limit blood flow to the skin Common heart medications may interfere with the ability to regulate heat. Beta blockers slow heart rate and blood may not circulate fast enough for effective heat exchange. Diuretics may worsen dehydration Some antihistamines and antidepressants reduce or block sweating In certain conditions (i.e. dementia, Alzheimer’s Disease, Parkinson’s Disease) thirst signals may not be sent due to the brain’s slow response to dehydration. Balancing Heat and Diuretics Congestive heart failure brings additional strain on hot days. Since the heart is weaker, the body has a harder time cooling. The risk for heat stroke, heat exhaustion and dehydration is greater with heart failure. Also, diuretics may increase the risk for dehydration and high sodium levels. Patient education should include compliance with physician instructions for fluid intake during hot weather. Diuretics and fluid intake may need to be adjusted to compensate for increased sweating and water loss. What to Watch For Nurses have a responsibility to educate heart patients on what to watch for during hot weather. Weakness and/or dizziness Nausea and vomiting Cool skin Headaches Dark urine Muscle cramps High fever* Uncharacteristic behavior* Confusion* Rapid respirations* Rapid pulse* Seizures and unconsciousness* *May indicate heat stroke Be Proactive and Safe Nurses are the constant across all areas of healthcare. Therefore, nurses carry the responsibility of educating heart patients on precautions to take on hot days. Patient education may include: Avoid activity outdoors during the hottest part of the day Consider exercising indoors or try out a water work-out in the pool Talk to your physician about guidelines for staying hydrated, especially if fluid intake is restricted When sweating, drink sports drinks to replace electrolytes Don’t wait until you are thirsty to drink Consider other sources of hydration such as popsicles or fruit juice Avoid alcohol and caffeine to reduce risk of dehydration Wear loose, light-weight and light-colored clothing If going outdoors, use sunblock Talk to your doctor about your specific self-care needs during hot weather Keep informed of you local humidity levels Check on a friend or neighbor and ask them to do the same for you Patient education should also include tips on maintaining a cool environment. Stay indoors with air-conditioning as much as possible. Don’t rely on fans as the primary source of cooling If your home is not air-conditioned, contact your local health department to locate a local air-conditioned shelter Limit the use of stove and oven for cooking and laundry dryers Cool down with cool baths or showers If time must be spent outdoors, avoid the hottest part of the day and find a shady area Conclusion Hot and humid weather can be dangerous for anyone, but the risk is greater for those with heart disease. Be prepared to educate your patients on how to prevent over-stressing the heart while beating the dog days of summer. Protect Your Heart CDC Information Related to Extreme Heat Heat is hard on the heart: Simple precautions can ease the strain
  20. This is an articled filled with irony because I am very guilty of all the irritating “triggers” at some point described below. I have always been told I have a lot of patience when it comes to dealing with people. I have also been asked “do you ever get mad or just lose it?”. I am that person who doesn’t notice the drip, drip, drip of a faucet or become unnerved when plans change. On the outside, I project tranquil and serene waters, but, my internal dialogue is a completely different story. There are times, especially with the stress of nursing, I have to create a small vent to simply release frustration. It is in these “I’ve had enough” moments I become acutely aware of my faithful triggers. Before I share my work triggers with you, I want to share a little secret. I am just self-aware enough to know it is my own reaction to stress sending me over the edge and nothing to do with my triggers. My work triggers are specific to my job and duties nursing on a 17 bed inpatient rehabilitation unit. The Half a Coconut Covered Donut Trigger When I am stressed, I easily noticed a family or vendor graciously provided donuts for staff to enjoy. But wait…. The prior shift enjoyed the donuts leaving only half of a least favorite donut. The Disappearing Diane Trigger What a magician! Diane is able to make herself disappear during medication pass, call lights flashing and phone ringing. Sometimes Diane provides and encore by asking if I could help her take a patient to the bathroom and as we enter the room…..Poof! The Personal Information Dump Trigger I am usually in a charting zone when things are quiet. But when I am on edge, my co-worker frequently describes, in great detail, the intimate ins and outs of her current relationship. The Wasting With Wayne Trigger There are times I am on edge, but make it through the work night. I am preparing to report off to the incoming nurse and Wayne asks if I can return a narcotic with him. Unfortunately, Wayne pulled pain medications at the beginning of the shift for his assigned patients “just in case” they needed it. Guess what? They never needed it. The You Can Put On But I Can’t Take Off Trigger The temperature on our unit is controlled centrally and we do not have the ability to adjust up or down. There is one person I can rely on to place an ice container next to the temperature sensor. I don’t look so good hot. My face becomes beet red and I sweat…. Alot. My internal dialogue makes a very heated argument that if this person is cold it is easy to put on a sweater, jacket ect. If I am hot I am 95% sure….why don’t we just go with 100% sure no one wants to see me wearing anything less than my scrubs. The I Just Rolled Out of Bed But At Least I Made It Trigger Nurse R arrives 10 minutes late and needs to make a pot of coffee before receiving report. Nurse R looks as if he/she rolled out of bed, puts on scrubs that look like one more wrinkle would transform it to crepe paper, jumped in the car and came to work. Nurse R has the energy level of the number 0 and early in the shift states “I just hope I can make it the whole shift”. If this was an isolated incident, I would encourage Nurse R to go home. Unfortunately, the wrinkled scrubs make regular visits. The My Earbuds Make it Hard For Me To Hear Trigger I am a team player and enjoy coordinating with my coworkers. We do have nurses wear earbuds to listen to music or play on the phone. This trigger can be partnered with disappearing Diane and the nurse is unable to hear and magically disappears. My internal dialogue makes a list of what these individuals miss- call lights, questions from staff and being an engaged part of the team. The Let’s All Work in the Dark Trigger The patients on my unit work hard during the day in therapy and hopefully sleep well. Once medications are passed and patients asleep I am totally onboard with dimming the unit lights to reflect a calm and restful environment. When I am on edge, there is always a co-worker who goes a few levels darker than dim. My internal dialogue? “How in the world do they expect me to see with my unpolycoated trifocals?”. By now, you (the reader) may be of the opinion I am the poster child of learned helplessness. If If I do not take care of myself, practice self awareness and tolerance, then yes, I am in full victim mode. There are times when my triggers are legitimate and it is on me to professionally communicate my concerns to management. In most cases, my wrecked nerves have nothing to do with the individuals or behaviors. My triggers become problems when I focus on the previews and miss the movie. How do you back away from the edge when stressed? Epilogue How I trigger my peers…. my co-workers will competently count the ways.
  21. Nursing is an important and essential profession, and nurses serve as the backbone of the healthcare system. As such, various types of frequent large and complex demands are placed on this population on a continual basis. Challenges within the healthcare industry can create significant social (i.e., absence of fairness) and organizational (i.e., work overload) sources of chronic stress and burnout for the nurse. These sources have been found to be the largest contributors to nursing burnout. Sensory Processing Sensitivity Indeed, nursing is a stressful profession with high levels of burnout. Hence, researchers have been investigating other associations to stress and burnout as well. From an individual perspective, personality has also been found to play a partial role in the experience of stress and burnout. Dispositional variables such as the Five Factor Model (FFM; i.e., extraversion, openness, negative emotionality, etc.) personality types have been researched within the context of nursing to gain a deeper understanding of their impact on one’s chronic stress. The inclusion of those such as the FFM has helped this research along, but recent evidence suggests that the unique and innate personality trait of Sensory Processing Sensitivity (SPS) may also provide further insight into this issue. Having this trait increases one’s potential to be overwhelmed by certain aversive stimuli both internally and environmentally, thereby leading to emotional and behavioral difficulties. Examples of aversive stimuli might be negative social situations, rapidly changing or unpredictable environments, or certain or personally overwhelming noises, lights, smells, or odors. Thus, overwhelming or aversive stimulation can lead to increased stress, placing those with SPS at risk for occupational stress and burnout. This may be important to consider, given that it is estimated that approximately 20% of all people have the SPS trait. According to Gray, the three most common nursing stressors are workload, death and dying and inadequate preparation. Maslach’s three burnout dimensions are emotional exhaustion, depersonalization and personal accomplishment. SPS has yet to be expansively and exclusively studied within this particular context of nursing, or even nursing in general. The current research explored the most common nursing stressors as well as burnout levels in nurses that are considered highly sensitive by nature in comparison to their less sensitive peers. Distribution of Highly Sensitive People in Nursing: Stress Results 252 registered nurses and licensed practical and vocational nurses were recruited from Allnurses, Facebook, Reddit and a Southern Texas hospital. Results revealed that nurses with SPS were significantly more prone to stress and burnout after controlling for potential covariates and other significant personality factors. Upon hierarchical regression, after age, gender, years of nursing experience and the FFM types were controlled for, SPS was significant at p<.01 with 3.3% of the variance for overall nursing stress. Inadequate preparation (pertaining to the inability to deal effectively with patients and their families) was significantly predicted by SPS, with p<.01 with 5.8% accounting for the variance of nursing stress. Workload was also predicted by SPS, with p<.01 with 5.3% accounting for the variance in nursing stress. Negatively emotionality was the only FFM personality type that significantly predicted nursing stress, representing 5% of the variance at p<.01. Gender was a non-significant predictor for both stress and burnout. Negative emotionality was significant at p<.01 with 11% of the variance for stress. Burnout Results For burnout, SPS was significant at the p<.01 level with a variance of 9.2%. Emotional exhaustion was also significantly predicted by SPS, with p<.01 with 7.6% of the variance. The implications of these findings overall reveal that SPS is a unique construct which predicts stress and burnout separately and in addition to the commonly used FFM types. In general, this study shows that Highly Sensitive People (HSPs; those with the SPS trait) are more prone to increased stress and burnout as nurses, particularly emotional exhaustion. Due to this finding, people who happen to be highly sensitive in an already emotionally demanding profession such as nursing may also be able to better understand part of the reason for their current predicament with regards to chronic stress and burnout from emotional exhaustion. Knowing this should empower them to re-assess the level of stimulation that they can tolerate on a day-to-day as well as long-term basis. Implications In practical terms, this means that the HSP may have to figure out other ways to preserve their emotional energy during each shift, as most of it will be spent with people in general. For instance, the nurse may want to make an assessment of which people require the most expenditure of energy during interaction. The HSP could then better determine in a disciplined manner on appropriate time limits for spending with each person, including patients, and also how they choose to interact with those individuals or when they interact with them. In other terms of practicality, the HSP may also have to make an even more difficult decision on whether or not to stay in the current nursing setting or environment. HSPs take longer to recharge emotionally, and highly or chronically stressful work tends to bleed over into one’s personal life, affecting other areas of life not previously considered to be associated with a stressful work environment. Thus, for the HSP, it is highly important to be present in a work environment in which one does not feel constantly emotionally drained from. Lastly, the current study’s findings naturally implicate the organization. On this level, working to alleviate the most frequent and intense nursing stressors would be the most practical way to assist all nurses in addition to HSPs themselves. Conclusion In conclusion, a better understanding of the trait of SPS would most likely provide valuable contributions to many stressful and helping occupations. Since SPS exists in roughly 20% of the world’s population, the societal impact of this construct could be significant. Furthermore, the field of Psychology recognizes the importance of individual differences. As more of these differences are discovered, the increased complexity of the human condition will be more fully represented by studying traits such as SPS. To the Allnurses community: Thank you for all of your help with my thesis research. I sincerely could not have done it without you. I have as of recent successfully defended my thesis at the university I currently attend.
  22. Let’s focus on some personal results from being too busy and challenge how it affects your lifestyle: YOU aren’t present. When have you been so swept away in a busy situation that you waived off an overture from your spouse, child, friend because you didn’t have time for them? YOU miss out on opportunities. When has an opportunity arisen that you really wanted to pursue but were too busy to take the time to explore it? YOU forget to love and care for yourself. When is the last time you did something nice for yourself, like a massage, spa day, weekend getaway? YOU don’t make time for doing nothing. How often do you unplug, detach and just “be” without doing? YOU don’t have time to think. When do you take the time to ponder and process issues in your life and work? YOU neglect to set boundaries. What is the effect on your day when you don’t set boundaries? YOU aren’t working to your potential. What goal do you wish to achieve that you are too busy to pursue? YOU become emotionally unavailable. What relationships are in jeopardy because you are too busy to nurture them? YOU forget to dream. How would your life be different if you took the time to imagine a perfect life for you? YOU forget your “why”. How often do you take the time to contemplate the reason you are here on this planet? Does this exercise give you some insights about the effect of busy-ness on the quality of your life? Or does it cause even more stress than you already have? Not to worry. I have solutions. But before I share, YOU need to make a decision about whether you are willing to make some changes in your life and take back the time and energy you lack right now. Top 10 solutions for reducing busy-ness and improving your health: 1. Examine your lifestyle Write down everything you do in a day Label what is important and what is not Stop doing what is not important 2. Follow your intuition Sit quietly for 10 minutes with eyes closed Imagine that your intuition is speaking to you about your busy-ness. What is it saying? Check in with your intuition whenever you feel overwhelmed and ask for answers 3. Say no Before you say yes - ask yourself: Do I have time for this? Do I want to do this? Does it fit with my values? 4. Network for support Talk with someone who seems to have their life in control Ask them what techniques they use to prevent being too busy Find an accountability partner while you begin making changes 5. Prioritize your health Determine how important your health is to you Schedule “health improvement time” on your calendar daily Create a reward system for yourself as a motivator 6. Calm your mind Focus on taking slow deep breaths whenever you feel tense Count to 10 if you feel you might blow up at someone Schedule time daily for meditation, calming music, relaxation strategies 7. Refresh your body Get up and move around every hour; or sit down every hour if you are always on your feet Do stretching exercises every hour Take breaks by walking outside or up and down stairs 8. Use food for brain power Create your lunch and snacks at home so you don’t waste time at work finding food Eat whole real food, low glycemic, not processed Drink a lot of water, half your weight in ounces 9. Create a workable schedule Honor a start and end time to your day and stick with it Avoid taking work home. If you must, determine if it’s necessary or can wait until the next day. Create an annual calendar that locks in self-care days off and vacations 10. Get enough sleep Pull the plug on technology after 8pm Spend quiet time to unwind before going to bed Set a sleep schedule of 7-8 hours Hopefully, these tips will be useful for you in your quest to reduce the busy-ness in your life and restore well-being. Feel free to share how you manage your busy lifestyle so we can all learn from each other. For a more in-depth look at this issue, I have a new book being released soon – Too Busy for YOU – How to Prioritize Yourself for a Balanced, Mindful and Happy Life. Let me know if you want to be notified when it is available. Resource: 21 Reasons Why You Should Not be Proud of Being Busy
  23. The ebb and flow of life bring moments of peace and contentment. Occasionally, stress and anxiety are a normal part of life, especially when faced with change, challenge and difficult decisions. Everyday events, children going to school, job promotions, illness, vacations and more, cause some level of anxiety. During these times, anxiety levels heighten temporarily but most people work through and shake off the worry. However, there are those who are weighed down with excessive worry and unable to work through the anxiety. Generalized anxiety disorder (GAD) characterizes a condition of extreme and excessive worry that is usually accompanied by physical symptoms. Symptoms may include trembling, muscle tension, twitching, irritability, sweating and feeling light-headed. Diagnosing GAD The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) characterizes GAD as having excessive worry more days than not for at least (6) six months. Excessive worry is worry or tension without a specific threat or that is out of proportion to the actual risk. The following table provides a comparison between “normal” or reasonable worry and excessive severe worry. Everyone experiences stress and anxiety intertwined with relaxed and peaceful moments in life. But what happens when anxiety becomes a roadblock in your ability to function in day to day activities and relationships? This article explores what happens when excessive worry leaves you unable to work through stressful situations. Reasonable/Normal Anxiety Excessive/Severe Anxiety Not in the way or interrupt your daily routine (job, school, social life etc) Able to control anxiety effectively Unpleasant, but does not cause emotional or physical distress Lasts for only a short period of time Significantly disrupts routine life Unable to de-escalate or control Extremely upsetting/stressful Worry about things and feel like the worst is always around the corner Excessive anxiety experienced most days than not Without panic attacks present, we may think we are "just worrying too much." Our struggles of constant worry may be minimized or dismissed and, in turn, not properly diagnosed. Most of us feel worried at some point in our lives and experience situations that can cause us to feel anxious, so what are professionals looking for to help determine if someone struggles with GAD? An evaluation of symptom criteria, as outlined in The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (also known as the DSM-5), is the first step—and looks for factors like excessive, hindering worry paired with a variety of physical symptoms, then use of proven diagnostic assessments to make a diagnosis and rule out other possibilities. Symptoms The DSM-5 outlines specific criteria to help professionals diagnose generalized anxiety disorder. Having a standard set of symptoms to reference when assessing clients helps them to more accurately diagnose mental health concerns and, in turn, provide a better plan of care. When assessing for GAD, clinical professionals are looking for the following: The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive. The worry is experienced as very challenging to control. The worry in both adults and children may easily shift from one topic to another. The anxiety and worry are accompanied with physical or cognitive symptoms. In addition to behavioral symptoms of GAD, the presence 3 common physical symptoms (In children, only one symptom is necessary) supports the diagnosis of GAD. Many of the symptoms are associated with the “fight or flight” response to anxiety. Supporting symptoms for diagnosis would not be attributed to any other physical problem or illness. Physical symptoms include: Tensing of muscles and body aches Headaches Feeling tired, low energy Shakiness or muscle “twitches” Difficulty swallowing Difficulty falling asleep or staying asleep Difficulty concentrating- mind drifts off or goes blank Irritability Increased sweating Increased pulse or palpitation Nausea Feeling dizzy Tingling in arms or legs Feeling out of breath or smothering sensation Flushing Increased trips to the bathroom Other symptoms that are not related to any other cause GAD is Treatable GAD is typically treated with psychotherapy, medication or both. Psychotherapy helps to identify sources of anxiety and effective coping strategies for relieving excessive worry. Coping strategies may include meditation, imagery, relaxation techniques, restructuring negative thinking patterns and healthy lifestyle changes. Ultimately, the goal of psychotherapy is to change the way we react to stressful triggers or events. Medications are sometimes used to help relieve symptoms but are not a cure for GAD. Antidepressants, specifically serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs and monoamine oxidase inhibitors are often used as first line medication treatment. Beta blockers, used to treat high blood pressure, may also be prescribed to help with the “fight or flight” symptoms of anxiety. Benzodiazepines are often used for acute and short term relieve of symptoms. There are drawbacks due to the risk of tolerance, dependence and abuse of benzodiazepines. Buspar is a non-benzodiazepine medication specifically for the treatment of chronic anxiety. Risk Factors We all experience stress and anxiety at one point of our lives. Researchers are finding both genetics and environment can contribute to the risk of anxiety disorders. Risk factors may include: Traits of shyness and behavioral inhibition as a child Exposure to stressful and/or negative life events in early childhood or adulthood Family history of anxiety or mental disorders Substance abuse or other health conditions (i.e. thyroid disorders, heart arrhythmias) can also produce or exaggerate symptoms of anxiety. For more information: Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., & Cashman, L. (2002). The reliability and validity of the GAD-Q-IV: a revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy, 33, 215-233. National Institute of Mental Health Fact Sheet
  24. Nurses understand stress. From the time your feet leave the comfort of your home until you head back at the end of your shift, you can experience a smorgasbord of stressful situations. You might practice mindfulness, yoga, pilates, or even have an active prayer life to combat stressful feelings. And, while these are all excellent ways to deal with stress, you might be surprised to learn that adding in certain foods can help lower your stress levels too. Before we get to the list of foods to try, let's review the basics of stress. Stress 101 Some situations trigger a biological process when you feel threatened. This reaction causes chemicals and hormones to surge throughout your body, which is the first thing you notice during times of stress. Your body responds to stress by initiating the fight-or-flight response where you either stay to fight the fear or run away. Not all stress is bad, but you need to recognize stressful situations and create an action plan. Nurses and Stress It's no secret that patients are sicker today than ever before. The demands of the bedside nurse can make you feel like your crawling down the hall of the unit with the weight of the world on your shoulders. A few factors that increase stress levels for nurses include workloads, lack of social support, exposure to workplace violence or threats, and understaffing. So what's a nurse to do? Here are five foods you can add to your diet to help alleviate your stress at the end of a long day. Go Green If you're anything like me, stress causes you to crave all things bad for you! But, before you get that double-order of cheese fries, you might want to think again and choose green leafy vegetables instead. Leafy greens, like spinach, contain folate, which produces the "pleasure" chemical, dopamine. Folate, also known as folic acid has been shown to improve cognitive function and lower symptoms of depression. Yield to the Benefits of Yogurt Bacteria in your gut might be contributing to your stress levels and feelings of anxiety. When your stress levels are up, the brain stimulates the gut, which is why you might experience gastrointestinal symptoms during times of stress. According to Psychology Today, probiotics and foods high in these good bacteria have been shown to alleviate psychiatric symptoms. So, instead of running through McDonald's on your way to work for a McGriddle, pack a yogurt loaded with probiotics. Some brands that contain high levels of probiotics include Fage, Dannon, and Noosa. Look for The National Yogurt Association's Live & Active Cultures seal to ensure you're getting at least 100 million active starter cultures per gram of yogurt. Break With Some Blueberries These tiny fruits are full of stress-fighting nutrients. Vitamin C has been shown to help people not show the mental and physical effect of stress during acute challenges. And, they might be able to bounce back quicker than those who don't consume high levels of vitamin C. Blueberries also contain phytonutrients and antioxidants which helps you to improve your responses to stress. Try adding blueberries to yogurt, oatmeal, or cereal. You can also pack a small bag full of blueberries and eat them on-the-go. They are an excellent alternative to sugary sweet snacks. Ask for Almonds One ounce of almonds (about 23 whole nuts) contains around 75 mg of magnesium. This nutrient has been shown to reduce the level of serotonin in your brain, which helps to lower stress levels. They are also excellent at satisfying the need to crunch away while snacking and decreasing stress. Take a Tea Time Sipping a cup of warm herbal tea in the afternoon or evening is an excellent relaxation technique. You might have always thought that it was just a coincidence that you felt better after a cup of chamomile or green tea, but science has proven that these herbal teas have properties that reduce stress levels. Chamomile can calm your nerves and help you get the rest you need during stressful situations. The amino acids that naturally occur in green tea promote relaxation and might even be able to assist in the treatment of mental health conditions. What are your go-to stress relievers? Are there other foods you eat on a regular basis to minimize your stress levels?
  25. traumaRUs

    The Grinch of allnurses.com

    Okay, not to be a Grinch, but really Christmas has become just so ridiculous. We all want this season to be happy with family get togethers, joy, peace and harmony. However, there are certain expectations of us too that we might not always be able to meet. The holidays can be stressful for many reasons. Here are some of my stressors. Can you identify with any of them? Please share what stresses you out during this season. Christmas starts tooooooo early. At Halloween, fully two months before the actual date, we are forced to view Christmas decorations, Christmas pre-pre-pre sales, and the start of "what should you buy your kids for Christmas commercials. Hallmark and Lifetime Christmas movies - ugh is all I can say. I can't do the continuous story of girl moves to the city for a great job, gets her heart broken by some guy, girl moves back home, girl meets hometown boy, falls in love, and gets a dog. Grrrr - I just can't stand all the sugar. Why not just be real? The holidays are stressful for many reasons - how about showing some real people at the holidays? Emails after emails wanting me to spend money on "the greatest sale since the creation of sales." Any place I've ever ordered from is now sending me oodles and oodles of emails begging me to spend money with them. And what's with Black Friday, Black Friday Weekend and then Cyber Monday? So...we have day after day after day of sale notifications. When should I purchase, what should I purchase? So many choices. The positive for this (and yes there are some holiday positives even for this Negative Nancy - :)) is that I do like online shopping - efficient, quick and convenient. The "guilt me" commercials on TV - you know the ones; where if you don't buy the latest laser gun, bicycle or video game/console for your child, you are somehow going to be perceived as a bad parent. Oh and of course these commercials are geared towards the kids so you have your kids begging for the next big thing too. And did I say the next big thing is $200+? Office politics are high on my list some years too. Do you buy something for close co-workers, do you have some type of grab bag or something else? Is there a dollar limit? Are presents not allowed? I've worked several different places with different rules. In some places this added to the stress of the season too. Christmas decorations - the biggest discussion at our house is when to put the decorations up. I am now (the day after Thanksgiving) looking at our decorated tree, with the outside lights twinkling. So, when is the optimal time to put up decorations? Is our house decorated too early? Or, should we have waited until two weeks before Xmas, like I wanted? And the next discussion is when to take the decorations down? I vote the day after Christmas. However other members of my family feel that they should stay up for another week or even two....another discussion. Weird gifts - just saw a commercial saying I should gift my family with new toothbrushes. My family would probably be offended if this appeared in their stockings. Subscriptions to different apps seem to be another (at least to me) a weird present. So, as the self-proclaimed Grinch of AN, surely I'm not alone? Come on guys help a Grinch out? What's your least favorite part of the holidays? What aspect of the holidays drives you crazy?
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