Mental Health Is a Global Issue

Mental Health Is a Global Issue

October 10 is World Mental Health Day, and nurses are in an excellent position to notice when patients might be suffering from a mental health condition.

Nurses have the knowledge and authority to offer patients the facts about mental health, and they can normalize conditions like depression or anxiety. They can convey the important fact that, like any other medical condition that needs to be treated properly, mental health conditions are a physical and chemical imbalance and not a character flaw.

Although the general attitude toward mental health conditions is gaining more mainstream discussion and acceptance, the attitudes vary greatly. Factors like location or family culture can either normalize depression or obsessive-compulsive disorder make it a forbidden topic. Knowing a little about how your patient sees mental health conditions can help you adapt your approach.

On World Mental Health Day, nurses worldwide can spread the word by offering access to online screening tools through places like Mental Health America or the Anxiety and Depression Association of America. They can offer referrals to area mental health providers if appropriate. This year’s theme focuses on mental health in the workplace, so it’s also a good time to open up discussions in your workplace about paying attention to our own mental health and how it impacts job performance.

But nurses can also just talk about mental health issues in a nonjudgmental manner to put patients at ease. If someone is struggling with something like racing or unusual thoughts, severe anxiety in public places or about specific topics, or experiencing significant impacts to daily life because of sadness, they want to know they are not alone. Nurses can fill that role with care, compassion, and expertise. They are also there to offer hope that with treatment, the person can feel better and can begin to resume a life they are happier with.

Of course, some patients are reluctant to talk about their mental health directly, but they might bring it up in ways that are less obvious. Nurses can ask direct questions or they can listen for clues in conversations. What are your patients saying? Are they gaining or losing weight? Having trouble sleeping? Becoming more argumentative or less engaged with their family and community? Are they missing work or getting in trouble at work for being late or making errors? Are they drinking more or using recreational drugs?

It’s good to remind patients that a mental health condition doesn’t always require medication, although that is often a good option, and it isn’t always a lifelong condition. Other treatments like therapy, stress reduction, and healthy living basics like exercise, quality sleep, and a good diet also help lesson some symptoms. Sometimes problems are a result of a different condition or a side effect of a medication—factors many people don’t know. Getting to the root of the problems will help a patient find the right treatment plan.

The important message is that help is available, treatment works, and that first step can bring them enormous relief. Your positive attitude and compassion can make a big impression and can influence how people see their condition and think about treatment.

On World Mental Health Day, remain alert to what your patients are telling you. You may be able to help change their lives in a way you didn’t expect.

Opioid-Free Approaches to Pain Management

Opioid-Free Approaches to Pain Management

As the country continues to grapple with an ever-increasing opioid addiction crisis, the medical profession and patients alike struggle to treat real pain issues while managing their pain safely.

Sherry McAllister D.C., M.S (Ed)., CCSP, executive vice president of the Foundation for Chiropractic Progress recently answered some questions from Minority Nurse about how to navigate this tricky path. October happens to be National Chiropractic Health Month and is a good time to begin thinking about managing chronic pain with medication-free methods when possible and safely with medication when it is necessary.

“The human toll of prescription opioid use, abuse, dependence, overdose, and poisoning have rightfully become a national public health concern,” McAllister says, noting that opioid drug abuse was named an emergency by President Trump. “The sheer magnitude of America’s prescription opioid abuse epidemic has evoked visceral responses and calls-to-action from public and private sectors. As longtime advocates of drug-free management of acute, subacute and chronic back, neck, and neuro-musculoskeletal pain, the chiropractic profession is aligned with these important initiatives and committed to actively participate in solving the prescription opioid addiction crisis.”

What can concerned patients and health care teams do? “Begin treating pain with conservative options first,” says McAllister. Many people suffering from pain just want it to go away and often hope the pain medication will hasten that. As nurses know so well, pain medication treats the symptom, but not the underlying problem. “But the opioid emergency demonstrates that masking pain can lead to long-term persistence of both the pain and the drug use,” she says.

The necessity for finding alternatives that will help people without exposing them to the risk of addiction or dependence is clear. “Data released by the Centers for Disease Control and Prevention (CDC) revealed that ‘opioid deaths continued to surge in 2015, surpassing 30,000 for the first time in recent history,’” says McAllister. The rates continue to rise.

Often addiction starts with something as simple as dental work or as common as a back injury. McAllister cites an April 2017 report on lower back pain in the Annals of Internal Medicine that “strongly recommends non-pharmacological treatment” that suggests a long list of first-line alternatives including heat, massage, acupuncture, exercise, multidisciplinary rehabilitation, mindfulness-based stress reduction, tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation.

If those options don’t work, moving on to medication trials of non-steroidal anti-inflammatory medications (like Aleve or ibuprofen) or muscle relaxants should be tried. Opioids are considered an option if all these other methods have failed to provide necessary relief. But they should only be prescribed after assessing each individual case and with a discussion with the patient about realistic pain management expectations and what the risks are.

Nurses can help deliver information about pain management options to their patients while not minimizing the impact chronic pain has on their lives. They can encourage therapies that don’t include medication and back it up with the proven evidence that these approaches help patients in the long term.

Opioids, in particular, can also cause a host of associated health problems, with addiction being the most well-known. But patient’s bodies can also become adjusted to the drugs and require increased does to deliver the same pain relief. McAllister recommends Chiropractic: A Key to America’s Opioid Exit Strategy or Chiropractic: A Safe and Cost-Effective Approach to Health for more information.

Why Listening to Your Gut Matters

Why Listening to Your Gut Matters

When dealing with patients, there are times in which nurses need to be their advocates. But have you ever thought about if the instance occurred when you had to act as your own advocate? Janetta Olaseni, RN, BA, HN-BC, CHC, administrator and director of nursing at Hands of Compassion Home Care, Inc., had to do just that.

In February 2013, Olaseni says that while performing a monthly breast self-exam, she discovered a painless lump about the size of a bouncy ball in her left breast. Of course, she went to see her gynecologist. But he told her that it was a normal cyst and that since she was young and didn’t have a family history of breast cancer not to worry about it. If it did become painful, he told her, she could have it removed. Despite what her doctor told her, she felt that something was wrong.

“I immediately did not feel good about his diagnosis and started making plans to have it removed,” says Olaseni. As time went on and life got busier, seeing a surgeon became less important.

“In the meantime, the small ‘ball’ had grown and started to hurt and fill with fluid,” says Olaseni. She quickly made an appointment to be seen. Like her gynecologist, though, the surgeon was treating the lump like a normal cyst and would drain the fluid. After three weeks of this, she requested a lumpectomy.

In September, when she woke up in the recovery room, Olanseni’s surgeon told her that she couldn’t remove the entire lump because she would have had to have taken out nearly half her breast. The once 3 cm lump had grown to 8 cm.

When the biopsy came back, Olanseni’s diagnosis was Stage 3b Invasive Ductal Carcinoma.

Today, Olanseni is cancer-free, but who knows what could have happened if she hadn’t insisted on the surgeon listening to her.

“This journey made me so much more compassionate and empathetic towards my patients and their families,” says Olanseni. Ten years ago, she started a home health care company that emphasizes facilitating compassion regarding patient care.

“When you’ve been on the other side with the hospital gown on, having your hair shaved because you do not want chemo to take it out, when you’ve had your porta cath accessed daily, when you’ve had the radiation beam hit close to your vital organs, when you have undergone multiple surgeries, when you’ve gotten therapy and wound care, then you are a true patient advocate,” says Olanseni. “Not only can you say you understand, you really do understand.”

The Caregiver’s Guide to Planning for Retirement

The Caregiver’s Guide to Planning for Retirement

As a nurse, you spend most of your life taking care of others — but who’s going to take care of you when it’s time to retire? A Fidelity Investments Money FIT Nurses Study revealed that 56 percent of working nurses don’t feel confident when it comes to financial planning. The same study found that 41 percent of nurses who don’t have confidence about financial planning cite lack of time to focus on financial goals as the reason. Cultural differences and language barriers can further stand in the way of working nurses as they strive to save for the future.

It’s tough being a nurse because you’re pulled in different directions every day, but taking the time to put your financial ducks in a row for retirement will pay off big when it’s time to hang up your scrubs for good. Here’s how to get started or bolster your savings efforts while there’s still time.

Know the Lingo

There are several programs that can help you save for retirement. These include 401(k)s or 403(b)s in the case of tax-exempt workplaces, like hospitals; IRAs; and Flexible Spending Accounts. If you don’t know the difference, now’s the time to learn the language of personal financial planning.

IRAs, which stands for individual retirement accounts, are funded solely by you whereas 401(k)s are funded partially by you. Employers typically offer matching 401(k) plans. For example, if you elect to contribute 5 percent of your earnings to a 401(k), your employer may match that rate, netting you an extra 5 percent in savings for retirement. In 2017, you can contribute up to $18,000 to a 401(k) account if you’re under age 50. You get an extra $6,000 if you’re older than 50.

On a related note, think carefully about your health care needs in retirement, especially if you’re not quite ready for Medicare, which starts at age 65. A high-deductible health plan paired with a health savings account may help you keep monthly premiums low while allowing you to save for unexpected medical emergencies. Understanding the different benefits and drawbacks to retirement saving options can be confusing, so it’s wise to talk to a financial adviser about your choices before committing to just one plan.

Start Right Now

You don’t need to set aside thousands of dollars right away. Make small changes, and focus on simple, achievable steps so that you can reach big milestones later. Here are a few simple ways to improve your saving habits:

  • Start planning – today! Writing down your savings goals is the first step to implementing them.
  • Focus on eliminating debt – you can aim to get each credit card paid off individually, try transferring your balances to one card, or negotiate lower interest rates.
  • Cut back on unnecessary expenses – can you eliminate some small charges here and there, like a Netflix or Spotify subscription? Are you sure you’re getting the best deal on your cell phone bill? There’s more than one way to whittle down your monthly discretionary spending, so it can pay to get creative!

Nurses may tend to think less about their own future and more about the immediate needs of their families, such as paying tuition for adult children or taking care of elderly parents. However, you can’t take care of your loved ones if you don’t have any funds after you retire. Estimate how much you’ll need to live on comfortably once you stop working, and build a plan based on that figure.

Find a Support System

It’s critical to find a financial adviser who can guide you through this process. There’s no need to settle either. Seek out recommendations, do some digging and interview prospective advisers with the same scrutiny that you’d use to find a lawyer or doctor. A good financial planner will help you sort through your current finances, identify areas that need improvement, set up a solid retirement plan and answer your questions as you go. Look for advisers with the right credentials too, such as those certified by the Financial Planning Association.

Don’t let unfamiliarity about financial planning keep you from living the retirement life that you’ve earned. As a working nurse, it’s important to find a financial adviser who understands your unique needs and can get you on the right track. Start early, do your homework and be diligent about saving. Your post-retirement life will thank you!

6 Ways to Practice Mindfulness

6 Ways to Practice Mindfulness

Does your mind easily wander? Do you find yourself performing tasks at work without much thought? Research shows that people spend almost half of their waking hours thinking about something other than what they’re doing, which weakens their performance, creativity, and well-being, according to Harvard researchers.

If this behavior describes your mindset, you belong to a club where membership only requires habitual ways of thinking, doing, and feeling. The bad news? It’s not a great place to be. Mindfulness – with all its benefits – is where you want to head.

Mindfulness, which means being focused in the present moment, can strengthen your job performance as well as your mind, body, and spirit. Mindfulness engages your senses to allow you to participate fully in daily tasks.

So how do you achieve it? Here are six steps to practice moment-to-moment awareness at work.

1. Reflect and plan.

Start the workday by focusing on your organization’s purpose and how you contribute to it by being present and engaged. End each day by preparing for the next to help avoid anxiety or procrastination.

2. Relax.

Slow down. Set aside five minutes daily to breathe. For a minute or two, breathe deeply. Focus only on inhaling and exhaling. Consider adding a few minutes of stretching, which allows more oxygen into your body and encourages blood flow.

3. Walk more.

Concentrate on the sights, smells, and sounds that accompany your movement. If you can, spend a few minutes walking outside to observe nature.

4. Feel thankful.

Once a day, take a few minutes to think about an accomplishment or something else that fills you with gratitude. Practice finding joy as doing so you can change the direction of your day.

5. Enjoy your meal.

This sounds simple, but how often do you think about what you consume? Try to taste each ingredient or observe how thoroughly you chew.  Pay attention to your food and how it makes you feel.

6. Breathe when there’s a ring or ping.

Instead of instantly reaching for a ringing phone or pinging computer, take several breaths before responding. Emails and calls raise stress levels, research shows. It’s important to pause and calm down before reacting.

Mindfulness is the antidote to multitasking and possible burnout. With practice, you can build your mental muscles to keep your mind from wandering and engage in what’s happening right now. That’s a win for you in and out of the workplace.

World Hepatitis Day Raises Awareness

World Hepatitis Day Raises Awareness

To shine a light on a deadly disease, World Hepatitis Day on July 28 gives this chronic liver infection the attention it deserves.

According to the World Health Organization, more than 300 million people worldwide are afflicted with hepatitis B (240 million) or hepatitis C (80 million). The infections contribute to approximately 1.4 million death annually, numbers similar to deaths caused by tuberculosis, HIV, and malaria. World Hepatitis Day calls attention to these staggering numbers, but also shows hope that the disease can be eliminated.

In fact, the Global Health Sector Strategy on Viral Hepatitis is an aggressive goal to eliminate viral hepatitis as a public health threat by 2030. Like other communicable infections, hepatitis is hard to control.

According to the sector report, the five strains of hepatitis infection (A, B, C, D, and E) can occur through different transmissions. Hepatitis B and C are blood-borne and can be spread through tainted medical practices, injections including drug use, mother-to-child at birth, and sexual contact. Hepatitis D is also blood-borne and only infects those with a co-infection of hepatitis B, so is preventable. Hepatitis A and E are spread through unsanitary food and water conditions. Neither of these causes a chronic infection and so do not pose a threat of long-term liver damage including cirrhosis and liver cancer, but can be miserable to cope with.

Luckily, hepatitis A, B, and E are preventable with a vaccine series (and hepatitis D by proxy of receiving the B vaccine series). There is no vaccine for hepatitis C, although it is preventable and new treatments can cure up to 90 percent of infections.

The challenge comes because hepatitis infections have not received the traditionally high attention of other communicable and preventable, although equally deadly diseases. Many people aren’t aware they are infected and can spread the disease unknowingly, and access to affordable, preventative vaccines and health care, accurate medical information, and government funding is spotty at best in some parts of the world.

Nurses can use World Hepatitis Day to inform patients about hepatitis infections and about their risk for infection. Remind them that hepatitis infects people globally and can happen in anyone—even sharing a razor with someone who is infected puts you at risk because of the potential exposure to bodily fluids. Talk to patients who might be at obvious risk (those who received blood transfusions, those who could be traveling to countries that might have active A and E problems, or those who have been IV drug users at any point in their lives or sexual partners of past or present IV drug users). Also have conversations with those whose risk is less obvious (those who might not discuss unsafe sex practices, who could have been infected during an unsanitary tattoo or piercing).

Discuss topics like prevention through available vaccines and safe practices around sexual activity, preventative hygiene habits (not sharing razors, toothbrushes), and drug use. Also be willing to guide patients to available testing and have some information about current treatments.

With such a push to end the threat of hepatitis across the globe, nurses can do their part from the close relationships they develop with patients. The earlier hepatitis infection is detected, the greater likelihood of starting treatment that can be potentially life-saving.