February is all about heart health—what you can do to improve it, ways to prevent damaging it, and finding out what heart-healthy habits work for your lifestyle. Stress is a big contributor to poor heart health, so relieving stress is a natural way to improve your odds.
But reducing stress, especially when you’re a nurse, is not always as easy as it sounds. Sure, you can try (and probably have great success with) yoga classes or even with the scientifically proven meditation. But if you want to find something a little off the beaten track, try these odd ways to give your stress the boot.
1. Bake Bread
Baking bread is such a huge stress reliever that some medical professionals tell their patients to try it. But you have to put the bread machine away for this one. This is bread baking the old-fashioned way. All the banging and kneading of the dough not only gives your upper body a workout, but the repetitive motion is incredibly soothing. Then call a friend to come over and share your wonderful loaf of bread.
2. Laugh Really Hard
There are lots of formal and informal laughing groups that gather strictly for the purpose of laughing. People get together and try to force a few big laughs, but the resulting honest laughter can really relieve your stress. You can also get your laugh meter going the old-fashioned way. If you want your laughs to come from something funny, tune your radio into some comedy stations, download some funny podcasts, or get some comedians’ CDs from the library. You might have to seek it out, but ticking your funny bone really is good for your health.
3. Carry a Fragrant Cotton Ball
This might sound weird, but carrying around a cotton ball infused with an essential oil can have a huge impact on your mood. Carry your scented cotton ball in a baggie or a small plastic container (remember the idea of this blog is weird ways to relieve stress!) so you can sniff it periodically throughout the day. Lavender is an excellent and well-known relaxing scent. Citrusy scents like lemon, lime, or grapefruit are invigorating and might help your brain out of an afternoon slump.
4. Rest Your Eyes on Beauty
When there’s no way you can step outside or escape to the blue ocean of the Caribbean, find an app with a flickering fireplace or with soothing ocean waves or the bird songs in a rainforest. Spending a few minutes looking at something peaceful (bonus for added sounds) will bring your blood pressure down a few notches even if it’s not the real thing. You can spend just a few minutes gazing and then get back to your day a little more relaxed.
5. Watch a Sad Movie
This is not for everyone! But if you are one of those people who feels relieved after a good cry, you might want to turn on a good tearjerker. A good crying jag can release a lot of pent-up emotions and, in fact, get rid of some of the stress you’re holding in. But, if you’re someone who takes a long time to shake the sad feeling of movies that make you weep, skip this tip.
Finding out what makes you feel better is always good–even if it is a little out of the ordinary. In the end, what matters is your health, so find a great stress reliever and stick with it..
Hospitals will face a major dilemma if the current federal administration repeals the Affordable Care Act (ACA) without a suitable replacement. The ACA offers millions of Americans affordable health insurance, and hospitals have seen their revenues, and their quality of care, rise as those newly insured citizens access their services. If the ACA goes away, those health care patients and their accompanying insurance payments disappear, putting even more stress on today’s health care labor force. With profit decline comes employee decline, both in number and quality. This will first and foremost affect nursing staff, putting some out of work and others in-over-their-heads.
An Uncertain Health Care Future
Before enactment of the ACA, existing law required (and still requires) that health care facilities provide “stabilizing care” to any person who requests services, regardless of their ability to pay. Medicaid covered these costs. Without ACA coverage, many patients will be forced back to receiving only the substandard “stabilizing care,” and will not receive the services they need to regain their health.
In that circumstance, the medical facility will be forced to balance the volume of unsubsidized, stabilizing care offered against the revenues generated by paying patients, cost reductions, or staff workload increases. If they offer excessive unsubsidized care, they risk declining income levels, staff numbers and possible bankruptcy. If they provide too little, they risk losing their Medicaid/Medicare funding. In both cases, the facility, its staff, and America’s uninsured patients will suffer.
Unpaid Care Is Expensive for the Medical Office …
Every medical consultation generates a series of cost-creating actions, from those of the scheduling secretary to the attending medical professional, and all the way through to the deposits made by the final billing clerk. According to the American Hospital Association, hospitals provided $35.7 billion in uncompensated care to their patients in 2015 alone. When a hospital absorbs these losses, it is also forced to reduce the services it can afford to provide.
Consequently, it is not unheard of for doctors to reduce the size of their bills by limiting the services they provide or the number of recommendations they make, based on their perception of what the patient can afford. Other studies confirm that uninsured patients are checked into a hospital for shorter stays, and they are offered fewer interventions for their condition. For the health professionals, these painful decisions are in direct conflict with their oath to provide the best care possible for every patient.
… And Hard on the Staff
One group of hospital workers that will certainly absorb a significant percentage of additional work due to funding cuts are the nurses. Reduced funding often leads to reduced staff numbers; remaining staff end up working longer, harder shifts, with more responsibility and less break time. And nursing is already a challenging job, with a high demand for significant physical labor that also takes an emotional toll. In fact, between 2002 and 2012, nurses have reported the highest stress levels of all health care professionals.
Additionally, long hours may not allow nurses to get the sleep they need. Inefficient sleep has been associated with a deficit in performance, caused by cognitive problems, mood alterations, reduced motivation, increased safety risk, and physiological changes. These effects only get worse with total sleep deprivation, common among nurses who work consecutive shifts.
Additional Stress Factors
Research reveals that the changes in the nursing profession in particular and the health care system in general, contribute significantly to the problem:
- Sophisticated technology offers immense benefits but adds additional layers of responsibility on already overloaded schedules;
- Burnout is common, too. Protocols can change as resources ebb; nurses are compelled to follow evolving practices without the opportunity to add input regarding their patient’s care. A 2012 study published by the Canadian Federation of Nurses Unions found high levels of burnout correlated to lower ratings for quality of care.
- Reduced staff numbers also drive nurses to work even when they are sick. Many choose to potentially infect their patients rather than leave their colleagues unsupported on shift.
The reality for America is that, before the ACA, unpaid hospital bills were often eventually born by other elements of the system, including taxpayers and patients who incurred higher medical care costs. Repealing it won’t save the country money, but instead will add extra stress to the system and further erode the health of millions of its citizens.
Of all the risk factors for heart disease, the areas you have no control over are often the ones that are especially troublesome. While you can make inroads to a healthier diet, more activity and exercise, reducing stress, and even taking appropriate medications, it often feels like there’s nothing you can do to change your family’s track record of heart disease.
As February is American Heart Month, now is a great time to take stock of your own heart health. Knowing that your family carries a higher risk for heart disease is actually a great motivator to keep your own heart as healthy as possible. In many cases, if you ramp up your efforts to control what you can, you can negate some of your family’s health lineage.
Can you change your family’s past? No – if you had a father and three aunts who died from heart disease in their 40s, you need to take that very seriously. But it doesn’t mean you will take the same path.
How can you beat your genetics?
Know Your History
The American Heart Association recommends gathering as much family history as you possibly can. If you are at least able to start with members of your immediate family, that will help you assess your risk.
Look for family members with a history of heart attacks, strokes, high blood pressure, high cholesterol, or congestive heart failure. Find out how old family members were when they were diagnosed and how old they were if they died from the disease. And try to notice any patterns – is the predominant problem heart attack or stroke?
Accept (But Don’t Give Into) Your Genes
There is virtually no way to change your genetic makeup. But if you carry an elevated risk, it can make you feel unsure of what’s to come. So while you can’t change your genetic cards, you can change how you live your life.
A lifestyle that is heart-healthy, heart-friendly, and heart-supportive can contribute greatly to your overall heart health and start to bring your elevated risk into a more normal range.
Talk with Your Team
Talk to your healthcare providers to make sure you are getting all the tests you need to uncover any early indicators of heart disease. Discuss medications and other therapies that can lower your blood pressure and your cholesterol and even get things like triglycerides into normal range.
Some minority populations are more predisposed to heart disease (including African Americans and Hispanics), so go over some of those risk factors. And have a discussion about any other conditions you may have that could put you at a higher risk including diabetes, depression, and even psoriatic arthritis.
Make Heart Health a Priority
No one else is going to put your heart health first, so that’s going to be up to you. Put caring for your heart at the top of your to-do list. That means taking a look at obvious things like your eating habits, your weight, your blood pressure and cholesterol numbers. But it also means making sure you get enough sleep (lack of sleep raises your risk of heart disease over time) and making sure you take the time for pleasure.
Loneliness also contributes to declining heart health, so develop a rich social life and figure out exactly what that looks like for you. Some people want three parties every weekend and others are happiest having dinner with best friends every couple of weeks or a favorite book club every week.
No matter what story your family health patterns reveal, it doesn’t mean that’s your destiny. With some changes and lots of diligence and close observation, you can keep you heart healthy and strong.
She didn’t know her words would haunt me for years to come. It was a night like any other night. I stood at the bedside of a relatively stable patient, and I was dutifully giving him his meds. The floor was quiet, patients and nurses preparing for the night shift a few hours away.
Like a fire klaxon, a voice cut through the relative peace of the hospital floor. “My husband is dying! My husband is dying!”
Instinctively, I dropped the medicines and darted out of the room. In the middle of the hall, a middle-aged woman ran toward me, screaming about her husband in the room across the hall. “He’s dying,” she yelled into my face.
Mouth dry, heart pounding, I pushed past her and entered the patient’s room. Of course, he was unconscious, blue, and not breathing. I started CPR, but the craziness was not over.
I wasn’t exactly a new nurse. I had been through a few codes, and they all went rather smoothly. I never experienced the stomach-churning nausea of having a family member witness their loved one dying.
The patient wasn’t mine, but I knew about him. He had recently had coronary artery bypass grafting surgery and was due to be transferred to the ICU any minute because his heart rate and rhythm were abnormal. His doctor was on the floor, writing the paperwork for the transfer.
Others had heard the wife call out in anguish, and everyone came running, including the doctor. He burst into the room, shouting, “I need an intubation kit! Get me an intubation kit!”
I could hear the rumble of the crash cart coming down the hall, but it hadn’t quite reached the room yet. The doctor continued to yell at me, to point, to spit. His hands shook, but I had been here before. I yelled back, “Hold on a second! It’s coming!”
I realized then that the doctor was more afraid than I was. The cart arrived, the patient continued to code, and the doctor got his intubation equipment. Although we managed to get a sustainable rhythm on the patient, he soon died in the ICU.
Of all the codes I experienced over my years as a nurse, this one sticks out as the most horrible. When codes start, nurses become the ultimate professionals. No one runs. No one yells. Everyone works as a team.
As a relatively new nurse, I never experienced the terror that “normal” people experience when someone starts to die. For me, I knew how to handle it. A patient going south deserves my close care, but the emotion is usually not high during care involving advanced cardiovascular life support. Afterward, I would cry and shake, but not when I needed my faculties about me to do everything I could to save a life.
This code was different. In fact, I can live it over and over in my mind, and I still feel as scared now as I did then. The wife and the doctor were breaking the rules. They didn’t know how to deal with death, and I don’t really blame them. I just know their actions scarred me deeply.
Trauma is a real problem in nursing, and situations like these can cause a nurse to relive moments that didn’t go well. This is especially true of new nurses. New nurses make mistakes, and they haven’t developed the ability to be the calm professional yet. This means that the trauma of extraordinary events can stay with them forever.
I never dreamed that I would face a family member who was screaming that her husband was dying. I can only imagine the torment she was going through, the heartbreak of knowing that her loved one was slipping away before her eyes. She reached out for the only help she could.
And that help was me.
Her terror has stayed with me all of these years. In that moment, I became her. I empathized with her, as any good nurse will do. I felt her sorrow, and despite our best efforts, we couldn’t save her husband. I find myself imagining how she felt when he actually passed away.
I will admit that this situation scared me, and I have dwelt on it more than I should. Nurses, especially new nurses, have to develop a sense of detachment from the patient and family. But what about the human side of the equation? Too much distance leads to too little caring.
I am happy to say that I took part in codes after this one, and I did the best job I could. In fact, I was praised for my work in situations where a life was on the line. But I never forgot the distraught woman in the hallway, or the surreal feeling of dread that her words—”He’s dying!”—caused in me.
It remains a trauma that has impacted my life forever. Nurses need to realize that they experience traumas, too, and that it is okay to talk about them. It is okay to be afraid. It is okay to reflect on the situation and examine the emotions the trauma awakens. Without this reflection, the emotions become buried. Ignored emotions manifest as substance abuse, out-of-control feelings, and hatred of the job.
My trauma is just one example. Almost every nurse has a story of when she or he was scared and traumatized. Talk about it. Don’t pretend to be so strong that you don’t need to ask for help.
I wish I could have saved that man. I wish I could have wrapped that wife up in my arms and made it easier for her. I couldn’t, but it will stay with me forever as the trauma in my career that haunts me, because I couldn’t hide behind the façade of the calm professional.
I am the calm professional, but I am human, too.
November is National Diabetes Month and while many nurses know the exceptional challenges their patients with diabetes face, some know the obstacles personally.
As a nurse with diabetes, taking care of yourself is extremely important. And while managing diabetes is 24/7, the holiday season can be especially difficult. Nurses have seen patients go through all the ups and downs of this disease including trying to keep blood sugar levels within range when faced with holiday dinners and parties. Add some pressure from family and friends (both well-meaning and some that’s just uninformed) to “just try a little” of each and every buffet dish and getting through the holidays while trying to manage a disease that varies based so much on food is exhausting.
Both the American Diabetes Association and the National Institute of Diabetes and Digestive and Kidney Diseases recognize this month with tips and information to keep yourself healthy. But as a nurse, you can share your experiences to help your patients and sometimes even learn from what they say.
The holidays make things difficult. You’ve got additional responsibilities – from cooking to gift buying to volunteering to hosting – and all the changes those new tasks bring about. Staying with your normal routine can help, but that’s not always possible. Planning ahead and developing strategies will help keep you on an even keel.
If you shop for gifts, you often have to manage that with your normal work and family duties. And if your time to get all that done hits during a mealtime, you have to be prepared and think ahead. Are you going to grab something quick, eat at a restaurant, or pack something to bring?
This year’s presidential election is affecting just about everyone. It’s causing so much stress, arguments, and overall negativity, that we couldn’t even get any nurses to go on record with tips on how they remain less stressed in this crazed political time and help their patients remain so as well. Many were concerned that if they gave their opinions—even about how to help others—that because it had to do with politics, they may be reprimanded or even possibly lose their jobs.
That says a lot. Most nurses love to help other nurses. But in this case, the fear was tangible.
Instead, we contacted professionals in the mental health field to get their advice on what you can do to reduce your stress in this final week before the presidential election and how to keep it reduced after it’s over.
Use the Oxygen Mask First
If you’ve ever flown on an airplane, you know that the flight attendant always instructs people that in case of an emergency, to put your own oxygen mask on first. You won’t be any good to others, if you can’t breathe yourself.
The same case applies with lowering your stress. “In ‘helping’ professions, it is common for providers to ignore their own needs. Focusing on self-care, though, is critical during high-stress times like election season,” says Lisa Long, PsyD, a licensed psychologist, executive coach, and interventionist as well as owner of a private practice in Charlotte, North Carolina. “Taking a personal inventory of one’s stress level and well-being is a good start. Paying attention to yourself is a major aspect of doing and feeling your best. If you notice changes in yourself and how you are feeling, make the time to get connected with people you can talk to. Keep a list of things that make you feel relaxed, and make time to do at least one—even when you feel you have the least amount of time for it. Listen to your own body and needs—just like you do with your patients.”
Laura Dzurec, PhD, PHMCNS-BC, ANEF, FAAN, a dean and professor of the Widener University School of Nursing in Chester, Pennsylvania, says that recognizing that an individual, emotional response is not going to change the election is an important first step in lowering your stress. “The stresses accompanying the debates, deliberations, discussions, and arguments surrounding the presidential election have encouraged emotional responses,” she explains. “One important tip to use in lowering stress is to pay attention to personal responses. Are they defensive? Angry? Anxious? By backing away from pointless debates and thinking through responses that are immediate, nurses can lower their own stresses regarding what’s happening with the election.”
Tips To Help You Reduce Your Stress
Let’s face it—although we’ll get some relief after Election Day, there will still be fallout for some time no matter which candidate wins. Now that you have been reminded to take care of yourself first, what can you do?
“Humor is a fantastic coping strategy when it comes to situations that seem out of our control. Think of all the political parodies at the current time. Turning to humor helps reduce the experience of stress,” says Marni Amsellem, PhD, a licensed psychologist with a private practice specializing in health psychology. “Another great strategy—regardless of the stressor—is trying to tune out or take some time away from the stressor. For example, if the negativity of the conversation happening around you is becoming overwhelming, temporarily remove yourself from the situation, turn off the TV, take a social media holiday, and the like.”
One of the easiest things you can do is just breathe. “My tip for all nurses is to set the alarms on their watches or cell phones to remind themselves several times per day to perform two activities—breathe and practice mindfulness. Three nice deep breaths several times a day can do a world of good to clear the mind and refresh the body. As for mindfulness, take a few seconds, clearing the mind of all thoughts except for noticing the temperature in the room and being mindful of all safely and calmness,” recommends Mary Berst, PhD, the associate program director of Sovereign Health Group in Palm Desert, California.
Amy Oestreicher, a PTSD peer-to-peer specialist, health advocate, and speaker for TEDx and RAINN, suggests deep breathing as well and agrees that humor works. “Humor creates a common language the breaks barriers,” she explains.
Oestreicher also suggests that nurses try a couple styles of management with themselves, two of which are Active Management and Calming Management. With Active Management, she says, you take all of the energy that’s fueling that stress and use it—exercise, run, shout, or scream. Do whatever makes you feel better.
With Calming Management, you do just that—take actions that will work to keep you calm. That might be breathing deeply, meditating, getting a massage, or even taking a warm bath.
Finally, A.J. Marsden, PhD, a former Army surgical nurse and current assistant professor of psychology and human services at Beacon College in Leesburg, Florida, suggests that nurses encourage optimism and refute negative thoughts. “Smile! Research shows that people who smile really will feel better,” says Marsden. “Focus on all of the good work you’re doing. When we feel that our work is making a positive difference and an impact on the world, we feel more positive and happier.”