As the nation struggles through the health, social, and economic upheaval of the COVID-19 crisis, nurses are at the crux of it all. As nurses cope with the physical and emotional impact of working with so many critically ill patients and in conditions that often threaten their own well being, they are simultaneously juggling worries about their families and loved ones. The toll on the nation’s nurses has been steep and many are feeling the effects of mental health struggles with burnout, exhaustion, anxiety, depression, and post-traumatic stress disorder symptoms.
If you’re experiencing any symptoms of mental health struggles, there are resources available to help. It’s always said that you can’t effectively help others until you take care of your own needs and that is especially relevant for nurses right now. It also poses a dilemma as many nurses barely have time to eat or sleep with the schedules they are keeping and the demands being placed on them. In that kind of situation, it can seem impossible to try to get help for yourself when you have no time to have a thought.
But it’s important. As nurses have supported this country through the crisis that is still unfolding, they will continue to see a need for their services. The COVID-19 crisis is not going away for many months, possibly longer, and nurses need all the support they can get to make it through.
If you’re a nurse and you’re noticing signs of depression or anxiety in yourself or your colleagues, acknowledging that support is needed and warranted is the first step. If you’re personally experiencing symptoms, prioritize times when you can fit that kind of support into your schedule, so that you can find the help when you can access it. If you’re a manager, make sure your employees know how to recognize when they could use help and have the resources to access it. Many organizations offer free counseling as part of their health insurance plans, so that’s also an option to investigate.
Here are some resources:
If you’re experiencing thoughts of suicide, feel in danger of hurting yourself, or need immediate help, call the National Suicide Prevention Hotline at 1-800-273-8255.
American Nurses Association offers specific resources for nurses who are experiencing mental health distress of any level.
The National Alliance on Mental Illness (NAMI) can help you understand some of the typical treatments available to help.
Mental Health America offers specific tips for those experiencing COVID-19 stress and for first responders.
National Institute of Mental Health (NIMH) has brochures and fact sheets for education and awareness of many symptoms and how they are best treated.
The World Health Organization has information on how policies are shaping priorities around nursing and mental health.
MentalHealth.gov can help you determine if you’re experiencing symptoms of post-traumatic stress disorder.
The personal risk of ignoring the signs of mental distress is particularly significant for nurses. To have the very people the nation is leaning on continue doing a herculean job without help for their own struggles is unacceptable. There needs to be time and resources for nurses to get the help they need and to unburden themselves of the intense and unrelenting stress they have experienced.
Critical care nurses, those who work on critically ill patients in intensive care units, emergency departments, and other units, have likely had some of the most intense moths of their careers this spring. As the last week of National Critical Care Awareness Month is celebrated, this designation brings attention to the specialty work performed by these nurses across the nation.
Because of the unpredictable and often hectic cases they work with, nurses in this specialty need to have an innate ability to work in a calm and steady manner no matter what the conditions. As their patients face serious and life-threatening situations, critical care nurses are there to assess the patient, monitor for changes, treat injuries or problems, and provide thorough and immediate hand-off instructions.
Critical care nurses can work in various locations, but the care they provide is especially important for patients whose conditions are not stable. As these nurses have seen and relayed many times over, the COVID-19 crisis has shown why this kind of nursing is so essential. Patients with COVID-19 are often improving, says nurses, or showing signs of only minor distress before their conditions abruptly worsen. As a critical care nurse, watching that patient closely and continuously monitoring for any changes in vital signs, comfort level, breathing and talking, or overall general behavior can help give the patient the right care. Critical care nurses all over the world have been alert to these kinds of changes in condition and have been able to implement life-saving measures for many. As a nurse in this specialty, many nurses have also faced the opposite situation and have had many patients die despite being given the best treatment and care.
Becoming a critical care nurse requires a commitment to getting at least your BSN or most likely your MSN, continuing with certification and additional professional development, and recognizing the personal and very real impacts of this role. The American Association of Critical Care Nurses and the Society of Critical Care Medicine offer excellent resources, tips, and guidance for those considering this career path and for those who are already experienced critical care nurses. Critical care nurses face the highest highs and the lowest lows, often within one day, and sometimes from gut-wrenching situations. As a nurse in this field, it’s essential to understand how you’ll process so much emotionally. Managing job stress is a top priority. Of course, nurses enter the field because they do well under pressure and can keep calm and focused for the sake of their patients, their teams, and themselves. But sustained and traumatic caseloads, as have happened with COVID-19, or even a case that can strike an emotional chord for some reason, can take a toll on nurses. If you’re considering this field, honestly understanding if this is something you’d be suited for is critical.
There is high demand for critical care nurses in the job market, so your skills are needed across the country. If you think this is a good career path for you or if you’ve already chosen this path, the rewards of being a critical care nurse are significant. You are the voice of your patient and you’re able to make choices and be the best advocate for your patient. Being able to do that and knowing you have provided the best care possible while ensuring your patient’s best interests is gratifying.
Oncology Nurses Month is honored throughout the month of May and celebrates the broad options of this nursing path.
Nurses who pursue this career specialty and who work with patients who have cancer are open to many career opportunities. They are often on the cutting edge of technology and working with new treatments that change evidence-based practice with each successful development.
“With over 34,000 clinical trials occurring to test new drugs, combination therapies, and supportive strategies for patients, novel cancer therapies and care strategies are constantly emerging and being integrated into practice which provides exciting new treatment options for cancer patients,” says Erin Dickman, Oncology Clinical Specialist with the Oncology Nursing Society (ONS).
“An oncology nurse can be in the role of a staff nurse, nurse practitioner, clinical trials nurse, clinical nurse specialist, or administrator just to name a few,” she says. Because of this, oncology nurses can work in various healthcare settings and treat patients of all ages. And oncology nurses are constantly learning from their patients, their professional development, and each other. Oncology nurses should keep asking questions and working through the evidence-based practice process to ensure that all practices are evidence-based to ensure the best outcomes for your patients, she says.
Oncology nurses know that each patient will respond differently to cancer therapies, so they need to have the critical thinking, clinical experience, and expertise to respond to each patient’s individual needs. “They administer drugs within a treatment plan and the supportive medications that help to prevent and manage side effects,” Dickman says, “and they create individualized care plans for each patient that identify needs and risks of the patient, come up with a plan of interventions to achieve positive health care outcomes.”
Nurses in this field are an integral part of the care team and will work and communicate with various providers, family members, caregivers, and support services. As a result of working so closely with patients, nurses, says Dickman, are advocates for them and may be the driving force in getting access to additional care or specialty consults.
The COVID-19 crisis presents challenges for oncology nurses. “Nurses have had to flex, innovate, and adapt in the midst of the COVID-19 pandemic,” says Dickman. “Treatment protocols have been offered in different locations and some appointments are even switching to telehealth visits. Oncology nurses have especially been challenged in helping patients differentiate between COVID-19 symptoms and those associated with the disease process and treatment through additional remote monitoring and screening they have been providing to their patients.” They are also determining how treatment plans will need to change to protect patients’ health and are navigating the loss of support systems during visitor restrictions. “The oncology nurse has stepped up to be the hand holder and person to reassure the patient of their strength,” says Dickman.
Even as they are using their technical nursing skills, oncology nurses are also finely tuned to how their patients are responding to their condition and their treatment. “Sometimes overlooked, is the role that nurses play on the psychosocial and emotional well-being of patients and the role nurses play as advocates for their patients,” says Dickman. And nurses must trust their intuition. “When you think something may be wrong with your patient and they may require some intervention — either physically or psychosocially, they usually do,” she says.
If oncology nursing sounds like a career path you’d like to pursue, Dickman recommends talking with oncology nurses and even finding a mentor who can help you find the best subspecialty for your interests and skills. She also suggests talking with current and former cancer patients to find out about how nurses impacted their care.
Nursing students can choose to pursue many avenues to boost their knowledge of the field. “Other options are to find a shadowing opportunity, volunteer or become a nursing assistant on an oncology unit, seek out internships or externships, or build your knowledge base in oncology by taking select oncology focused classes,” she says. “There is also free student membership to ONS so you can stay up to date with what is happening in cancer care.”
A cancer diagnosis not only affects the patient’s physical and emotional health, but it also transforms a family and is a life-defining moment. “There are many ups and downs to cancer treatment, but having the opportunity to walk with patients throughout the journey is a gift,” says Dickman. “There is no greater reward than knowing you have helped a patient and family through a very difficult time, shared their joy, and helped them cope with sadness.”
Nurses across the globe are working together as a united front against the COVID-19 pandemic and as a much-needed support for each other. Today’s International Nurses Day honors that dedication with the motto of “Nursing the World to Health,” a theme that’s spot-on appropriate for the times.
Sponsored by the International Council of Nurses (ICN), a federation of more than 130 nursing organizations throughout the world, International Nurses Day is always held on the birthday of Florence Nightingale, long considered the founder of today’s nursing profession. The day honors nurses for all they do and helps spread the importance of support for the nursing industry all over the world.
Because nurses work with all people and treat a range of short-term and chronic conditions and health problems, they are the caregivers who address the global health problems from the very front lines. Whether it’s in the most state-of-the-art hospital facility or in a patient’s living room, nurses provide care, education, emotional support, and resources. They do this in the most dire circumstances and within the safety of structured organizations, sometimes worried about their own health and safety.
The Nursing the World to Health theme highlights some of the challenges nurses face every day across the globe. The incorrect ideas that they aren’t leading, active participants in healthcare or some of the discrimination they face on and off the job are addressed in the ICN’s report for International Nurses Day 2020 Resources and Evidence.
Promoting the lifesaving work nurses do, how involved they are in healthcare leadership, and their vital role in reshaping progressive healthcare policy worldwide is all essential to helping the public understand the value and relevance of the nursing industry.
The COVID-19 pandemic has shown the world exactly how dedicated nurses are to their patients—even risking their lives, and some losing their lives—to provide care to people who need it. It has also shown clearly that nurses need more support and that the world needs more nurses. The shocking reports that healthcare staff ran short of personal protective equipment shows glaring faults that exist and put nurses directly in harm’s way. Nurses are also called to navigate the systems in different countries that place healthcare on varying levels of importance and relevance to the greater good. And they also must work within the confines of the resources available to them where they are.
THE ICN sees hope in the growth in nursing leadership and influence throughout the world. As each nurse works to provide the best care, to maintain or exceed the nursing standards, to commit to lifelong learning, and to support their fellow nurses and healthcare teams, the nursing industry will see positive change.
Happy International Nurses Day!
When Neuroscience Nurses Week arrives every May, nurses in this specialty champion the vast choices they have within this career path.
For Ebonye Green, MNSc, APRN and director-at-large for the American Association of Neuroscience Nurses (AANN), becoming a neuroscience nurse was hardly something she planned. “I have my bachelor’s in chemistry, and I was going to go to pharmacy school or med school,” she says. She actually ended up going to pharmacy school and was two years into the program when an off-chance comment by a patient she saw every month changed everything. “He said, ‘This isn’t for you. You should do something else.’”
Green took a chance. She shadowed people at a university hospital while still working with outpatient pharmacy patients. “One night, I was pulled into the neuro ICU,” she says. Other nurses said she was going to hate it because the patients can be unpredictable. The talk made her nervous to go in, but the result was transformative. “I loved it,” she says.
When fall semester came around, Greene didn’t go back to pharmacy school, instead enrolling in nursing school. “That was totally out of character for me to quit something,” she says. “My parents were surprised because I am a planner. I am a Type A, which actually fits in really well with neuroscience nursing.” But she had everything worked out from finding funding to moving credits around. “People thought I was crazy,” she says. And while she says she really didn’t know what to expect, she had a gut feeling that she was on a path that suited her. “It felt right,” she says. “I didn’t feel like I was going to work. I have never felt that way. I always learn something new every day. It’s eye-opening. It’s exciting.”
Green says making connections with other neuroscience nurses early in her career helped her gain her footing and gave her a sounding board. She talked to other nurses through AANN, and they gave her career-boosting tips. She was told how important it was to gain additional certification in her specialty or sub-specialty. They also let her know about neuroscience journals and about how conferences for neuroscience nurses were a great way to find other like-minded professionals.
Green understands why the nurses so long ago thought she might not like neuroscience nursing—it’s not a field that will appeal to everyone. “Things are happening with your patients and you can’t see it,” she says. There’s no cast to show a broken bone healing and no pacemaker to check on, she says. “It’s in the brain and you don’t see the moving parts,” she says. “You have to rely on your exam and what you know about the patient.”
But those very things are what keep Green motivated. “For me, it’s all about education,” she says. “It’s about wanting to know more to take better care of my patients.” It’s easier today to find the information she needs, but when Green first started, not many people were using the internet the way they do today. “You couldn’t Google something on a phone,” she says. “I was opening textbooks and showing my patients.”
Calling neuro recovery “a marathon, not a sprint,” Green says the education piece of recovery is vital. She works with patients, families, and caregivers who often just have to come to terms with a long, uncertain recovery. Finding out what can help patients calms everyone’s fears a bit, she says. Like pieces of a puzzle, as Green sorts out the reasons someone is under her care, she can help formulate the best path back to having the best life possible.
Nursing students who think neuroscience nursing is appealing should also realize the specialty, like a nursing career, is broad. “You can create your own avenue,” says Green. If you want to work with stroke patients, you could find yourself working with them from the time they hit the door in the emergency department or in rehab after they have had initial treatments. You could even find a place in the OR as a neuroscience nurse. “While you are on different rotations, decide what you want to do,” says Green.
Green particularly likes being able to follow her patients through their recovery. “We are in this together,” she says. “This is a very challenging and extremely rewarding field.”