The holiday gift buying season is upon us! You’re probably going down your shopping list and trying to find just the right gift for friends and family. You may even have nurse friends and colleagues that you want to gift with fun nurse-themed items you hope they’ll love.
But what about you? Maybe you, like many nurses, have a tendency to forget to take care of yourself. (It’s hard for many caregivers to remember that they need to take care of #1!)
When you’re in the thick of a crazy work shifts and off-duty holiday goings on, it’s easy to become overwhelmed. You need a little break, though you may not know the exact remedy that your mind and body needs in hectic moments.
So, why not find some go-to self-care items for whenever you need a pick me up in 2019? Have fun doing your self-gifting by shopping online (Amazon is the biggest bazaar!) or at local independent shops and craft fairs. You can combine convenience and also support makers on Etsy. It’s like a massive online craft pop-up with thousands of amazing shops from around the world. Not only can you find one of a kind pieces, but you’re also supporting small creative enterprises.
Here are some favorite gift ideas on many nurse wish lists this season.
Socks, footies, and shoe inserts—not glamorous but oh so comfy.
If you’re on your feet all day long, a great gift idea may be a thick pair of warm footie socks for the winter season, or a pair of compression socks (there are some stylish choices out there!), or a foot massager and DIY pedicure kit. Shoes need some cush? Try a comfort insert from a drugstore or specialty shoe store that stocks the Birkenstock brand.
Warm, snuggly blanket for hygge comfort, or a weighted blanket for stress-relief.
Enjoy your days off under a perfectly knitted wool throw, chunky or light as a cloud—the type of knit that invites you to snuggle in with a good book. Or try one of the new weighted blankets that are gaining popularity for their health benefits. They help many people reduce workplace stress and improve sleep, especially nurses on shift work suffering from off-kilter circadian rhythms.
Healthy snacks for the active nurse, or artisan food and drink for foodies.
Being a nurse means being on the go, so nurses may not have extra time to pack a lunch or snack to bring to work. That often means relying on a vending machine or cafeteria to fuel up for long shifts. Disaster! A gourmet gift basket of healthy treats like nuts and dried fruit may help you hold out until you can enjoy a nutritious meal. On your days off, sip on a favorite at-home drink, such as a matcha green tea latte. And savor it in an encouraging mug, with a witty or wise nurse-life quote and graphic.
Manicure, pedicure, massage, or other spa treatment!
Hand lotion gift sets make great gifts to help sooth away skin that gets dry from a grueling hand-hygiene regimen. (Harsh hand cleansers and sanitizers are murder on delicate, weather-beaten skin!) Bubble bath products and spa baskets filled with bath products in a keepsake basket will give you a night of much deserved pampering.
Or better yet, treat yourself to a mani/pedi or an all out body care pampering session at a spa. Men make up a fast growing percentage of spa goers, so don’t let gender stereotypes stop you from getting or giving a gift certificate for spa services.
A journal, some gel pens, and washi tape.
If you equate journal with diary, and you haven’t kept one since middle school, you may be surprised at the popularity of new journaling methods. Bullet journals are one way to goal-set, and keep yourself motivated and organized. Many nurses also love to express themselves in a “bujo” through doodles, watercolor, fancy lettering, or stickers and washi tape.
You can treat journaling as a time to explore your inner life, a form of meditation, if you like. In that case, the Nurse’s Journal from the Josie King Foundation is wonderful. Create an introspective ambience by lighting a couple of candles. Artisan candles—with sparkles, soy waxes, exotic oils, or delicate flower petals— add some magic.
I hope that seeing some of these ideas will inspire you to treat yourself to some self-care. We all need reminders to take time to relax and do what makes us happy!
This past spring, Chenjuan Ma, PhD, and Amy Witkoski Stimpfel, PhD, RN, both assistant professors at NYU Rory Meyers College of Nursing, published a study in the Journal of Nursing Administration that examined whether working overtime can negatively influence how nurses collaborate with other nurses and physicians. In their study “The Association Between Nurse Shift Patterns and Nurse-Nurse and Nurse Physician Collaboration in Acute Care Hospital Units,” the researchers concluded that one third of all nurses work longer than they are normally scheduled, and as a result, their ability to collaborate decreases.
Drs. Ma and Stimpfel took time to talk about the study and its results.
Why did you decide to do this study in the first place?
Dr. Stimpfel: There has been increasing interest in how to manage shift work and overtime hours for nurses due to the impact of fatigue on patient safety and quality. Collaboration has been identified as being a factor that is influential in patient safety and quality as well. We know that our ability to work effectively and regulate emotions—key to collaboration—diminishes with increasing wakefulness and fatigue. We could not find literature to support the relationship between work hours/overtime and collaboration in the nursing literature, which is why we conducted this study.
It’s interesting that nurses who work regular shifts of 11.88 hours or longer regular shifts of 12.17 hours don’t have a decrease in collaboration. But if nurses working that first shift of 11.88 hours had to work a shift of 12.17 hours—which would mean overtime—they would have a decrease in collaboration. Did you discover why this happens?
Dr. Stimpfel: Our data did not detail why working overtime resulted in decreased collaboration. However, the conceptual model in our study helps guide our hypothesis about why this relationship occurs. As nurses work longer shifts, often unexpectedly, this increases wakefulness. Prolonged wakefulness can result in less ability to make decisions and regulate emotions, which may lead to greater difficulties in collaboration. As suggested by our findings, this is more likely to happen when nurses have to unexpectedly work longer than scheduled.
Does any amount of overtime cause problems with collaboration between nurses and other health care professionals?
Dr. Ma: With our current study design (i.e., observational, cross-sectional design), we were not able to detect the minimum amount required to lead to changes in collaboration. However, as the very first study of its kind, our study provided empirical evidence of a significant association between work hours/overtime and collaboration. Our current study suggested that one hour of overtime was associated with 0.17 decrease on the RN-RN scale. In other words, a 0.17 decrease from mean score of the RN-RN scale suggest that a unit’s rank on the RN-RN score would drop from 50th percentile to approximately 30th percentile.
Why is collaboration so important?
Dr. Ma: Collaboration is critical for quality care and patient safety. When working collaboratively, different parties in the patient-care team—including nurses and physicians—will share objectives, responsibility, decision making, and power to achieve patient care goals.
Previous studies have shown that patients receive superior care and have better outcomes in hospitals where nurses collaborate well with other health care providers. Without good collaboration among health care providers, quality patient care may be compromised.
Were you surprised by the results of your research?
Dr. Ma: Not really. Maybe the high number of nurses—one in three nurses—reported working longer than scheduled.
Do you have any suggestions for what should be done so that collaboration doesn’t diminish?
Dr. Ma: One highlight of our findings is the significant association between longer overtime and decreased collaboration. This finding suggests that one strategy to improve collaboration is to minimize nurse overtime as much as possible by a variety of means, better shift scheduling, and predicting and ensuring adequate staffing, etc.
Is there anything regarding this research that you think is important for readers to know?
Dr. Stimpfel: Our findings have broad implications, not just for nurses, but also for other health care providers who are at risk for shift work-related fatigue. Effective teamwork and collaboration are critical to patient outcomes, thus, managing shift work and overtime hours are important for the entire heath care team.
Of all the various facets of the nursing field, hospice, many people think, is the most emotionally difficult to work in. But Connie O’Malley, RN, a hospice nurse for the past three years at Gilchrist Hospice Inpatient Unit in Towson, Maryland, loves her work.
That’s not to say that the work isn’t challenging; it often is. But it also holds a lot of rewards.
How long have you worked in hospice? Why did you get into this area of nursing? What drew you to it?
I’ve loved hospice for more than two decades. I was a geriatric nursing assistant about 25 years ago and worked on one of the medical nursing home floors. A patient with metastatic bone cancer could no longer live at home, and there was no space on the inpatient hospice unit. His prognosis was approximately four to six weeks. He was 60 years old an army veteran and a really wonderful, beautiful human being.
When I first met him, I didn’t want to bond with him because he was dying. And so I put up a barrier around my heart and gave him good care, but was not my normal self like I was with other patients. I found this exhausting after only a week.
One day when his hospice nurse came to check on him, we spoke about this. I told her that I was holding back from getting to know him and love him because he was dying. But at the same time, I felt like maybe our paths have crossed for a reason. This hospice nurse said, “Don’t think that we don’t love our patients and grieve for them when they die. When we care for people in their homes, we are invited into their families. We sit in their favorite chairs and interact in their lives in a way that is different than any other kind of health care. We grow to love them, and when they die, we are sad. You are allowed to love him, and it is okay if you cry when he dies. You can’t have a meltdown where you need to be sent home or take a bereavement day. But if you go take a 5- or 10-minute break to cry on the patio, that is okay. You will find your own way to grieve the patients you lose—whether it is a special song you listen to on the way home or if you drive home silently. You will make your own way to grieve them and honor them. But please love your patients.”
Some people might say that working with those who are dying is depressing. Do you feel that way? Why or why not? What do you think you bring to people who are dying?
Working with dying people is an honor and completely humbling for me. I get to care for people when they are at the very end of their life, and for their families in one of the hardest parts of life’s journey. The majority of families open themselves up and allow me not only to provide my nursing expertise and care for their loved one, but also love the patient and their family.
When you care for someone for several weeks, nurses and staff become family to the patient and their loved ones. It is an honor that I am aware of every day that I work. It is much like being with a friend who is giving birth—it is a special place between this world and the next. To be able to help someone’s body be comfortable through the process and provide education and support and normalcy to their loved ones is an amazing thing.
When I first came to hospice, a dear friend told me he thought that it was such a depressing job. I don’t allow myself to focus on the fact that I lose patients. I feel the exact opposite—I get people. I get to care for people at their absolute most vulnerable state of being. I get to hold their families’ hands and help them learn how to let go. I get to give them education to make a terrifying situation less scary and a little bit easier. Every family changes my life, and I don’t feel that I lose them when they die. I feel fortunate that our paths have crossed and that I have been able to be their nurse at this time.
How do you keep your spirits up?
Being a hospice nurse is exhausting—especially in the inpatient setting. We care for people of all ages. Young people are especially tough on our hearts and minds, and sometimes when families are struggling, it wears on us.
To combat the heaviness that I carry, I make sure that when I am off work, I do things that make me happy and are relaxing. I’m a creative person. I like to crochet, and I make sure that I have projects to work on. I spend time with family and friends enjoying them. Simple things like getting coffee at a diner or spending the night at my mom’s apartment and watching movies together are priceless.
What kind of skills do nurses need to be able to work in hospice?
I came to hospice with four years of cardiac telemetry hospital experience. Despite our patients being at end of life, we use all of our nursing skills daily. We still have patients that have complicated care that needs to be given, so anyone with any kind of nursing background would do well. Very often a lot of people have the idea that everything is very low-key in hospice, but honestly there are nights that I am clinically busier than I ever was on a cardiac unit.
What are the biggest challenges of your job?
Families who fear medication interventions for comfort. Even though hospice has been around for 30 years, there is still a lot of fear around administering morphine and other comfort medications to patients. My biggest challenge is to educate families in what pain looks like and reassurance that medication does not accelerate death. The second biggest struggle is educating people about normal end-of-life occurrences—mainly the truth that everyone stops eating at end of life and that it is normal. A lot of families and visitors struggle when our patients stop eating.
What are the greatest rewards?
The greatest reward is to meet a family on their first day who is struggling with a terminal diagnosis for their loved one, and who are so resistant to any comfort measures and any education about what happens at end of life, and to watch them walk the path and see their minds and hearts change and grow in this process.
A lady was with us for 10 weeks, and all of the staff grew to love her and vice versa. When she was in her last few days, I approached her husband to ask for a good time to come say goodbye to her as I did not want to intrude on his and their daughters’ time with her at the end. He put his arm around my shoulder with tears in his eyes and said, “You come when you want to and as often as you’d like; you are family. Please tell all of the staff too. You have loved us all and become our family, and you are welcome at this time just as much as the last 10 weeks.”
If nurses would like to work in hospice, is there any specific training, certifications, or experience that they would need?
A valid nursing license in whichever state you want to work in. I would say that hospice is a field that a nurse has to be drawn to. It is intense and there is a lot of psychological and emotional weight that we carry on a daily basis. A large number of the nurses that I work with have had family members—parents especially—who have died under hospice care, and it seems that we seek out this work to repay that care that we received when our loved ones were dying.
During the last three months, I had the opportunity and privilege to participate in a work program that collaboratively raises standards for learning and teaching, leading students to the highest levels of engagement and success. This was an eye-opening experience, allowing me to evaluate my own teaching practices in higher education and giving me additional tools to be more adventurous as I continue on with my role in academia.
Here are my five takeaways from the experience:
1. Make sure your students are actively learning enough.
Current evidence in higher learning no longer supports the effectiveness of sole lectures in the classroom setting. Instead, increase use of Active Learning Strategies (ALS) in the classroom setting to offer improved student learning and outcomes. Examples of ALS include: Minute Paper, Think-Pair-Share, Small and Large Groups, Role Playing, Storytelling, etc. One of the biggest student complaints with ALS is the idea that students are teaching themselves. When properly implemented, ALS helps to initiate learners and faculties into effective ways to help learners engage in activities that encourage deep learning.
2. Traditional “lecturing” still has a place in the classroom.
Many educators are considered the “experts” and offer a wealth of knowledge when they step foot in their classrooms. Most of us are familiar with traditional lectures in the classroom setting, where we had a professor “lecture” for hours in front of the classroom. However, many can argue that these professors are not necessarily “Sages on the Stage” but rather “Bores at the Board” for the majority of the time. Do not forget that higher education encourages educators to be more “Guides on the Sides” and become facilitators of student learning as they guide them from the sideline. Whichever method you choose to do in the classroom, you must be humble enough to accept if certain practices require tweaking for improvement.
3. Preparing the adult brain for learning: Evidence has shown that deep learning requires the adult brain learner to be primed.
But how does one prepare the brain to be at the optimal state in which the learner is alert and focused on learning? Several techniques have been noted to help students learn best, including but not limited to: Breathing Exercises, Nutrition, Music, Aroma, and Visualization. All these techniques work in various ways, but more importantly can help in how the adult brain is able to process information. How are you helping prepare your students for learning?
4. Technology belongs in the classroom.
Imagine a classroom without technology… For most of us, this can be very strange, as we are surrounded by technology on a regular basis. And our students are ALWAYS using technology, whether they are using laptops or tablets to take notes or their own personal devices (mobile phones) to stay in touch with their social media world. We must embrace that technology is here to stay, and figure out better solutions in including them in the classroom setting.
5. As educators, we must also be willing to learn (from peers and our own students).
Just because we have completed our studies and are now educators does not preclude us from learning new things. We must never cease to inquire and acquire knowledge. If anything, being an educator challenges us to be the best that we can possibly be for the students that we serve.
What has been your experience with student learning, both good and bad? Please share your own experiences, as I want to better myself as an educator. To be able to meet the students from where they are at, and take them on their own educational journey!
This year, National Influenza Vaccination Week (NIVW) is December 2-8. NIVW provides an opportunity for nurses to promote flu vaccination before flu season swings into full gear. The flu can be dangerous and result in serious health problems (complications), such as pneumonia, bacterial infections, or hospitalizations. Flu can sometimes even lead to death. All people are at risk for serious flu-related complications and certain groups, such as young children, pregnant women, people with certain chronic health conditions like cancer, diabetes, heart disease, asthma or lung disease, and people 65 years and older, are at higher risk.
Getting a flu vaccine is the first and most important step in protecting against the flu and its serious complications. Annual vaccination is important because influenza is unpredictable, flu viruses are constantly changing, and immunity from vaccination declines over time. Flu vaccination can also prevent serious medical events associated with some chronic conditions. A meta-analysis study published in JAMA shows that flu vaccination has been associated with lower rates of some cardiac events (i.e., unstable angina, heart failure, or stroke among people with heart disease).
In the United States, flu viruses are most common during the fall and winter. The exact timing and duration of flu seasons can vary, but influenza activity often peaks between December and February, and it can last as late as May. The CDC recommends everyone at 6 months of age and older gets a flu vaccine by the end of October, before flu activity begins every year. However, getting vaccinated later can still be beneficial.
Here are some essential preventative actions that we can do, in addition to getting a flu vaccine, to beat the flu and protect ourselves, our families, and our patients.
- Wash your hands often, especially after coughing or sneezing. Cover your nose and mouth when you cough or sneeze and wash your hands often and thoroughly. After using a tissue, throw it in the trash and wash your hands.
- Frequently clean and disinfect surfaces and objects that may be contaminated with germs like flu.
- Boost your immune by getting adequate sleep, eating plenty of fruits and vegetables, drinking plenty of water, and taking time to exercise.
- Last but not least, stay home when you are sick. If you are sick with a flu-like illness, the CDC recommends that you stay home for at least 24 hours after your fever is gone.
The Josie King Foundation believes that nurses are leading the charge for a safer, more compassionate health care system. But they realize that in addition to the joys of healing, nurses face many emotional upheavals related to patient suffering, a complex workplace, new technologies, and fear of clinical errors. When personal pressures from everyday living are added to the already heavy load, the weight can lead to nurse stress, anxiety, depression, or burnout.
The Josie King Foundation developed the Nurse’s Journal in 2004, to help alleviate stress through expressive writing. (The journal was a response to results from a research project, Care for the Caregiver, that indicated it was sorely needed.) Created with the help of experts on the topic and specifically for nurses, it is offered by the nonprofit as a tool for self-directed writing or through facilitated journaling workshops.
The Nurse’s Journal is an attractive 61-page spiral bound notebook and is filled with helpful content such as evidence-based theories about journaling, before and after stress evaluation forms, and suggested resources to help nurses cope with work-related stress.
The majority of pages are low-content, with just short guided writing exercises to help you reflect on the stresses of your work life and personal life. For instance, the first one is titled “Guided Writing: Signs of Stress,” and includes the following prompt:
“Things to consider. Do you notice stress-related symptoms in your life? Is there a particular time of day or day of the week in which you feel more stress? Do your stress symptoms affect your job performance or your quality of life? What do you do to combat your stress?”
The page ends with a quote from the Dalai Lama about avoiding the burnout associated with witnessing great suffering.
In between the prompt and the quote, the page is empty so that a nurse is free to write out their own personal thoughts and feelings, as an antidote to workplace and life stressors.
Since launching the Nurse’s Journal in 2004, the Josie King Foundation has distributed them to more than 15,000 nurses. Many hospitals buy the journals in bulk as a gift for nurses during the winter holidays, or to mark Nurses Week, or at anytime for staff training and development purposes.In addition, they offer a companion Nurse’s Journal Guidebook for anyone who would like to facilitate journaling workshops for nurses.
For more information about the mission of the Josie King Foundation and their line of specialty journals for nurses, caregivers, and patients, visit http://josieking.org.