Laughter is the best medicine for Kelli Dunham, RN, BSN, a NYC-based nurse, comedian, and writer who has been performing comedy as a nursing side gig for 25 years to help nurses deal with the profession’s stress.
Dunham’s latest show she wrote and is performing in is called Second Helping: Two Dead Lovers, Dead Funny. Dunham will be performing in NYC, on the Lower East Side’s Caveat on May 18th at 4 pm (with a virtual option May 18th).
The show is part stand-up comedy, part sit-down tragedy, with love and body fluids in the cracks in between. A hilarious queer tragicomedy about death, grief, nuns behaving badly, exploding knee replacements, and the limitations of bootstraps.
“Second Helping is…a love letter to the power of community. This show is a must-see for anyone who’s ever hesitated before asking for help” -Bechdel Theatre.” Second Helping is drop-dead funny” –Go Magazine.
Get Your Tickets
Caveat is at 21A Clinton Street, New York, NY.
Tickets are $15 (early bird, one week before the event), $18, or $23 at the door.
Livestream is $8 and is available for ten days after the event.
Get tickets here.
Admission includes a zine and a special commemorative coloring sheet.
Running time for the opening act and Second Helping is 80 minutes.
Dunham’s sister, who is also a nurse, is opening for her, making it a two-nurse comedy show! She plans to perform the show in Philadelphia and is doing a Midwest tour this summer.
On the surface, the show is about losing partners to cancer, but the actual theme is about learning how to ask for and accept help. “We’re excellent at helping other people but not very good at accepting help,” says Dunham. She says all the clinical instructors she’s talked with have agreed that helping nursing students figure out how and when to ask for help is one of their biggest and most challenging tasks on the hospital floor.
Dunham says she just returned from Hiram College in Ohio, where she performed Second Helping for a group of nursing students. Afterward, they had a two-hour discussion. “They really identified with the theme,” she says.
As a nurse, you’re empathetic and compassionate and go out of your way to ensure you provide your patients with the best possible care. But when it comes to looking after yourself, self-care may get prioritized far down the list – or not at all.
Such a mindset may be harmful to you and, ultimately, your patients. Nurses are great patient advocates, but “we do need to start advocating for ourselves because you can’t keep helping everyone. Then you don’t have anything left in your reserves,” said Linda Roney, EdD, RN-BC, FAAN, associate professor, Egan School of Nursing and Health Studies, Fairfield University.
“I think you have to be selfish, which is hard in a selfless profession to balance, but I think that is one of the ways that we can keep ourselves healthy. You have to prioritize yourself,” said Crystal Smith, DNP, RN, NE-BC, director of the medical-surgical unit at Children’s Nebraska.
As healthcare professionals and organizations celebrate Nurses Week with its theme of “Nurses Make the Difference,” now is a perfect time to assess your attention to self-care. In this article, we’ll offer practical strategies to help you care for yourself.
No Perfect Time
When it comes to self-care, “one of the biggest lessons for me is that self-care is not a one-size-fits-all,” said Roney. Nurses need to be aware of their unique needs.
Another awareness is not to wait for the perfect time for self-care. Roney said you can work on “small, incremental changes” for five or ten minutes that can accumulate over a day. You might try “habit stacking”: combining a potentially burdensome task with something enjoyable, notes Roney.
Days Off and “Zen Dens”
Smith meets with her new nurses at Children’s Nebraska in Omaha to discuss a self-care plan. If a nurse is struggling, Smith can consult the nurse’s plan and see the measures that might help that person.
One self-care policy at Children’s Nebraska allows nurses to take a day off if they need to recharge—if “your tank isn’t full enough to come in and give all of yourself that day,” said Smith. There are no negative repercussions should a nurse choose to do so.
Nurses are also encouraged to disconnect completely when they need a break. “It’s very hard to get away from the work when you’re at work,” Smith explained. Nurses are encouraged not to take their work phones on break but to trust that the staff can handle the patients while away.
Another self-care tactic involves “Zen dens.” When the hospital opened a new tower two years ago, these rooms were built into each unit. Zen dens have a lock, a massage chair, essential oil diffusers, books, and low lighting. A nurse can connect a phone to a speaker to play quiet music. “You can go in there and decompress how you need,” said Smith.
Smith noted that accessibility of these Zen dens is key. “We as organizations have always had places for people to do that, but never right on the unit. It’s tough to get a nurse or even a doctor to leave the unit where their patients are without any way to communicate with them.”
Added to these measures is a “Thrive” team, a department dedicated to employee wellness, noted Smith. Two members of Thrive are Howie, a golden retriever, and his handler, David. They may, for instance, join the staff for a debriefing after a difficult patient or family situation. Besides Howie and David, Thrive has a team of trained peer supporters and group facilitators available 24/7 for clinical and non-clinical team members.
Howie, the golden retriever, and his handler, David, make their rounds
What’s more, staff are encouraged to go home after a death in the facility. Death in general is very hard, noted Smith, “but I would say especially in pediatrics, it’s usually very traumatic. To expect the nurse who just went through that with a family and a patient to turn around then and take an entirely new patient, the mental load of that is really heavy. And so, to the best of our ability, we try to give them the option to go home.” At the same time, the facility understands that a nurse may want to stay at work instead of going home as a way of coping.
Back to Basics
As a nurse, you also need to take to heart the common-sense advice you probably give to patients about self-care, such as the following:
Sleep and downtime. You may want to spend some downtime on your phone, but be wary of it, noted Roney. “You feel as if you are relaxing and having a positive experience. But all this time is going on, cutting into your sleep/wake cycle.”
Nutrition and hydration. “If you talk to any nurse, most of us would agree we would put our needs after our patient, so there are many times we might miss a lunch break, or we may eat several hours later than we usually do because there might be something going on with our patient and we need to put their needs first,” said Roney. As a solution, “really be intentional and plan on bringing your meals and snacks to work.” Stay hydrated throughout your shift, noted Roney.
Simple measures such as making sure to take your breaks, eat your meals, and use the bathroom regularly while on shift are a start for self-care, according to Sarah K. Wells, MSN, RN, CEN, CNL, clinical practice specialist, practice excellence team, American Association of Critical-Care Nurses (AACN). Next, prioritize quiet times and activities that bring you joy each day.
Moments of Gratitude
Practicing gratitude can also help with self-care. In talking to an experienced nurse who was struggling, Smith told her, “You guys have to remember that the tiniest things you do make the biggest difference.”
Smith says, “Sometimes we must find and center ourselves around those tiny moments of gratitude. It’s easy to leave work and feel like your entire day was terrible. But really, you probably did many good things throughout the day.”
According to the AACA, in 2022, 80% of nurses in the United States were white/caucasian. With nurse burnout already a problem nationwide, being a minority in the industry can create even more unique challenges. That includes things like racism from patients or co-workers, discrimination, and even economic hurdles depending on your background and where you grew up.
All nurses must care for themselves and infuse wellness into their daily work. However, it might be even more essential for minority nurses to integrate holistic approaches into their careers.
With that in mind, let’s explore the importance of a holistic approach in healthcare and provide actionable insights you can use to enhance patient well-being and improve overall nursing effectiveness.
What Is Holistic Nursing?
As a nurse, you may be tempted to scroll past the ideas of holistic healthcare practices. But, holistic practices have been used for centuries to help people look inward for physical and mental wellness. Holistic nursing combines Western medicinal practices alongside complementary and alternative care solutions. Holistic nurses go beyond the physical and physiological aspects of medicine and focus on the values and beliefs of their patients. Nurses who practice holistic care also hold themselves to an extremely high standard and lean into five core values of practice:
Holistic philosophy and education;
Holistic ethics, theories, and research;
Holistic self-care;
Holistic communication;
Holistic caring process.
Paying attention to a person’s entire being can make a big difference in how they feel, especially when in a compromising medical situation. It’s one reason more midwives are taking holistic approaches to pregnant women. A holistic nursing approach can also help to improve your entire department, especially if you’ve been struggling with issues as a minority nurse. When holistic practices are implemented, people will start to look at you as a whole person and value your well-being rather than focusing solely on race identity.
Planning Healthy Holistic Practices
If you want to integrate more holistic practices into your career, it starts by leading a more holistic lifestyle yourself. Changing lifestyle habits and career practices, as well as even influencing your department, can feel overwhelming at first. One of the best ways to start taking a holistic approach to your work and life is to set goals for yourself. SMART goals can keep you motivated and help you recognize when you’ve hit milestones and achievements. SMART goals are:
Specific;
Measurable;
Attainable;
Relevant;
Time-Bound.
For example, if you want to focus on specifics, ask yourself what you want to achieve with holistic practices. Why is it essential to make a change, and who will you involve?
You’ll be able to measure your goals through achievements. Maybe you’ll start to feel better, personally. Perhaps you’ll see a change in work culture or the challenges you typically face as a minority. You might even begin to see your patients differently, which can help you fight back against burnout and find more joy in your daily interactions.
As you set goals and develop a strategy for holistic approaches, keep in mind that holistic medicine doesn’t have to somehow diminish your medical knowledge. Rather, it should serve as a complementary approach beyond basic treatment. A holistic approach to healthcare can inspire you to integrate more holistic practices into your daily routine on and off the clock.
Holistic Practices That Can Make a Difference
When you look within to begin your holistic integration, it starts with self-care. Again, this is essential for all nurses. But, when you face some of the unique challenges of being a minority nurse, self-care becomes even more necessary to maintain your mental and physical well-being. Thankfully, these practices don’t require much extra time or effort. Integrate some of the following into your everyday routine:
Prioritizing sleep;
Eating a healthy diet;
Journaling;
Connecting with colleagues;
Deep breathing;
Showing self-compassion.
Daily affirmations can also make a difference, especially when you’re heading into a long shift or dealing with difficult co-workers. Say things like, “I choose to trust my skills and abilities,” or “I know I am a skilled and compassionate nurse.” It might take some time to get comfortable with affirmations, but they will go a long way in improving your overall mindset. When you are kind and compassionate with yourself, you’re more likely to pass on that care to your patients.
Practicing mindfulness is another excellent way to lead a more holistic life and career. Mindfulness can help you manage stress and anxiety and keep you focused on the present. You’ll be less tempted to think about something a patient or co-worker might have said that bothered you or worry about the “what ifs” of your next shift.
There is no question that being a minority nurse comes with a few obstacles. However, by integrating holistic approaches in your life and career, you can reduce personal stress, improve patient care, and change the course of your department and practice.
Nurse burnout continues to hinder the healthcare system across care settings. Hospital margins are thinning, and allocating resources to nurse retention and engagement is imperative to offset the cost of losing nurses. The average cost of turnover for one bedside RN is $52,350 – which can add up to expenses between $6.6M-$10.5M, according to a recent retention and staffing report stating “each percent change in RN turnover will cost/save the average hospital an additional $380,600/year.” In skilled nursing facilities, regulated staffing levels will likely impact quality care scores and reimbursements in the future. Staffing and reducing turnover are top of mind for healthcare leaders everywhere, even more so as they continue to look ahead to 2024.
Overcoming Nurse Burnout
While the industry challenge of nurse burnout is clear, the right approach to ease nurses’ burden is harder to decipher. Staffing leaders must balance competing priorities, such as investing in expensive agency labor versus racking up internal hours and offering nurses more flexibility to choose the best shifts while ensuring every shift is filled.
Three themes are among the top strategies to address nurse burnout: improving communication, increasing flexibility, and supplementing staff.
1. Improving Communication Between Nurses and Managers
Many organizations need help in traditional staffing workflows, tediously tracking multiple spreadsheets or using one-by-one phone calls or text messages to make scheduling adjustments and fill last-minute openings. This approach is not just time-consuming; it’s disruptive, siloed, and does not take advantage of widely accepted and expected technology.
With healthcare workforce software to deploy one-to-many communications, nurse leaders can post shifts, set rules for shift selection, and relay scheduling needs quickly – for example, by implementing a first-come, first-served open shift approach or shift bidding based on seniority or other factors. This respects nurses’ time and frees up time for nurse leaders to focus on their team’s growth and development, supporting operations, and improving patient care.
2. Giving Nurses More Flexibility
More shifts are not the answer to nurse burnout – but more scheduling options could be. With real-time scheduling available at their fingertips, nurses have the necessary flexibility. More choice empowers them to select schedule changes that best fit their work-life balance. It gives nurses the freedom to trade shifts or take on open shifts and makes them feel like they have control over their schedule, motivating them to do their best work.
Greater scheduling flexibility can reduce the likelihood of no-shows or call-outs and reengage nurses in their work, preventing turnover. Meanwhile, nurse leaders can ensure these individual choices are made with commitment rules in mind by defining scheduling rules that make their staffing software work with their team’s unique needs.
3. Supplementing Staff with Agency Nurses
For some healthcare leaders, agency staff can be an expensive response to reducing burnout and attrition. However, it could be the more affordable option in the long run. Compared to the cost of losing a nurse and the time it takes to hire a new nurse, the investment in supplemental agency staff could greatly outweigh the costs of staff turnover. If managed well, agency staff becomes an extension of the team – used as needed, but not the immediate response to every open shift.
At the core of all these decisions is data and using available technology. Schedulers must have confidence in who is doing what, when it’s happening, and where it’s taking place. Clear, at-a-glance staffing data differentiates between taking a one-size-fits-all approach and making appropriate staffing adjustments based on an organization’s most significant contributors to burnout and resignations.
Accessible staffing data revenue objectives and organizational goals empower healthcare leaders to take a holistic approach. They can weigh their options and resources from a united front and choose investments to target specific challenges while understanding the impact this may have on another aspect of the organization.
Smarter Planning Leads to Reduced Stress, Higher Satisfaction
While there are many options to address nurse burnout, one thing is clear: better staffing management is necessary. In fact, 57% of nurses planning to leave the workforce would reconsider returning to their position if their workplace implemented a more flexible approach to scheduling and shift management.
With data and a smart workforce management solution, staffing leaders can make thoughtful, more informed choices that fluctuate seamlessly with day-to-day, real-time scheduling needs. Nurses can impact their schedule and sign up for shifts that give them the best work-life balance through technology customized for their practice. Managers can refocus their time to make strategic staffing decisions. And ultimately, patients get high-quality, uninterrupted care.
