Although more than 3 million people in the United States have glaucoma, awareness of this eye disease, how it starts, and how it progresses isn’t widespread.
The Glaucoma Research Foundation says January’s Glaucoma Awareness Month, can help people become more knowledgeable about this disease. Glaucoma can eventually lead to blindness, but obvious symptoms of it are almost nonexistent. For that reason, glaucoma is known as a silent or sneaky disease.
According to the American Academy of Ophthalmology (AAO), glaucoma is a leading cause of blindness in people over 60. The disease causes fluid to build up in the eye which can damage the optic nerve and cause irreversible damage. The disease has some hereditary traits, and it can affect one eye but not the other.
The good news is if glaucoma is caught early, significant damage can be prevented, saving the patient’s eyesight. Regular eye screenings are vital to finding the pressure buildup in the eye, so if any patients have a history of glaucoma in their family, they should be aware of how important these screenings are. According to The Glaucoma Foundation, age alone is also a risk factor, and glaucoma is more commonly found in people over age 40 rather than those in younger groups.
There are other risk factors to be aware of. Preexisting conditions including high blood pressure, diabetes, an eye injury, long-term steroid use, and nearsightedness can predispose someone to glaucoma. In addition, those of African, Hispanic, Latino, and Asian descent have an increased risk of developing one or both of the two types of glaucoma—angle-closure glaucoma or normal tension glaucoma.
If you or any of your patients notice any vision changes, it’s wise to consider the possibility of glaucoma. By the time symptoms develop, some damage has occurred, so it’s essential to get any symptoms checked early. Things to look for include any blurred vision, cloudy or dark spots in the field of vision (including peripheral), eye pain, or even headaches.
According to the American Glaucoma Society, treatments for this eye disease include anything from medications and eye drops to reduce the swelling in the eye caused by fluid buildup. Advanced cases may require surgery to help drain the excess fluid in a permanent manner. This can include a laser surgery to improve the drainage capability of the eye.
With treatment, eye damage can be slowed, but some low vision can still happen, even if the final result isn’t blindness. People need to learn how to live with the disease and manage the resulting symptoms as much as possible. Working as a team with a good ophthalmologist can help, but the patient’s entire medical team can also act as a resource and support for managing glaucoma for the long-term.
As a nurse, you can help patients become aware of this disease and the risks associated with it. And in your personal life, you can help your family and friends, as well as yourself, keep up with screenings to catch any early signs of the condition.
What comes to mind when you hear the words, “Physical Activity”? For some, it might conjure up a negative connotation while for others, they may already be a go getter for an active lifestyle. Believe it or not, physical activity and exercise are two different terms although used interchangeably. Physical activity is any movement of the body done through skeletal muscle contraction that causes the energy expenditure to go beyond its baseline. Simply stated, physical activity is movement, in any form.
Sadly, less than 5% of adults participate in 30 minutes of physical activity, and 28-34% of adults aged 65-74 are physically active in the United States. It is important to gather some perspective on the impact of a sedentary lifestyle and how it is more common than physical activity. According to the Center for Disease Control, physical inactivity is even more common among ethnic and racial groups in most states. The CDC’s January report from 2020 showed overall, Hispanics had the highest prevalence of physical inactivity (31.7%), followed by non-Hispanic blacks (30.3%) and non-Hispanic whites (23.4%).
We all have heard of vital signs. Part of that assessment should also involve the type of physical activity one engages in. As nurses, we are the largest body of the health care workforce, and studies show that we are not following healthy practices when it comes to our self-care and well-being. The American Nurse Association even launched a Healthy Nurse, Healthy Nation initiative to address the core elements that address nurse’s self-care and well-being, Activity, being one of them which goes to show that this is a pressing concern.
Some of the challenges posed as to why people do not take part in physical activity is location. The neighborhood in which people live may not have access to outdoor parks, paved streets, or recreation centers. Depending on your home environment, you may not have the space to exercise in.
The good news is just doing any activity, especially one in which you enjoy doing is acceptable in burning calories. Anything is better than being sedentary. The risks of sedentary behavior are universal and it is important for nurses to adopt a more active lifestyle. Physical inactivity is closely related to premature death, preventable disease, and health care costs.
Exercise is a subset of physical activity and is defined as an activity that is organized, planned, and reoccurring which is done with the intent of improving or maintaining one or more components of one’s health. Having said this, physical activity can involve any movement and does not have to involve a schedule or with an “all or nothing” attitude. For those who are trying to lose weight, exercise is not as important as much as your food intake. There needs to be a calorie deficit in order to lose weight. Nutrition and physical activity work in tandem but about 80% is based on nutrition and 20% should be focused on physical activity.
Physical activity come with benefits such as: heart health and prevention of diabetes, improved strength and mobility, release of dopamine, endorphins and serotonin (the “feel good” hormones), increased lifespan, and increased insulin sensitivity. Carrying on extra weight can contribute to joint pain. For every additional pound that you are overweight, an extra 5 pounds of pressure is exerted on your joints.
It cannot be argued that the majority of nurses are female and women tend to hold onto more fat than men; that is how nature intended us to be designed. As we age, we are also at risk for bone loss. For that reason, we do not want to lose weight too quickly because we also want to protect our bones, which is why muscle resistant training is so important. Half a pound per week of weight loss is the ideal; it is all very specific to how much weight the person needs to lose. Even a 5-10% weight loss can reap positive effects on overall health.
Nurses, especially those of other ethnicities can become role models and advocates for system changes at the workplace as well as at home. Even if nurse leaders are not fully on board, it is important to heighten awareness on the benefits of physical activity which would improve morale as well as productivity. Identifying barriers is the first step and serving as a role model would also provide an impetus for behavior change.
Just like with patients, we need to assess our readiness and meet ourselves where we are at. We need to give ourselves permission to work on our fitness regimen so it can be more sustainable. The best exercise to lose weight is the exercise you will do. If you have to ask yourself, “Should I work out today?” hopefully, the answer is yes. If you choose “No”; well, yes you should.
The thyroid gland might be small, but any changes to its function can pack a huge wallop on how you feel every day. During January’s national Thyroid Awareness Month, pay attention to any possible symptoms that could indicate problems in you or any of your patients.
Symptoms of hypothyroidism are frequently dismissed by patients. As a nurse, your patients may complain about being excessively tired or lacking energy or even that they have a worsening mood. They may have noticed their hair is thinning or falling out or seems especially brittle. Hypothyroidism can cause people to gain weight and to feel cold in temperatures that were previously comfortable. Often, people will attribute these symptoms to stress, a particularly busy time, or seasonal changes.
It might seem that symptoms of hyperthyroidism would be the polar opposite of having hypothyroidism, but that’s not always the case. Because hyperthyroidism can speed up the metabolism, patients might also pass off symptoms like a racing heart, more-than-normal sweating, or mood changes to job stress, lots of activity, or even an increased fitness routine. But they can also experience the fatigue and hair loss that hypothyroidism presents. Some patients may notice more prominent eyes (Graves’ disease) or even feel their thyroid gland itself is enlarged.
According to the American Cancer Society, rates of this cancer have increased in the last decade in young adults (3 percent increase annually) and adolescents (4 percent increase annually), and even those who have had no prior thyroid problems can have thyroid cancer. This highly treatable cancer often presents as a lump in the neck rather than with symptoms like those of hyperthyroidism or hypothyroidism, and even blood tests don’t show anything abnormal.
If any of your patients mention these symptoms, a blood test may be in order. According to the ATA, a simple lab test will check thyroid hormone levels. If the levels of thyroxine (T4) or triiodothyronine (T3) or of the thyroid-stimulating hormone (TSH) are too high or too low, follow up will help determine next steps of medication, treatment, and referral to a specialist. If you or they notice any kind of lump in the thyroid gland, follow up tests are necessary to check for cancer.
Thyroid problems are fairly common and approximately 20 million Americans have some kind of thyroid disease. Listen to your patients as they describe any physical, cognitive, or emotional changes they have experienced to help detect any changes in the early stages.
In 2020, COVID-19 has made a lot of changes. So as the holidays are rolling around, it’s not surprising that it would change how they are celebrated.
Oftentimes, nurses would have potlucks during various shifts at work, hold present exchanges, and play games. But life has changed.
We reached out to get some tips on how nurses can hold safe holiday celebrations while at work.
From Jenna Liphart Rhoads, PhD, RN:
Have a toy drive for children in need: in exchange for bringing in a brand-new toy for a child in need, nurses could be given a raffle ticket to win something like a massage, an extra 8 hours of PTO, or a gift certificate for a new set of scrubs.
Staff nurses could bring in an ornament to help decorate the unit Christmas tree
A snowman decorating contest: nurses could anonymously color or decorate a snowman (or snowwoman). Staff could then vote on their favorites, and a winner gets a prize.
From Alaina Ross, BSN, RN:
On the floor of the hospital where she works, the nurses are having a catered lunch from a local restaurant. “[This] reduces the risk you’d get with a potluck of 20+ different dishes being cooked in 20+ households. The lunch comes from a clean and safe kitchen at a restaurant—and has the double bonus of supporting a local business,” says Ross.
Secret Santa Gift Exchange: “The Secret Santa style gift exchange reduces exposure and interpersonal contact, as there isn’t a large group get-together like you’d have with a white elephant exchange or party. It’s just one person secretly delivering a small gift to another by leaving it in their locker.”
From Thomas Uzuegbunem, BSN, RN:
He also suggests that instead of having a potluck to order from a restaurant that does individual servings (for example, Chinese food, etc.). “One person can take responsibility for ordering, and everyone can reimburse that person through PayPal or Venmo,” Uzuegbunem says.
Play Fantasy Sports or a unit game on smartphones: “These are good options to get a group of people involved while still social distancing.”
Digital Secret Santa: This is like regular Secret Santa—except for the large gathering. “You’ll pair people up and then the purchases will be either digital or mailed to their homes.”
The contributions of a nurse in today’s crisis – stricken society are countless, especially in the midst of this pandemic. For that reason, thorough explanation of the nurses’ role is imperative for greater appreciation. Nurses have well known responsibilities including but not limited to recording medical history, vital signs and symptoms, patient advocacy, monitoring patient health and administering medications and/or treatments. Nurses collaborate with members of the interdisciplinary team for better patient outcomes and educate patients and their families about the management of illnesses. In academic settings, we educate aspiring nurses and propel them to achieve their goals in the midst of challenging life circumstances. As they say, nurses wear many hats, and as a result, nurses are burning out.
A nurse must advocate for patients beyond the health care environment while utilizing a holistic care approach; a patient may be admitted to a hospital or other health care setting for a particular ailment. However, the nurse must question this patient’s ability to care for themselves on their own, and if incapable, ensure that adequate support is in place upon discharge. Nurses also care for patients’ families. Often times, difficult conversations must occur and nurses are challenged to interact with those on the receiving end. Nurses are usually the first to notice irregularities due to the first phase of the nursing process – assessment. Nurses are the punching bags for the frustration of others on a daily basis. While nurses ought to possess qualities of resiliency, they are also human, and if empathic in nature, easily carry the stress of others on their shoulders. Hence, while taking work load, work environment, and coping mechanisms into consideration, nurses are at increased risk for burnout.
Burnout is defined as a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed, emotionally drained, and unable to meet constant demands. It has many physiological effects. In a recent study conducted by Salvagioni et al (2017), burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. Specific to nurses, in a 2019 study, 14.4% were found to be unengaged with their work, 41% of those respondents reporting feelings of burnout. Due to the physical and emotional demands of the job, nurses ought to be cognizant of the warning signs of burnout (anxiousness, chronic fatigue, insomnia, and frequent illness) because they are putting their health in jeopardy. Please take into account that these statistics are not reflective of the impact COVID-19 has had in the nursing industry. Therefore, in 2019 – 2020, these statistical figures are presumed to be more alarming.
In September 2018, I recall being transported by an ambulance from a clinical setting to the hospital. Runs of atrial fibrillation and ventricular tachycardia flooded the heart monitor as I struggled to maintain my strength, oxygenation and my life. “Look! You can show these rhythms to your students!” said the EMT as life threatening rhythms printed from the monitor. My usually jovial self immediately thought, “Did he really have to say that and could this get any worse?”
At the time, I was a nursing education supervisor for a technical school. The program grew exponentially and I was expected to supervise both day and evening programs. This not only meant overseeing and executing the curriculum’s development and application, but also subbing for instructors as necessary, which was quite often. I was a single mother in need of more support. My divorce was recently finalized. Ageism and racism were also my contenders in the work environment. I was challenged when giving direction to a group of women, my staff, who were older and looked different from me. I was expected to provide hope for my students who had lost hope in themselves due to extenuating life circumstances. Inadvertently, I experienced the warning signs of burnout such as anxiousness and chronic fatigue, but ignored them, leading to my experience in September 2018.
In the year of 2019, I went on a quest to find a work environment that was more holistic and welcoming. The familiar saying, “Nurses eat their young” resonated within me. My mental health suffered as I experienced feelings of being unappreciated and belittled. Nonetheless, in the midst of all of this rain, the sun did shine again. I decided to return to my home district as a school nurse, which gave me an opportunity to give back to my community and encouraged healing for my broken soul.
As a survivor of burnout and the consequences that came with it, I feel the need to bring awareness to the fact that nurses need to be nursed. So, who nurses the nurse? If possible, nurses must nurse themselves by doing the following:
Evaluate Your Own Personal Life.
Ask yourself, have I recently experienced life changing events and have I taken enough time to ride life’s emotional rollercoaster? Trying to balance work and these emotions can lead to a very bumpy ride (burnout). One may need to request time off from work or even take a leave of absence. Taking these actions does not mean that you are weak. It just means that you are taking a step closer to healing.
Identify Sources of Support.
As John Donne said, “No man is an island. No man stands alone.” It is impossible to navigate through these difficult times in solitude, so finding a trusted confidant is important. It may be a family member or a close friend. For some, it may involve getting help from a licensed therapist. Once having adequate support systems, you will come to the realization that you are not alone. This notion generates healing thoughts and behaviors.
Ask For Help.
Nurses have a tendency to practice autonomy and often forget about asking for help. We always give but do not want to receive.
Diet and Exercise.
You are what you eat, therefore in order to promote feelings of wellness, we need to eat foods and participate in activities that support wellness. Overall, one should base their diet on whole grains, increase fruit and vegetable consumption, and reduce fat, salt, and sugar intake. We should also aim for 30 minutes of moderate physical activity daily.
Watch Your Water Intake.
Men and women need approximately 3 liters of fluid daily, however water requirements vary depending on weight. As it pertains to burnout, water can help maximize physical performance. Water also significantly affects energy levels and brain function.
Make Time For Hobbies.
Do not forget about your interests. Make time for these activities. It could be as simple as listening to music or watching an interesting TV show. I’ve always loved dancing. Since my experience in 2018, I joined a ballroom dancing/social community.
Practice Mindfulness Meditation.
This is the practice of actually being present in the moment which in turn trains you to become more mindful throughout the day, particularly during stressful situations. There are an abundance of mindfulness meditation exercises that can be found on the internet. I do these exercises daily.
Get Enough Sleep.
We need at least seven to nine hours of sleep daily to function at our best. If you are having a hard time achieving this, talk to your doctor. You can consider non-pharmacological methods such as teas and lavender oils. According to the National Sleep Foundation, obtaining healthy sleep is important for both physical and mental health, improving productivity, and overall quality of life.
Watch Your Appearance.
If you think you look good, chances are you will feel good too. Participate in practices that enhance positive feelings about personal appearance. Do a facial. Get your eyebrows waxed and your hair done. Do you!
The above recommendations highlight the importance of self-care. I urge each and every nurse to take part in such practices before it is too late. The disease processes that result from lack of self-care are probable, but preventable. So before you become dependent on a caretaker due to illness, remain independent by being your own best nurse.
Special Thanks: Desmond & Lillieth Gayle; The Wong Family; Nayomi Walton, PhD, RN; Therelza Ellington, RN; Anisa Cole, LCSW; Bloomfield Public Schools
A typical winter’s colder temperatures and messy weather makes getting outside more challenging for many people. This year, with so many people spending more time inside and isolated from others, winter could spike loneliness and poorer health.
Spending time outside in the winter has lots of health benefits. It is often invigorating being in the fresh air and moving around can help combat the unhealthy habits of being too sedentary.
But motivation to get outside and get moving is sometimes tough to come by—especially if you’re not someone who naturally thrives on colder temperatures (yes—those people do exist!). Thankfully, it’s possible to learn to manage the cold so you can stay healthy, improve your mood, boost your resilience, and even keep your social life active!
1. Bring Out Your Inner Meteorologist
Listen to the news, check online, or install a weather app on your phone to keep up with changing weather forecasts. Pay attention to the real feel temperature—that tells you what the air really feels like once wind, humidity, and temperature are factored in. The real feel temperature can make all the difference to getting outside comfortably. A day that’s 40 degrees and sunny with no wind is going to feel a lot different from the same temperature with no sun and strong wind gusts. Know what kind of weather you’ll be out in so you can plan the right way.
2. Dress the Right Way
Being active outside is a great way to clear you mind, reduce stress, and boost your immunity. But if you’re shivering because you’re too cold or sweating because you’re overheated, your mind isn’t going to focus on anything but being uncomfortable. Dress in layers when you’re heading out and if you’re planning to move—from a moderate to fast paced walk or more intense—dress so that any sweat isn’t absorbed by that first layer. Moisture-wicking clothes keep you warmer because they don’t get damp from sweat which means you’ll be more comfortable.
3. Don’t Forget the Extras
Make yourself comfy by protecting you head, feet, and hands. Hate hats? Use an ear warmer band. You ears are going to get cold quickly, especially if there’s wind. If it’s especially cold and windy, a thin glove under a thicker mitten or heavier gloves will help. Use heat pads in them if you tend to get very cold extremities. The same goes for your feet. Moisture-wicking socks layered under wool socks keep your feet dry and warm. Protect your face with a gaiter or scarf over your face covering.
4. Have the Right Equipment
Snow and ice can make the simplest hike perilous, and you don’t want to fall. Wear proper shoes that have thick rubber soles because running sneakers are no match for a patch of ice on the sidewalk or on the trail. If you aren’t out all the time, investing in a pair of inexpensive shoe coverings (like Yaktrax) gives you extra traction on slippery surfaces. If you’ll be out when the sun is setting or rising, have a flashlight. And wearing reflective gear and bright colors at all times of the day and night will help drivers see you. That’s as easy as putting on a reflective safety vest over your coat—no need to buy a new coat or clothes.
5. Get a Crew
The pull of staying inside can be pretty strong. If you meet up with a friend for a socially distanced walk or join a group dedicated to being outside, you’ll be much more motivated to keep those commitments. And you’ll be more successful at keeping with your plan. Meeting someone outside for some exercise will help stave off the loneliness that is so common right now during the pandemic. If meeting up isn’t easy, plan to make a date to call someone so you can talk and get outside (just use one earbud, so you can hear what’s going on around you).
This winter, try to get outside for some sunshine and fresh air and see if your mood, and your health, improves!