Men’s Health Month is recognized every June, but it’s not a month exclusively for men. Men’s Health Month is an opportunity for men to learn more about their own health and how to protect it, but it’s also a time when women who have men in their lives—partners, husbands, brothers, fathers, friends, sons, mentors—can help support their healthy efforts.
Men have different health challenges from women. According to the Centers for Disease Control and Prevention (CDC) the leading causes of death among all men and of all ages are as follows:
- Heart disease
- Unintentional injury
- Chronic lower respiratory disease
By age group, the patterns are clear. Men aged 1-44 die most often from unintentional injuries. From ages, 45 to 84, cancer takes over as the leading killer of all men. For men aged 85 and older, heart disease is the top threat.
While heart disease, cancer, and unintentional injury cause untold suffering, there are steps men can take throughout their lives to help improve their health and lessen their chances of dying early.
Heart disease is a top killer worldwide and is often a silent disease, sometimes striking without other overt symptoms. It can lead to heart attacks, stroke, and heart failure.
Some common health problems are significant contributors to heart disease. The American Heart Association points to heart disease risks such as high blood pressure, high cholesterol, smoking, sedentary lifestyle, genetics, and obesity as contributing to the condition. Cancer is often caused by similar or the same triggers. According to the American Cancer Society, some cancer risk can be mitigated with healthier lifestyle choices and habits. Smoking, obesity, diet, activity level, and screening and vaccinations can help prevent some cancers.
As the third leading cause of death for men, unintentional injury seems like one that is out of the control of most people. But there are ways to incorporate safety measures into day-to-day life that will help men stay safer.
The Office of Disease Prevention and Health Promotion says the complexities around what causes an unintentional injury can have roots deep in social issues. But individuals can take steps to keep themselves physically safe in many instances. Alcohol and drug use can play a major role in events that lead to an unintentional injury, as can safety and anti-violence measures in the home and neighborhood environment.
Some easy fixes are never swimming alone, always wearing a seatbelt, making sure there are no loose rugs or other fall or trip hazards at home, careful home improvement activities, nurturing relationships, and not texting or being distracted while driving. Other factors are much harder to remedy easily including equitable access to reliable healthcare and emergency services, as well as perceptions and attitudes toward violence.
As men strive to live healthier lives and take control over the factors that can impact their short- and long-term health, beginning with what they are able to control is the first step.
Travel nurses are in great demand right now, as they are helping to relieve frontline workers during COVID-19. While health care facilities are doing everything they can to make environments safe, there are still specific risks that travel nurses are dealing with during this pandemic.
Georgia Reiner, Senior Risk Specialist, Nurses Service Organization (NSO), gave us the latest information about what’s happening with travel nurses, what the risks are, and what they can do to protect themselves.
Are hospitals throughout the country calling on travel nurses to relieve frontline workers? Is the main purpose to alleviate burnout of the frontline workers?
Travel nurses are in high-demand across the United States as hospitals work to treat surges of coronavirus (COVID-19) patients. This crisis arrived at a time when nurse staffing was already a concern due to a multitude of factors, including the growing health care demands of an aging population and nurses aging out of the workforce. Therefore, the demand for travel nurses seems to be primarily driven by a need to build up hospital capacity to handle the influx of COVID-19 patients.
Data from different staffing platforms show that throughout the pandemic, travel nurses are in highest demand in areas most impacted by the coronavirus, like New York and Washington State, and certain nursing specialties like ICU/Critical Care, ER/Trauma, and Med/Surg.
Certainly, as the pandemic continues, the sense of burnout among health care workers will intensify, and travel nurses will likely play an important role in helping to alleviate burnout.
This is a different situation for travel nurses. One risk is checking licensing in different states. What can travel nurses do to be sure that their license transfers? If it doesn’t, but frontline workers are still needed, are exceptions being made?
Before deciding to accept a job, nurses need to ensure that their licenses will allow them to practice in that state/jurisdiction. Multi-state licenses are available for nurses who meet the requirements, which include elements like background checks and education criteria. Temporary licenses are also an option—these are generally reserved for travel nurses who have accepted a job in another state and are awaiting their permanent license.
During the nationwide public health emergency due to COVID-19, some statutes and regulations regarding licensure portability may be relaxed or waived, so it is important for nurses to be aware of what the requirements are both during and following the emergency period. The National Council of State Boards of Nursing (NCSBN) has compiled information about the nurse licensure compact and emergency action taken by states, which is a great starting place for information.
When travel nurses are thrust into an unknown situation in a hospital/medical center that isn’t familiar to them, and they are working with systems they’re not familiar with, what’s the best way for them to cope? How can they avoid burnout themselves? Please explain.
Working in a new environment is inherently stressful. Getting used to new processes, technologies, hospitals layouts, and new people can be overwhelming under normal circumstances, and can be amplified during a crisis like COVID-19. Travel nurses should make sure to take time for self-care to preserve their mental health. This is a stressful time for everyone, so don’t be afraid to reach out to colleagues with questions and for support. Failing to make an effort to cope with these rapid changes can have a negative impact on personal wellness and patient care.
What about a nurse’s scope of practice? what can nurses do to make sure that they are acting in the scope of practice? What if the facility allows them to do more than their own state? Does their scope of practice relate to the state they’re in or the one they’re licensed in, or both?
As the COVID-19 crisis rapidly evolves, travel nurses may be given patient assignments outside of their typical practice areas and locations. When faced with situations that exceed the scope of practice for the state in which they are practicing, or the skills or knowledge required to care for patients, travel nurses, like all other nurses, should develop and implement proactive strategies to alleviate unsafe patient assignments. Nurses need to advocate for patient safety and for their nursing license by speaking up if an assignment does not fall under their scope of practice.
When the assignment is within a nurse’s scope of practice, but not within their realm of experience or training, saying “no” to the assignment could lead to dismissal. At the same time, if the nurse does not feel they are equipped to handle the assignment, they could potentially put patient safety at risk. In these scenarios, nurses should tell their supervisor that they have very limited experience in that area and should not be left in charge. The nurse should describe the task or assignment they don’t feel equipped to handle, the reason for their feelings, and the training they would need to be more confident and better prepared.
What changes have occurred during COVID-19 regarding travel nurses and the risks they face that you think should be permanent either for the near future or forever?
Currently, there are certain state and federal regulations, declarations, and orders that extend liability immunity in the fight against COVID-19. What’s not clear at this time is the breadth and scope of these regulations and orders.
For example, it is not clear if these orders and declarations extend to all providers in all areas of service or if such immunity will be limited and specific to certain types of health care providers. Since there is lack of clarity in terms of immunity, it is prudent for nurses to not presume they have any immunity.
Further, plaintiff’s counsel can file a lawsuit, immunity or no immunity, if the plaintiff’s counsel believes the client was injured and that injury was the direct result of the nurse or other health care professional providing or failing to provide professional services. In the best-case scenario, the suit brought against the nurse will be deemed baseless and their malpractice insurer will work to get the suit dropped/dismissed.
Is there any other information that is important for our readers to know?
The COVID-19 pandemic is still evolving, and there is much we still do not know about the virus. All nurses should continue to follow the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) for updates and guidance to help prevent the spread of the virus and protect themselves and their patients.
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.
In 2014, Melisa Wilson, DNP, ARNP, ACNP-BC, the Clinical Operations Director and Pulmonary Hypertension Program Coordinator at AdventHealth Orlando, discovered a lump in her breast. Fearing a cancer diagnosis, her husband encouraged her to see her doctor immediately.
Wilson nearly didn’t. After all, she didn’t have a family history of breast cancer. She thought it was a mammary duct drying up as she was pumping breast milk less for their child.
Thankfully, she listened to her husband. An ultrasound led to a biopsy and then a diagnosis.
“I was taken entirely by surprise. The journey was swift from the time we felt the lump to diagnosis—just eight days. I did not expect to hear, ‘I am sorry, Mrs. Wilson, you have breast cancer,’” Wilson recalls.
Wilson’s diagnosis was Stage IIB HER2 positive, and for the next 18 months, her treatments included Herceptin, Perjeta, Carboplatin, Taxotere, and Neulasta. Her inspiration was her son, who had been born at 23-weeks. “He fought for his life, and in turn, it inspired me to fight for mine,” says Wilson. “My faith in God got me though.” She also had tremendous support from her family, work family, friends, and her oncology team, including her NP, MD, and LCSW.
The most challenging part of her journey, Wilson says, was financial. “The bills for oncology treatment came in quickly and were very high. I maintained my full-time job as a nurse practitioner, though, with some accommodations. I would work up to the day of chemo, take six days to recover, and then return to work for another two-week cycle,” she recalls. “It was hard, and the bills would be overwhelming to deal with at times. I remember being at chemotherapy and getting a call asking me to pay several thousand dollars to pay for a test I needed.”
Wilson beat the cancer, and she says that she now can more easily empathize with her patients because of what she’s experienced. “As an NP, I can relate to my patients on so many different levels. My patients have a rare cardiopulmonary disease—pulmonary hypertension. Most have no idea what pulmonary hypertension entails,” she says.
A few years ago, Wilson says, she had a patient who was scared about having a line placed in her chest. This needed to be done for infusion of pulmonary hypertension treatment. The patient experienced a lot of pain due to being on a subcutaneously infused machine. “One day I called her and asked for her to come in for an office visit with me. I explained that I had done as much as I could to manage her pain, and she needed to consider a different route of infusion. She was tearful and upset. She was concerned about her body image,” says Wilson. “I showed her my port, though it was different and showed her my head, which was hairless due to chemo. I told her, ‘I understand what it is like for your body to change in front of your eyes, but these are the things we do to survive.’ We cried together, and she went on to have the line placed.”
Just recently, Wilson says that her mother was diagnosed with breast cancer. Wilson believes that she went through her journey so that she can help others and that cancer taught her how to live and not be as fearful. “My tribulation shaped me, and now I help my Mom. I am happy to be her advocate,” says Wilson. “Being there for her and not feeling helpless is rewarding. I know it gives her comfort.”
There hasn’t been a National Nurses Day like this one. In the middle of the COVID-19 pandemic that shows signs of simultaneously slowing down and speeding up according to location, nurses around the world are relying on their skills, their teams, and their resilience like they have never had to do before.
Minority Nurse turned to Summer Bryant, DNP, RN, CMSRN, president-elect of the Academy of Medical Surgical Nurses (AMSN) and managing consultant of BRG|Prism Healthcare to talk about why National Nurses Day 2020 is so weighty this year. Nurses have been called on to work in ways they haven’t done before, with a disease they have little information about, and all the time they are worried about their health and the health of their loved ones.
Bryant says she’s not surprised by how nurses have responded, and she’s hopeful that positive change will follow when the crisis has passed. On National Nurses Day 2020, there’s a lot to be proud of.
Q: The current COVID-19 crisis has shown a clear spotlight on the critical role nurses play in our nation. It has also revealed some serious cracks in the system as well—especially in the protections nurses deserve and aren’t getting. In what way do you think nurses have revealed just how they are the backbone of healthcare?
A: I think this opportunity has certainly allowed nurses to demonstrate their courage and empathy for their patients and the communities they serve. We’ve seen nurses step up to this challenge without batting an eye—they are working tirelessly (sometimes without the correct protective equipment), and they keep going back to work day after day, night after night. They are also caring for each other, which much like a backbone, the support is necessary and vital to continue moving freely and giving of oneself to others.
It has also amazed me how many nurses have gone to New York and other hard-hit areas to work and help their fellow nurses in order to give them a break and support the need for extra hands. I think we’ve seen the ultimate sacrifice of the nurses who are living away from their families in order to protect them from getting the virus. Ultimately, nurses keep going to work to care for these patients that need them desperately, and without the nurses to coordinate the care from all of the different providers, patients may not be getting the best possible care that they could get during this pandemic.
Q: Going forward, how might this crisis inspire change and what kind of change would you like to see for nurses?
A: I’m positive this crisis will inspire change. I hope the change sheds light on what it is that nurses actually do when caring for patients and how integral nursing skills are to positive patient outcomes. Nurses are highly skilled in science and the technical skills needed to stop disease processes and improve patient functioning. In addition, I think this crisis has allowed the public to see the caring side of nursing—how hard they work to connect patients with their family members while in isolation, and how willing they are to stay with a patient for hours after their shift is over so they do not die alone.
Nurses have been the most trusted profession for many years now. I think now that people can see their work in action across the country—this will only solidify that trust even more.
Q: This is also changing how nurses see their work reflected in the country. Across the nation, people are seeing firsthand what nurses have known all along about how important nursing care is for helping patients. What kinds of ways are nurses maybe seeing their roles differently?
A: I think nurses are modeling the way where courage and sacrifice are concerned. They are doing this by being reassigned from their normal work environment in an outpatient clinic, the operating room, or in the quality department, and going to work in another area. They may be screening patients and visitors who enter through the hospital lobby, or they may be testing people for COVID-19 in parking lots. Many nurses are working in ICUs or medical-surgical settings to care for COVID-19 patients and using the team nursing approach which is foreign to many nurses.
They are proving to themselves how adaptable they can be and how they have value practicing in any setting where they care for patients. It is difficult to learn a job in a new area with different coworkers for anyone, but to do it during a pandemic shows grit and the flexibility to meet patients where they are. In fact, AMSN has tools to help nurses working in different capacities during this crisis—a self-assessment which can help nurses evaluate their skills and communicate with employers where they may best be reassigned.
Q: And many people, in seeing what nurses are doing, are concerned for these nurses’ health and well being. What would you like to tell nurses across the country on National Nurses Day who are exhausted and even traumatized by the events of the past six weeks?
A: I am one of those people who is concerned about nurses’ health and well being after watching the pandemic unfold in the last many weeks. I would like nurses to know that their sacrifice and courage is not going unnoticed. I am also not surprised at all at how they have stepped up to meet this challenge. I encourage them to seek out resources to protect their mental and spiritual health. I know many hospitals have increased these resources for the staff, and I hope they are finding time to take advantage.
I think it is extremely important that nurses find ways to care for themselves first and give themselves permission to work through the emotions they are facing every day. AMSN has many resources for self care as well as discounts for goods and services to assist nurses in caring for themselves on our website. In addition, AMSN is trying to support nurses in whatever ways we can including providing resources for staffing models, podcasts, advocacy for personal protective equipment and other necessities, and an online community in which to connect with other nurses experiencing the same issues.
Nurses in the United States are facing unprecedented hardships that increase the risk that they will experience burnout. Health care workers, especially nurses, often experience high levels of stress due to the long hours they put in and the sheer number of patients that they interact with.
Avoiding burnout is necessary for a long career in nursing and it is important that nurses do their research when it comes to methods for preventing burnout. While there is a pharmaceutical answer in the use of antidepressants, this method merely treats the symptoms that can lead to burnout. For many nurses, the answer lies in a more natural path that will give them the tools they need to combat burnout holistically.
Health care workers have been shown to be particularly susceptible to experiencing burnout due to the fact that they are expected to perform patient care with consistent and constant empathy and patience. This can lead to emotional exhaustion which, coupled with the physical exhaustion that comes with working in the medical field, eventually morphs into what we know as burnout. Naturally, the stresses of this line of work can lead to fatigue that impacts motivation in the workplace and a misplaced sense of failure.
One of the best tools available to nurses in the fight against burnout is the development and strengthening of resiliency skills. When nurses possess a solid foundation of resiliency skills they are better equipped to bounce back from a particularly intense shift more easily and are able to maintain their ability to work effectively. Taking breaks during shifts, scheduling time to hang out with coworkers outside of work, and learning how to say no to taking extra shifts if they need breaks are all ways to increase resiliency.
The prevalence of burnout and resiliency’s effectiveness in combating it has led to the development of nurse resilience programs designed to arm nurses with the proper tools before they begin their careers. Through cognitive-behavioral training, stress inoculation therapy, and various other methods, nurse resilience programs are effective in preparing nurses for what lies ahead of them in their career and can be invaluable in the fight against burnout.
Taking Care of Mental Health
Another natural proven method for nurses avoiding burnout is simply taking care of their own mental health and well-being. While it might seem like obvious advice, for those working in high-stress environments like health care can find it far too easy to forget to take care of themselves. Self-care is vital for nurses who want to dodge burnout, and even something as simple as keeping a journal to acknowledge positive things that happen in life can be enough to stymie burnout.
Many nurses suffering from burnout experience feelings of inadequacy, low self-worth, and depression. It is important that nurses recognize that these feelings, while they can be intense, do not represent the reality of the situation and do not reflect their actual performance or capabilities either at work or life in general. Quieting that negative inner-voice is an effective way for nurses experiencing burnout to boost their self-esteem and sense of self-worth.
Learning how to practice mindfulness meditation is another excellent natural way to look after one’s own mental health in even the most stressful of situations. Mindfulness meditation has a whole host of benefits from helping to increase attention and concentration to improving practitioners’ heart rates and blood pressure, all of which can help to manage stress and fight off burnout. While there are plenty of books on the subject, there are also a multitude of free resources available online that are secular, simple, and can get a struggling nurse on the right track.
Looking Towards Nature
Should building resiliency skills and working on maintaining good mental health fail to do the trick, spending time in the great outdoors has also been proven to help prevent occupational burnout. Engaging in physical exercise outdoors helps to reduce fatigue and improve overall cognitive function and can result in a marked reduction in tension, depression, and anger. While nurses do indeed have wildly busy schedules, making an effort to set aside time for themselves in the outdoors can yield incredibly positive results for them.
If a nurse finds themselves unable to break away from the concrete jungle, there are still ways in which stress can be reduced naturally without going outside. Taking the time to unplug from technology frequently can reduce stress and allow for moments of silent self-reflection untainted by the constant and looming force of the internet and social media.
Finally, nurses that are looking for a way to combat burnout but are wary of getting a pharmaceutical prescription to manage its symptoms can always turn to mother nature. Cannabidiol, or CBD, is a compound found in cannabis that has no deleterious or psychoactive effects and is becoming a popular stress-reduction tool for many. While the science regarding CBD is still in its infancy, there is a huge amount of anecdotal evidence that points to the compound being an effective treatment for stress and a host of other symptoms and disorders.
At the end of the day, nurses and health care practitioners are some of the most important people in a functioning society. It is vital that they receive all possible help when fighting against burnout, whether that comes in the form of resilience training, mindfulness practices, or spending time with mother nature.