Almost any nurse knows 2020 can’t be compared to any other point of time they have lived through. And 2021’s progress is in sight, but it’s slow going getting there. Vaccines are on the horizon and some nurses have even completed both doses, but hospitals are still seeing more patients than they can sometimes handle and the new strains of COVID-19 bring the threat additional surges. Nurses are seeking short bursts of stress relief to combat the burnout they are feeling.
The COVID-19 pandemic has left a path of devastation few are equipped to deal with physically, emotionally, or spiritually. As front-line workers, nurses bear the brunt of overwhelming stress, grief, and exhaustion. Stress relief is a priority, but hard to come by for most nurses.
Minority Nurse recently spoke with Crystal Miller RN, past president of the Infusion Nurses Society (INS) about the ways nurses are just trying to get through these times when days blur together and overtaxed is the normal state.
The emotional toll on nurses can’t be overlooked, she says. “Anyone in health care has been impacted,” says Miller. “Even if it’s not every shift, it has challenged us emotionally.” Nurses, who are problem solvers by nature, aren’t always able to find a solution, let alone the best solution, out of many choices. “The patients are so so ill and you can effect only so much change,” she notes.” And it’s not necessarily for a positive outcome.”
Maintaining a patient connection is now a hard-to-grasp process, but Miller says her team makes a significant impression in any way they can. “We’ve been put to the test in so many ways,” she says. “Making sure we have eye contact –that’s pretty much the most impactful contact we can have right now.”
What else helps? Miller offers a few suggestions based on her conversations with other nurses.
Talk to a Professional
“It’s about more than us and the care we provide and the equipment we use,” says Miller. “It’s about us being emotionally resilient and maintaining our mental health.” Miller, who has spoken or interviewed many nurses who are fighting back tears, says the hurt and the pain nurses are feeling is so dominant. With her own team, she tries to promote the use of employee assistance programs that offer counseling services and encourages that resource. “Sometimes it’s better to talk to someone who doesn’t work in health care and gives you a new perspective,” she says.
Find a Distraction
From watching quick and easy-to-digest TikTok videos to feeding the birds to deep breathing—finding something fast to calm you or make you laugh is valuable. And don’t worry how silly it might seem to others—you need relief and an immediate escape. If a few bursts of cat videos or watching reality TV or breaking out in song and dance help you, then just do it.
Try Journaling
“I can’t stress journaling enough,” says Miller. Again, you’re not going for profound entries. You can write that today was a horrible day and just get that out. Or you can write that out of the horrible day your coffee was perfect and you’re grateful for that one thing.
Find Your Own Soothing Habit
“One person I know grounds herself before her next patient interaction,” says Miller. She touches the door or doorframe before entering the room as a way to say “I am going to see someone else now.” The purposeful action provides a divide between the experience she just had and the one she is beginning.
Acknowledge Your Limits
“Right now, most of us are of the mindset of work, go home, go to bed,” says Miller. “We are so tired.” Still, the grinding workload doesn’t mean nurses have lost their legendary spirit that keeps them going even when things are bleak. “At the end of the day, we just try to enjoy moments of levity when they present themselves and however they present themselves,” says Miller. “And chocolate goes a long way in my book.”
As the coronavirus pandemic reaches new heights across the country and hospitalizations rise, nurses are facing extreme and unprecedented demands. A recent study from the Journal of Occupational Health found that the coronavirus pandemic has significantly impacted the mental health of health care workers, especially frontline staff.
The heightened risk of exposure, coupled with inexperienced nurses providing care in fields where they have limited experience and veteran nurses feeling severe burnout, has caused many nurses to quit and move to outpatient clinics or home care.
As a result, hospital systems are turning to short-term travel nurses to fill the gaps in care as they continue to rely heavily on their nursing staff to manage the increase in hospitalizations due to COVID-19. These temporary nurses often struggle to feel connected to the resident nurses which can result in miscommunication and lapses in effective patient care.
These rapidly changing circumstances have put hospital systems in a tough place. Many are focusing all their energy on dealing with the crisis at hand, rather than addressing the deteriorating mental and emotional health of their nursing staff.
To protect one of their most valuable resources–their nursing staff–it’s crucial for hospital systems to think proactively about building resilience among their nursing teams and leaders. In my work with Innovative Connections, we we’ve been able to help nursing leaders at Baptist Health in Montgomery, Alabama, do just that.
In May 2020, it was clear to Gretchen Estill, MSN, RN, CNML, Chief Nursing Officer at Baptist Medical Center East (BMCE), that her nursing leadership team was emotionally exhausted from the nonstop care needed to handle COVID-19 hospitalizations.
“We had a multifaceted challenge,” Estill said. “This strong group of leaders were beginning to run on empty as we realized that this was not a transient pandemic. We are a very relational group, and we were missing the ability to get together in person and debrief.”
Meanwhile, at Prattville Baptist Hospital (PBH), chief nursing officer Meg Spires, RN, MSN, recognized a similar pattern of fatigue and frustration among her team of clinical leaders. Her close-knit leadership team still felt a strong commitment to their mission of putting patients first, providing passionate care, and pursuing perfection. However, the challenges from the pandemic made this mission seem impossible to carry out.
Although investing time in team development and resilience work during a pandemic may have seemed counterintuitive, these nursing executives at Baptist Health understood their teams needed emotional and psychological support to make it through the ongoing challenges of COVID-19.
Nursing teams participated in weekly team coaching sessions facilitated by Innovative Connections, a management firm in Fort Collins, Colorado, via videoconference. Nurses were able to discuss mindfulness, dealing with grief, changing their perspectives and building resiliency.
At the end of each training we give them a mindfulness practice to help ground them during their work. We had nurses dedicate the 20 seconds they wash their hands multiple times each day to practice mindfulness. Instead of adding one more thing to their non-stop schedules, we were able to incorporate this self-care practice into something they already have to do throughout the day.
“This resilience training is a necessary investment before and especially during a crisis,” Laurie Cure, CEO of Innovative Connections said. “If a team has been working to build trust, they are better positioned to show up and do their job when a crisis hits.”
Initial feedback found that the nursing team was grateful to have an opportunity to connect as a group in a designated place to debrief about how they were doing mentally and emotionally with their teammates. Many enjoyed the chance to unplug and understand how others on their team were coping to focus on their collective contributions and strengths during such a stressful time.
“I’ve heard repeatedly from my leaders that they’re extremely appreciative that we, as an organization, cared enough about them and their emotional health to invest in them,” Spires said.
Dedicating the time for resilience and team building during the demands of the COVID-19 pandemic may have seemed counterintuitive at first. However, the awareness that these key team members gained from having protected time to rejuvenate and support one another was invaluable. Pursuing this intervention has contributed to increased efficiency and connectivity for these nursing teams.
“The team had to acknowledge that we have to take care of ourselves before we can take care of others,” Spires said. “We focus on our physical health, but we don’t pay as much attention to our emotional or mental health. We can’t do justice to our patients or our team members if we’re not emotionally healthy.”
From the time spent waiting for an organ for donation to the post-surgical recovery, transplant nurses play an integral role in the lives of patients involved in transplants. Today, National Transplant Nurses Day, recognizes that work.
The International Transplant Nurses Society started a national recognition day for transplant nurses in 2006. Since then, they have attracted attention to the day and boosted recognition for all these nurses do in their field. The organization even builds pride with an essay contest in which patients may nominate a nurse who has had a particularly important impact in their lives.
But the day also shines a light on the varies responsibilities of nurses who are an integral part of the transplant team.
According to the Health Career Institute, transplant nurses’ duties can range from prepping patients for transplant surgery and assisting in the transplant surgery itself to monitoring post-surgery for organ rejection or complications.
Before deciding on this career path, prospective transplant nurses generally gain experience in the field by working in a transplant unit. Eventually, certification as a clinical transplant nurse will help you provide the best patient care and will also signal to your organization how committed you are to your job. Certification in the field through the American Board for Transplant Certification shows you are willing to go beyond your job requirements and gain additional training and education to remain on the forefront of transplant-related practices.
Nurses who work with transplant patients and their families may be involved in cases of living donors or deceased donors. They must remain sensitive to the complex emotional environment surrounding the origins of the donated organs while remaining a vigilant advocate for the organ recipient’s health first and foremost.
Transplants are becoming more and more complex, with multi-organ transplants a more common surgery than ever before. Transplant nurses on the leading edge of the field will want to be well-educated on all the body systems involved and the varied ways that can present challenges in the human body. Because the transplant team includes many diverse specialists, transplant nurses have to work well on a fast-paced team where situations change in an instant and the clear path isn’t always obvious. They have to have excellent critical thinking and be knowledgeable and confident enough to make excellent decisions based on the patient in front of them.
With the emotional challenges and complexities around transplantation and the patients and families involved, transplant nurses have to be sure to have resources to deal with the emotional extremes–from grief to joy—that will become part of their daily routine. But they are reassured about the impact they are making for the patients they treat. A lifelong connection often develops from playing such an essential role in someone’s journey.
Although many people don’t like to think about death and dying, it will happen eventually. When it does, those who are fortunate enough to have hospice and palliative care nurses caring for them will understand the importance of these nurses’ roles.
Palliative and hospice care nurses provide care for those who are the end of their lives. They are there for the final transition and use an entire array of medical knowledge and tools, skills, compassion, and life experiences to help in the best ways they can. Hospice and palliative care nurses strive to make patients as comfortable as possible both physically and emotionally. As their physical body shuts down, these nurses can use a combination of medication, music, talk, touch, and companionship to make the process something the patient is comfortable with.
The Hospice & Palliative Nurses Association and the National Hospice and Palliative Care Organization offer resources and education about this nursing specialty. Palliative and hospice nurses often provide education to the public as many people think of nurses as providing life-saving care and aren’t sure what end-of-life care entails. If they haven’t had interactions with hospice care, they may not comprehend all that goes into the nursing practice as someone approaches end of life.
While many find the end-of-life stage difficult to cope with, these nurses often consider it a supreme privilege to be present during someone’s last days. Nurses often develop deep connections with these patients as they try to meet their wishes and help them die with a sense of dignity and control. They also become close to families and even provide guidance and education to help families cope and to make them feel like they can take an active part in offering comfort and acceptance.
Hospice and palliative care nurses deal with grief, often very profound grief, on a daily basis. While the dying patient is coping with life coming to an end, a circle of loved ones is doing the same and trying to prepare for life after the person’s death, while also making the most of the final days. These nurses are especially skilled in managing grief and helping others learn coping skills while they still focus fully on the patient.
Hospice nurses need to take special care to make sure they are also able to cope with profound levels of grief and death in their lives so they don’t get burned out or experience compassion fatigue. Forming strong relationships with other nurses in this specialty is important as is joining professional organizations devoted to hospice and palliative care and even continuing education like certification or additional coursework or conferences. There is much to be learned from others in similar work and hearing how they cope and even what might be a red flag to take notice of. Turning to others and counseling professionals if needed can help nurses stay focused while acknowledging and honoring the challenges of providing end-of-life care on a daily basis.
This career path is one that offers great rewards and hospice nurses are often remembered as a steady presence in a chaotic time.
Pediatric nurses serve as a voice for patients who may not have one or who may have no reference for the words they need to say. As their advocate, you become their nurse and their voice.
From October 1 to 5, pediatric nurses are honored for the work they do with the children in their care. This is also a time to recognize the undeniable ripple effect that happens with the care pediatric nurses give. While they might provide treatment and care directly to their young patients, they are also impacting the families of those little ones and even the larger community they belong to.
Each pediatric nurse who offers empathy, caring, education, and compassion to the families of pediatric patients helps them get through what is likely a trying time. In turn, that also helps community members who rally around the children and their families, including extended family, school friends, and faith community members.
Often pediatric nurses spend considerable amounts of time with the families of the children and infants they care for. These are excellent opportunities to help educate families about a diagnosis, treatment, continuing care at home, and expected prognosis. As an expert, families will look to you, so it’s important to honor that trust, but it’s a fine line. If you feel families could use some additional emotional support or additional resources, you can help turn them in the right direction. It’s a good idea for your team to have that information ready if it’s something that might be needed.
A pediatric nurse often forms strong, life-long bonds with some patients. Depending on the circumstances and how often nurses interact with the same patients, they will often find themselves in contact with those whose lives they had such a powerful impact on.
As a pediatric nurse, each of your actions can leave an indelible impression. Your goofy impressions, your colorful tops, your cheerful songs, and your calm manner can all give pediatric patients a courage to get through a scary time. Pediatric nurses can also help their patients understand that trips to hospitals, physicians’ offices, or healthcare centers aren’t necessarily fun, but they certainly are a place where kids are welcomed, cared for, and helped to feel better.
Because pediatric nurses care for children, they have to be especially careful to take care of themselves in their personal and professional lives. It is heartbreaking to see young children who are very ill or who are in pain. It is devastating when they die. Pediatric nurses must be able to call on special reserves of dedication and self-care to deal with the grief that can be a natural part of their job. Developing relationships with mentors or with other pediatric nurses can help nurses deal with feelings that might come up.
If you are a pediatric nurse, congratulations for all you do to help children. If you have a pediatric nurse in you life, offer a heartfelt thanks for the care they give.
