National Disability Independence Day on July 26 honors the signing of the Americans with Disabilities Act (ADA) on July 26, 1990. With the passage of the ADA came opportunities for people with disabilities, including greater access to previously inaccessible public areas and job training skills for employment.
With one in four Americans reporting having a disability, nurses with disabilities exist in the field while providing value in clinics, hospitals, and other areas of work by showcasing the importance of inclusion and diversity, especially in patients with disabilities.
Despite the increased opportunities for nurses with disabilities in the workforce, they are often confronted with high levels of burnout in the healthcare industry. Having to manage their disabilities while dealing with the fast-paced demands of nursing may make them more vulnerable to burnout or even lead them to leave the nursing profession altogether.
So, what are some ways nurses with disabilities can practice self-care to prevent burnout?
Find Accommodations That Work for You
For nurses with disabilities who work in clinical settings, many of them struggle to obtain accommodations, or are unable to do certain tasks that can lead them to quit or think about leaving their job.
It can be hard to advocate for yourself in this situation. Some workers have invisible disabilities or disabilities that aren’t physically apparent to others. Examples of these disabilities include diabetes, traumatic brain injury, chronic pain, and mental health conditions.
In this case, consider your situation and decide what first steps to take to ensure you get the support you need.
Here are some other ways you can advocate for yourself at work:
Find personal accommodations for yourself. It might be optional to tell a manager or supervisor about accommodations you need. If you find yourself in this situation, discover ways to make your job easier for yourself. Ask a fellow nurse to tag team with you on a client load, or take more breaks to relax if you need to sit down.
Learn how to communicate what you need. If you do need accommodations from your workplace and leaving your job isn’t a reasonable option, talk with your employer about what accommodations you need. It’s likely that they don’t know exactly what you need, so be prepared to ask for specific accommodations that can benefit you. These can look like assistive technologies such as screen reader software or a modified work schedule that is suitable for you.
The ADA requires employers to provide accommodations for employees who ask for them, so feel encouraged to ask for the help you need to do your work effectively.
Discover How to Self-manage a Disability with Coping Skills
There are many coping skills you can use to manage living with a disability. These skills can significantly help on bad days when it can feel like your disability is keeping you from doing the things you want.
“Self-managing” with strategies doesn’t always mean dealing with all of your symptoms by yourself. You can find a friend, family member, or someone with the same disability to be an accountability partner who can guide you through challenges at work.
Try out other coping skills below and see what works for you.
Be Aware of What You Can Control
Those with physical or mental disabilities can be overburdened by emotions or physical pain. It can be easy to slip into a negative spiral of “I can’t do this” and other thoughts that leave us feeling bad about ourselves. However, catastrophizing only leads us to stay stuck and isolated.
You’re not alone in this type of thinking. Adults with disabilities are five times likelier to have mental distress than those without a disability. However, it’s important to note that thoughts about how to care for yourself in the future are valid and show that you care about your health.
Consider taking actionable steps to help you live a more well-balanced life. Do you need any assistive technology at home? Search for what you need to get an idea of assistance available near where you live. If you’re struggling with your mental health, write down what you’re dealing with through journaling or another mindful technique.
Find an Activity You Enjoy
Spending time on a hobby can help us get out of our heads and engage in something we love to do. If you can’t do something you love because of your disability, find an interest you have and create an activity out of it.
For example, hiking in nature can be good for exercise but difficult for people with chronic pain. Painting landscapes, light walking, or photography are other options for people who want to get outside but can’t always do so.
This is also a good way to meet like-minded people who share similar interests. Yoga, gardening, and reading groups are other common groups, so you might find some near you to share and expand your support system.
Takeaway
Practicing self-care doesn’t always involve baths and long naps. While it can be that way for some, advocating for yourself and taking time to enjoy fleeting moments are other ways to take care of ourselves and ensure that we’re living a happy, rewarding life.
Shift work — so many nurses do it or have done it at least once in their careers. While patients definitely need care around the clock in certain settings, the nurses who care for them also need sleep.
According to Amy Witkoski Stimpfel, PhD, RN, an Assistant Professor at the NYU Rory Meyers College of Nursing, “Shift work—particularly nights and evenings—misalign our body’s natural circadian rhythms. Simply put, as human beings we were not made to be awake late at night or very early in the morning,” she explains. “Thus, there is a cascading effect on this circadian misalignment on the rest of our body’s functioning.”
The biggest problem with this is that nurses must be able to provide safe care and going without sleep can be problematic. “Obviously sleep disruption is one of the biggest and most dangerous consequences of circadian misalignment caused by shift work. Being sleep deprived is also especially difficult because we are not good judges of how impaired our functioning is when we are sleep deprived. So, as nurses it can be very dangerous to practice when sleep deprived,” Witkoski Stimpfel says.
She cites the National Academy of Medicine, which recommends that nurses not work more than 12 hours every 24-hour period or 60 hours per week. There is also evidence that shows nurses should work a maximum of two to three shifts in a row.
Witkoski Stimpfel gives the following tips for nurse on how to best perform at their jobs when working overnight shift work:
Achieve enough adequate sleep during off shifts
Judicious use of caffeine
Use blue-blocking sunglasses on the way home after a night shift
Use blue-blocking apps/filters on smartphones and other electronic devices before getting sleep
Limit voluntary overtime hours
Have a bedtime routine that doesn’t include alcohol, nicotine, or other drugs
The bedtime routine can include taking a bath, listening to music, medication, talking with a spouse, friend, or family member—these will all help the body to shut down for rest.
Know that you can make mistakes when working nightshifts. “One of the biggest mistakes nurses can make when working night shift is to not sleep before a shift. Most studies on this topic indicate a small portion of nurses simply do not sleep before going into night shift, which is very dangerous,” says Witkoski Stimpfel. “Using melatonin or other sleeping aids should only be used under a provider’s guidance.”
If you have to switch from dayshift to nightshift in one week, Witkowski Stimpfel suggests the following, “It will be challenging to get “good” sleep when working one off night shifts, which is why that kind of scheduling should be avoided. If it happens occasionally, the nurse should try to get a nap before the night shift and definitely sleep as much as possible following the night shift. Using caffeine at the beginning of the shift and taking a walk or going up a few flights of stairs around 4 a.m. can help with alertness during the shift. If possible, using public transportation or having a friend or family member drive the nurse home after the shift could help to avoid drowsy driving,” she says.
Remember that these present, strange times we’re in have caused a lot of additional stress on everyone, especially health care workers. So it’s important to get the sleep you need. “The COVID-19 pandemic has placed additional and unprecedented stress on nurses, often resulting in disrupted sleep,” states Witkoski Stimpfel. “It is really important to reach out for help, whether it is therapy or counseling, meditation, a consultation with a sleep medicine physician, etc. Sleep is crucial for functioning across the board, both mentally and physically.”
Are you like most nurses, filling your days with taking care of everyone else but yourself? That may seem heroic, but putting yourself last ultimately leads to a dip in on-the-job productivity and career burnout. But when you take care of your own needs first, not only do you benefit, and so do your coworkers and patients.
Is there a secret formula to boosting your health and happiness? Fortunately, there is no secret. It’s simple, though not easy, to make yourself a priority in your own life.
By attending to your own self-care, you’re more likely to head off the symptoms of overload which can cut your nursing career short. But where do you start, when there are so many components of a happy, healthy life?
Self-care is easier to establish if you know what’s most important to you at this particular point in time. You may want to focus on a major life activity—eating, exercise, sleep, or relationships—because they seem like obvious drivers of well-being. Improvements in any of those important areas can certainly yield major benefits, but they’re usually tough to crack.
Even if you highly prioritize self-care, it’s difficult to say “No” to that big slice of cheesecake, fit in workouts, or turn in for bed on-time. Especially when your schedule is already jam-packed, your shifts are long, or you work nights.
Why not try another tactic? Consider setting a self-care habit in motion by starting with baby steps toward your ultimate goals. Improvements don’t have to start in your “hot zones” either. Like dominoes, a shift in one habit or routine will cascade down to every other area of your life.
Here are two powerful ideas to spark your thinking:
1. You Need a Budget.
Who even uses a budget anymore? It sounds so old-school, like playing music on 8-track tapes and paying with paper checks at the supermarket. But sitting down to crunch the numbers, and getting a grip on your income and outgo, can be an effective stress-reliever. Your financial situation may remain the same, but seeing the actual facts can stop the free-floating anxiety that’s fueled by imagination.
Your budgeting system doesn’t have to be fancy, either—just use a notebook and pencil to note and track your household expenses and income. Some people like to allocate cash to specific purchases, using an envelope system popularized by Dave Ramsey. One envelope for cafeteria lunch money, another for…
And don’t forget to plan for seasonal outlays (holiday gifts or taxes) and emergencies. That way if you need to replace a dental crown, you’ll have a buffer fund to cover it, and won’t panic as much.
There are also many apps out there for budgeting, including the grand-daddy, You Need a Budget (YNAB).
2. Do a Digital Detox.
Are you always texting, Skyping, Tweeting, Facebooking, or otherwise deep in your digital stream? That’s the case for many “social media natives” and even for their oldest colleagues.
Even if you’re following social media guidelines for nurses in your workplace, you may find that digital is a distraction, always in the back of your mind, ringing, buzzing, or vibrating to get your attention. You could get relief from all sorts of social media ills, from text neck to FOMO, by choosing a set time to disable it, for hours or days.
Some people like to set aside long weekends to go away on formal retreats, like the ones offered by Digital Detox while others simply reduce everyday use. Digital refers to all smartphones and computers (sometimes TV’s too), so resolving to stay away from electronics and screens after 8:00pm could be enough to calm your down, and make it easier to get to sleep at a decent hour.
Oh, but wait, what if you ditched your alarm clock? There are all kinds of new devices for improving your sleep hygiene that you may want to check out. One example is the Philips Wake-Up Light Alarm Clock with Sunrise Simulation, which costs less than $50. The light on this clock slowly gets brighter over a 30-minute span, to gently awaken and welcome you to the new day.
It’s important for you (and your patients) that you engage in self-care every single day. So resolve to take a baby step toward making yourself a priority in your own life.
The term “self-care” is a big umbrella that covers a ton of wellness topics, such as life-balance, stress relief, weight management, fitness, relationships, spirituality, and much more. It’s tough to pinpoint just one life arena you’ll want to make changes to in order to become happier and healthier. But it’s possible and may make your self-care journey easier.
Here’s a tip: Start with sleep.
Why Sleep Is So Important
This is probably the number one area where you can improve your health and well-being. Nurses are notorious for not getting enough sound sleep on a regular basis—odd shifts and rotating schedules don’t help the body to regulate rhythms. Fatigue is one thing but it’s worst when a sleep-deprived nurse actually nods off while at the bedside or on the road after a late shift. Obviously, that’s extremely dangerous—for you, your patients, and everyone near you.
Most American adults don’t meet the guidelines for sufficient sleep (seven to eight hours) and many of us consider it a luxury we can’t afford, or try to “bank” shut-eye by sleeping for 5 hours on work nights and 10 on days off. We like to think that getting along on little sleep is a sign of superhero strength and those who prioritize rest are weaklings. None of those beliefs are accurate. Here’s how you can take care of yourself, in spite of our hyperactive society’s mistaken take on rest and sleep.
The Basics of Sleep Hygiene
Chronic sleep deprivation and sleep disturbances, such as sleep apnea, can be improved by following good sleep hygiene protocols. Try these tips:
Cut out caffeine later on in the day. (That includes certain soft drinks and chocolate, as well as coffee and tea.)
Drink alcohol in moderation, or not at all, because it’s more likely you’ll wake at night after a drink or two.
Another reason to stop smoking cigarettes: nicotine interferes with sound sleep.
Finish your last meal of the day a few hours before bedtime so you’re done digesting.
Don’t do heavy exercise late at night, though gentle stretching or yoga can be a restful entrée to sleep.
Setting the Right Environment for Rest
Digital sights and sounds make it harder to slow down and get ready for bed. Younger nurses, being social media natives, are especially prone to texting, tweeting, Pinteresting, and streaming movies in their bedrooms. Make it a rule to keep your smartphone, iPad, or other devices out of your bed. That way, you won’t be tempted by social media, news, or entertainment right up to the time you turn off the lights. Some nurses even set a digital curfew and power down devices two to three hours before bedtime.
When Your Mind is Too Busy to Turn Off
Some nurses find that the simple act of journaling before bed helps them quiet the worry, anxiety, and fears that may be keeping them awake. Nursing is an emotional occupation and there isn’t always an opportunity to process what happens during the day while on the job. That’s when a notebook and pen by the bed can be a curative. One of the principal researchers in the area of journaling and health is James Pennebaker, a psychology professor at The University of Texas at Austin and author of “Writing to Heal.” His studies have shown that expressive writing (journaling) is a simple and effective way to relieve stress while boosting both mental and physical health.
Very soon it will be Halloween, the start of a holiday season that researchers warn adds an average of eight pounds — if you’re not careful about sweets and snacks.
Ouch!
Nurses have a lot of practice saying “no” to treats at work – boxes of candy from grateful families to trays of pastries from coworkers. Temptations abound, but they become especially intense during the next two months of the year.
Of course, we love getting together with teammates to mark Halloween, Thanksgiving, Hanukkah, Kwanzaa, Christmas, Solstice, or the New Year. Plus, we’ll continue to toast other happy occasions: birthdays, anniversaries, weddings, graduations, and job promotions.
So what’s the problem? Some surveys show that nurses are more likely to be overweight than the general population. Could the reason be extreme workplace stress and long shift hours? Or maybe it’s because the nurse population is aging, which correlates to a higher BMI.
You may not be able to do anything about events at work or your own slowing metabolism. But you can control your own actions, which will help you keep on the nutritional straight and narrow.
Here are a few ideas that have worked for other nurses:
First try to become aware of any emotional basis for your cravings for sweets and treats. It’ll then be easier to make behavioral changes, which will go a long way toward keeping you at your healthiest weight.
Decide beforehand on your “food rules” for this season, and then don’t deviate from them. For instance, you may decide to bring low-calorie snacks to events so that you’re not so tempted by sugary, fatty, or salty offerings. A cup of cubed cantaloupe is sweet (only 7 grams of natural sugar), while cut vegetables with Greek yogurt dip and air-popped popcorn with chili spices are savory.
Devise a healthy-eating phrase to repeat silently to yourself when you’re most tempted. Here are a few mantras to try this Halloween, and if some prove helpful, to keep handy all year long.
“My stress level is through the roof, but chocolate is not the solution.”
“Sugar is not the best antidote for fatigue from 12-hour shifts.”
“I can accept the good wishes, but resist the treats from families and staff.”
“I deserve better than sugary goodies when I work a night shift.”
“Sweets can not change my not-so-sweet feelings of anger at work.”
In addition, try to cut out sweets in other areas of your life, too. The American Heart Association says to limit added sugar to 6 teaspoons for women and 9 for men. That’s a tall order when you consider that the American average is 22 to 30 teaspoons a day.
You have to be a good detective because sugar hides where you least expect it, like in coffee drinks. Compare a Starbucks’ Grande Vanilla Latte vs. plain coffee with a packet of sugar. The difference is a whopping 32 grams of sugar!
Of course, plain black coffee would be best, but that would probably be too big a shock to the system for a coffee drinker with a sweet tooth.
It’s better to make small and sustainable changes, such as eating and not drinking your snacks and meals. Fruit smoothies, for instance, enjoy a “health halo” but can pack on the pounds because they’re high-calorie, high-sugar, and apparently innocuous.
Sometimes it doesn’t pay to fight the inevitable, like candy on Halloween, though you can sidestep some of the danger. So, don’t go hog wild but instead enjoy a fun-sized piece of candy (80 calories for most bars), and you won’t do too much damage.
It goes without saying, but don’t be the health saboteur who brings bags of candy to work. Your fellow nurses and other staff members won’t appreciate it.
At home, buy your least favorite candy for trick-or-treaters – and fewer bags than you think you’ll need to prevent leftovers. If you want to avoid temptation altogether, give out mini-toys or stickers instead of sugary treats. In a pinch, just reach into your wallet or piggy bank for some quarters and dimes. The youngest goblins appreciate even pennies!
It’s not easy to limit treats around Halloween, but remember, you’re taking good care of yourself, and setting a good example for your patients.
