All my life I have rarely been sick, in fact there have only been two times that I can recall. So, about three months ago when I started feeling bad, it was out of the ordinary. I did not have any obvious symptoms, such as nausea, vomiting, headache, runny nose etc. I just had a lack of energy and no appetite. During this time it made me realize that “I would rather have great health, more than any material thing”; not that I do not like nice things or places. As children, many of us dreamed of growing up and having lots of money, big houses, cars and anything else that money could buy. We were only focused on the “material” things. There were never any thoughts about our physical or mental health.
I would rather have excellent health, than all of the money in the world. If you are sick and cannot get around, what good is having money and things, if you cannot enjoy it? Some people may say that they would use their money to hire the best doctors, but that is no guarantee that you will have good health. I often think of our patients that we are taking care of in the hospitals and clinics, they are relying on us to give them the best possible care to make them feel better. During this time, they become dependent on the healthcare staff and this may be hard for many that are used to having control of their own lives. Before you make an assumption that the patient is “difficult” or “hostile”, remember that these are people that were working, taking care of themselves and families and making their own decisions. We need to include them in all aspects of their care, instead of dictating what will be done. Although we may have our daily assignment planned, discuss with the patient the Plan of Care and let them have some input on the order of some things, to give them that feeling of control. We still have to stay on task, but we need to make them feel like adults and not like children being told what to do. Some people may think that this will interrupt your normal day, but imagine if it were you laying in that bed, how would you want to feel?
I have decided that I am going to enjoy life, spend more time taking care of myself and creating experiences with my daughter. I have been privileged to accomplish a lot of things in my life: writing my first children’s book, starting a home-based travel business, building my photography portfolio, traveling domestically and internationally; all while being a mom and nurse. We spend a lot of time taking care of others; but we must start taking care of ourselves; otherwise we will not be here for others.
So, the fatigue and loss of appetite that I was having was due to my Vitamin D level being critically low. I am currently working remotely, so eight hours of my day is spent inside on the computer. When I get off work, I wait until the sun goes down to go on my evening walk; therefore I was getting minimal to no sun. I am happy that this is a condition that can be easily corrected by diet, taking nutritional supplements and spending a few minutes sunbathing (in moderation). The benefits of sunlight is that Vitamin D is produced when your skin is exposed to the sun and it is one of the many vitamins our bodies need to stay healthy, relieve stress and increase energy.
I realized that work will be there; so I have made it a point to sit outside on my breaks and lunch. I am glad to say that I am feeling a lot better now. Never take your health for granted. You only have one life and you need to make sure to maintain your health. Take care of yourself, mind, body and spirit. The six best doctors in the world: sunlight, exercise, rest, diet, self-confidence and friends. Maintain them in all stages of life and enjoy a healthy life. Remember Health is Wealth!!
When your job involves taking care of others, it’s important not to forget about your own health and well-being. All too often, nurses and other health care workers are so focused on helping their patients that they neglect their own self-care needs. Unfortunately, if your own needs aren’t met and your mental health declines, it can affect your work and your ability to properly care for others.
The health care industry is often fast-paced and chaotic, meaning health care workers often don’t even realize that their own well-being needs attention until they hit a breaking point. Minority health care workers are especially at high risk of experiencing burnout and emotional distress due to the added struggles they face. It’s important to take breaks and listen to your body as a health care worker to identify potential mental health conditions the same as you would use your knowledge to help your patients.
How to Improve Your Mental Health and Well-Being
Finding ways to maintain your mental health is a must for nurses and other health care workers. To continue delivering quality care to your patients, you have to take care of yourself as well. The following are ways you can help maintain your mental health or work to improve it if you are already feeling low:
Get Enough Sleep
This one should go without saying, but resting and getting enough sleep is essential. It’s common for health care workers to lose sleep when they work long hours, especially those who work night shifts, but it’s important to find time to sleep when you can.
Process Your Emotions
Working as a nurse can be psychologically draining. Dealing with patients and their families can be challenging, especially when you lose a patient. Often, health care workers will try to brush it off as simply being a part of the job, but it’s important to acknowledge and process your emotions when you have time to yourself. Just because losing a patient or dealing with other emotional and stressful situations is part of the job doesn’t mean you can’t feel sad or angry. It’s essential to find healthy ways to process the stressful things you deal with as a health care worker on a daily basis.
Create a Relaxing Home Environment
When you’ve had a rough shift, coming home to a calm and relaxing environment is crucial to maintaining your well-being. The environments we spend our time in can have an impact on our mental health. Understandably, there are things at home that may need attending to as well, but it’s important to create a space where you can get away from distractions and relax.
Find Ways to Disconnect
Many nurses struggle to find time to themselves because when they do have days off, they have other things that require their attention, like family, social engagements, and other responsibilities. However, it’s important to find time to get out and disconnect to give yourself a break. Getting outdoors, for example, even if just for a short walk every day, can help you feel refreshed and re-energized.
Eat Healthy Foods and Exercise
Another part of maintaining your mental health and feeling refreshed is getting physical exercise and eating healthy, well-balanced meals. It can be difficult for nurses and health care workers to find time to stop and eat, but healthy meals and snacks throughout the day are important to keep you energized and feeling your best. It’s also important to find time outside of work to move your body and get in some exercise when you can. Physical activity can go a long way towards boosting your mood and helping you get better sleep.
Practice Mindfulness and Gratitude
It’s easy to forget about appreciating the good things we have in our lives when we are tired and stressed, but practicing mindfulness and gratitude can positively influence our mental health, especially for health care workers. The more joy we can find in our lives wherever possible, the easier it is for us to maintain a positive state of mind. A great way to practice mindfulness is to journal or write down things at the end or start of your day that you want to work on or that you are grateful for.
Final Thoughts
Though you may feel that your work and your patients should always come first, you can’t give them the quality care that they need if you are struggling with your own mental health. It’s important to remember to take time to focus on your needs. The stigma around mental health can often lead to it being neglected, but there is nothing wrong with prioritizing your well-being and speaking up when you need help.
Dealing with mental health conditions and asking for help is not a sign of weakness. As a nurse or other health care worker especially, you must advocate for yourself and your needs. Maintaining your mental health can ensure you continue to deliver quality care and avoid feeling overwhelmed and burnt out.
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
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.”
When you were in nursing school, your professors and your mentors undoubtedly warned you about the hard times. They said you’d be tested. They told you there would be times when you wanted to quit, times when you just didn’t think you had the strength to go on.
But no one could have prepared you for the test that is COVID-19. In your worst dreams, you never could have seen this coming.
Now it’s here, though. And you’re slogging through one day, one hour, sometimes one minute at a time. But with infection rates surging, there doesn’t seem to be an end in sight, at least not anytime soon.
If you’re going to make it, then you’re going to have to take care of you. And that begins by setting boundaries, even with your precious COVID patients and their families.
Claiming Your Right to Self-Care
As a nurse, it probably feels only natural to put other people first. It’s what you do every working day of your life, after all. And that habit likely doesn’t change when you’re off the clock.
That’s not a healthy or sustainable way to live in the best of circumstances. Lack of self-care, especially as a result of overwork, can take a devastating toll not only on your physical health but also on your mental and emotional health. It’s also debilitating to your relationships, those emotional support systems that keep you strong in body, mind, and spirit.
One of the greatest risks, of course, is that the demands placed on you as a pandemic nurse is that you might easily lapse into work addiction. You might find yourself unwilling, or even unable, to leave your work behind you when you come home. You might feel as if the only “right” or “noble” thing to do is to work yourself beyond all reason, giving yourself wholly to your work, supposedly for the sake of your patients but, really, for the sake of your addiction.
But whether you are simply facing extreme overwork, or you are falling into a full-fledged work addiction, as a nurse in the age of coronavirus, failure to practice self-care by nurturing your mental health isn’t just hurtful, it’s downright destructive. Right now, you are bearing physical, mental, and emotional burdens that you never thought possible.
Recognizing the signs that you are struggling and you need help is neither weakness nor selfishness. It means valuing yourself as much as you value those under your care. It means allowing yourself the right to the same kind of love and care that you give your patients. It means taking care of yourself so that you can take care of them.
But How?
You’ve probably been taking care of others for so long that you’ve forgotten how to prioritize your own needs. You might never have learned how to protect your well-being by setting boundaries. When you have boundaries, you’re going to have more emotional energy and a stronger sense of agency and power, something that this pandemic has taken from far too many of us.
Setting boundaries, though, is not rocket science and it doesn’t have to be hard. You can start simply, by ensuring that when you’re off the clock, you’re actually off the clock. That means that when you get home, you need to turn off all the COVID coverage and you need to let yourself be taken care of for a while.
If you’ve been working with COVID patients, unfortunately, you’re probably not going to be comfortable being physically close to your family and loved ones. But you can still let them nurture you from a distance. Get your kids to make dinner and do the laundry. Have your spouse draw you a warm bath and turn your bathroom into the perfect spa retreat.
Above all, make it clear that no pandemic talk is allowed unless and until you want and are ready to share. And that also means resisting the urge to constantly check on your patients. For the sake of your physical and mental health, when you are off duty, you must do your utmost to get away from thoughts of the virus and to nurture yourself, instead, with the things that you love in the best way you can.
Get Out(side)
Setting boundaries as a COVID nurse means standing up for your right to take time away. Scheduling a weekend getaway to the outdoors is good for your physical health, reducing your stress, and boosting your immunity. But it’s also ideal for your mental health, helping you to rest and decompress, to calm your mind and regroup.
Studies show that spending time in nature can help nurses build resiliency and avoid burnout. And there’s never been a greater need for that than right now.
Seeking Help
No one needs to tell you that the pandemic is one of the worst health crises in modern history. You’ve been on the frontlines for months now. You know the score. And because you know the score, you also know that this crisis isn’t something you can, or should, handle alone.
If you are 65 or older and have Medicare, you likely qualify for mental health care coverage. And if you’re covered under your employer, then mental health benefits are also likely included in your group insurance plan. On the other hand, if you’re uninsured or your plan doesn’t include mental health benefits, you can still reach out for free or low-cost care in your community.
The Takeaway
Nurses are superheroes and the world knows it now more than ever. But even superheroes need caring for. And that begins, above all, with recognizing your right to self-nurturing and setting the boundaries you need to ensure that the one who cares for everyone else finally gets the TLC she or he deserves.
