It is an unprecedented time in the lives of nurses working in hospitals worldwide. Nurses face evolving obstacles on a daily basis. They must contend, as always, with complications that include last-minute shift cancellations, extended work hours, continuing education needs, and other established practical considerations. At the same time, COVID-19 illnesses have brought a host of historic challenges for those in the profession.
Consequentially, it is easy to lose sight of nursing’s essence: it stands as one of the most dynamic, stimulating, fulfilling, and important career-choices in 2020; nursing means taking part in a noble pursuit dedicated to healing the sick and providing a personal touch to the vulnerable. If you are considering joining the ranks of hospital nurses, you can hold on to that ethos even as you focus energy toward dealing with day-to-day working challenges. By taking the following actions you will thrive in the field.
Practice What You Preach
Projections show that nursing employment should increase at a faster rate than the combined average of other professions. If you are employed where supply does not yet meet demand, you may face long shifts with large patient loads. Combine this scenario with a job profile that includes your continually facing the unexpected, and you will see that you have to take care of yourself around the clock.
Practicing good sleep hygiene may be one of your greatest challenges, yet you need to make this a priority. Sleep deprivation is a leading cause of working errors and job burnout. Unfortunately, when you experience multiple nights of reduced slumber you build sleep debt, a condition that compounds mental and physical fatigue.
You must also pay attention to your nutritional needs. The job’s unpredictability means that finding the time to eat well can be unpredictable too. As a health professional, you are aware of what constitutes a good diet, particularly for you. While you may not be able to sit down to a relaxing lunch or dinner, you can prepare good snacks ahead of time that you grab throughout the day. Also, you may find you have gone a whole shift without drinking. Pack a water bottle, since hydration is important.
Dress the Part and Fit in the Fitness
Working in a hospital, you will find yourself on your feet far more than behind a desk, and some of your duties will involve moving and lifting patients and equipment. You must work to prevent injury and wear to your body.
While you may not be able to choose your uniform top and pants, you can wear the most comfortable shoes for your situation. They will need to fit well, of course, but they also must provide support, stability, and traction. They should be durable, too, so that they do not shed pieces in the middle of rounds, and you don’t have to waste valuable time looking for replacements several times a year.
You must be fit to handle the job’s physical demands. Developing a workout routine consisting of strength, flexibility, and aerobic conditioning will reduce your chances of spending off days in the hospital’s rehab department. Also, the better your conditioning, the better you will feel when you settle in at home at day’s end. As part of your healthy-lifestyle approach to the job, try to eliminate smoking and reduce your alcohol consumption, if either is a significant part of your day.
Be a Lifelong Learner
Your learning begins when you prepare to enroll in an accredited nursing program. It continues throughout your time taking classes, but knowledge acquisition does not end when you receive your certificate or diploma.
For example, the continual growth of advanced technologies for use in medicine is one of the bigger changes to nursing in recent years. If you are not comfortable using technology, you will become a liability. You need to be able to keep up with the revolution by continuing your education every year of your career.
Be the Part and Be in the Moment
Patients can create their own challenges. You may not be certain of a patient’s mood, mental state, or overall temperament as you enter the room. It can be difficult at those times to face upset or frustrated ones. However, it helps to be open to your patients’ points-of-view. Many are understandably anxious and uncertain, and in a bureaucratic hospital setting, they can feel particularly dehumanized.
Your own mood and behaviors go a long way toward easing a patient’s fears. To put on your optimistic game face, remind yourself of the importance of your role in the whole care of each person in every room on your floor. This is backed up by polls that show nurses rate highest in areas of honesty and ethics among professions. Your patients trust you and, they rely on you to be partners in their care.
Your ability to step back and take stock of your worth is an asset you should bolster throughout your career. By being proactive in facing and addressing the expected and unexpected challenges nurses face, you can be certain to enjoy a long, successful career.
Well it has been a while since my last post, due to the “busyness” of life. Often times we let the things in our life take so much of our time, that we forget about taking care of ourselves. As nurses we are focused on taking care of others: our patients, our family, our friends, and sometimes even strangers. We have heard of the saying “Take care of yourself, so you can be there for others,” but how many of us actually practice this? This really hit home after hearing about the unexpected death of two colleagues over the past month. They both devoted so much time to their job and neglected to relax and take care of themselves.
Credit: Leslie McRae-Matthews
We have our plates so full with other people’s issues, cares, and needs, yet there is no room on the plate for us. There has to be a balance between work and relaxation. This is not new information for us—we just need to apply it to our lives. Many of us advise our patients about taking time to relax, meditating, and thinking about things they enjoy to decrease stress. These are some of the same principles that we can use.
When you start noticing that you are feeling anxious, moody, or depressed, these are signs that it is time to step back to refocus, recover, and renew. Many people relax by traveling, but you do not have to spend a lot of money to relax. Engage in simple activities, such as drawing, photography, taking a walk to enjoy nature, riding on a swing, or going for a swim. These activities are not an escape from reality or stepping into a “fantasy world,” but they will help you take your mind off of work or other issues, so that you can refocus. Take care of yourself and find that balance.
Nurses have intense experiences that most other health care workers don’t. As a result, they tend to have a great deal of stress. Having friendships with other nurses tends to alleviate it and help in more ways than you might imagine.
Only nurses understand what other nurses truly go through, says nurse practitioner, former attorney, author, and career/lifestyle blogger Meika Mirabelli, JD, MSN, FNP-C, founder of BeautyinaWhiteCoat.com, which helps both health care students and professionals live balanced, successful lives through sharing career and studying tips. Mirabelli knows firsthand how having friendships with other nurses can make a huge difference in the workplace—and how not having them can hurt.
“I have experienced horrible treatment by nurses who were in the field of nursing longer than I have been. During those times, I would have to lock myself in the bathroom to hide and cry. I would count the days until I was done with that job and celebrated when I turned in my resignation,” Mirabelli recalls. But the good has outweighed the bad. “I have also worked with great nurses with whom I still have a bond today. My experience with those wonderful nurses definitely reduced stress and made me a better nurse and a better person. I have thoroughly enjoyed my shifts when I have coworkers that I could call my friends. I also was able to sleep better at night and looked forward to going to work.”
Research has shown that
friendships between nurses can reduce stressful situations. A 2016 study published in PLOS ONE found that the “degree of cohesion among friends had a positive impact on the level of job stress experienced by nurses.” The study concluded overall that the “strength and density of such friendship networks were related to job stress. Life information support from their friendship network was the primary positive contributor to control of job stress.”
While it’s important to understand what research has discovered, it’s just as—if not more—crucial for nurses to know how this can help them in real-life situations.
Why Friendships Help
“There will always be bonds and friendships forged when you work with people in close proximity for long periods of time,” says James LaVelle Dickens, DNP, RN, FNP-BC, FAANP, who serves in the U.S. Department of Health and Human Services regional office in Dallas, Texas, as the senior program manager officer for the Office of Minority Health. “Having strong friendships at work is known to reduce stress. A study by Gallup found that people with a best friend at work are seven times more likely to be engaged with their job.”
“I can think of many times when friendships with other Nurse Practitioners (NPs) have made a difference in my life,” says Dickens. “Sometimes, it’s having someone lift our own spirits after we’ve delivered a difficult diagnosis to a patient. Sometimes, it’s offering a younger colleague with coaching to help them be the best professional they can be.”
“Nobody really understands what a nurse does like a nurse, so those relationships provide support, and that support helps bring stress down,” says Benjamin Evans, DD, DNP, RN, APN, PHMCNS-BC, president of the New Jersey State Nurses Association.
Evans explains that what makes nurses so different from other health care professions is that they are with patients more than anyone else. Other health care professionals may come and do a test, treatment, or procedure on a patient, but then they leave. The nurses are the ones who stay behind and help the patients cope with their stress, pain, or fear resulting from these processes or their conditions.
But this is just one example of why nurses have so much stress. Dickens says that other reasons are heavy caseloads, interactions with patients and their family members who may not recognize the significant challenges of their complex health conditions, and dealing with death.
“Oftentimes, the families are more demanding than the patients,” says Evans.
“Every decision a nurse makes affects the health status of their patients,” says Judith Schmidt, RN, MSN, ONC, CCRN, CEO of the New Jersey States Nurses Association. “The public doesn’t realize how stressful these areas can be. If a nurse makes a mistake, it can mean a patient’s life. You have the life-and-death situations with the patients, their families, and the administration.”
“Nurses have the type of job that requires a lot of mental clarity, physical demands, and empathy towards patients and their families,” says Flo Leighton, MS, RN, PMHNP-BC, a board-certified psychiatric nurse practitioner in private practice at Union Square Practice as well as an adjunct faculty member at New York University Rory Meyers College of Nursing.
The difficult work, both physical and mental, is why having friendships is necessary. It’s also great to have others who completely understand you.
Friends “Get” You
Erin Parisi, LMHC, CAP, owner of Erin C. Parisi Counseling & Consulting, LLC, learned about nursing friendships while working as a therapist in a residential treatment setting alongside nurses every day. “My biggest takeaway has been that having friends who are ‘in the trenches’ with you helps manage stress. In nursing, not only are you coping with the system you work in, with a boss/manager you may or may not like, and office politics, but you also have a really specialized knowledge that not everyone has,” says Parisi. “In a system where not everyone you work with is in the same role, you might end up feeling a little more alone in your job. Non-nurses who don’t have the same or similar training may not understand your jokes or fully wrap their heads around your stressors.
“A lot of nurses have a dark sense of humor, which not everyone has an appreciation for. Not only is the friendship of a fellow nurse providing stress relief, but being able to make dark/weird/gross jokes to someone else who will understand and also think it’s funny can reduce stress in a big way,” explains Parisi.
“Sharing a laugh in the midst of a stressful day lowers your blood pressure and helps put everything in perspective,” says Dickens. Having someone else who understands what makes nurses tick and what makes the profession unlike any other serves as the backbone of these types of relationships, he adds. “Having that support network and camaraderie does an NP’s mental health a ton of good.”
Shanna Shafer, RN, BSN, nursing expert, managing editor, and strategic communications manager at BestNursingDegree.com has spent ten years in the nursing field working in everything from home health, hospice, a community health center to vascular access, and in a burn intensive care unit. At the burn unit she says, “Friendships with other nurses blossomed and were essential to my own survival and mental health.” The bonds that nurses develop in various situations are amazing, she adds.
Parisi adds that nurses witness and work on a daily basis with experiences that most people do not. While everyone else in a nurse’s group outside work—non-nurse friends, family, spouses, and significant others—can provide support, they simply can’t connect with nurses like other nurses or coworkers can.
“Given the fact that nurses spend so much time at work—sometimes even more time than at home with loved ones—having friends at work can help make a shift more enjoyable. Nurses who work with you know what the day-to-day struggle looks like on any given shift,” explains Leighton. “The ability to get perspective from a work friend who understands how to handle on-the-job situations builds resilience and normalizes stressful situations. It makes us feel like we’re understood and not alone in the tasks that challenge us.”
Having someone who “gets” you, can reduce stress and make you feel better in various workplace situations. “Research has shown that social health is an importance factor in stress management. Therefore, friendships among nurses could influence rewarding benefits in processing work-related stressors,” says Amy Moreira, LMHC, owner of More MH Counseling, LLC. “The nursing field is a challenging, demanding, and rewarding job with its own characteristics that are, at times, not fully understood by the general public…A nurse who finds friendship with other nurses can benefit from their shared direct experience, allowing themselves to feel better heard and understood—which is an important part of healing in stress management. Potential solutions can be offered from a different perspective with a more solution-focused outcome than advice from other friends and family. Workplace friendships among nurses allows for in-the-moment support and allows for open processing without the need to explain certain contextual aspects.”
Nurses Eat Their Young
There’s the old adage that “Nurses eat their young.” Some more experienced nurses have been known to let the young ones flounder. Nurse.org, though, has a new campaign to dispel this adage called “Nurses support their young.” The campaign is significant because when nurses are friends, the stress of the entire unit, floor, or facility can decrease.
“It’s important for nurses to friend new nurses to allow for effective learning and adjustment on the team, including the patient,” explains Moreira. “Establishing friendships and aiding newer nurses can contribute to a more positive workplace environment and job satisfaction. Friendships between nurses can allow for a more experienced nurse to take on a ‘coaching’ role that enables stress-free learning with laughter, support, and understanding. Working past any frustrations associated with newer nurses lacking knowledge can often be processed when reflecting upon past mishaps in the experienced nurse’s own career.”
“It makes for a healthy work environment when there are coworkers whom you work with whom you can be friends with and discuss difficult issues and challenges that you couldn’t to someone outside the profession,” says Schmidt.
And a healthy workplace will influence other people and environments as well.
The Ripple Effect
When nurses are friends, they aren’t just nice to each other, but they look out for each other. While working as a staff nurse, Leighton developed a core group of nursing friends. “We collectively pitched in to make sure that if someone needed a day off or a last-minute shift coverage, we helped one another. It was an unspoken understanding that we took care of one another,” she recalls.
“While I think that friendship is important in all aspects of our lives, we do know that workplace friendships are tied to higher levels of job satisfaction, engagement in work and performance, as well as overall team cohesion,” says Dickens. “I wholeheartedly believe that a support system at work and in our personal lives is key.”
Nurses who have friends in their workplace can also assist each other during stressful situations by giving each other someone to vent to. “It can put that nurse who is stressed in a better frame of mind. It almost permeates an entire unit if one nurse is stressed and could cause others to become stressed,” he says.
Dickens adds that if a nurse is stressed, patients can sense it in the nurse’s voice and body language. But the opposite is true as well: a happy nurse can make a happy patient.
And sometimes a happy nurse, can just make a happy nurse. That can be essential enough. Nurses who are less stressed because of friendships can have improved mental, emotional, and physical wellness, says Moreira. “Nurses with reduced stress often prioritize self-care, which allows them to give their best selves to others.”
Every day, nurses come to work providing care for patients requiring multiple levels of skilled nursing care ranging from basic to complex. Some patients may require vasoactive or vasopressor drugs to reduce or increase a patient’s blood pressure and other devices, such as a ventilator, intra-aortic balloon pump, or continuous renal replacement therapy, just to name a few, in order to preserve a patient’s life. In addition to caring for patients, nurses also have to make sure the patients’ family members understand the different aspects of the patient’s plan of care, such as the medications’ indication, side effects, and expected outcomes, as well as blood tests and diagnostic tests.
On a daily basis, nurses deal with the various level of stress caring for their patients and family members. These stressors could be the workload, time management, difficult patients and/or family members, discharges, admissions, and cardiac or respiratory arrest events. While nurses set goals to provide quality care that leads to better patient outcomes, nurses have the tendency to neglect themselves while working for the welfare of their patients by occasionally taking shorter meal breaks.
The big question is: who cares for nurses so they can continue to provide quality care every day to achieve positive outcomes? I see myself as a guardian angel for nurses whom I work with every day. Driving to work, I talk to God and ask him to help me make a positive difference, whether it is a soft touch of my hands, my soft-spoken voice, or my tight hugs. I believe that nurses should be cared for similarly to the way we take care of our patients and their families. Therefore, I look for a bible verse that would facilitate me making a difference in the lives of others. The bible verse I read is Proverb 3:6, which reads: “In all thy ways acknowledge him, and he shall direct thy paths.” The reason for this particular verse is that I need God’s guidance so I can be a blessing to others. The way I believe that I am a blessing to others is demonstrated by monthly birthday cards and luncheons for coworkers who are born in a particular month as well as greeting cards and gift cards for expecting mothers and fathers or weddings. I also recognize coworkers if they have achieved any type of certification or graduated from college.
Sometimes, I make and bring in desserts and have food delivered for lunch. On our unit, we are a melting pot of people. Every year in August, we celebrate International Culture Day where the staff brings an entrée from their culture and shares a little bit of history and its meaning. Additionally, I show concern about them as a whole and will ask them how they are feeling, what is going on with their children, dogs and/or cats, and their commute to work. The admiration of taking care of nurses and others as extended family members at work gives me great joy and pleasure that leaves my heart full of exhilaration every day.
Instead of ingesting sugary treats to celebrate National Nurses Week (May 6-12), consider pursuing activities to feed your spirit or mind instead.
1. If you are feeling artistic and need to relax, why not color?
There are several nurse coloring book pages you can download, draw and post to social media, thanks to the Madison School of Healthcare, where stories from nurses were turned into art. The pages cover familiar scenarios, from amusing night shift shenanigans to a heartfelt scene of chipping in for a patient. You can download all here. Want to share your work? Showcase your drawing on Facebook and Instagram with the hashtags #NursesWeek and #ColoringWithNurses.
2. If drawing is not your thing, consider a massage.
Here’s the rub: don’t wait for the weekend. Get a massage in the middle of the week. Sometimes you have to yield to whim! So instead of a second helping of cake to celebrate the fabulousness of being a nurse, imagine the sensation of your aches and stresses being kneaded away. Yes, put down the dessert and go ink in a well-deserved massage appointment.
3. Another way to treat yourself is to curl up with a book written by one of your hardworking peers.