For the last 15 years, Ashley Watkins, MSN, RN, has worked at the University of Maryland Midtown Campus. When she’s not working in the Perioperative Department, she’s probably involved with her side gig, Little Picasso Events.
She took time to tell us about her side business and how she manages both.
How did you come up with the idea for Little Picasso Events? Why did you want to do this? How long have you been doing it? What areas do you serve?
Little Picasso Events has been in business for almost 6 years. Two lifelong friends decided to mesh their talents to create something beautiful! I am a self-taught seamstress, crafter, and painter. Because I’m really creative and is not easily defeated by new tasks, I also have a keen eye for colors and design. Ashley Fadiora is the co-owner, and is known for her sociable and free-spirit. She loves art, planning, organizing, and has more than 10 years of experience training and facilitating group activities.
Our company was created with the goal to bring family and friends together to create lifetime memories. Little Picasso Events serve all areas of Baltimore City and County in Maryland.
Explain to me what Little Picasso Events is, does, and what ages it serves.
We are a mobile Sip & Paint company offering art activities for children and adults ages 4 and older.
Each Little Picasso event includes a guided painting activity for a theme of your choice. We hope to disrupt technology, if only for a few hours, to promote personal growth and stimulate social skills. We believe technology has put a huge strain on everyday life. The reintroduction to art in this form aids in nurturing talents that technology may limit. Providing opportunities to be creative during structured group activities affords children and families an opportunity to acknowledge and accept the differences in others. This helps with social skill building, communication, and the development of coping skills for our customers.
Do you find that this is easy to do even while working as a nurse?
Running the business and working has never presented much difficulty. Painting is therapy. It’s self-care and actually helps to decompress from any stressors presented during the course of the week.
What do you like most about working with Little Picasso Events?
We really enjoy getting to meet so many different people, making them smile, and helping them to create something they didn’t think they could. As a nurse, oftentimes when families come together, it’s not always for a joyous occasion. Working with Little Picasso Events changes the narrative and allows the opportunity for decompression and self-expression.
What are your biggest challenges with this side gig? What are your greatest rewards?
We can be our own worst critics. Oftentimes participants are super critical of their work, or doubtful of themselves even before they get started. Sometimes it can be challenging to help change that mindset. We have all of our participants recite a pledge before each paint session to help boost self-confidence and remind them that whatever they create will be great.
We have them point at their canvas and repeat:
“This is my canvas, It’s all mine, Whatever I paint, It will be just fine!”
It is extremely rewarding to be a part of helping others create positive memories. We have the pleasure to be involved with many celebrations and events including birthdays, anniversaries, bridal showers, camp activities, conferences, and mixer events.
There’s a nursing shortage that is not only affecting the United States, but the entire world. And research is showing that it could to get worse.
That’s why it’s crucial for nurses to stay happy and not completely burnout. And it’s not only up to them to stay that way, but for their employers to keep them pleased and working as well.
Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse of Health Learning, Research & Practice at Wolters Kluwer, an acute care/critical care nurse practitioner at Penn Medicine, Chester County Hospital; a clinical adjunct faculty member in the graduate nursing program at Drexel University, and author of COVID-19: Transforming the Nursing Workforce in the New Paradigm of Care took the time to answer our questions.
What could the current nursing shortage mean for hospital care quality?
The nursing shortage is actually a global issue. According to the latest research, it is estimated that the world will need an additional 13 million nurses by 2030; in the U.S., the need is projected to be 1.1 million (International Council of Nurses). There are several reasons for the nursing shortage. As the population of the world increases and Baby Boomers continue to age, the need for care will increase. This is compounded by the fact that nursing schools around the country are struggling to meet the rising demand for nursing education due to limited faculty, resources, and clinical sites; they turn away an estimated 80,000 qualified applicants each year in the U.S. due to this supply and demand issue (American Association of Colleges of Nursing). A large portion of the nursing workforce was set to retire in the next 10 years. However, the pandemic has accelerated this event, and nurses are leaving sooner than expected due to widespread burnout and exhaustion.
If nursing staff are feeling overworked and undervalued, they will more readily leave their institution, and perhaps the nursing profession altogether. This, in turn, increases the current nurse shortage, and the problem continues to worsen. Hospital care quality suffers if nurses are burnt out and overwhelmed, just as it suffers if nurses are missing. Patient wait times increase, and bedside care suffers. For hospital care quality to improve, there needs to be a concentrated effort to fix the supply and demand issue in nursing education, and there needs to be a concentrated effort on workforce well-being and fostering resilience—that is the bottom line.
What can hospitals/medical centers do to increase resilience among their existing nursing staff, while making sure that they don’t burnout and leave?
To foster resilience among the workforce, organizations need to acknowledge there is an issue and focus on workforce well-being. This means providing a safe environment in which to practice and provide patient care. Providing adequate staffing based on acuity/severity of illness and competency not just on numbers is the first step. Building up float pools that are cross-trained to work across adjacent specialties and move from one area to another is essential. While nurses do not like to float outside of their units, in an emergency or disaster situation, having the staff cross-trained to work in adjacent specialties helps to create an agile, efficient workforce.
Health care institutions need to invest in their workforce. Providing adequate breaks, healthy meals, self-scheduling, shorter shifts, and being able to take time off is crucial to preventing burnout. Nurses want to feel valued—providing continuing professional development activities and having the ability to meet career goals with lateral or vertical moves can make the difference between keeping the talent and losing it.
Health care systems must recognize when burnout and moral distress are occurring. That means having trained personnel up on the units evaluating what is really happening and then providing mental health support through employee assistance programs. Often nurses are worried about their families; health care institutions need to provide alternative child or family care or even financial planning. Burnout can be prevented or at least minimized if health care institutions are actively on the lookout for it, address the issues that cause it and invest in their workforce well-being.
How can nurses prevent their own burnout? Especially when hospitals, etc. are understaffed?
Preventing burnout is no small task, but nurses can certainly take steps to reduce their stress and prioritize self-care when they feel overwhelmed in the workplace. It’s important for nurses to know how to evaluate their own well-being, recognize their limitations, and be able to advocate for themselves when something is beyond their bandwidth.
Learn to be comfortable with saying, “No.”
Saying no is one of the hardest things for nurses to do; we are a caring profession and we often sacrifice our own self-care to care for others. We need to understand that if we don’t care for ourselves and find our own inner peace, there will be no one left to care for others.
Personally, I recharge by finding my inner peace and joy by reading, enjoying the outdoors, and sitting by water. Reclaiming “me time” within my day to recharge allows me to show up fully ready for my next day of work.
What are some proven strategies for creating a more agile workforce that both addresses the nursing shortage as well as avoids reliance on traveling or temp nurses?
The agile care model is based on patient acuity, competency of the workforce, and alternative care delivery models. It provides agility that allows hospitals to move their nursing workforce when and where they are needed and uses other members of the health care team to support patient care such as unlicensed assistive personnel, licensed practical nurses, and others. It also switches the care delivery model from a primary nurse model to a hybrid team model of care as needed.
The backbone of this model is cross-training the float pool to work across adjacent specialty areas and as a backup, having the full-time staff cross-trained to work across adjacent specialties in an emergency situation. This interdisciplinary team-based approach facilitates the rapid deployment of staff to areas most in need in a crisis, such as what we’ve experienced with COVID-19, and provides better care for a greater number of patients.
This addresses the nursing shortage by improving the quality-of-life nurses experience at their workplaces. With more nurses trained to work in adjacent areas, staff will be able to take time off and recharge. When nurses feel practice-ready, confident, and able, they are less likely to burn out because they will experience less overall stress at work. Health care institutions must also be on the lookout for early signs of burnout and encourage their nurses to take time off when it is needed.
What are the biggest mistakes that hospitals/medical centers can make with their current staff that could lead faster to burnout and them leaving?
Health care organizations need to understand that their biggest asset is their workforce. Without nurses and other medical professionals, hospitals and medical centers cease to function. Nurses need to be recognized for their value—their workplaces should support them by looking out for signs of burnout, offering mental health support, offering family/childcare support, and encouraging a healthy work-life integration. Without these basic acknowledgements, it is no surprise the burnout and shortage levels are what we are seeing today.
Nurses’ mental health matters! Nurses need to talk to their organization and be vocal about how they can better support their nursing teams. Whether that is more frequent review of their workforce policies, more transparency in the workplace, or more vacation time, nurses shouldn’t be afraid to speak up and stand up for themselves and for their fellow nurses.
As a woman with a successful nursing career, you know that there is nothing more important in life than the health and safety of your child. Whether you are expecting a new baby or you have a bunch of kids already running around, it is essential to cultivate balance within your life so you can successfully manage motherhood and your career while also protecting your own health and well-being.
Unfortunately, that is not always as easy as it sounds. As it is, minority women are already at risk of subpar medical care, as studies have shown that many minorities, including black patients, are not even prescribed the medication that their white counterparts are provided on a routine basis. Because of all this, you must take good care of yourself as a pregnant nurse or a nurse with children. Let’s talk about some great ways to create the balance you need during this exciting time in your life.
Inform The Hospital If You’re Pregnant
As soon as you discover that you are pregnant, you must inform the hospital, and one reason why is because it makes it easier for you and your employer to prepare for the future. Inform them of your due date so they know when you will be taking your leave and will no longer be available. A good tip is to save your paid time off (PTO) for when you take your leave as you may need more time than your maternity leave will provide.
The other reason you want to inform the hospital of your pregnancy is so that you are not put in any dangerous situations that could harm you or the baby. According to federal regulations, your employer must make reasonable accommodations for you if your job puts your pregnancy in jeopardy. For instance, if you typically work in an area where there is constant radiation exposure, you may want to ask for a transfer. Also, it’s a smart idea to stay away from any section of the hospital where patients are dealing with contagious infections so you aren’t put at risk. On that note, with COVID-19 still being a factor, you will still want to wear your mask during this time.
As all nurses know, hospital shifts can create their fair share of stressful situations, but stress can be very dangerous for pregnant women as it can lead to health risks such as high blood pressure and heart disease. To prevent unneeded stress, you might request to work in the recovery area or a department within the hospital with fewer high-risk patients. The same goes for when you return from maternity leave. You’ll want to tell them how you are feeling and potentially adjust your schedule so you can still support your family and your new baby at home.
Take Care of Yourself
If you are expecting, it is also important to practice self-care while you work so you stay healthy and protect the well-being of your child. It is essential to drink a lot of water during your shifts so you can stay hydrated and prevent fatigue. It is also important to have healthy snacks throughout the day to maintain your energy through long shifts. Almonds are a great go-to because they provide nutrients for you and they help to regulate the weight of the baby.
Many pregnant women also feel symptoms of morning sickness, and nurses are no exception. While it is not typically dangerous, you may experience nausea and vomiting, so if you are feeling sick, make sure to take a break. Also, eat plenty of chicken and bananas, which are rich in pyridoxine (vitamin B6), which has been proven to reduce the chance of nausea in pregnant women.
It is also important to know your limits, especially as you get closer to your delivery date. A work/life balance will be essential at this point. You may not have the stamina to work 12-hour shifts and that is okay. You need plenty of rest, especially if you have other children living at home. You do not want to neglect your family. If your company values you as an employee, they will be perfectly understanding of this modified schedule.
Change Your Profession
When you have children at home, the demands of working in a hospital may just be too much to allow you the quality time you need to have with your family. If you are in this boat, then it may be time for a career change that will still keep you in the health field but will also provide the time you need to be with your children. For example, you could become a school nurse where you can still provide healthcare but in a less stressful atmosphere. If you can become a nurse in the school where your children attend, that is even better.
There is also the opportunity to become a home health nurse. In this profession, you go to the homes of patients who are ill, elderly, or disabled, or otherwise lack mobility. The great aspect of this job, especially for working mothers, is that you can often set your own hours and you can choose to work with patients that live close to your home so you can tend to your children quickly in the case of an emergency.
For a chance to really be close to home, you could also opt to become an at-home nurse who stays at home and helps patients via a telehealth platform. Again, you can often set your own hours and be with your family all day. It is also great for pregnant nurses as it allows them to sit for their shift instead and avoid constant standing and walking.
If you are a nurse with children or you are expecting, follow the tips above and learn to balance work and motherhood. By giving your family and your patients equal care, you are making a real difference in your home and community, which should make you very proud.
There’s no questioning the difficulty of a career as a nurse. You may have to work long hours, deal with a variety of patients each day, and spend most of the time on your feet. You also have to deal with the risk of things like patient violence or the general sadness that comes from losing a patient you’ve been working with. But, nursing can be an incredibly rewarding career when you’re in the right work environment. A toxic work environment, however, is a different story. It can make getting your job done feel nearly impossible. If you come home each day feeling absolutely drained, and perhaps even frustrated or helpless, you might be dealing with a harmful environment at work.
So, how can you know what a toxic work environment looks like? What are your rights, as a nurse, to a healthy environment, and what can you do to make sure those rights are upheld?
What Does a Toxic Work Environment Look Like?
As a nurse, you probably already understand the importance of being able to adapt to different work cultures. If you’re not sure how to learn more about a specific culture or atmosphere within a workplace, there are a few things you can do to get a feel for it quickly, including:
Watching and learning from others
The more you observe and the more questions you ask, the easier it can become to see if you’re dealing with an unhealthy work environment. Bear in mind that if you don’t like your job or you’re not satisfied with your work, that doesn’t automatically mean you’re in a toxic environment. You may need to try a different career path. But, toxicity in the workplace is very different. You can recognize it through some of the following signs:
There is an overall lack of communication
There are cliques, exclusions, or groups
The workers aren’t motivated to do their jobs
Growth is discouraged
Everyone is burnt out
Finally, there’s nothing wrong with going with your gut. If you get a “bad” feeling about your workplace, even if you can’t quite put your finger on it, don’t ignore those feelings.
How Can It Affect You?
A toxic work environment is more than just an inconvenience. It’s more than just something to “trudge through”. In fact, an unhealthy work environment can contribute to a variety of physical and mental health issues. Some of the most common problems include:
High blood pressure
The toll on your mental health is nothing to take lightly, either. You might find yourself constantly feeling stressed and overwhelmed at work. It doesn’t take much for that to carry into your home life if you can’t let the feelings of the day go when you walk in the door. That constant feeling of stress can lead to mental health conditions like anxiety, or even depression. As that continues, you may end up needing to get extra help just to deal with those conditions.
Working every day in a toxic environment can wear you down. So much so, that it can even weaken your immune system, making it easier to get sick. As a nurse, you know the importance of taking care of your mind and body. If you don’t make self-care a priority, it could impact your personal life in a negative way. Your work environment shouldn’t be the thing that compromises your health.
How to Find a Healthier Environment in Your Field
If you find yourself in a toxic work environment, the best thing you can do is leave. An environment that large isn’t likely to change, even if you address the issues. You need to prioritize your needs when it comes to your career and your overall well-being. But, leaving a job isn’t always easy if you need the income.
Waiting to leave until you have another job lined up is always a safer option. Or, you might consider going a more nontraditional route with a remote job. Remote jobs allow you to work from home (or anywhere!), eliminating everything from toxic employees to negative patient interactions. Working remotely can help to reduce your stress levels and offer more flexibility.
Obviously, not all nursing jobs are able to be done remotely, but there are some that will allow you to work from home while still caring for others, including:
Clinical appeals nurse
Telephone triage nurse
Some larger hospitals and even national health care groups are always looking for nurses who can work remotely and fulfill these needs. These particular jobs might be different from what you’re used to, but that could be exactly what you need to break free from a toxic environment. In doing so, you can learn to enjoy your work again, and find fulfillment in helping patients while taking care of yourself, too.
What comes to mind when you hear the words, “Physical Activity”? For some, it might conjure up a negative connotation while for others, they may already be a go getter for an active lifestyle. Believe it or not, physical activity and exercise are two different terms although used interchangeably. Physical activity is any movement of the body done through skeletal muscle contraction that causes the energy expenditure to go beyond its baseline. Simply stated, physical activity is movement, in any form.
Sadly, less than 5% of adults participate in 30 minutes of physical activity, and 28-34% of adults aged 65-74 are physically active in the United States. It is important to gather some perspective on the impact of a sedentary lifestyle and how it is more common than physical activity. According to the Center for Disease Control, physical inactivity is even more common among ethnic and racial groups in most states. The CDC’s January report from 2020 showed overall, Hispanics had the highest prevalence of physical inactivity (31.7%), followed by non-Hispanic blacks (30.3%) and non-Hispanic whites (23.4%).
We all have heard of vital signs. Part of that assessment should also involve the type of physical activity one engages in. As nurses, we are the largest body of the health care workforce, and studies show that we are not following healthy practices when it comes to our self-care and well-being. The American Nurse Association even launched a Healthy Nurse, Healthy Nation initiative to address the core elements that address nurse’s self-care and well-being, Activity, being one of them which goes to show that this is a pressing concern.
Some of the challenges posed as to why people do not take part in physical activity is location. The neighborhood in which people live may not have access to outdoor parks, paved streets, or recreation centers. Depending on your home environment, you may not have the space to exercise in.
The good news is just doing any activity, especially one in which you enjoy doing is acceptable in burning calories. Anything is better than being sedentary. The risks of sedentary behavior are universal and it is important for nurses to adopt a more active lifestyle. Physical inactivity is closely related to premature death, preventable disease, and health care costs.
Exercise is a subset of physical activity and is defined as an activity that is organized, planned, and reoccurring which is done with the intent of improving or maintaining one or more components of one’s health. Having said this, physical activity can involve any movement and does not have to involve a schedule or with an “all or nothing” attitude. For those who are trying to lose weight, exercise is not as important as much as your food intake. There needs to be a calorie deficit in order to lose weight. Nutrition and physical activity work in tandem but about 80% is based on nutrition and 20% should be focused on physical activity.
Physical activity come with benefits such as: heart health and prevention of diabetes, improved strength and mobility, release of dopamine, endorphins and serotonin (the “feel good” hormones), increased lifespan, and increased insulin sensitivity. Carrying on extra weight can contribute to joint pain. For every additional pound that you are overweight, an extra 5 pounds of pressure is exerted on your joints.
It cannot be argued that the majority of nurses are female and women tend to hold onto more fat than men; that is how nature intended us to be designed. As we age, we are also at risk for bone loss. For that reason, we do not want to lose weight too quickly because we also want to protect our bones, which is why muscle resistant training is so important. Half a pound per week of weight loss is the ideal; it is all very specific to how much weight the person needs to lose. Even a 5-10% weight loss can reap positive effects on overall health.
Nurses, especially those of other ethnicities can become role models and advocates for system changes at the workplace as well as at home. Even if nurse leaders are not fully on board, it is important to heighten awareness on the benefits of physical activity which would improve morale as well as productivity. Identifying barriers is the first step and serving as a role model would also provide an impetus for behavior change.
Just like with patients, we need to assess our readiness and meet ourselves where we are at. We need to give ourselves permission to work on our fitness regimen so it can be more sustainable. The best exercise to lose weight is the exercise you will do. If you have to ask yourself, “Should I work out today?” hopefully, the answer is yes. If you choose “No”; well, yes you should.