Yes, I'm a nurse! Celebrating Nurses Week

Its that time again! To celebrate nurses and all the amazing things we do! Yes, we do amazing things. I don't usually like to brag about it; in fact what we do, whether you are an LPN, RN, CNS, NP, and administrator or educator it is hard work. We have all been there at the bedside doing things no one else would or want to do. We have cried with patients and families. We have gone home and put our uniforms right into the trash. We have cried in the shower, swearing we could not possibly go back and do the job another day. But we do. Again and again.

I told my husband just yesterday that even when I come home after being screamed at by a desperate family member who is watching her mother with progressing Alzheimer's turn into someone she no longer knows, that I still love my job as a hospitalist. Even when I spend over an hour explaining there are no more options to a patient and her husband, that it is time for hospice and watch the hope fade from their eyes, yes, I still love my job.

I love being a dual-boarded APRN. I love teaching future nurses and APRNs this incredible profession. I love using my voice so that one day my state will be 'green' too!

Photo credits: AANP State Practice Acts and Administrative Rules

There are so many amazing things that nurses can do beyond the bedside: clinical education, quality, health policy, academia, informatics, professional organization, special interest groups, leadership, community health and volunteering - I could go on!

So this week, we take a moment and celebrate all that nurses do for patients, their families and each other. We reflect on where nursing has been and what lies ahead. Nurses are leading the way with inspiring nurses leaders like ANA President Pam Cipriano PhD, RN, NEA-BC, FAAN who was recently selected among Top 25 Women in Healthcare and future and past AACN and AANP Presidents. We reflect back on history to influential nurses like Dorothea Dix who is attributed with creating the first mental health system and Mary Eliza Mahoney the first African-America nurse in the United States. And of course our beloved Florence Nightingale who became an advocate for the poor and infirmed, dedicated to improving the conditions for treating patients and used data to improve care. Our first nurse mentor that we still honor on her birthday.

Remember this week and every moment why we became nurses. Celebrate the good and amazing things we do. We have a lot of work to do but we are strong and compassionate professionals. And our patients deserve the best care we can provide to them.

Put one foot in front of the other...

I have to admit that is what I first thought of when the President-elect new theme was unveiled. Then I gave it more thought..Dare to Step Forward...nice. The themes fit very well. Of course all of the themes fit well...these are very smart woman and NURSES!

It was a week a firsts for me. My first trip to Boston. My first time sightseeing in a city by myself and see the path of great Patriots. My first time presenting at NTI. A week of stepping out of my comfort zone and into something bigger. I can hear all the past themes running through my head.

We are once again reminded that we, as individuals not to mention as unified group can do great things. Each one of us. We all matter. We deserve to be happy. And we must rest. Wow...powerful stuff.

In the weeks before I left for Boston, I was struggling with whether or not I still wanted to go and if I had it in me to present at NTI in the API track (step forward). Whether I wanted to travel to a city that had suffered a brutal, cowardly attack (together, stronger, bolder). Whether I wanted to go essentially alone, save my colleagues and friends from my AACN Chapter. I was so wrong...I not only wanted to go, I needed to go (dare to).

I learned so much - not just about clinical practice and being an advanced practice nurse but about myself (act with intention)

There are so many things that left an impression on me. So much that touched me and is pushing me to work harder and to do more (stand tall)

So the big questions is how will you Step Forward this year?

One foot in front of the other

Burning out: Combating compassion fatigue & moral distress

Most of know that feeling as being "burned out." When you fell like you cannot do your job another shift let alone the rest of your working days. The irony is that we became healthcare providers (nurses, medics, physicians, etc) because we wanted to care for others. To make a difference. We knew our work was that of service and that some days it would be hard. And although television often portrays healthcare as glamorous and adrenaline-producing every moment of every day, we know the real truth.

Compassion fatigue is defined as a loss of compassion and caring over time. It is a condition that is hallmarked by emotional, physical and spiritual exhaustion that occurs from caring for and internalizing the suffering of others. Compassion fatigue is also referred to as secondary post-traumatic stress disorder. Nurses have a propensity to carry on the burdens and problems of others - their patients, coworkers, families, and friends which may leave them exhausted and feeling empty. (I recommend reading Bertice Berry's Blog, especially Day 145: Seeing Miracles)

Moral distress is another term often used related to burn out, however often there is an ethical component or dilemma associated. Nurses frequently find themselves in the middle of conflicts involving patient care issues, especially related to end-of-life or futility of care. This produces a great deal of stress for the nurse whom often has no outlet.   

We have all seen it - burned out coworkers call out more, are late to work, have no interest in most of what they do, chronic fatigue, decreased productivity, high turnover, workplace injuries, reduced satisfaction in work and home, and even more patient complaints. Not to mention patient safety events; if our head is not in the game so to speak how can we be sure we are not going to make a serious error or failure to rescue or prevent harm to a patient.

There are many reasons that nurses become burned out with their jobs. High patient acuity, staffing issues, conflicting values and expectations for time between work and other life responsibilities and difficult or devastating patient situations.We talk about it. We say, "Oh, I'm so burned out, I just don't care anymore." Yet we do little to nothing about it. At work we barely support each other; often because we are so busy ourselves and consumed with our own tasks and crises. Helping and supporting each other through difficult situations and even the everyday ones has to be a priority. It is wearing us out and creating an undercurrent of distress and hostility and resentment. Having formal systems in place to help us deal with difficult emotions is important not only for the staff member involved but all other staff, and more importantly for the patient. 

At home we do even less. We set no priorities of care for ourselves. Do not allow ourselves to grieve a loss at work or at home. We do not give ourselves permission to really care for ourselves in a healthy way - sleep and eat well, exercise, rest and relax, read a good book, play and so on.

I have posted some very good resources on moral distress, compassion fatigue and burn out. I strongly encourage you to read them and develop resources in your workplace to combat this insidious foe to our job satisfaction and personal happiness.

Addressing Moral Distress: An Important Step toward a Healthy Work Environment

Six Ways to Deal With Compassion Fatigue and Burnout, Kendra Mims, ENA Connection (Mar 2012)

How do I deal with compassion fatigue?

6 Ways Nurses Can Beat Compassion Fatigue