A Nurse Reminder – The Importance of Humanity

We are back in the Holiday Season again friends, and the flavor of the month is kindness and giving.

You see it on commercials, billboards, and soda cans. The hospital is full of potlucks and gift exchanges. You may be getting ready for your holiday party and trying to find the right outfit that is not scrubs or yoga pants. It can be a cheery time when looking from the outside of the unit.

But in your department, it is probably a different story.

The census is high. Patients are sick. Staffing is short. There is no time to sit, pee or hardly stuff any of that potluck food in your mouth between call lights and IV pumps sounding off.

We are all busy in the winter. It’s a fact. Nurses wear their fun scrubs and Christmas light necklaces that shine so brightly, but their mood is dark and cold like the weather outside. Your department has run out of everything – no more sandwiches, personal belonging bags or the good, fitted sheets for the beds. Administration is sending out emails thanking you for all your hard work, but also asking you to pick up some extra hours to fill in the staffing holes. It is easy to get resentful and cranky.

These are the days that we see holiday silliness in the emergency department that seems only to arrive in winter – 19 dialysis patients with clotted vascular access in 4 hours, patients with sore throats on a Buy 1 Get 30 Special, and so much epigastric pain (mine included) that it can only be the weeks after Thanksgiving.

And you will get those patients that no one wants to deal with but who take an extraordinary amount of time - the homeless men and women who come for what seems like complete BS. Maybe the EMS call will be for a 67 year-old homeless woman who fell and can’t (did not want to) get up or possibly a 46 year-old transient man who is having a flair up of their chronic thumb pain. I agree, this is not an emergency. This is a waste of an EMS rig. We are receiving a person who does not need emergency medical care services.

However, I want to take a moment to remind us all that while these people do not need emergency medical care, or possibly no medical care at all, they are people who still need care. These are often the forgotten, the hungry, the cold, the mentally ill, and the individuals that our society is failing. They are not getting the medical or mental health care that they need. They are most likely lacking the absolute basics – clean clothes, a place to shower, decent food, and a safe place to sleep.  

**And I hear all of you who are saying that there are lots of people who choose this kind of life and just use and abuse the healthcare system. I agree. There are those people, lots of those people. But let’s just remember that they are still people.**

I had a patient like this yesterday. They needed nothing medically and were definitely taking up a bed that we needed for a sick patient. But as I tried to get them out of the ED, they told me about how much they just wanted a shower and some sleep. They told me how they had been eating out of the trash and scared to sleep because they never know who is around and what they might do.

This is not a person who needed any medical care, but they did need someone to care. We tried to help. We gave them clothes and food. We let them wash up. I led them to the waiting room to eat and rest while the ED continued to provide medical care to those who needed it.

I finished my shift and went home. And I was frustrated and sad. The emergency department should not have to be caring for the basic welfare of our patients. I truly feel that humans all have the right to clean food and safe housing.

And I can’t always make that happen. Shelters are often full. The department doesn’t have enough food to feed everyone a meal. Hospitals can’t be the fixer for all of these problems.

But for what it is worth, I know that I can always try to remember to care – to care enough to give each person the most dignified and respectful interaction that I can and to care enough to keep their humanity in mind even during the busiest time of year.

- Sarah @ New Thing Nurse


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!




When the Shift Hits the Fan.

It is inevitable. It will happen to you.

No matter if you are a new graduate or veteran nurse, there will be that shift that will almost break you. Staffing is short. Your patient is crashing. Maybe it’s downtime to boot. The stress is overwhelming. You are heading to the med room to cry.

I have been there and shed those ugly tears. You feel like you’re drowning, and there is never enough help. I wanted to write a quick post with some advice about stress-management strategies that have helped me cope during those really hard moments when the shift is really hitting the fan.

Remember - You can’t do it all.

That moment when you start to feel like you need to clone yourself 10 times, stop and remember that you cannot do it all. THAT IS OK. You are a single human with a maximum capacity to take on tasks. Luckily, nursing is a team sport. Reach out to others and throw up the S.O.S. signal. Get some help. This is not a sign of weakness. This does not mean that you are not a good nurse. You are recognizing your limitations in the moment and putting patient safety first. It is appropriate to ask for assistance. If you try to do it all alone, you are putting yourself and your patients at risk. Don’t do it. That is never OK.

Take a deep breath. Try counting to 100 by threes.

Victor Lipman wrote for Psychology Today – “Get your body in hand first, and the mind will have a better chance to follow.” By using distraction techniques (like breathing and counting), you start to take control of yourself physically. This will help slow down your racing heart, help you avoid hyperventilation and allow you to think clearly. Nursing is a high-stress job. We are asked to do an impossible number of tasks (see the previous section) as fast as possible with less and less support. And not to mention, we are responsible for human lives. It’s normal for you to physically respond to that kind of stress. To succeed in a time of crisis, you will need to calm the body as well as the mind.

Triage. It is time to triage.

I am 100% an ER RN, so I am going to preach the importance of triaging your situation. It is time to get organized. You need to sort out what are the tasks that need your immediate attention, what you can delegate out to others, and what can go on the back burner. We already established that you cannot do it all. By triaging the urgency of your duties, you will complete the super STAT things quickly and figure out a way to get the other things finished without losing your mind. There is the possibility that you might not get it all done. And that is also OK. If all your patients are alive, your documentation is done, and no one is yelling at you, then all that extra stuff probably was not as necessary as you thought.

Don’t buy into the crazy.

When it’s busy, everyone gets stressed out. Emotions will be running high and sometimes, logic starts to fly out the window. It is SO important to not start down the road to Senselessville. Medicine has standards of care. Hospitals have policies and procedures. There is always structure to be found, even when it seems like the walls are crumbling around you. Let those rules guide you in the times of chaos. It can be very comforting (not to mention extremely helpful) to tap into those policies and procedures when the shift is blowing up. If you’re not sure if what is happening is kosher, take a minute and check the rules. You may be surprised at what you find.

Thank your coworkers.

Gratitude works magic. If you had someone come help you in a pinch, find them later and give them a “thanks” and a high-five. Nurses and other healthcare workers do not appreciate each other enough. We do some amazing work in ridiculous conditions. Find a minute to tell your colleagues that they did a good job. I find that appreciated coworkers are more apt to help in the future. 

Take time to decompress.

This is for after the shift-show has calmed down. You need to take some time to process. Whether it is in the car on the way home, in the shower after your shift or during a run the next day, find some quiet and let yourself go through the stress of the day. When we carry around too much stress, it can manifest as physical symptoms. By allowing yourself to work through the bedlam of your nurse life, you will find better balance in your personal life.

Have a great shift!

Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



An Interview with the Interviewer: Elizabeth Scala

This week has been very exciting here at New Thing Nurse.

On Wednesday, April 25th, an episode of the nursing podcast "Your Next Shift", hosted by the imitable Elizabeth Scala, MSN, RN, MBA, went live. This episode features an interview with myself, your New Thing Nurse friend and founder, and Elizabeth where we talk about all things nursing, self-care, travel, rugby and of course, New Thing Nurse.

LISTEN TO MY INTERVIEW ON "YOUR NEXT SHIFT" WITH ELIZABETH SCALA HERE!!

I have never been on a podcast before, this again making me a #newthingnurse. I was SO nervous when we recorded the interview last month as I have been a fan of Elizabeth Scala's for quite some time. If you are not already familiar with her work, Elizabeth is a Johns Hopkins-trained Registered Nurse, best-selling author, keynote speaker, and consultant on burnout prevention for nurses in all specialties. She is the CEO of ElizabethScala.com and founder of The Art of Nursing - a Nurse's Week program providing education and inspiration to thousands across the country. Elizabeth also hosts the incredible podcast "Your Next Shift", where she interviews nurses from diverse roles from across the spectrum of nursing.

I mean SWOON, right? #nursecrush

In addition to inviting me to be on her podcast "Your Next Shift", Elizabeth was also game to play a little "Interview the Interviewer". Below is a brief interview between myself, Sarah @ New Thing Nurse, and the "Your Next Shift" hostess with the mostest - Elizabeth Scala, MSN, RN, MBA.


Sarah @ New Thing Nurse (NTN): I have been a big fan of yours for a long time but for those who aren't familiar with you and your work, can you introduce yourself and tell us about your work?

Elizabeth Scala (ES): Sure, Elizabeth Scala here. Professionally, I work as a Registered Nurse. Personally, I love gardening, jigsaw puzzles, my pup and dancing to jam bands all over the country! I have my dual masters' degree in nursing and business. And even though I am quite the homebody - I do love to travel and teach others.

NTN: I love hearing about other nurses' professional journeys. How did you fall into nursing? And what area of nursing did you start in?

ES: Great question! And totally worded appropriately for me. I definitely am on that "fell" into nursing. It was NOT my agenda;  growing up, hospitals would scare me! So, senior year of college I was moving into my apartment off campus with three other girls. Two of my roommates were in nursing school. One of my roommate's mothers was a nursing faculty. And the three of them, along with my own mother, decided that after I graduated with my psychology degree that I could go straight into the accelerated nursing program. I didn't have concrete plans yet after college so I thought, "Why not!?!" I started out in psychiatric nursing, worked some in the community, and am currently a research program coordinator at a large academic medical center.

NTN: The focus of New Thing Nurse is supporting nurses as they fine their "new thing". What made you step away from the bedside? And what was your first "new thing"?

ES: Gosh - what made me step away from bedside nursing was me. I wasn't taking any care of myself. My health was in the toilet; my emotions were on a roller coaster ride. I felt miserable and one night - since I RARELY slept through a night - I was having another sobbing tantrum. My husband and I both agreed that I could not keep going at the pace I was at. I needed to take a break, and I needed to focus on myself. I left my psychiatric nursing job and made a risky decision to work just part-time at a local wellness center. I was still able to work as a nurse - as they needed a RN to head up a physician referral program - so that was kind of neat! And during that time I had many "new things". To thing about what was the first... hmm. I think it was remembering that I was an athlete growing up. I loved sports, was always in good shape, and highly competitive (smile). Being at the wellness center and around all of the equipment, personal trainers, and healthy bodies - I was like "Ohhhh yeah..." It woke me up first physically to the shape I was in. After that, more and more started to unfold and I started to feel healthy, happy, and whole again.

NTN: What helped you make that transition into your "new thing"?

ES: I would say that many things helped me. My husband being supportive and allowing me to leave my full-time job with all of the perks that went along with it. Boy, I do NOT know how we made it financially - but we did! Then, my own curiosity. My own pause and need to do things that I enjoyed. Being at the wellness center, I was surrounded by resources. I asked for help, hired a trainer myself, and got back into shape. My boss at that job was super helpful. He introduced me to the concept of "coaching" and I went into a certified coaching program. Then, even one of my clients at the wellness center helped! She was a marketing specialist and started to talk to me in between her sessions about social media, blogging, and all sorts of things I never had heard of. I guess the main thing that I believe helped is an open mind and a desire to learn more. Even if I didn't know how something would work out, saying "yes" without hesitation was super productive in taking the next step!

NTN: Do you have any tips for anyone out there who might be considering jumping into a "new thing" of their own?

ES: Hmm, interesting question. I think that it depends on what their "new thing" is. For some new things, you definitely need to wait before jumping. What I mean by that is I have done a TON of things wrong in my online work. And even now, I am at a place where I am assessing and re-assessing decisions and plans. So, if you are considering a new thing that you know nothing about, do your research. Learn more before taking a plunge.

Next, I would say to the person considering a new thing... is it YOUR thing? So often we get wrapped up in what we think we "should" be doing. I think of all the dirty words - SHOULD should be at the top of the list (LOL). That being said, I mean is the new thing something that you desire or something you are going to do for someone else? I have learned along the way that when I get into something new that isn't 100% my true heart's desire... it doesn't work out all that well. Now, other "new things" that are a bit less heavy (like trying a new hobby, such as tango dancing) - for something like that, jump in head first! I do think we need to do more new things that are fun, adventurous, and will fill our spirits!

NTN: You have been a self-proclaimed warrior against nurse burnout for a long time. What drives your work to help the nursing community fight burnout? Did you have a personal experience with nurse burnout?

ES: As shared above, yes. Yes. And, yes again. In fact, to be honest, I am noticing that I may be back in burnout again. I think from everything I have shared above speaks to this questions, but to state it another way... Burnout happens when we are riding on someone else's train. When our values, desired, strengths, and assets are not being actualized. When we are living life along the "should" of what other people want and need. Now, I do agree that we all report to somebody - at work or at home. Sure, there are things that we may not 100% enjoy. And yes, work is work, and there will be stress on a job. However, when we get away from our true heartfelt desires, then we find ourselves in trouble. Couple that with working too hard, not getting a break, or forgetting to do things that are good for your mind, body, and spirit - all of this added up leads to burnout. I do agree that the workplace needs to be supportive and help us be happy and healthy professionals. At the very same time, it is up to us to stand up and take responsibility for our own well-being.

NTN: If you could give our readers your top tip or tips towards avoiding burnout, what would they be?

ES: Do what you enjoy. Set healthy boundaries. Schedule down time, me time, and non-work time. Change it up. If you are stuck in a rut - figure out why and what needs to shift. Focus on the positive. Sure, there is a tone out there that is scary, miserable, and bad. And, even through the greatest of tragedy we can learn, grow, and transform our lives. Live as much as you can in the moment. It is when our mind wanders to the "what if" or the "should, could, would" is when we get into trouble. Stop and breathe. And don't take yourself or your life so seriously. Smiling and laughing - that can be some of the very best medicine!

NTN: Do you have any "new things" on the horizon? New Thing Nurse readers want to know!

ES: I believe that I do, but most I am not even aware of yet. As I honestly (and maybe for the very first time) shared above - I am a bit into burnout right now. And, being someone that knows the signs, causes, and what to do about it - I need to stop. Really stop everything and take pause. What are my next steps? What lights me up? How can I best serve others? I can say that I have a very special course coming out soon. The content is done, and we are working on some of the aspects of how folks will be able to interact with and enjoy the program. I also know that some of my other "new things" involving ending some things that I hae been doing for several years now. In a way, ending things is the first step to the new beginnings, right?

NTN: How can our readers find out more about you and your work?

ES: Sure, well the easiest place to find me is at ElizabethScala.com. I also have a Facebook page and community. I do hang out quite a bit on LinkedIn. And, if you're looking for resources you could check out Nursing from Within or Your Next Shift - two of my very favorite books!

Oh, and I cannot believe I forgot to mention this at all so far... my podcast! Now that I am assessing where I am at and what I enjoy - I can tell you. The podcast is NOT going anywhere. I LOVE to interview other nurses - highlighting their triumphs and lifting the profession of nursing up!! So, definitely check that out. I am sure that you'll see some familiar faces, smile.

NTN: Do you have any other advice for our readers?

ES: Boy, I could go on and on, for sure. I think I shared a lot above. To close it out, just be yourself. And, if you don't know who that is or what that self wants, take the time to figure that out. First off, you will be happy that you did. Things will go so much smoother. It gets easier when you live life as your best you. If you get off course, it's all good. Even the best of us experience burnout! And guess what? We can thank it. It is that gentle reminder that we are not living life as our highest self.

Thanks for the opportunity to hang out with y'all! I hope to "see" you online. Enjoy YOUR new things!!


ISN'T SHE AMAZING??

Hear the "Your Next Shift" podcast episode featuring the interview between Sarah K. Wells, MSN, RN, CEN, CNL and Elizabeth Scala, MSN, RN, MBA in its entirety below.

A Shift In Perspective with Sarah K. Wells - Your Next Shift with Elizabeth Scala

- Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



FOLLOW NEW THING NURSE ON INSTAGRAM - @NEWTHINGNURSE

How Travel Makes Me a Better Nurse.

I want to go everywhere.

Since I was a wee child, my parents were always ready to pack me and my sister into the car for a road trip. I grew up in a small town in southern Georgia, but we left as often as we could. My family caravanned up and down the east coast, once in a school bus that my mom bought (a long story). My dad drove me from Georgia to the Grand Canyon and back along historic highways, making sure to stop in musical meccas like New Orleans and Graceland along the way. I was a veteran car co-pilot by middle school, adept at navigating on the giant, paper atlases that dominated our dashboards. The GPS years did not come until my mom bought a new-fangled TomTom that always seemed to want to take the shortcut through a cotton field. Travel was a part of my life early on, but it was definitely limited to ground transport on four wheels - unless it was the school bus which had a lot more (again, long story).

Everything changed in Paris.

Just before I started at the University of Georgia, I got the opportunity to study abroad on a college program in Paris (France, not Texas) for 6 weeks in the summer. I became an instant Euro-nerd. The food, the art, the wine and the people had me enamored from the start. I started freshman year at UGA feigning extensive knowledge of the world. Posters of the Eiffel Tower covered my walls. I bemoaned the lack of Fanta Limon in our cafeteria. In short, I was an intolerable person to be around. My dorm roommate was a saint for not throwing me out the window.

I had the travel bug, BAD.

The following summer I returned to Europe but this time chose Madrid as my destination under the pretense of practicing my terribly accented Spanish that I was just starting to learn. Tapas, flamenco, siestas… it’s pretty hard not to love Spain. My Spanish got a little better. The travel addiction worse.

Over the next few years, I spent a lot of money on plane tickets.

A semester in Valencia, Spain was followed by a gap year in Monteverde, Costa Rica where I also backpacked from Panama to Mexico. Plus I met a boy who lived in Germany, which led to many transatlantic voyages validated by love. Then there was a volunteer trip to Peru for nursing school, followed by graduation which lead to a real job and a real paycheck. Then the flood gates were open. I have now been to Colombia, Thailand, Australia, Argentina, Hong Kong, Italy, Brazil, England, Cuba, Japan, Guatemala, Switzerland, Cambodia, Wales, Morocco, the Czech Republic and many more fantastic (and not so fantastic) destinations. The travel bills have been large, but out of it I got a husband (the boy who lived in Germany), a new language (Spanish), many new friends and memories, plus a global perspective that has made me more aware of myself and the world that I live in.

We get it. You’ve been a lot of places. What does this have to do with nursing?

Healthcare is as diverse as the world we live in. Our patients and colleagues come from everywhere. In my emergency department alone, we have at least a dozen nations represented by our staff at any given time. By experiencing more places and cultures, one becomes better able to navigate the individual needs of each of our patients and are able to work more cohesively with their care team. Culture drives so much on how we approach healthcare. Our personal perspectives, biases and opinions are all shaped by our own cultural experiences. When you put yourself in a foreign environment, you are forced to see things in another frame of reference. That may be the same frame of reference as your patient. If you can relate to their point of view, you will become a more effective healthcare provider.

Nursing varies globally.

Another thing that I like to do when I travel is find my way into healthcare facilities (hopefully not as a patient) or hear about the healthcare experiences of people from those new countries. I have been in hospitals, clinics, ambulances and local traditional healer’s homes. I LOVE seeing how other countries approach healing. The greatest experience, in my opinion, is to find the person called “nurse” and see who they are. Sometimes they are heavily educated practitioners who work with incredible autonomy. In other instances, nurses have very little training and work heavily in the homes instead of clinics or hospitals. Some cultures approach medical care similarly to the United States, with great beliefs in pharmacological and surgical treatments for ailments. In other places, traditional medicine is the standard with much more spiritual-based health practices. However, all of these providers may go by “nurse”. It is a powerful word with many definitions and meanings depending on where you are.

The experience of seeing all of these variations in the role of nurses and the structure of healthcare helps me better understand the expectations of my patients. Often our patients have just arrived in the United States and come to the emergency department with very specific ideas of what their care experience will be. Not only do I then have to treat the patient in the American medical approach, but also educate our patients on what their experience will actually be. I also have to meet their emotional and cultural needs to the best of my ability, using the resources that I have available. Those resources are often few and far between, so frequently the best available resource is me.

By traveling, my nursing practice has evolved.

I feel that I can provide much more holistic and culturally sensitive care as I often have a personal point of reference of where my patients are coming from. I just as frequently have no idea how the patients are feeling as I have never seen their home country or experienced their native traditions. This motivates me to continue to experience the world for myself, but also for my patients and colleagues. I am a better nurse with every new experience that I have.

So now I have to experience the world to be a good nurse? SUPER!

I am definitely not saying that one needs to visit every country in the world to be a good nurse. Some of the BEST nurses that I have ever worked with have never left the state where they were born. What I AM encouraging you to do is to take opportunities to experience other cultures and consider other perspectives. That can mean going out and trying a new cuisine. Food is such a strong part of cultures. Knowing the common dietary options from other countries can help you better determine what food recommendations to make for your uncontrolled diabetic from El Salvador. Maybe you could watch some international movies. Or go to a concert with music from another country. Read a book set in a foreign land. Even just talking to your colleagues who might be from other cultural backgrounds can help you expand your point of view.

There are so many ways of looking at the world. Challenge yourself to see things in a new way.

-       Sarah @ New Thing Nurse


Want to travel with Sarah & New Thing Nurse?

Sarah will be heading to Puerto Vallarta, MX with ExpeditionEd in July. Join the fun for adventure & 12 CEs while enjoying a relaxed environment, engaging in some self-care, invigorating beach activities and networking with other emergency nurses in beautiful Puerto Vallarta, Mexico.

Check out the ExpeditionEd website for more details - www.expedition-ed.com


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!