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!

HAVE A NEW THING? CHECK OUT OUR SERVICES.

FOLLOW NEW THING NURSE ON INSTAGRAM - @NEWTHINGNURSE

#covid19 cases are surging. 🦠 Everyone can help slow the spread by wearing a #mask CORRECTLY. 😷 Thank you to the @cdcgov for making this visual which shows how NOT to wear a mask & the correct way to do so. 👏🏽 As far as I’ve seen in the

#nurses are here to take care of everyone. #happypride ❤️🧡💛💚💙💜🖤🤍🤎
•••••••••••••••••••••••••••••&b

🚨 You can be fired for what you post on #socialmedia as a #healthcare worker 🚨 •
This is 💯 true & is happening every day. Let me do a quick breakdown on how & why: 🖊 When you are hired at a #healthcare facility of almost any size, yo

What could go wrong? #wearamask #covid19 #nursehumor.

#healthcare is the ultimate team sport & #cnas are the backbone of it. Today is the end of #cnaweek, but know that each of you - #cna, #nursingassistant, #patientcaretech, #patientcareassistant & all your other titles - are what makes success

Have an upcoming #interview? @newthingnurse can help with that.
•••••••••••••••••••••••••••••••

Wearing a #mask means you #love your #family & #friends & want to prevent them from being sick, that you love your community & want it to stay #strong, that you #love your country & want it to be able to safely get to our new normal,

I have been sitting on this post.

I wrote this post recently, but was not planning on sharing it. I was not sure how I felt about sharing my personal story on the blog. There is a lot of stigma related to mental health in the healthcare community (and world) and while I am pretty open about my own nursing journey, I was not confident yet that I was ready to put my mental health story out in the great, wide world of the interwebs.

However yesterday there were some comments made on the New Thing Nurse social media that reminded me why it is so important to share our stories. There is an expectation that nurses need to have a "thick skin" to be successful in medicine, or it might not be the career for you. That people with anxiety or depression or other mental health diagnoses cannot be strong, capable & amazing nurses.

I THINK THAT IS CRAZY.

Nurses don't need thicker skins. They need better support. They need better coping strategies & stress management techniques. They need better work conditions. They need to know that their job is hard, that what they're feeling is normal, and that it is OK to admit if you're struggling and to talk about it.

Nurses, like all humans, have mental health. We should be concerned about their mental and emotional wellness. Nurses have to take care of themselves, so that they can take care of others.

Now, let me tell you a story.

Let’s start with a story, my story.

I was born a baby ER nurse in 2011, and it seems like only five minutes ago.

I remember being a newly-minted nurse, hyperventilating on my way to those first night shifts. I had finished nursing school in an accelerated 16-month, master’s-entry program. It was disorganized. It went by way too fast. I did not feel prepared to save lives.

During nursing school, I was anxious.

I was nervous about classes and tests. I was terrified during my first weeks of clinicals. The first time I went to take vital signs on a patient, I went with my classmate to record a blood pressure, heart rate, SAO2 and respiratory rate. We divided and conquered the tasks, and I almost passed out while trying to put on the patient’s blood pressure cuff. I am sure that the poor patient thought we were completely inept, but she was kind enough not to tell me to buzz off during the encounter.

Most people would say that some academic anxiety is normal. Sure. It probably is, but I have always been a nervous person. My anxiety was magnified by a million in nursing school. Because everyone kept telling me that it would get better, I shook off the fact that I cried constantly when I was alone and stress ate like it was going out of style. I once showed up at my classmate’s house and just ate a whole cheesecake. That isn’t normal.

Then I started my first job.

I was working nights, like everyone does when they start out, and was SO excited about being in the ER. It was my dream, and I was working in a great department with a very supportive staff. Yet I was barely sleeping. I was still stress eating, and sometimes I liked stayed in bed for days at a time when I was not working. When out with a crowd, I was usually fine, but I was frequently tearful at home. My then boyfriend, now husband, dealt with extreme mood swings and many crazy, sleepless days/nights. I thought it was all because I was working night shift, so I made excuses and soldiered on.

I moved to California and worked as a traveler, then as a staff nurse at several ERs. I continued to work nights. I had a terrible time sleeping, continued to be anxious and tearful when home alone and had many days where I could not get out of bed. I blamed everything and everyone for my continued anxiety and down moods. There was no way that I had a problem. It was always situational, at least that is what I continued to tell myself.

Then one day about three years ago, I was at home, an anxious, hot mess.

I was working 4-6 shifts a week at two jobs that I was juggling while trying to pay off my student loans. There had been a string of really brutal patient cases that had made me sad to the core of my being. I had not worked for several days yet at home that day, I was jumpy and crying. My husband was away on a business trip. I started looking for something to blame my mood on, but I could not think of anything - I had stopped working nights. I had gotten married. I had an amazing community of family and friends. I had a job that I loved.

So, I did what any good nurse does. I got a consult.

I found a therapist. She changed my life.

Through a lot of talking, time, exercise, mindfulness work, self-care and medicine (YES – I take medicine for my mental health), I have come to realize and accept that I have problems with depression and anxiety. For most of you reading this, you probably could have told me that years ago just by reading my story. That would have been great! But when you are on a journey of mental health self-assessment, it usually takes a lot of time to come to accept help and realize the deeper causes of your problems.

But I work in healthcare, so why didn’t I figure this out sooner?

Nurses and other healthcare workers historically HATE talking about their own mental health. We will diagnose and treat others ‘til the cows come home, but we will not discuss our own feelings for a million dollars. ER nurses may be some of the worst. We are so cowboy and pride ourselves on our ability to see the saddest, grossest, most traumatic cases and just keep going. That’s why we like to binge eat/drink/exercise/Netflix/craft. Call it what you want, but a lot of that is coping mechanisms in the extreme. I mean, have you ever seen any stress eating like a night shift pot luck? Think about it.

Things are changing.

The healthcare community is starting to talk more and more about the relationship between our work and our mental health. There are many organizations and foundations working to advocate for increased awareness of healthcare workers’ mental health needs (see below). Self-care and stress management is becoming more a part of the conversation, in addition to the need to combat compassion fatigue and burnout. This is a positive evolution for nurses and other healthcare providers everywhere. The world is starting to take note of the toll that our work is taking on us.

What else can we do?

I personally have made stress management and self-care a part of all of my education for both nursing students and veteran nurses. While awareness is the first step, we have to actively engage in self-care to protect ourselves from the negative effects of the stress of our jobs. Humans are incredibly resilient, and nurses are super stars in the resiliency game. However even super stars can burn out. We have to take the steps to not just continue to make nurse mental health a part of the conversation, but also to actively work to making self-care, mindfulness and stress management a part of our daily nursing and personal practice.

So, am I all better?

My anxiety and depression are going to be my forever friends. Sometimes they hang out with me, while other times they go on vacation. I have to continuously work on the things that keep me mentally well so that I do not backslide into the depths of Depression Town. I see my therapist regularly. I take my medicine. I (try to) eat well, sleep enough and exercise. I have started to try to meditate and stretch more. I surround myself with positive humans. I travel. I read. I stay engaged with my professional and personal community. I continue to do work that I love – ER nursing, ENA volunteering & of course, New Thing Nurse. However, I am human, and I do not always succeed. I love donuts and cookies. I do not like to work out in the cold. I sometimes get too affected by things outside of my control (i.e. politics, family, donuts). But I do my best and most of the time, I feel like a fulfilled and happy person.

Also, I am, and continue to be, a strong and awesome nurse.

Having my own struggles with depression and anxiety have never made me a weak or bad nurse. On the contrary, I feel that I am a better nurse and advocate for both my patients and colleagues because of it. Additionally I have lead a successful ER nursing career, started a business to support the nursing community, lectured at the local, state and international level, and supported nurses and nursing students all along the way. My mental health challenges have never stopped me from being successful or effective in any role. I just have had to work harder and overcome more to achieve my goals.

Final Thoughts.

If you have read all of this, I commend you and thank you for sharing in my story. I want to make nurses everywhere realize that if you are feeling anything on the spectrum of anxious, self-doubting, irritable or sad, YOU ARE SO NOT ALONE. I have been there. I will be there again. There are so many more of us out there than you think. There are lots of other nurses talking about their own mental health journey on social media. Check them out! Let’s not keep how we are feeling a secret anymore.

Let’s keep the conversation going about our nurse mental health.

Let’s talk about it.