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!




An Interview with Anna Rodriguez from The Burnout Book

Confession - I really like social media.

I have been overly involved with social media for years, but got REALLY into my accounts when I started discovering the nursing social media community. From your phone, you can interact with nurses from literally all over the world. It is so wild how much you can have in common with people that you have never met and who are located in geographic areas that are literally thousands of miles away.

It was on Instagram that I first “met” Anna Rodriguez, the curator of the incredible IG account - @the.burnoutbook. I was immediately drawn into her posts about self-care, strategies to fight compassion fatigue and manage stress, her videos of her doing yoga with her Corgi, Walter, and her personal experiences that she would share about working through nurse burnout herself. I completely identified with her narrative and felt like I had found a kindred spirit who also wanted to help support the nursing community!

As luck would have it, Anna happens to also be very active on IG! We now have become regular commenters on each other’s accounts and decided to combine our passions for sharing nurse stories by featuring each other on our own blogs! Isn’t life neat sometimes?

It is now with much pleasure that I introduce you to Anna Rodriguez of The Burnout Book… or better yet, I'll let her introduce herself!


Sarah @ New Thing Nurse (NTN):  ANNA! I am so excited! Can you introduce yourself to our New Thing Nurse readers?

Anna Rodriguez (AR): Hello! I'm Anna Rodriguez, I'm a critical care float pool nurse in Washington state! I've been a nurse for 10 years now (which seems crazy), and I've had a variety of roles in that time: bedside nurse in med/surg, telemetry, CVICU and then as a nurse manager in CVICU, then I transitioned back to bedside care as a travel nurse and then to my current job. In the future, my plan is to pursue a masters in nurse education. Through all the different jobs I've had, I discovered I find a lot of job satisfaction when I'm in a supportive role, helping others learn new things or helping make their jobs or lives a little easier. So, at the moment, I'm still working as a full-time nurse and started a blog on the side focused on nurse burnout reduction and prevention.

NTN: The New Thing Nurse Blog is all about learning from each other by sharing our professional journeys. How did you fall into nursing? And what area of nursing did you start in?

AR: I’m sort of an anomaly. I figured out what I wanted to do pretty early on and stuck with it, no changes in my major during college! I was in 6th grade and my best friend's mom worked as a CNA and her sister was a nurse, and so she introduced the idea to me. At the time, we envisioned ourselves in a pediatric clinic, playing with babies and kids all day and maybe having to clean up some vomit now and then. All these years later, we both became nurses but both ended up preferring to work with adults! But during high school, I made sure to do some volunteer work at the local hospital so I could be exposed to the environment and make sure I enjoyed it. I would help transport patients around to procedures or to their vehicles when they were discharging, and I found that I really like interacting with patients and being helpful. Nursing is a really good fit for me. I'm so glad I ended up choosing this path.

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

AR: I believe bedside nursing has a bit of a shelf life, at least for me. I admire the nurses who are able to make a career out of bedside nursing, but I'm at the point now where I'm ready to branch past that that and into a non-traditional nursing area, like nurse blogging and education. That's probably what I'd classify as my first "new thing." Although, I'm always looking for opportunities to grow as a nurse, whether it's by attending a conference or volunteering on a committee!

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

AR: First and foremost, I have an amazing husband who always encourages me to do new things and is incredibly supportive. I've also found an amazing nurse community on social media, and we're always encouraging and learning from each other. So definitely find your people who cheer you on. Second, I'm always staying curious and trying to learn new things and stay challenged. From a practical perspective, if you're a nurse who wants to start a blog, I highly recommend the book "The Nurse's Guide to Blogging: Building a Brand and a Profitable Business as a Nurse Influencer" by Kati Kleber (Fresh RN) and Brittney Wilson (The Nerdy Nurse). It's so, so good.
 
NTN: Do you have any tips for anyone out there who might be considering jumping into a "new thing" of their own?

AR: Don't wait until it's a "good time," there's always something going on that will make it inconvenient. You will find time for the things that matter to you. With that being said, it really helps if your new thing is something you're passionate about! Something that you think about non-stop, dream about at night, and talk to all your friends about. Pick THAT new thing, and you'll find time for it.

NTN: Your slogan says you're passionate about "helping nurses keep their spark!" What drives your work to help the nursing community fight nurse burnout? Did you have a personal experience with nurse burnout?

AR: My drive and passion for fighting nurse burnout definitely comes from a personal experience. I was working as a nurse manager for two years and during that time, I witnessed burnout in my staff and went through my own experience simultaneously. I was the manager when we implemented our new Extracorporeal Membrane Oxygenation (ECMO) program with nurses running the machine at the bedside. It tested us in a lot of ways, physically and emotionally. These are really sick patients who require a 1:1 nurse to patient ratio (sometimes 2 nurses for 1 patient!) and we were working extra shifts to account for this staffing matrix that we weren't anticipating. And because we were seeing sicker patients, there was a lot of moral distress and compassion fatigue occurring. I was considered a "working manager" and would frequently work full or partial shifts at the bedside to supplement the staffing needs while still doing my manger role. I worked some nights when we didn't have a charge nurse, I came in on a weekend for a family conference and missed a funeral for a very special long term patient of ours. We started experiencing nurse turnover (mostly on night shift) for a variety of reasons: interpersonal relationships with physicians, scheduling issues, the acuity of the patients, etc. I realized pretty quickly that I was putting in way too many hours and that my personality made it difficult to let go of a lot of the issues when I walked out the door. I would stress about conversations I needed to have the next day with staff or patient's families. It wore on me physically, mentally, emotionally and I was burned out within two years. I knew transitioning back to bedside nursing would help (at least from a time management perspective) so I helped train my replacement and moved on to travel nursing. It's been almost two years since I quit managing, and I'm still recovering from that experience. I share all my burnout tips on my instagram page (@the.burnoutbook) and on my website and blog, www.theburnoutbook.com.

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

AR: I’m going to link to one of my first blog posts, "What to Do When You're Starting to Feel Burnout." It covers the first steps you should take if you suspect you're in that chronic state of physical/mental/emotional exhaustion that we call burnout.

First, talk to someone who you trust. Not only can it help you feel a little less alone when someone else knows your struggles, but it can help provide perspective. Second, write your experience down. Reflective journaling can help you process emotions and deal with negative things. But most importantly, I love writing down the positive experiences: the patient thank you, the compliments from peers, the positive and humorous interactions that you have as a nurse. The Burnout Book started as a little notebook where I documented those positive things so that when I had rough days and felt burned out, I could go back and read through the book and remember why I do what I do.

The last tip is all about self care, which can take many forms. It can simply be saying "no" when the staffing office calls to try and get you to work an extra shift. It can be doing things on your days off that are relaxing or energizing. It can simply be spending time with loved ones. I highly recommend setting healthy work boundaries and know what your limits are. That can go a long way.

NTN: I love nursing professional organizations. You seem very involved with the American Association of Critical-Care Nurses (AACN). What can you tell our readers about the AACN, and how it has enhanced your nursing career?

AR: One of my favorite “new things” I've done recently has come about because I'm a member of a nursing organization, AACN (American Association of Critical Care Nurses).

The AACN is a national organization that creates a community of acute care and critical care nurses. There are a bunch of perks to being a member! You get access to a ton of continuing education, they have several journal publications that come in the mail, they provide discounts for certification tests and study material, they hold an annual nursing conference where you can meet nurses from across the nation (and around the world!), and a whole bunch of other online resources. There are other nursing organizations you can become a member of with access to similar things. This is the organization I chose 8 years ago because I was in a Telemetry unit with plans to go into critical care and it made sense at the time.

More recently, I've had the opportunity to be a volunteer on a committee to help create questions for a nursing certification exam, and I've been a social media influencer for their national nursing conference! I'm amazed at all the opportunities that have come because I'm apart of this organization!

NTN: Your IG account is full of videos of you doing yoga, often with your adorable dog Walter.  How does yoga help you? Do you incorporate yoga into your nursing practice?

AR: I’ve always enjoyed yoga from an activity standpoint. I love testing my flexibility and stretching, it's very relaxing. After going through my burnout experience, I've found a huge benefit from yoga because you are practicing breathing techniques and meditation to quiet the mind while being active. My mind used to be so distracted with what I had to face at work that I was constantly in a state of anxiety and even experienced what I'd call a panic attack. Yoga helps refocus my thoughts and bring them to the present instead of being fixated on things outside my control. But man, it takes time and practice. You can’t flip a switch. It takes time to retrain your thought patterns.

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

AR: “New things” on the horizon: moving to a new city, I'll be getting a new job at that time, continuing to work on building The Burnout Book community online and collaborate with others! In the next few years, I hope to pursue my masters degree in nursing education as well.

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

AR: There are many things that can contribute to burnout that are outside of our control: staffing ratios, meaningful recognition, leadership support, etc. But what I suggest is find the things that ARE in your control and develop a self-care plan that works for you! Maybe it involves meeting your social needs by going out to lunch with a friend a couple times a month. It may look like finding new and fun ways to be active, like taking a barre class or going on a hike. Maybe it will come in the form of counseling, assertiveness training, practicing saying “no”, changing jobs, or getting a medical provider to help you with your physical and mental needs. You can't pour from an empty cup. Put your own oxygen mask on first.

Y'ALL - DOESN’T SHE GIVE THE BEST ADVICE?

Now - check out the Anna & Walter cuteness below!


Want to learn more about Anna Rodriguez, The Burnout Book & Walter, the Corgi?

Email - anna@theburnoutbook.com
Website - www.theburnoutbook.com
Blog - www.theburnoutbook.com/blog
Instagram: @the.burnoutbook & @anna.the.nurse
Facebook: Anna the Nurse
Twitter: @anna_the_nurse

- 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

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!



The Future of Nursing is Looking BRIGHT!

The next generation of nurses is looking strong.

I had the opportunity to give a workshop to members of the East Bay Student Nurse Association in Hayward, California this week. There was a great turnout of enthusiastic recent graduates and current nursing students. They were excited. They were eager. They were looking for help on how to jump headfirst into their nursing careers.

The title of the workshop is “I survived nursing school! Now what?”. It focuses on how to navigate that stressful transition from nursing school to new grad nurse in regard to self-care, stress management and all things related to getting that first job – networking, the job search, resumes and interviews. It was a great session. The participants were so interested in how to shift from successful nursing student to successful new nurse.

I love working with nursing students. In my opinion, nursing students are the toughest, most flexible and resilient students out there. They are asked to do the impossible – manage full-time clinical rotations, class time and personal lives – all while paying for the privilege to do it. These students were no exception. They arrived telling me stories of how they juggled their clinical rotations, nurse internships, volunteer work, classes, and part-time jobs. Each of them had incredible perspectives on patient care and the ever-evolving landscape of the American healthcare system. I was overwhelmed with their passion and determined spirits. The future of nursing is looking bright.

How can we help future nurses?

The major need that I hear from nursing students everywhere is that they need more opportunities. Nursing students need good preceptors and clinical rotations. If you are approached to precept, think about offering to help. New graduate nurses need to be considered for nurse positions. There needs to be more new nurse training programs and budgets to support them. New nurses need good mentors.  If you work with a new grad nurse, offer supportive guidance and a sympathetic ear when they need to talk to someone. Help them grow and avoid the burnout that so many new graduates face in their first jobs.

Our next generation of nurses is excited to get to work. Let’s help them be the best nurses that they can be.

- 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!