The “S” Word We Never Talk About In Nursing

No, not the 4-letter word. We talk about that too much; It’s the 5 letter word: SHAME. As a profession predominantly made up of women who care for people professionally and personally, we want people to like us. Sometimes in order to sustain that positive image, we keep our shameful secrets hidden from those that might judge us.

Personal issues such as divorce, children failing school or family suicide can trigger shame when we can’t sustain the image we attempt to create. Narcotic access has created some issues for Nurses. I have worked with at least three Nurses who have lost their nursing license (at least temporarily) for stealing drugs and/or using during work hours. I’ve known other Nurses who have lost their license from driving under the influence of alcohol.

Brene Brown has done a tremendous amount of research studying shame. One of the most important things she has said is that “vulnerability is NOT weakness”. Think back to a time when you had a difficult conversation and were vulnerable, perhaps in a romantic or personal relationship. It takes a lot of courage to drop our guard, be exposed, let go of control and be open to not knowing what comes next. That is not weakness. We have a choice, we can chose silence and go down the self harm route of depression, anxiety, and addiction or we can open up and talk about it so it loses its powerful hold over us.

If you or someone you know is going through a difficult experience, find someone who creates safety to be comfortable to share the experience with. If you are the listener, be just that – a listener. Notice the judgments come up and let them go so that you can bring empathy to help the healing process. For more about  Brene Brown, check out her Ted talk on vulnerability.

Have you watched your stress lately?

This week, the participants in the MBSR course I’m teaching had permission to go out in the world, experience stress when it showed up and then react with their natural habitual reactions. In other words, they didn’t have to create a pretty response to stress. The only requirement was to be mindful of how they react to stress.

imgres-1.jpg

Try this yourself. Notice how your body reacts with muscle tightening, tension, sweating, feeling hot, or a change in the heart rate or breathing pattern. What are the consequences to your reaction to stress? Perhaps verbal and non-verbal communication alters relationships. Denying, repressing, distracting or fleeing the scene can be a temporary relief but also brings other ramifications.

Tara Brach, a Buddhist meditation teacher speaks about the acronym RAIN, which can be helpful when working with habitual stress patterns.

R: Recognize the stressful situation

A: Allow the experience to be here (It doesn’t mean you have to like it)

I: Investigate your experience with curiosity and kindness

N: Non-identify and don’t personalize the experience

Here is an example from class. A Charge Nurse noticed her patterns of stress often came when she had to deliver unpleasant news, such as informing a nurse of a patient request to not have that nurse assigned to them. Here is how RAIN comes in handy.

R: She recognized she felt stressed, feeling tension in the shoulders and feeling her heart beating faster.

A: She allowed the experience to be here even though she didn’t want it. She didn’t ignore it or distract herself from dealing with it.

I: She investigated her experience. I don’t want to hurt this person’s feelings. This is awkward. I hope she doesn’t resent me for telling her this. The nurse is now more conscious and aware of her own thoughts and emotions.

N: How can I make this not about me? This is the sweet spot for this nurse since many of her stressful events are personalized when the circumstances are beyond her control. Reporting the facts as a weather report can be helpful. Patient doesn’t feel comfortable. This nurse needs to know. Clear and direct communication is needed. My role as the Charge Nurse is to address this issue. I’m making the best decision with the information and resources I have.

We establish our patterns of reacting to stress to survive. We continue to use them and function on autopilot in these habitual ways. It is worth having a look at whether these patterns are truly working for you. If you had a close friend going through a difficulty, would you advice them to approach their situation the way you do?

Here’s an example of a very deep well-established pattern of approaching stressful situations by “sucking it up”. This pattern is alive and well among healthcare workers. Sucking it up has served me well in productivity, efficiency and “getting it done” but it hasn’t always been in my best interest.

About five years ago, I received a call at work that my aunt had been run over by a tractor-trailer in New York City. I immediately felt shock and sadness and tears welled up in my eyes. I mentioned it to some co-workers and booked a flight for that night. Then I tucked it all away, neat and tidy and got back to work as I had so many times before when faced with tragedy as a nurse. My habitual response: I’ll process it later but for now, I will suck it up. I’m sure at the time I had my reasons to stay at work. Perhaps I was being a martyr or didn’t want to waste precious PTO. A few more hours of work wasn’t going to kill me but could a lifetime of this pattern kill me?

It is only through bringing kind awareness to investigating my habitual response to stress that I am now able to incorporate self-compassion as well. When wisdom walks hand in hand with compassion, it makes a great pair. I’d like to think my family has met our quota for pedestrian or bicycle accidents with vehicles but if we haven’t, I’m definitely taking the day off with any future call.

 

5 Steps To Becoming A Happy Nurse

This week, I had the opportunity to meet a number of nurses in various specialties, including ICU, med-surg, perioperative, obstetric, and oncology (Bone Marrow Transplant, in particular).  In my career as a nurse, I have worked in fifteen different work environments (many as a traveling nurse).  Each has provided me with different levels of work or life satisfaction. On some occasions, I was significantly challenged and stressed out at work; other times, I accepted boredom because my personal life demanded more from me.  I’ve gone through phases where my work has been the center of my life, and I didn’t want it any other way.  There were other chapters when the priority was income or the flexibility to pursue other interests, such as a Masters degree or Ironman triathlon.  Each nurse needs to find the right balance for him or herself.

by creativecostumes.com

by creativecostumes.com

Meeting so many nurses this week, I can’t help but reflect on the wide array of workplace satisfaction. The nursing pool is filled with happy nurses with gratitude and genuine joy for the job, and co-workers to disgruntled nurses on the verge of collapse. Many of these dissatisfied nurses have experienced significant mental and emotional impact from their work environment.

So how does the disillusioned nurse find his/her way to happiness?

1.  Reflection

You need to actually identify that there is a problem.  Sometimes this surfaces as depression, anxiety, or physical health changes such as hypertension or recognizing a potential drinking issue.  You can’t create change unless you identify the problem in the first place.

2.  Get an objective opinion

Consider working with a coach or therapist.

Is it you or is it the job? Sometimes an outside perspective can support nurses through stressful times and transitions. If the problem lies within the job, then break down the source of the problem: management, co-workers, or the patient population. As a coach working with nurses, I help nurses identify what role they personally play in contributing to their own unhappiness.

3. Look with new eyes

A beginners mind or a fresh perspective can open us up to new possibilities and leave our jaded judgments behind.  Can you imagine what pressures or difficulties your co-workers or managers are going through? That alone, may change the way you chose to communicate and relate with them.

4. Get some chutzpah

Have the courage to be uncomfortable with change.  Rather than stay in a job that doesn’t suit you– for whatever reason, take a leap!  There is nothing wrong with planting yourself in one unit, one career for forty years if it satisfies you.  However, when nurses stay because they are paralyzed by fear – they have no idea of the positive changes that await them. I met two nurses this week that remained in their specialty but transferred to a different hospital.  It has rocked their world, and they are reaping the benefits of positive work environment for the first time in their career.

5. Love the one you’re with

photo by listal.com

photo by listal.com

Oh, if only we worked with George!

If a job change isn’t within your capacity, how can you create a new level of acceptance with your employer?  Sometimes the grass isn’t greener, and the grass is on fire elsewhere.  I discovered that this week.

Is there a way that you can find 3 things you are grateful for each workday and write them down? Committing to that practice for one month can have a positive impact on your mental status.  If you are still miserable, refer back to #4. If you can’t find your chutzpah, give me a call for a free nurse coaching session

Finding your feet in the whirlwind

photo by bottled_void

photo by bottled_void

This week I taught a class called Striking A Balance With Stress In Nursing.  Most nurses would agree that a typical day in the life of a nurse is stressful, regardless of the specialty. The advances in technology, electronic charting and hospital mergers may benefit institutions and provide efficiency here and there, but it is often at the expense of pulling nurses from patient care.

We discussed the physiological and psychological impacts of the stress response.  Often we feel overwhelmed in the midst of a full-blown stress response.  The ability to find a place to rest in the midst of the experience can bring a sense of peace.  But how does one do that in the thick of things?

If you are able to break down the experience and feel the sensations in your body, simply “name” or identify what that felt experience in the body is.  For example: There may be a conflict with a co-worker or perhaps your patient is receiving news of a terminal diagnosis.  You may be overwhelmed and want to flee, yet your role requires you to stay present.  Simply note what is happening in your body.  I’m feeling heat, I’m feeling an elevation in my heart rate, I’m noticing my mind feeling scattered, I’m noticing a sense of sadness or watery eyes.

photo by Emilian Robert Vicol

photo by Emilian Robert Vicol

What can be helpful at times like this is to connect with your feet on the ground.  Even unlocking the knees and creating a slight bend in the knees can shift the energy to the lower body. Often when we are anxious, our energy moves up to our head and it can be helpful to simply feel the feet rooted on the ground.  Some people may also find it helpful to simply touch the wall.  It may seem silly, but it is an act that changes your sensory input and take you out of your place of overwhelm.

photo by THOR

photo by THOR

Ultimately, we all need to use discernment to know when caring for ourselves means removing ourselves from a difficult circumstance.  If we have the strength and courage to simply stay, bring our full self to the experience, we can find the capacity in our heart to be open to anything.  The strength is not found in protecting the heart with a hard shell.  It is found in the courage to show up with the vulnerability of an open heart that has the capacity to receive anything.

Upcoming classes on workplace toxicity and careers in nursing