Tuesday, January 14, 2014
Tall, in her 50s and sporting a perfectly coiffed salt-and-pepper pixie cut, the woman was one of the most respected nurses in the hospital. She had nearly three decades of clinical experience, so older nurses and doctors valued her insight, younger ones sought her approval, and those of us in between tried to stand a little straighter in her presence.
One morning, however, she arrived at work to find that the hospital was full and her unit understaffed. It wasn’t the first time she had to cover for more patients because of staffing issues, but by the end of this 12-hour shift, she noticed a slight twinge in her lower back — a minor muscle sprain, she thought, from helping one of the other nurses lift a patient.
A week later, the slight twinge turned into debilitating back pain.
But she continued to work through the pain. “What else could I do?” she said one afternoon, pointing out all the patients who would suffer without the additional nurse. “I thought I was going to be lucky and make it to retirement without getting hurt, but now I just want to be able to put in a few more years so I can retire.”
When she rubbed the heel of her palm against her back, I saw her lower lip begin to quiver slightly.
“How terrible is it that we do everything to care for the health of others,” she whispered, “but we cannot care for ourselves.”
Nurses make up the largest group of health care providers in the United States, working in venues as varied as doctors’ offices and biotech firms, governmental agencies and private insurers. Trusted more than almost any other professional, nurses exert a wide-ranging influence on how health care is delivered and defined.
But nurses’ work is not easy, particularly in the hospital setting, where they must deal with intense intellectual and significant physical demands over three or more grueling 12-hour shifts each week. Not surprisingly, nursing ranks among the worst occupations in terms of work-related injuries, and studies have shown that in a given year, nearly half of all nurses will have struggled with lower back pain.
The obvious question, then, is this: If the nurses are grappling at work with all these injuries, what is happening to patients?
Recent research published in two journals, The American Journal of Nursing and Clinical Nurse Specialist, reveals that when nurses suffer, so do their patients.
Researchers developed a questionnaire for registered nurses working at hospitals, asking them about their own health and the extent to which their injuries or illnesses might affect their work. Analyzing more than 1,000 responses, the researchers found that almost 20 percent of the nurses questioned had symptoms of depression, an incidence twice as high as for the general population. In addition, roughly three-quarters of the nurses experienced some level of physical pain from a muscle sprain or strain while at work.
The researchers then looked at the quality of the nurses’ work. A small percentage of nurses reported that they had made a recent medication error or that a patient had fallen while under their care. Adjusting the analysis to take into account how the nurses were feeling, researchers discovered that the risks of a patient fall or medication mistake increased significantly – by about 20 percent – the more a nurse was in pain or depressed.
Extrapolating the individual costs of these lapses in care to a national level, the researchers estimate that medication errors and patient falls that occurred as a result of nurses’ health issues incurred as much as $2 billion annually on the health care system.
“We have money bleeding out the back door because we don’t have a healthy work force,” said Susan Letvak, the study’s lead author and a registered nurse who is an associate professor of nursing at the University of North Carolina at Greensboro.
Tuesday, January 14, 2014
Knowledge of the emotional demands facing today’s nurses is critical for explaining how work stressors translate into burnout and turnover. Following a brief discussion of how the experience of burnout relates to the nursing shortage, we examine the scope of nurses’ emotional experiences and demonstrate that these experiences may be particularly consequential for understanding the higher levels of burnout reported by younger nurses. Using survey data collected from 843 direct care hospital nurses, we show that, compared to their older counterparts, nurses under 30 years of age were more likely to experience feelings of agitation and less likely to engage in techniques to manage these feelings. Younger nurses also reported significantly higher rates of burnout and this was particularly true among those experiencing higher levels of agitation at work. We conclude by suggesting the need for increased awareness of the emotional demands facing today’s nursing workforce as well as the need for more experienced nurses to serve as emotional mentors to those just entering the profession.
Citation: Erickson, R., Grove, W., (October 29, 2007). “Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses” Online Journal of Issues in Nursing. Vol. 13, No. 1.
“You can recruit till the cows come home, and that’s what we see nurse recruiters in hospitals doing. Pull out all the stops, do the sign-on bonuses, basically bribe them in some way to get them in the door. But until you can stop the bleeding, they’re coming in the front door and leaving out the back door” (Bozell, 2004).
In 2002, the Bureau of Labor Statistics (BLS) projected that the United States would be 800,000 registered nurses (RNs) short of the national need by the year 2020. Recently, this number has increased to over one million RNs short of the need by 2012 (BLS, 2004). Although there has been some indication that the entry of older nurses into the profession, along with efforts to recruit foreign-born nurses, have helped to ease the shortage, scholars project that the predicted trends are likely to continue (Auerbach, Buerhaus, & Steiger, 2007; Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2006; Larkin, 2007). As such, the need for understanding the factors contributing to the nationwide shortage has never been greater.
The current shortage is a problem of both supply and demand (American Hospital Association, 2006). As the population ages, there is increasing demand for nursing care both in hospitals and nursing homes (Hecker, 2001). At the same time, fewer individuals are choosing nursing as a career, the most experienced nurses are quickly approaching retirement age, and others have been leaving the profession before they reach retirement age citing poor working conditions as their reason for doing so (Buerhaus et al. 2006; Gordon, 2005; Hecker, 2001; Pinkham, 2003; van Betten, 2005). These trends have led many to speculate about the causes and solutions to the current shortage of registered nurses. In what follows, we show how attending to the emotional dimensions of nurses’ work environments provides new insight into the experience of burnout and why younger nurses may be particularly at risk for experiencing high levels of burnout and, potentially, lower rates of retention.
Burnout and the Nursing Shortage
Burnout is a unique type of stress syndrome that is fundamentally characterized by “emotional exhaustion” (Cordes & Dougherty, 1993; Maslach, Schaufeli, & Leiter, 2001). Because of the nature of their work, health care professionals are at especially high risk for experiencing the emotional exhaustion component of burnout. This is problematic because, as Lafer (2005, p. 36) observed, “the stress, danger, exhaustion, and frustration that have become built into the normal daily routine of hospital nurses constitute [the] single biggest factor driving nurses out of the industry.” Others have echoed this link between current work conditions and high rates of turnover (Peterson 2001; Vahey et al., 2004), noting the close connection between feelings of burnout and intentions to leave one’s job. In an international study on hospital care, Aiken and her colleagues have demonstrated, for example, that nurses experience burnout at significantly higher rates than expected for medical workers based on national norms (Aiken et al., 2001). In another study, 43% of surgical nurses who reported high levels of burnout said that they intended to leave their jobs within the next 12 months. In comparison, only 11% of nurses who were not burned out stated that they intended to leave their jobs (Aiken et al., 2002).
Exhausted, discouraged, saddened, powerless, frightened – these are the emotions experienced by nurses on a daily basis. Nurses’ negative feelings about their jobs, including their feelings of burnout, tend to be influenced more by the organizational practices governing the workplace than by the challenges inherent in caring for others (Aiken et al., 2001, 2002; Aiken & Sloane, 1997). Supporting this view, a report based on the National Sample Survey of Registered Nurses indicated that it was the “structure of the job, rather than the composition of the work” that influenced nurses’ job satisfaction (Spratley, et al. 2000, p. 31). Despite the prominent role that feeling and emotion play in nurses’ self-reflections about their work (Payne, 2001; Savett, 2000; Ufema, 2000), few researchers have systematically examined the emotional components of nurses’ work experiences and their relationship to the experience of burnout.
Such neglect is particularly surprising given the results reported by the ANA (2002) concerning “how nurses felt as they left their jobs each day.” The ANA reported that the four most frequent responses were: Exhausted and discouraged (50%); discouraged and saddened by what I couldn’t provide for my patients (44%); powerless to affect change necessary for safe, quality patient care (40%); and frightened for patients (26%). Exhausted, discouraged, saddened, powerless, frightened – these are the emotions experienced by nurses on a daily basis. Recognizing that burnout is rooted in such intense emotional experiences is integral to specifying the facets of the work environment that are directly affecting nurses’ well-being and to effectively managing the hospital work environment in ways that can improve nursing outcomes. As others have shown, having a healthy and satisfied workforce is consistently associated with higher rates of patient satisfaction (Leiter et al., 1998; Vahey et al., 2004). This is especially true in the case of nursing, a profession whose “ethic of care” is central to its claim for professional distinctiveness and in which the ability to effectively manage one’s own and others’ emotions is critical to the provision of excellent patient care (Sumner & Townsend-Rocchiccioli, 2003).
Despite the central place that emotion holds in the conceptualization of burnout (Aiken et al., 2001), and studies indicating that the experience and management of emotion are critical to nursing practice (Henderson, 2001; Bolton, 2000; Smith, 1992), scholars know relatively little about how emotional experiences may differ among nurses or whether such experiences correlate directly with job burnout. ...scholars know relatively little about how emotional experiences may differ among nurses or whether such experiences correlate directly with job burnout. As an initial step toward increased understanding, this paper explores the types of emotional experiences reported by direct care hospital nurses and how these are related to burnout. In what follows, we examine the prevalence with which direct care hospital nurses experienced and managed their emotions at work, and the extent to which these occupational experiences were associated with reports of job burnout. Because turnover has been shown to be particularly high among registered nurses who are under the age of 30 (Barron & West, 2005; Bowles & Candela, 2005; Kiyak et al., 1997), we further explore how these emotional experiences and their effects on burnout may vary by age. In the final section of the paper, we discuss the importance of emotional mentorship for novice nurses and the need to increase awareness of the emotional context of nursing care.
Registered nurses employed within two acute care hospitals in an urban midwestern city were provided with a questionnaire at their place of employment. Eighty-one percent of the eligible registered nurses returned completed surveys. Although data were collected from both direct-care nurses and nurse managers, in this paper we limit the sample to the 829 registered nurses who provided direct care to hospital patients and for whom complete data were available.
Sample. Of these 829 registered nurses, 96% were female and 95% were Caucasian. In regard to education, approximately 30% had, as their highest level of preparation, graduation from a diploma program, 13% were prepared at the Associate Degree level, 53% were prepared at the Baccalaureate level, and 4% had earned graduate degrees in nursing. Seventy-five percent of the sample was married and sixty-five percent had children living at home at the time of the survey. The mean age of respondents was 41.5 years old with an average having about 16 years experience as a registered nurse. Our sample included 110 RNs under age 30 (13%) and 719 RNs over age 30 (87%). In regard to work characteristics, 63% of the sample worked at least 30 hours a week and 59% worked the day shift. Among clinical areas of employment, 22% of the sample was employed in medical-surgical units, 36% in critical care, 15% in operating or recovery units, 19% worked in maternity with the remaining 8% in psychiatric or other units.
Measures. In this study we examined the emotional exhaustion dimension of burnout, emotional experiences, and emotional labor both generally and by age. For the purposes of this study, nurses’ age was measured in years and then dichotomized to create a variable identifying those under the age of thirty (Over 30 = 0; Under 30 = 1). The emotional exhaustion dimension of the Maslach Burnout Inventory (MBI) was used to assess job burnout (Maslach, Jackson, & Leiter, 1996). Emotional experiences were assessed using a question that asked nurses how strongly or intensely they felt twelve different emotions while they were at work during the past week. Consistent with Erickson and Ritter (2001), factor analyses indicated that positive emotions and agitated emotions were the most commonly reported and, as a result, they serve as the focus for this paper. The “positive emotions” scale was created by summing the responses for happy, proud, excited, calm, and relaxed (Cronbach’s alpha reliability = .78). The “agitated emotions” scale summed responses for the feelings of frustration, anger, and irritation (Cronbach’s alpha reliability = .89).
Hochschild (1983) reported that surface acting and deep acting represent two distinct techniques to manage emotion. When emotion management is part of what it takes to perform a job effectively, as it is in nursing, the task is referred to as “emotional labor” (de Castro, 2004; Mann & Cowburn, 2005; Sumner & Townsend-Rocchiccioli, 2003). Surface acting involves managing the outward expression of feelings in the hope that authentic emotion will follow. In contrast, deep acting involves the attempt to actually feel the emotions one is expected to display. We examine both emotional labor techniques here. Consistent with the methodological approach introduced used by Brotheridge and Lee (2003), we asked nurses to what extent they managed their emotions in interactions with others by covering up (surface acting), pretending to have unfelt emotions (surface acting), and making an effort to actually feel emotions that were expected at work (deep acting). However, where Brotheridge and Lee asked only about interactions with customers, we asked the nurses about their interactions with patients, patient families, doctors or residents, their unit manager or director, nursing co-workers, and non-RN staff. As with other measures, the results were summed to create an overall index for each form of emotional labor.
For burnout, emotional experience, and emotional labor, t-tests were used with each of the scales to assess the extent to which the results reported for each age group (e.g., under and over age 30) were significantly different from one another. In presenting descriptive information regarding these outcomes, dichotomous categories were created. Those reporting “high burnout” scored greater than 24 on the standard MBI scale that ranges from 0-42. This operationalization of “being burned out” is the same as that used by Aiken et al. (2001). For reports of emotional experience and emotion management, nurses identified as experiencing “high” levels of these phenomena are those whose scale scores were higher than the mean, or average, score reported for the entire sample.
Protection of Subjects . This study was approved by both the university’s and the participating hospitals’ Institutional Review Boards. Letters inviting participation informed the potential participants of the study’s objectives. Written consent was not obtained from participants in order to allow participants’ responses to remain confidential. Instead, voluntarily returning a completed survey was viewed as an indication of a respondent’s consent. Surveys were returned to the researchers via the United States mail system in a previously addressed, stamped envelope. We further protected the confidentiality of the participants by using numerical codes to identify the completed questionnaires.
Tuesday, January 14, 2014
When you walk into a dialysis center you may see the staff wearing medical “scrubs” and “lab coats.” You may wonder, since they’re dressed alike, if everyone has the same job. While the health care professionals who take care of you are all specially trained, they all have different jobs. In this series of eight articles we will see how each member has a specific purpose to make up your health care team. Let’s start with nurses.
What do nephrology nurses in a hemodialysis center do?
Nurses are caring individuals. After all, that’s what they do: provide care. Registered nurses (RNs) who care for patients who have kidney disease are called nephrology nurses. The word nephrology means, “relating to the kidneys.” Nephrology nurses are specially trained and educated to care for patients with kidney disease.
RNs working in a hemodialysis center plan and manage the care patients receive. The nurses responsibilities include:
checking the patients’ vital signs and talking with them to assess their condition
teaching patients about their disease and its treatment and answering any questions
overseeing the dialysis treatment from start to finish
making sure patients are given the correct medications ordered by their doctors
evaluating patients’ reaction to the dialysis treatment and medications
reviewing the patients’ lab work, home medications and activities and letting the doctors know about changes in their patients’ conditions
helping patients follow-up with their transplant center
supporting the entire care team in delivering quality care in a considerate, respectful manner
What do PD nurses and home hemodialysis nurses do?
Some dialysis patients don’t get hemodialysis in a center but perform peritoneal dialysis (PD) at home or hemodialysis at home. These patients also rely on nephrology nurses to plan, coordinate and oversee their care. While many of the responsibilities of the peritoneal dialysis (PD) and home hemodialysis nurse are the same as in-center hemodialysis nurses, there are some differences.
Read Full Article
Friday, December 27, 2013
Feeling tired, nurses, even after you’ve had your coffee? Wish the weekends were three or four days long so you could catch up? Resenting time spent at work?
Fill up your nurse health tank!
If your low fuel indicator is illuminated, then try a RenewalSHIFT™.
Here are three steps to boost your energy at home and work. Start today and see results immediately! That’s the great thing about a SHIFT- you increase your energy and get better results right away!
1. Breathe deeply
Each deep breath sends oxygen to your brain and forces you to slow down.
Try breathing in through your nose and out through pursed lips right now. Close your eyes to really focus on how good this feels.
As you breath in, think of something good (i.e., a loving child) and as you breath out, let go of something annoying (i.e., the difficult patient).
Enjoy the calm feeling that has taken over.
2. Do something nice for someone else
When you see someone who needs a hand, offer to help.
Friday, December 27, 2013
When I began Life Coaching many years ago, most people had never even heard of coaching outside of the typical sports connotation. They had no idea how this coaching concept could be applied to life. “Just wait”, I told my skeptical friends and colleagues, in a few years, not only will everyone know what coaching is all about, but everyone will either have one, know someone who is one, or want to be one - and that’s exactly what has happened.
Coaching is not only the new buzz word. Coaching is the “next big thing” in your nursing career, and for good reason - it works! Coaching is positive, pro-active and forward thinking. It is a synergistic relationship that helps take people to new levels personally and/or professionally, faster and more effectively than they would have on their own.
Now is the time to bring coaching into your hospital, clinic or institution, and you can be the start of a nurse-coach revolution!
Of course, there are a couple of stipulations. Coaching only works when the “client” is:
Ready - They have to be in the right place emotionally; it is definitely not therapy, nor is it mentoring, preceptoring or counseling.
Willing - As a coach, you can’t want things improved more than they do.
Open - As much as they put out, they will get back: give a lot, get a lot; give a little, get a little.
Honest - A no brainer, you can only work effectively with fact, not fiction.
Motivated - You are there to be a champion, but they do all the work.
Coaching works when you genuinely care about helping the other person be better.
Here are some general principles of coaching tnursing career coachinghat make it so successful:
I don’t have to know more than you to be more than helpful to you.
I don’t have to know you well to help you well.
I don’t take credit for what you do.
I don’t work in the past.
As a coach, you can be many, many things to your nursing colleague. For example, you may be called to be their:
Champion - Oftentimes believing in them more than they believe in themselves.
Sounding board - To bounce ideas off of and to give an impartial opinion.
Kick in the pants - When they need it.
Expert listener - Hearing what they aren’t saying.
Mirror - Most of the brilliance is discovered in this way.
Accountability Specialist - Once they commit, you are their checkpoint.
One of the best analogies of coaching compares it to learning to ride a bike, “What the heck is Coaching?” is a one minute read, here, if you are interested.
So, without going through formal coaches training, you can still act as a coach to a colleague, provided you both agree to the above terms. Wouldn’t it be great to create a win-win! You could take turns coaching each other.
Here’s how it might look:
You and Jan decide you are on a similar path of personal and professional development. Neither of you have ever been professionally coached, but both are interested in the process, understand the value, and are willing to “give it a go”. You genuinely care about each other and really want the other to succeed in every way. You can be happy to share in each other’s success and rejoice in each other’s triumphs.
I suggest you start with a 30 minute commitment every 2 weeks, over the phone. At the start of the call, make it very clear that one of you is in “coaching” mode - not friend mode, not colleague mode. This is a very important first step in the process. Everything said is confidential and every statement, advice, or comment, is said only within the parameters of helping. Sometimes, as a coach, you say things that a friend may not say. The “client” has the option of taking or leaving this information, but the coach must respond honestly all the time and follow their intuition to hear what is in between the words.
Friday, December 27, 2013
The success of anything we do depends on our attitude. If we decide that we are going to be successful at something, we are right. If we decide that we are not going to be successful at something, we are also right. Your attitude towards your job, your life, your friends, and your colleagues can sabotage your success in those areas. Many people start the day in a negative way that affects their nursing wellness. You know who they are. The reality is that you have control over the type of day you will have. It is your decision to have a great day. You need to simply show up and stay in the moment, give it your all and your day will go much better. We will always have times that challenge us, but with a positive attitude, you will be able to go home realizing that you did your best.
We all seem to have the tendency to look at big chunks of our lives and to compartmentalize our activities. Although we need perspective on the whole, actually, life is all about moments. These moments are woven together to create our memories and define our lives. The moments change over the day so even if our day starts off in a challenging way, it does not mean it has to end that way. When we look at the whole problem, or whole picture, we miss the moments. When was the last time you noticed a beautiful sunrise on your way to work? When was the last time you took time to stare into the beauty of a flower? When was the last time you truly enjoyed the smile of a baby? These are the precious moments that build our lives. Don’t miss them. Once lost, the moments are gone forever. Living in positive moments rather than continuously looking at the negative will help to reframe your day and your life.
Tips to keep you in the moment include:
Do not look at the whole, rather enjoy the moments. Learn to look for the moments. Next time you are at work, take the time to evaluate your patient interaction. Hold their hands and look into their eyes to identify their fears and appreciate their gratitude. They need you. Holding someone’s hand during their time of need is a moment to be cherished. Thank your nursing coworkers and appreciate all they do for you and all they do for the good of mankind. You have all dedicated your lives to the betterment of others. Doing what you do is a privilege. Also appreciate what other allied healthcare workers do for you throughout the day and thank them for their help. There are so many wonderful moments at work, regardless of the type of day you are having. Looking at those will improve the quality of the day.
Pay attention to your emotions. We all have things that frustrate us and evoke negative emotions in us.This may be a result of your value system, personal past experiences, or issues that you may be going through right now in your life. Awareness of what those are is the first step to being able to manage those feelings. If there is a patient that you feel you cannot take care of for some personal reason, be honest about that and ask to change assignments. If there are particular situations that you are uncomfortable with, stay away from those situations.
Friday, December 27, 2013
Prior to discussing my opinion of what the attributes of a great nurse are, it is important to first understand what nursing truly is and how we evolved into the most honored and trusted profession in the world. The reasons are simple; nursing is a profession steeped in rich values based on the work of Florence Nightingale, which has not degraded over time due to the character of the individuals that commit to the calling. Nursing, in my opinion, is a much higher spiritual calling than merely a profession. Our fundamental tenets have not changed over time, either. Those are described as:
Nursing is founded on specific human values.
Nursing is a scientific knowledge.
Nursing is a technical skill.
These tenets are based on specific nursing values that have been studied in literature and remain pretty consistent globally. These include:
Sense of accomplishment
Prevention of suffering
In my opinion, a great nurse lives these values and clearly understands themselves and their role in this fine profession. In an attempt to translate the values into behaviors, I would identify the actions as follows:
A great nurse is compassionate. Compassionate is defined as the feeling of concern and sympathy for others. We need to remember that our patients, apart from cosmetic work or delivering babies, are generally not in the healthcare setting because they want to be. They are fearful and at risk of losing their health, possibly their lives, and concurrently, those visitors with them may be at risk of losing precious loved ones. They are not in control and are frightened, and they need us for support. This also means that we are consummate advocates for the patient and willing to speak up when we do not feel the environment is as safe as it can be.
A great nurse is empathetic. Empathetic is defined as the ability and willingness to share in the feelings of others. It does not mean that we agree with the patient or completely understand what they are going through. It simply means that we are willing to make a concerted effort to listen to them, to put ourselves in their place and to attempt to understand their challenges. This needs to be done without judgment and with the understanding that everyone has their own set of values and their own life experiences that have brought them to this point.
A great nurse is selfless. Selfless is defined as the ability to give to others at the expense of themselves. I have countless stories of nurses over the years that illustrate this ability to give to others. This could be as simple as missing lunch to hold a patient’s hand or to do something extraordinary for someone else. I had one trauma nurse I will never forget who was caring for a homeless man hit by a car. When the patient was being discharged back to the street, the nurse realized that his shoes were not removed during the trauma because he did not own any. His foot size was the same as the patient’s, so he gave him his shoes and wore shoe covers for the rest of the day. I felt that this was a tremendous example of selflessness. We recognized him as an everyday hero. The stories go on and on and we need to celebrate them when they happen.
Friday, December 27, 2013
Your title is “Nurse” or “Health Care Assistant”, but you are so much more than that. And I know who you are! Among all nurses, yes, I know you!
It was you who gave quality nursing care for my dying husband with such amazing kindness and compassion. It was you who helped me to see things that I couldn’t see - or perhaps didn’t want to see. It was you who sat with me after tending to his needs - sat in silence when there were no words to express our shared grief. It was you who prayed with me and dried my tears. You touched my hand and comforted my spirit with your understanding heart.
Yes, I know you!
At first, your help was received with apprehension. There was reluctance on my part to give up my caregiving role to a stranger. And my husband - well, he totally rejected your services even though you brought gifts of compassion and understanding. He was so stubborn! No one was going to lift him from the bed but me! And certainly no one was going to bathe him!
But you persisted. Each day, after his blood pressure check and your nursing documentation of his physical status, you proceeded to create a bond, to open the door of his heart which had been tightly closed because of fear and regret. You became his friend, listening to stories I had heard a thousand times, but they were new to you.
Slowly but surely, you gained his trust. He finally gave in to your gentle persistence and allowed you to bathe him and tend to his personal needs.
Several months went by and your presence in our lives became a priceless gift. Because of you, I was able to relinquish some of the care giving tasks that had fatigued me over the previous two years when I was the only caregiver. Because of you, I could rest a bit and restore my body and my spirit. Because of you, I was confident that my husband was being cared for with dignity and respect. Because of you ...
Soon you began to occupy a very special place in our hearts - a place of high honor. Perhaps I shall call you “angel.” Yes! “Angel of Mercy” - “Angel of Compassion” - “Angel of Love.”
And then one day, in a serious and somber voice, but still in a whisper because of his weakness, my husband told me that he was in love with another woman! My heart sank. In that moment, I totally forgot that he was completely bedridden and unable to accomplish even the most simple of tasks for himself. He certainly was unable to leave the house and become involved with someone else! I was confused.
nurses lover, all nurses
Then he looked at me with an impish smile and confessed that the “other woman” was you, our Angel of Mercy, our Angel of Love.
Over the days and weeks that you tended to my husband’s needs and gave me a much-needed respite, he had fallen in love. Your eyes had met at first on the level of stranger to stranger, then caregiver to patient, then friend to friend. You both were devoted to making the best out of what was happening - his decline, his movement toward the end of his journey.
On that last day, when you looked at me with tears in your eyes, I was able to know without words that the end was near. Because of you I was able to spend those last moments with him before the coma engulfed his spirit, knowing that the two of us - my husband’s “new love” and I - had cared for him in an exceptional way.
Yes, you were my caregiver friend. My husband and I were walking along a road not of our choosing. You gave us strength when our hearts were so strained. You nourished us with gifts of love and compassion. You listened to our cares and concerns. You touched my shoulder. You gave a knowing smile, a nod of understanding.
My heart was uplifted because of you. We became kindred spirits, you and I, upon the road unknown and I am so much better for having known you.
Friday, December 27, 2013
As a young nurse, I worked on a cardiovascular and thoracic surgery unit; I learned a lot about touch there. We dealt with pain every day, significant pain. I learned that pain medication sometimes wasn’t enough, but that holding a hand for five minutes often was enough to ease pain and suffering. I learned that a reassuring touch could calm anxiety and get someone through a frightening procedure. I learned that sometimes it was a family member who needed a gentle touch or a hug. I learned that touch always goes both ways – I often initiated touch to calm someone and was calmed and nurtured myself by the interaction. It’s a beautiful thing.
And 22 years of parenting, 27 years of marriage and countless years of friendships have taught me similar lessons. Touch is powerful, and, I believe, necessary. Some people are naturally more comfortable with touch; I believe all of us need it. People need touch to thrive. Touch releases a set of hormones in our bodies that bond us to each other, calm us and make us “feel good.” Some even “prescribe” a certain number of hugs a day for health and wellness - not a bad idea. Nurses, how many hugs did you give and receive today? nursing touch
In recent years, I have noticed that many people are afraid to touch and have just stopped touching and being touched. How sad. Many teach children (and adults) to fear touch and even to avoid it. We fear inappropriate touch, giving the “wrong idea”, and/or charges of sexual harassment. Teachers are supposed to limit hugs. Business people are advised to touch only through handshakes.
We need healthy people and healthy families to be touch therapists to our world. We are social beings. We are physical beings. Touch is good. Touch is essential. Certainly we need to teach about inappropriate and harmful touch, but we shouldn’t stop touching.
3 Tips for Touching
Hug those you love and hold your hugs for 20 seconds. This is how long it takes for the release of oxytocin, a powerful “bonding” hormone.
Go out of your way to touch (gently and with kindness, of course) your ill or elderly friends and relatives, they nnursing toucheed it.
Wednesday, December 18, 2013
Money is in short supply this year in many organizations. So is energy, time, and employee engagement. “Only 79% of organizations are holding an office party for the holidays, according to Joel Stein, writing in BusinessWeek.com. International executive search firm Amrop Battalia Winston says it’s the lowest percentage in the 30 years that the company has conducted its poll.
“The figure is also down 2% from last year and 16 percent from 2002-04. Almost as bad, 27% of celebrating companies say their event will be more modest than last year’s.” The same article says that: “Even more disturbingly, Arlington (Va.)-based publishing company Bureau of National Affairs (BNA) claims that only 58% of company holiday parties will serve alcohol this year—down from an already startling 61% last year.”
The loss of the holiday office party may be symptomatic of the continuing economic woes. It may also reflect less tolerance for annual office party shenanigans involving career busting episodes with alcohol overindulgence. Employees demonstrate little appreciation for expensive investments in an office party when their personal compensation is already affected – and may be affected even more severely, by the upcoming healthcare overhaul and other Washington initiatives.
Employees are working with low salary increase expectations. Coworkers laid off have not been replaced, and the work has multiplied to fill more than the available time. Employees are working harder to accomplish the same goals. And, employee finances outside of work, are stretched to cover family holiday celebrations.
Celebrate Without the Traditional Office Party
But, it is still the holiday season, an opportunity for employers and employees to participate in team building, morale increasing holiday adventures - together. A time to involve employee families in fun interaction with their coworkers is encouraged and needed when holiday traditions, like the holiday office party, are on the skids. But, the emphasis for alternatives to the office party, is on low-cost activities with a big fun kick. Minimal investment of energy and time in planning and execution is also appreciated by stressed-out employees.
Here are ideas to create the merry, merry in the ho-ho-ho season, without committing a lot of employee time, hard earned cash, or energy. Your employees and their families will appreciate your low key alternatives to an expensive, energy-consuming office party.
Make Cookies for a Holiday Cookie Tasting
With company-supplied punch, soft drinks, and mulled cider, ask employees to bring in a plate of cookies to share with their coworkers. Keep the event low pressure by specifying that bakery products are welcome, too. Make sure the company orders a supply of bakery cookies to ensure that every employee has a chance to sample a variety.
Make the event festive with holiday music and gift certificate prizes for the bakers of the employees’ favorite cookies. If your employees are interested – and do ask, not assume interest from holiday-stressed bakers – you can also sponsor a cookie exchange.
Schedule an Ugly Holiday Sweater Day
In its third year, so well on its way to becoming an annual tradition, employees at TechSmith Corporation select a day to wear and enjoy their favorite glittery, holiday-only, ugly sweaters and sweatshirts. Selected and loved with poor taste and abandon, the contest to wear the ugliest holiday sweater of all sparks fun and laughter all day long. Accompany the festivity with photos and company-supplied refreshments for all.
Hold an In-House Catered Lunch With Employee Fun and Games
A client company’s annual tradition, instead of an office party, involved closing down production four hours early on an afternoon during the holiday season. Company-supplied beer and wine and a catered sandwich fixings / hot soups or turkey lunch highlighted the festivities, but the emphasis was on employees playing games together. Card games, shuffleboard, basketball, board games, Pictionary, table tennis, pool, and more, sparked hours of fun and friendly competition, and de-emphasized drinking.
Participate in a Holiday Card Exchange
Employees sign up to exchange cards with coworkers. As your company becomes larger, the cost and time involved in sending cards to all coworkers becomes prohibitive for many employees. Why not pull names from a hat so coworkers can still exchange cards, say 1-5, rather than sending to the whole office. Or, limit cards to departments. Spread the holiday cheer with holiday cards sent in smaller doses. If using a drawing, names should be entered the same number of times as the number of cards each employee agrees to send. Keep your recipients secret. Do the drawing at a company lunch, ugly sweater day, or cookie exchange.
Make a Charitable Contribution in Lieu of an Office Party
Employees find charitable giving motivational and exciting. Pinpoint the charities your employees support or carry our more giving for the charities identified in your company philanthropic plan, if you have one. Visual giving is most on display during the holidays. Employees enjoy seeing piles of food, gifts, clothing, and household items growing in the company lobby or break room.
Employees build team when they band together to paint walls for older community members to brighten their holiday season, for example. Whatever charitable pursuits you choose, you can pursue them as an alternative to the office party. Or, charitable giving can supplement any of the other ideas shared here.
Schedule an Employee Potluck Lunch
Employees may enjoy celebrating the holiday season with a potluck lunch at work. If you don’t do these too often, and you alternate them with company-supplied, catered feasts, employees enjoy showing off their culinary skills. Post a sign up list online or in the lunch room so employees bring a variety of foods to share. A potluck lunch is a festive occasion, especially when you combine the potluck with any of these other alternatives to the office party, including Secret Santa and Ugly Holiday Sweater Day.
In a special twist to the traditional potluck fare, one client company with a large number of employees from various countries, asked employees to bring a traditional dish that represented their country’s cuisine to the potluck. The annual holiday season potluck became the most looked forward to event of the year. Employees savored unfamiliar, but delicious dishes, that were native to their coworkers’ countries of origin.