Having a cancer diagnosis does not guarantee pain or suffering but unfortunately a significant number of individuals diagnosed with cancer will experience pain at some point during their treatment period. Improving the Quality of Care Through Pain Assessment and Management is the only required reading for this month. But if you want to become a "pain nerd" you might enjoy the following article, Understanding Cancer Pain Medications. Lastly, if you work on one of our in-patient units, the next article could be an interesting topic for a UBC meeting. Prescribing and Administering Opioid Doses Based Solely on Pain Intensity
Questions
- What is a multi-modal approach to managing pain? Incorporate the World Health Organization (WHO) analgesic ladder for cancer pain in your discussion.
- Why is the nurse / patient relationship so important in managing a patient's pain?
Discussion Question
Following the topic of pain, When It's the Nurse Who Needs Looking After is an interesting read and should resonate with most nurses. Your response to this article could include your personal view on caring for nurses, or what you do for your own health and self-care in order to protect and prolong your nursing career.
Pain Management at MRMC is lead by Doctors Abed and Raed Rahman who are both Anesthesiologist and Interventional Pain Specialists performing a variety of nerve blocks as well as the surgical implantation of intrathecal pain pumps. The Pain Service is also staffed by Sandy Beta, APN, Kristen Hilburger, APN, and Katrina Barger, PA-C who see outpatients in our clinic for consults and follow up appointments. The mid-level providers also see in-patients and rotate being on-call for in-patients. Crissy Clark-Boyd is our Administrative Assistant, her direct number is 872-6367.
Kristin Ackley, Melissa Eiserman, Mary Thyne and myself represent nursing in the pain service. The nursing role consists of follow up comfort rounds with in-patients that utilizes the nursing process. In-patient follow ups include assessment as well as medication and discharge teaching and education. Telephone triage for the service includes simple prescription refills, medication teaching and education, and working with patient's whose cancer related pain is poorly controlled. An unfortunate aspect of the nursing role is having to deal with insurance companies that want to deny opioids to cancer patients. ANCC board certification in Pain Management is a requirement for the nurses.
To have a patient seen by Pain Management, a physician order is needed. The "Pain Nurses" welcome any questions regarding pain medication, dosing and side effects.
Please send your answers to melissa.luebbe@ctca-hope.com
No post for the month of December, enjoy the holidays and then we will resume in January of 2018!
Ths article is timely. My daughter, who teaches junior high, just came home this week discussing that they had a course on self-care and the teacher. Her responses could have been a nurses. "Substitutes do not show, we worked short, had to give up my planning time, my lunch...". Self-care is needed but at times can be hard in many professions - not just nursing. We are "punished " for taking too many sick days but thankfully we have FMLA to protect us now. How do I care for myself? I now go to the gym and work out a few days a week after work. There are days I drag myself there but find that the benefits I reap outweigh the dread. Yes I have back issues - have had them most of career - thnakfully we now have lifting assitive devices that really help instead of picking the patient up off the floor with a bath blanket. My other self care that has really helped I discovered though a movie the holistic council showed at one of their meeting. I know it sounds silly but I bend over and stretch and try to touch my toes 10-20 times per day and it has made all the difference in my back. The second benefit is that it clears my mind. I know these are little things but everyone finds what works for them.
ReplyDeletePat, I'm going to start doing toe touches if it will help my back!
DeleteAsk Cindi Ingram for the movie. It takes an hour but is excellent and will help you make small changes in your life. It was amazing that in some countries they have a "quiet time" or meditation time set aside every day.
DeleteI would be curious to see that video as well.
DeleteIs that the video about meditation repairing the DNA?
DeletePat that is awesome! I also am interested in seeing the movie. I think every now and then we need a little reminder of how important self-care is, and it helps us encourage one another too!
DeletePat I completely agree, taking care of ourselves is so important. Morning stretches as simple as sitting at the side of the bed and bending over before getting up for the day helps to relieve back stiffness.
DeleteI totally agree with Pat, taking care of ourselves as nurses is very important, so we have to balance life and work. take some time to do regular exercise or just spend quality time your friends and family are some of the ways to doit.
DeleteI might have to give these toe touches a try! I want to be preventative in any aches and pains instead of reactive!
DeleteThe balancing act: The desire to help and care for others versus self care. The article really highlighted how easy it is to put others before ourselves. It can be very difficult to set boundaries and ask for self care time, when patients' lives are at steak. I was unable to remain in the inpt setting, partially for this reason. I had so much pressure I placed on myself to get done with little to no support when I was struggling. For me, I left inpt nursing and have been better with balancing the needs of patients with my needs since switching to outpatient. I commend those who work inpt nursing. And, I agree, that nurses need employer support to maintain their wellness in order to care for their patients. Over the years, this has improved some here with CTCA. It can definitely be improved more. I think that bringing up the idea self care, such as in this article, will hopefully spark inside nurses who are not taking care of themselves and motivate them to reach out for help.
ReplyDeleteGreat points Sarah, you continue to be an inspiration to a lot of us.
DeleteSarah, I agree that we really need support to guide us toward self care. Balancing life and adding in me time is difficult for most caregivers. We need to start seeing ourselves as worth the investment.
DeleteI have been lacking in self care. Before I had children, I worked out consistently 5 days a week. Now I run after the kids, which is exhausting but unfortunately doesn't count towards exercise. I welcome reading all these comments. I read recently that we're not aware of how much time we "waste" scrolling on social media and mindlessly browsing on the computer. I believe these are ways I can conserve time and find time to work out again. I do like that CTCA pays for a gym pass at ZPD...I wish I lived closer!
ReplyDeleteClinical Research Dept (oops!)
DeleteMy youngest teaches at a junior high. I would put that right up there with the top stress level. One of their benefits as she gets a gym membership to many gyms for $25 per month. Many of the gyms have babysitting...Fabulous benefit! I do appreciate that we get the park district but I live close so for me it works.
DeleteTheresa...I totally get this!!! Instead of always running after our kids we NEED to take the time for ourselves. Lets get exercising.....better yet.....SPA DAY!!!
DeleteYou are right, there is little time for the working mom. You feel guilty if working out but not home to read a book to the kids, or guilty not working out but sitting on the couch reading books to the kids. They grow quickly, enjoy chasing the little ones now. You blink and they are in college, then more time to yourself.
DeleteTheresa,
DeleteI remember when my children were young. My younger 2 were just under 18 months apart. I never had time to workout anymore. One thing I started doing was squats with the kids and used them as my barbell for chest presses. I actually began to enjoy this much more than going to the gym, however, on those rare occasions that I had a babysitter, I would go have a massage. I liked that way better than working out at the gym and it was much more relaxing in the few moments I had alone.
I remember when my kids were young and trying to get exercise and time for myself in during the day, now that they are older and we are empty nesters it's not finding the time it's taking care of myself with the time I now have. Everyone with young children enjoy every second because it flies by and don't forget to take time for yourself!
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ReplyDeleteWorking on a renal floor I had a lot of recurring patients with end stage renal disease that were dialysis patients. This one patient I had was a life changer. She was mean, bossy, persistent, crabby, hard headed and so intelligent. She drove me completely nuts every shift. She was a 15 minute before her pain meds were due call button, she got out of bed without calling and was consistently turning off her bed alarm. She got high doses of pain meds on an every- other hour schedule and break though pain meds here and there. She was enough to make you pull your hair out, but she was eloquent. She could cut you down, but then raise you back up through a lesson. I think I took care of her on at least 15 different occasions, and I was at her bedside with her daughter when she died. She was a nurse. She was a single mother. She was the matriarch of a family that now consisted of 22 grandchildren. She was younger than she looked, but wiser then she let on. She changed the way I nursed forever. She taught me some very important lessons. Pain is subjective, and no one understands it like the person going through it. So, when you are hurting figure out why and make it stop. Take time to celebrate your family. If you are always working, you won’t be home making memories. You can’t take it with you, but it really helps your family if you plan ahead. So, be financially responsible and make good decisions. Have fun, you don’t know when your number will be up. Take time for yourself every day. I try and follow her words, although we all know I could be doing way better at this taking care of myself thing. LOL!
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DeleteI keep discovering methods to keep myself healthy and motivated. I have always exercised, I am one those those odd people that enjoy exercising. I also get massages to relax, I read fun books to escape the oncology world, and chocolate is very therapeutic. I do not watch medical TV programs or movies as it is not an escape, it is what I do every day, so it is not relaxing for me to yell at the TV, "They don't have the siderails up on that cart!" (My husband is a patient man.) Taking trips, like hiking forests or mountains is an amazing way to help you count your blessings and be grateful for everything. This is a proud and valuable profession, but we have to learn how to survive it. Donna Krickl
ReplyDeleteI agree Donna-NO MEDICAL DRAMAS:-) I find them nothing but aggravating. I prefer something useful like Food Network or HGTV:-)
DeleteDonna,
DeleteOne thing I have started doing is getting up to walk, do squats or anything during t.v. commercials. During one show, I had taken over 1000 steps. That was a great motivation for me to continue moving during what is normally a sedentary activity.
I do think making time for ourselves is difficult. Of course nurses realize that it is important but actually making it happen is a different story. I have made it somewhat of a priority to work out and usually do so about 4 days a week. But how I am able to do this has definitely changed. I do work outs that are able to be done at my house using a DVD player and are at max 48 minutes. Surely, I can justify 48 minutes of me time, right. After sustaining a back injury here at work, I have also committed to going to the chiropractor on a regular basis even though my insurance does not cover it. When feeling tense, I try to be intentional about relaxing my shoulders and taking a few deep, cleansing breaths. Self care is difficult for nurses but we need to be intentional in order to make it a priority.
ReplyDeleteI do the same Tina, regular Chiropractic and massage therapy(the real stuff) is a must do and non-negotiable. I wish the insurance companies would realize the benefits and pay for it...it may just SAVE them money in the long run....
DeleteTina, I am glad you shared your experience with the chiropractor. I have been wanting to go see one but have been afraid to. It it good to hear from others that it makes a difference. It is helping me to overcome my fear and try it.
DeleteTina,
DeleteIt is great to see you really be mindful of keeping your body in balance after injury, and also knowing when to seek that chiropractic to help reduce tension and to take care of YOU! It really is a tough balancing act, but you have a great self-care mindset!
Our own health and self-care. So very important! How can we take care of others if we neglect ourselves? I currently work part-time, which gives me more down time than most. I am grateful for it. I have always enjoyed running, as it has so many positives - gets me outside, clears my head, brings on the endorphins, etc. I always feel better after a run, even if it's a crappy run! I also enjoy singing. Feeds my musical soul, and is a good stress relief. Laughing is also something our family does a lot. Often at ourselves! Can't take yourself too seriously. Time with my work peeps is also valuable, as noone knows our world like we know our world! And finally, I am a Christian,and I look to God for strength, for solace, for guidance, for everything, now and future. This brings the greatest wholeness to my life.
ReplyDeleteJen, you have a well balanced way of caring for yourself and have reminded me that I also have many of these resources and benefit from them as well in relieving stress and managing self care. You have really embraced mind, body, and soul in your self care.
DeleteWhy, thanks! I am learning. It's only taken 51 years...:)
DeleteSelf care is not only for the physical well being but also our mental and emotional well being. It is easy to get on a treadmill/bike to work the body but if all you do is think/stress about work, if really defeats the purpose. As difficult as it is, I try to block out anything to do with work when I am not there. One small thought can quickly blossom into a run of stress and anxiety. It may sound selfish, but clear boundries need to exist between work and your personal life.
ReplyDeleteGreat Point Julie, I have Med-Surg experience before coming into oncology. I find the oncology field more emotionally taxing then the previous discipline i was practicing. Being a faith based RN, I find it liberating when I give my cares/fears/worries to my Higher Power. One of my favorite verses I always refer to is the the verses in Romans 5:3-5..."But we glory in our tribulations also, knowing that tribulation produces perseverance and perseverance, character; and character, hope. Hope does not disappoint, because the Love of God has been poured out in our hearts by the Holy Spirit who was given to us" God bless you my colleagues.
DeleteI think that nurses are the worst in taking time for themselves due to our nurturing tendencies. When you leave work it can be the kids or parents you then start focusing on. I think here at CTCA we do a good job of promoting self care but I am not sure that we as nurses listen. I did start walking after work which allowed me to relax and enjoy the outdoors and really helped me to let the stress of the day go. As an inpatient nurse I did not worry about my needs ever as I was always focused on my next task, and even when I got home I had to replay the whole shift and make sure that I did not forget something to call to the nurse who replaced me. I continue to use walking as an outlet for stress relief and many times listen to music while walking. I think as nurses we have to stop feeling guilty for taking time for ourselves and just do it.
ReplyDeleteI agree Pam. I think as mothers, wifes and nurses we really have a lot of guilt going on. We always want to be there for our childrens needs first then our husbands needs and then the needs at work. Who has time for themselves after that? But I like your comment of Just DO IT! Let go of the guilt and just do it!
DeleteI agree with all of the above. I am truly blessed to be able to work part time. This allows me to schedule all those appointments and self care needs on my days off. I am truly in awe of my peers that are able to get everything accomplished while holding a full time and many times more than full time position.
DeletePam, I think you nailed it on the head when you said nurses need to stop feeling guilty for taking time for ourselves. As we have many people that need us, both at work and home, we must remember it is okay to take some time to regenerate ourselves.
DeletePam, some great advice given. We all need to find that space and just take that time for ourselves and not feel guilty about the time taken.
DeleteI agree Pam. I know you are very focused and motivated with walking which helps to relieve stress. I respect your motivation. It's always hard to balance work, family, and taking care of one self. The balance to adding self care to one self is always been a challenge for me. I feel as though I am always caring for others. I have to remind myself it is ok to take time for myself.
DeleteI so resonate with that "replaying the shift in my head" thing. We must, MUST work to give ourselves mental relief after work. We must find our thing and do it! Critical, really. Thanks for sharing.
DeleteThe balancing act of adding self-care to my life has been tough. I don't have any children, but I care for many people in my life after leaving the hospital. After going through the Holistic Nursing certification program, I really learned the importance of self-care. One thing I do for myself to try and maintain my health is working out. I make it a priority to work out at least 4-6 days a week, and always first thing on my days off. I also plan my meals so that I am eating nutritious foods that give me fuel and energy instead of dragging me down. I still have a great deal of stress in my life, but exercise and diet help immensely.
ReplyDeleteEveryone self cares differently. I think it is most importand to understand this. For some people it is exercise, for some reading, for others it is their pets, for others it is quiet, alone time. I think that physical activity, like Stephanie mentioned, it something everyone needs because, I believe, a healthy, strong body helps to create a healthier mind. I can say that in the area I work in, we spend a lot of time in laughter together, this has been that best form of nurturing the self that I can think of. Our patients love being engaged with us as well in this way. It gives them an escape from their cancer reality too.
ReplyDeleteI've always said I've never laughed harder than I do with my patients here. Even in the most difficult, dire, or disgusting situations, sometimes laughter truly is the best medicine! There's nothing quite like a good belly laugh.
DeleteSometimes that belly laugh keeps us from crying! Laughter is necessary. I am so thankful for my co-workers who enjoy a healthy, hearty laugh as much as I do.
DeleteYep - we are all wired differently. Gotta find our thing and DO it!
DeleteI used to feel so guilty about taking time out for myself and engage in a self care activity. Over the years I've learned that in order to be an effective and compassionate nurse I need to take care of myself so that I can take care of my patients. Since working at CTCA I've been introduced to essential oils and have invested in them. What a difference it has made! However, self care doesn't need to cost anything - at times I can just sit quietly and close my eyes and meditate with my pet...so peaceful and grounding. When I open my eyes I feel so calm yet so alert and energized. Everyone practices self care differently. We need to be adventurous and try different things and share our experiences with others.
ReplyDeleteMeditation has become one of the pillars of my self-care routine. I try to do it everyday, but if I miss a day or two or four, I don't worry about it. Actually, the app I use had a meditation that focused on not being hard on yourself when you break a streak of meditation. Ha! Meditation has helped me sleep better, stress less, and be a more pleasant person in general.
ReplyDeleteBy caring for myself in this, and many other ways (acupuncture, exercise, yoga, massage, skin care) I am able to care for my patients better as well.
For me my outlet is cooking. I enjoy planning our meals for the upcoming week, grocery shopping (couponing!!) and then having those few hours for myself in the kitchen to decompress and process the day. My husband exercises while I cook dinner so once the shower is going I know that I can begin to set the table and finish preparing. My husband and I turn off the TV and cell phone during our dinner time and catch up about the day and what we have going on for the next day. It has helped us to stay connected and I truly enjoy have that time together.
ReplyDeleteI have also learned that going to a therapist is very helpful for me. I see her once a week and since going to her, I have learned how to manage my emotions better, improve my self-awareness,and learn that it is ok to be vulnerable.
Vulnerable, that word kind of brought up different feelings for me. We don't allow ourselves to be vulnerable and I feel we really to harm to ourselves emotionally if we don't allow the vulnerable side come to the surface once in awhile. Thanks for your thoughts Elizabeth.
DeleteWay to know yourself, Elizabeth. I think every one of us could benefit from a therapist.
DeleteMy self care tends to be just quality time with my family, we all have such busy schedules that make it hard to connect and maybe vent a little or just enjoy each others company. Reconnecting sometimes at dinner with the kids is my self care, I just in general enjoy my time with them. Sometimes a little shopping tends to help me re-center myself as well lol!
ReplyDeleteI feel the nurse always needs to be looked after. Just like on an airplane, you can't take care of those around you if you don't put on your oxygen mask first. I have finally learned to take care of myself first so that I can better take care of others. I take the time to just breath and be in the moment. Once that moment or bad experience has occurred, I check in with my feelings and allow that to be a part of my past and not effect me in my present in a negative way. It is really hard to put myself and my needs first as a mother, nurse and grandmother but I have learned and continually remind myself. I find time to listen to music and sing out loud when no one is around to hear my horrible singing voice. I find time to watch the leaves fall and the wind blowing the leaves away, I find this very relaxing. Another thing I really enjoy, especially this time of year, is talking to my husband about different memories we have of our children growing up. We find ourselves laughing and finding old pictures to send our kids. I believe that everything I do that relaxes me or brings me joy helps me to be a better nurse. I think we need to make time for ourselves, even if it is getting up 5 minutes early or going to bed 5 minutes late to have time to yourself to do whatever you can for yourself.
ReplyDeleteI like how you give space to your good and bad moments, and then move on from them. I need to work on the moving on part~
DeleteI really enjoyed reading that article, it had a lot of great points regarding how we take care of everyone else but forget about ourselves. It kind of reminded me of one of the classes I took at the holistic conference, how nurses are all about the patient's I&Os but we go through a 12 hour shift with maybe going to the bathroom once and taking a 5 minute lunch when we can fit it in. It's really very important that we take care of ourselves because like the article states, our patients suffers when we suffer. My self care is when the day is winding down and I put on some music while i'm charting, music always relaxes me and melt my stress/tiredness away.
ReplyDeleteMusic is such a great idea. I wish I would've done this when I used to work inpatient. I probably would've been able to finish a lot faster. Im actually playing music right now as I'm working on this :) When my mind is "overworked" and I've had enough I have to get up, stretch, get water to start somewhat with a fresh mind.
DeleteMaking time for ourselves is difficult, but should be a priority. I enjoy walking or some type of exercise just for myself. This for me is very relaxing and a time to meditate. After the stress of work during the day exercise helps to reless the stress. If days go by that I'm not able to exercise I find my stress level higher and my tolerance is shorter. We have to remember that taking care of ourselves is not a selfish act it is a self caring act.
ReplyDeleteLaura,
DeleteI agree with your statements about exercise. It helps my stress level tremendously also. I have not been able to exercise lately due to a demanding schedule and I feel out of sorts. Its definitely time to make time for myself a priority.
Krista,
DeleteI've been a nurse for over ten years and I can still remember what one of my nursing school instructors told us as we approached graduation. She said, "Remember to also take care of yourselves." Nursing is a high-paced occupation that can also lead to stress. We must remember that we can't be an asset to our patient's or our employer if we don't take time to do something to rejuvenate ourselves through some type of exercise, yoga and healthy eating.
John Miller
Nurses tend to give a lot more than they get. Whether it’s in our nature or learned, it is something that happens with most nurses. That is one reason self-care is now being taught and pushed for nurses. Even here at CTCA self-care is being taught in the onboarding process.
ReplyDeleteWorking two jobs I have put in a lot of hours due to being on orientation at my new job. I am making sure to eat extremely healthy, stay hydrated, and get as much sleep as I can during this time. I am also studying to be a Nurse Practitioner. I know that I cannot keep up these hours for long, but in this busy time I am doing my best to stay healthy.
The American Nurses’ Association (ANA) Healthy nurse, Healthy nation, initiative is one great example of how nurses that take care of themselves can more easily, and safely, take care of patients.
John Miller
ReplyDeleteI work in the operating room and there are aspects of my daily tasks that can be physically taxing. Moving patients to and from the operating table, pushing patients to the O.R. in their stretchers and gathering heavy, cumbersome equipment can wear you out sometimes. It is important to use good ergonomics to prevent injuries from repetitive use and/or acute events. It is important to always use the proper devices at your disposal to make your job safe. One thing that I am always cognisant of is my posture. I am no longer a "spring chicken", so I always make sure I pump up my patient's stretcher prior to transport so that it is at an appropriate height for me. Avoiding unnecessary bending at the waist is important for me to prevent potential pain.
Posture is so important, I couldn't agree more. I try my best to remember that when charting, standing or with any patient care. It makes a huge difference to use the correct maneuvers.
DeleteFor me my release is planning dinner with family and meeting up with girlfriends. I also enjoy playing tennis and golf (in the summer) to release tension. As nurses we need to encourage and support each other through our physical and emotional days. We are truly "guilty" of working through pain and many other things. We need to take care of ourselves because in the end we are no help to others if we are helpless ourselves.
ReplyDeleteI feel that healthcare workers in general do not take care of themselves the way we educate our patients to do so. I feel that as hard as it is, we need to put ourselves first because if we are not healthy, then we can not give our patients the best care they deserve. I try to do yoga throughout the week, and drink plenty of water to give my body a break from the week.
ReplyDeleteI totally agree with you, we are just as important as the patient. We just need to realize it when we get injured or are ill at work.
DeleteI totally agree with you. We are just as important as the patient.
DeleteI do feel that nurses don’t always practice self-care for the reasons they provided in the article. It does seem when you get injured at work you are more likely to be penalized then cared for. Nurses are the glue that holds the hospital together, and if we aren’t feeling well, it is hard to perform our best for our patients. I think we need to realize we aren’t super humans and we need to step back when it is necessary for all people involved. We all work with great colleagues who will adapt to the situation if we have to be out while we recover. We are just as important as the patients, we just need to realize it.
ReplyDeletePreach.
DeleteAs a mother of 3 very active boys and a spouse who is gone most of the time, self care often seems impossible. I have to remind my self to change my thinking from "I have" to "I choose". I often feel overwhelmed with that I HAVE to do when in reality I need to CHOOSE me first. easier said than done.
ReplyDeleteElisa, I agree it is much easier said than done. There is always something that needs to be done in a home! I started to "make" time for myself out of the house when Im able to at least once a month. Even if its for 1-2 hours this is usually more than enough for me.
DeleteElisa - it is hard to choose. I always feel selfish when I put myself first... I know I’m not being selfish... I need to teach Anna that I am important, but it’s not easy.... maybe you help me 😬
DeleteWe are all busy. I am a single mom with 5 kids, so I know that firsthand just like you do. Self-care can be 10 seconds where you just stop and breathe a few deep breaths while you are putting laundry away. The point is to try to fit something small into your day while you are already doing what you are doing. I take an extra minute each time I am in the bathroom after I wash my hands is my reminder for self-care and I do some stretches. It helps me to de-stress, and it is my private time with the door locked where I can’t be bothered.
DeleteTry that to start and build on it from there!
Hugs,
Brenda Chiappetta
When I turned 40, I finally decided to take care of myself because nobody will. I started running and exercising, learn to cook and eat healthy food, learned to try and appreciate good wine and most specially I started to travel with friends. Taking trips, seeing different cultures is an amazing way to help you count your blessings and be grateful for everything.
ReplyDeleteThis is a great way to definitely take care of yourself, Victoria!
DeleteOMG, Victoria..you're 40 already. I thought you are only 27 years old. see what running, exercising, eating healthy and traveling with friends can do to you... I better start doing these things right here right now..
DeleteThat's why I started running with you. You made me feel inspired to be fit! Good Job.
DeleteThe balancing act of self-care is crucial for our health. If we don’t take care of ourselves, how can we continually give to others? There is an old saying about pouring water from a vessel; it cannot be continually poured out without ever refilling it because eventually it will dry out. That is the same with us as nurses. We must be able to take time to fill ourselves up so we don’t run dry. It is important to take a personal time out to refresh and fill ourselves back up. CTCA does a good job with this by offering the relaxation rooms with massage chairs and offering involvement of Holistic Committees. Personally, I take time every day to read my Bible and daily devotionals and exercise. It is also important for me to have healthy communication with my family and friends to stay connected. The more we take care of ourselves, the better we will be to our patients, coworkers and everyone around us.
ReplyDeleteGreat points Sheila! Renewing ourselves in return provides better care for our patients. CTCA does a great job supporting the renewal process for nurses.
DeleteSelf care is something that in a sense goes against the nursing philosophy of caring for others. Putting others needs before our own is something that nurses do so frequently making it difficult to make time for ourselves. Nurses as a profession are learning about self care and the importance of caring for ourselves to provide the best care to our patients. CTCA has several ways for nurses to take part in self care including: renewal rooms, mind body therapists and our holistic committee.
ReplyDeleteWhen I leave work I like to listen to music to unwind from a stressful day. Taking that half hour to reflect on the day and let go of work related stress helps me to come home refreshed and create a balance in my work/personal life. Listening to light music during the day at works helps to relieve some of the stress while at work too.
DeleteIt is really nice that CTCA does put focus on self care with the renewal rooms. I work offsite so I can't access them, but it is a wonderful thing to have for those who need to step away from a stressful day for a few minutes to relax and recharge a bit.
DeleteI feel as a nurse we do not take care of ourselves as much as we should because we are so accustomed to taking care of everyone else first. With this said, I have learned to give myself more "me" time to relax and to not take work home. We need to encourage each other to do the same so we have a better quality of life.
ReplyDeleteWhen I started my nursing career, I feel like my body can handle anything especially the emotional and physical demands if work. But then later on because of heavy workload in ICU early in my career and working 3-5 days a week, where you do everything no PCTs in particular, I started having back pains and get sick easily. One nurse talk to me and said,"Listen if you are sick, you are sick do not pretend that you are ok, just get some rest and think about getting better. You have a family to take care of too as well." That me realize that I also have to take care of my self to take care of others especially my family and future patients. Made some balance with work and life, but still sometimes it is still hard to ignore that because of nursing shortages at work.So here I am in PACU, would say it is less physically demanding than my previous job and I spend more quality time with my family.
ReplyDeleteWe all went into the nursing profession because we enjoy caring for others. Yes, its a lot of work physically and mentally but yet we love it. In nursing school we learn how to be a nurse and how to critically think but we are not taught how to take care of ourselves. I dont remember having a class about how to manage stress when I was in nursing school. We are so focused on our patients, the caregivers, making sure we are up to standard with what is required from us from management that we dont stop and think what about "me"? I think its great that we have so many different options here at CTCA for stakeholders to take for themselves. I personally just enjoy going home and spend time with my baby and my dogs. I can feel almost instantly my stress level go down.
ReplyDeleteBeing a nurse and a parent is a two full time job. I think most of us can relate. Just thinking about taking time for ourselves is very difficult, but as what others say, it has to be a priority. Taking a " me " time is not being selfish, but it can greatly help work-life balance. Few years back, I find it very hard to find a time for myself, but as years goes by, I've learned to incorporate it with my daily busy schedules and it somewhat change my perspective in a lot of things. For example, bringing my son to his basketball practices and travel tournaments is a big headache and takes a lot of my " me " time. Now a days, I don't look at it that way anymore.I used all those times and think it's my vacation & travel time with friends, team family and my own family watching live basketball games and making memories together. Another example of finding a " me " time in between busy schedules is using my time wisely during long hours in marching band training & camps and basketball practices for my son. I jog, hike and walk around the forest preserves or trails where we are if weather permits, or use the big gym if its cold outside. Finally, we really need to find time and take care of ourselves, whether it be running, jogging, walking, regular exercise, listening to music, vacation or eating healthy, for all these things helps prepare our mind, body and soul so we can help others too who are in need just like our dear patients.
ReplyDeleteWorking in ER and PACU is both physically demanding. I used to work 5 or 6 days a week with some night shifts in between. I'm thankful I realized how unhealthy that lifestyle is before it's too late. I reflected on the quality of life I am living and equally important is the care I am giving my patients. Right now I make sure I eat a balanced diet, exercise and have time for myself. Taking care of yourself is very important because your patients need a healthy caregiver too.
ReplyDeleteI am convinced that self care is the most important thing every human being needs to do. It is not a selfish act, as some might think; it is the absolutely necessary ingredient in life. I believe that one can only take care of another person once he/she took care of herself/himself. There is so much stress in modern life that it requires more effort to stay balanced. In terms of work, one is more productive and efficient when rested and well nourished. The holistic approach is a popular term these days, and we hear about providing that kind of care to our patients. Nevertheless, we should master it practicing on ourselves, so we are fully equipped to serve others in best way we can. Nursing in operating room can be very mentally draining. While there is no much room for direct patient care, there are many opportunities to interact with members of the surgical team. As a nurse, I work with many different personalities and had to learn how to handle stress. During my experience in surgery, I became more aware of human psychology and also learned more about myself as a result. My approach to staying sane and healthy is attending yoga regularly and meditating whenever time allows. I also put effort to healthy diet and positive thinking.
ReplyDeletewell said Anna, It is not a selfish act to take care of yourself . just like Whitney Houston song " Learning to love yourself , is the greatest love of all "
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ReplyDeleteMary ThyneNovember 27, 2017 at 7:19 PM
My self care is usually a hot bath with Epsom salt, essential oils and grape seed oil. Whether it is an emotional, mental or physical release, I usually turn to a hot bath. Just one of many things I have done to give myself, me time and let go. Other things I have found helpful are take a long walk, receive a massage, give and receive Reiki, sit in the sun (even on a cold day as long as the sun is out shining on my face and body)and just sit and listen to calming music. My Pastor records his sermons on Podcast and I will listen to them during the week usually while getting ready for work. Helps me to get to a positive frame of mind. And setting and sending positive intentions sets the tone for my day whether on my way to work or on a day off. I will agree sometimes it's easier said, then done. Thanks for listening everyone.
That is very comforting Mary. I like that idea.
DeleteMary, you are teaching me a lot since you’ve been working with Pain Management
DeleteGood points Mary. I guess I do more than I realized in the area of self-care. I also use Epsom salt baths to relax.
DeleteWorking out makes me feel good. It's my stress reliever. Watching movies and of course eating delicious food. That's my self care.
ReplyDeleteI love a good movie. It allows me to be outside of my own head for a while!
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ReplyDeleteWe can work on this together. I know what to do. I just need to do it! We can help each other and encourage each other.
DeleteNurses work in an increasingly stressful work environment. After work, I have a long drive home to unwind. I enjoy listening to music to relax, learn some new dance moves, read some inspiring or motivational quotes, spend time with my family, and eat energizing, healthy foods.
ReplyDeleteBrenda,
DeleteAll great ideas for self-care. I particularly like what you said about eating energizing foods. Food can have such an impact on our mood, how we feel, and our energy levels. When we are stressed it usually makes me want to grab comfort food which is not always the best choice. I need to focus on grabbing the healthier, energizing foods.
Thank you for that reminder.
Brenda Chiappetta
Self-care is so important. Equally important is to somehow try to make sure that your fellow nurses that you are working with have an opportunity to eat lunch, go to the bathroom, or use the massage chair rooms to distress. As nurse partners, we can try to make a conscious effort to say...”go use the bathroom “, or “go take a 10 minute break...I’ll watch your patients”, or “go take your lunch”, or offering to help them with something so they are able to do these things.
ReplyDeleteI have adapted several self-care practices while at work. I try to get to the massage chair once a week as my goal. I do shoulder shrugs as I am walking down the hallway to get my next patient. I take 2 minutes several times a day while charting at my desk to do neck stretches and it has really helped loosen up my tension in my neck. I have also just stopped for 30 seconds before I see each patient and take three cleansing breaths and become focused and I am more present with each patient.
Happy holidays everyone!
Brenda Chiappetta-Wound Care
i take care of myself by having a " me time " .Self care is very important because how can u take good care of others when u yourself i hurting. exercise, healthy diet and positive thinking and Encouraging others to do the same thing too.
ReplyDeleteAs nurses, we often put others needs before our own. We are always caring for others and sometimes forget to take care of ourselves. However, we have to try to make it a priority. I enjoy spending quality time with family and friends. I also like to get lost in a good book.
ReplyDeleteWe have the same priority.-read my books or just spend time with friends and family. We should not forget to do self-care.
DeleteNurses have a long history of poor self-care causing many health issues. I think self-care has become the in thing, thank goodness. It's more important than ever with the changes in health care. I also use Epsom salt baths to relax, walking in the woods, biking and digging in my garden. I love to read books about the power of our thoughts. And from our Holistic training, the deep breaths prior to entering a patient's room is awesome. And yes, supporting one another during the workday helps to let others know they are cared for.
ReplyDeleteI use Tina for my self care!!! Unfortunately I get terrible neck and shoulder pain when stressed. Tina has come to my rescue on several occasions. With being a certified Holistic nurse she has amazing insight in self care. She has given me many tips for relieving pain to my neck and back. She has even taken time out of her work day to give a quick massage. It is wonderful to work in a place that puts so much emphasis on self care for nurses, and I'm so thankful for coworkers like TINA!!!
DeleteIt's true that as nurses we feel guilty when we call in sick. We become short staffed and then try to do the job of the nurse that called in aside from our own workload. Here in stem cell care manager dept., we all work together to get our job done. That's called cooperation. If somebody is sick, we all pitch in to get thru the day.
ReplyDeleteSo, how do I do self-care?
I bought a fitbit and try to get my 10,000 steps for the day. I also enjoy our bonding time in SCTU-whether it's a dinner inservice given by drug rep or like the SPA day we had in Mario Tricoci in Libertyville. We even had our bonding time as far as Las Vegas where we watched shows or just walk in Las Vegas Blvd. after eating in the buffet. On my days off, I walk in the mall, play bingo or just stay home and read my books or watched my Korean telenobelas.
As nurses, caring is a part of our nature and sometimes with that comes the risk of caring for others and not caring for ourselves. Nurses must first take care of themselves in order to be able to take care of their patients. “Care for self” can refer to taking personal time, maintaining our own health, making time for family or friends, enjoying hobbies, and relaxation, among others. Self-care is an important concept and sometimes nurses may need to be reminded of that fact. It would be beneficial for nursing programs and employers to introduce this concept early on to instill self-care from the start. When nurses forget to take care of themselves, nurse compassion fatigue and burnout occurs. Nursing compassion fatigue can lead to poor patient care. We cannot forget to make time for ourselves!
ReplyDeleteSleep, sleep and more sleep. As a night shift worker sleep has become my most important self-care practice. I do my best to follow a healthy diet of fresh, natural whole foods. Making sure my body is rested and adequately fueled keeps me staying healthy and strong to care for the patients at the bedside. Another form of self-care is using good body mechanics to protect myself from possible injury. Beyond that I use essential oils, hot baths, reading, family time and playing with my dogs.
ReplyDeleteCathy, Whatever you do it works for you! You always have a joyfulness about you.
DeleteI come home everyday and spend time with my dogs. My daughter is now off at school. So, I’m able to take time for myself. I enjoy several podcasts while walking my dogs. My husband and I also take day trips. I’m still trying to learn how to take care of myself... I’m not very good at it.... I’m trying. Yes, Mary T - we will work on it together.
ReplyDeleteAs a RN I have seen many coworkers "suck it up" to make it through the day. I can share my personal experience of horrible pain for 3 1/2 years, just hoping to make it through each day. I am not good at relaxing though now that I am pain free and able to live life, I enjoy hiking, walking, swimming, and a great book which are all good self care techniques for me.
ReplyDeleteEvabeatriz Somentac- As CM for stem cell, I'm always on the phone the moment I get into the office until I go home. I experienced going to the bathroom 0 to 1X a day, no lunch, staying over an hour everyday. As I learned the ropes, things got better but then loads getting heavier. We bring food to share, vent to each other, laugh out loud and things are done by the end of the day. My stress reliever is my 3-year old son. I still have to play with him when I get home. Physically exhausted but I feel good. Hardly have a "me time" and still working on it.
ReplyDeleteHello Evabeatriz,
DeleteI could not agree with you more! Sometimes, in the midst of all the chaos, all I want is to spend some time with my girls! They are always THE best therapy and biggest driving force.
Jessica Mendez
Hello,
ReplyDeleteWhat I do for my own health and self-care in order to protect and prolong my nursing career is take time for myself. The manner this gets accomplished varies and can include a simple Target run or a more indulging day at the spa. This can be very challenging because I am currently juggling work and school along with a baby and the many other home demands. Luckily, I have a huge support system in my family that encourage self-care and always offer to care for my two little girls while I get some time to do whatever it is that I please.
Jessica Mendez
Target runs never fail! It is so easy to spend at least 30 minutes at Target. I will have to keep that as an option for myself only and use it as a de-stressor.
DeleteBeing a nurse we have the tendency to neglect ourselves." feel guilty to call "in sick" even if we are sick.I feel like I have to ask permission to be sick.But since the advent of Holistic nursing in our facility, the big push for "Nursing self care." I am taking care of my own self better. It reminds me of the instruction pre flight; in case of emergency; place your oxygen mask first before helping your family or the passenger beside you! Fair enough how am I be of help to others, if I myself is not in good shape to care for other people. I am so fortunate because I have attended the Holistic conferences sponsored by our organization and learned a lot of techniques to de stress myself. Whether just simple deep breathing; grounding, Reiki Yoga and others. These information in turn help me educate our patients/care givers and my own family. I still want to watch movies at home and Filipino telenovelas to relax me.Bottom line is; to be an effective and excellent care giver; Care should start from within.
ReplyDeleteAgreed Imelda! We can't care for others if we don't know how to care for ourselves. Glad you've learned some stress-relieving techniques.
DeleteTo preserve my own well being as a nurse I really try to leave my work at work, and leave my home at home. I make a point to not carry either back and forth. I like to separate my self, and I try not to take my self so seriously. When I leave CTCA I become MOM and the nurse/work part of me melts away because that's when the true work (life) begins. I try to keep in mind what truly matters and that's being a mom, wife, and taking care of my family.
ReplyDeleteCouldn't agree more!
DeleteI do find it hard sometimes to take care of the things I need for myself when there is a rotating schedule that never stays the same and lots of weekends worked. It takes away time from my family to dedicate to the families of my patients. I feel happy while I am at work and then look back some days on the times with my family that I missed out on. In a balance, though, I try to look at the positive and see the extra days I am off for working 12 hour shifts as a positive to make up that time with them or spend extra time pampering myself. No matter what, i always try to chip away at finding a balance in life so as not to feel overwhelmed and get burned out early on.
ReplyDeleteThis is so true! A nurse schedule is all about flexibility and time management. It also applies to the work life balance. The important things need to be kept in the central focus and everything else will adjust around it.
DeleteFor self care at work, I try to take my 30 minute lunch break at least 4 of 5 days. As a remote Care Manager, I'm sitting in a chair at the computer taking calls from patients and caregivers all day and even though that isn't physically taxing, it is very emotionally draining and mentally exhausting, and having a few minutes to decompress away from the phone is extremely important for mental health as well as physical health. While I'm not lifting patients and running the risk of back injuries, sitting in a chair all day has physical risk and I always worry about DVT so getting up and moving some is very important.
ReplyDeleteLisa Hammons RN, Remote Care Manager
Lisa, like you, most days I sit at the computer to do my work. I work remotely too and it's so easy to just sit and keep working. I have to remind myself to get up and get away from my desk, maybe do some stretches and walk around the house. Good you make it a point to get up and move. Good too you take your lunch break away from the phone and computer.
DeleteFor me, I always make sure that once I leave work and go home, that I do not take my work with me. I always make sure that my private life must be separated with my work life because it destresses me out. As nurses, we need to make sure that we focus on ourselves too as much as we want to focus on other patients because in the end who would take care of these patients if we are no longer functional because its either we are sick, debilitated, or dysfunctional as a person.
ReplyDeleteProps on your comments Richie. It is an exercise in futility for me sometimes and I really have to shun the thoughts out of my head.
DeleteAgain, being faith based, I give my worries over to my Higher Power-Father God.
I have to remind myself that whatever the journey, we always have to be rejoicing!
I'm glad to see that in the last several years there is a greater emphasis on self-care for nurses. In my early years as a nurse, I worked lots of extra shifts, on very little sleep. I remember staying "over" because we were short staffed or there was a problem with a patient. I was just doing what all "good" nurses did. Self-care in those days tended to consist of "self-medication" with alcohol and there were many, many well-attended happy hours at Chi-Chi's. That's what the RNs and residents/MDs did to relax and deal with the stress at work. Not very healthy! Over the years I learned there are better ways to deal with work stress and life in general. At one point I ended up changing careers, I was just tired of taking care of people/patients and got tired of being tired. That's when I finally understood that if I didn't take care of myself, I couldn't effectively care for others. Years later, I still have times when I don't quite get my work/rest of life balanced. Walking, being outside in nature, gardening, reading, spending time with family and good friends are things I enjoy. These things help re-charge me and make me happy. I can't care for others, and can't do my job well if I am depleted.
ReplyDeleteMerry Christmas! The article does a good job of associating the guilt of calling off for a sick day that RNs feel when they have to take a day off. I can relate to that. The guilt of patients suffering from inadequate staffing, and our colleagues suffer as well from the added load they have to pick up from lack of staffing.
ReplyDeleteThe goal is, therefore, to remain as healthy for as long as you can.
As a faith based RN, I am always asking for direction to care for my patients. My journey as an RN led to improved nutrition and health (which includes weight loss/control). Through my struggles and victories with my health, I was able to bring my experiences to the beside. Living with back pain for 25 years, I experienced a direct correlation between weight gain and increased back/knee pain. When my weight is controlled, so was my back/knee pain. When I experience weight gain, it is most often accompanied by increased back pain.
We can support colleagues by following the very same advice we give to our patients. By living healthy, we can help our colleagues and patients strive to be and stay healthy!
Some days I go home and talk about my day with my husband other times I go home and I don't want to talk to anyone. I feel drained and exhausted spending so much of my time and energy taking care of others needs. I am an introvert by nature and use a lot of my capacity of social interaction when I am at work. When my time off rolls around I just need quiet and alone time with my family. 2 Small kids doesn't really allow for this but I'm starting to understand my breaking point and my husband is understanding when I need "mama time" to re-energize.
ReplyDeletePeople ask me alot how I am able to take care of cancer patients. I always tell them I have learned over the years to leave things at the door. In other words, I do not let my patient's issues and stories continue to affect me when I am at home. On the other hand, I have ignored aches and pains during my shift and not taken care of these issues as they should be. Recently I have focused on weight loss by removing sugar and refined flours from my diet. Losing the weight has helped with aches and pains, and improved my overall self care, which has improved my mood and outlook. We can not care effectively for others if we are not caring also for ourselves.
ReplyDeleteNinfa Bontes
ReplyDeleteIt is always my self principle in life that if I am faced with stress or painful challenges I always bag it up in a brown bag and send it up there. I tried to decompensate by just praying that things will get better somehow. I am a true believer of prayers work wonders and it may not work all the time but it gives me hope and endurance to tackle the challenges. I look forward and not backwards since past is past but you learned somethings from the past that will keep you moving on to accept a positive future.