Dissonance and Harmony: Balancing Nursing and Home Life During the Holidays

Between worlds.

There is nothing quite like the holiday season in a culture obsessed with happiness at all costs to make me feel the complexity of navigating back and forth between work and home life as a pediatric ICU nurse.

Home life as a mother to two young children, wife, friend, and community citizen takes on an intense pace from just before Thanksgiving through the new year. I am coordinating celebrations with family and friends, keeping tabs on the kids’ school holiday programs, addressing Christmas cards, and deftly dodging BOGO promotional emails day and night. Life feels boundless with possibilities for activity and opportunity.

I arrive at work and enter the room of my patient, whose life has been brought to a screeching halt. She lies sedated, restrained by lines and tubes, barely oriented to day versus night. If not for the holiday decorations that we put up around the unit, there may be no indication of what season it is.

What is cheerful for me to anticipate at home during the holidays may be potentially disheartening for my patients and their families to consider. I can leave the hospital at will. They cannot. I am sensitive to this fact, and my demeanor when I talk about the holidays at work […]

Addressing Health Care Worker Trauma with an Off-Site, Overnight Workshop

Everyone experiences loss and other personal trauma, but those of us who work in health care are obliged to cope with our own personal grief and stress as well as witness the suffering and pain of our patients. Do these words ever describe you at the end of a shift at work?

” . . . angry . . . anxious . . . hopeless . . . stressed . . . depleted . . . depressed . . . frazzled . . . “

One health system gets serious.

There’s a lot of talk these days about addressing clinicians’ burnout, and in some workplaces staff now are offered a meditation room, or aromatherapy or massage.

But since 2013, Montefiore Health System in Bronx, New York, has seriously invested in their staff’s mental and emotional health by offering a two-day, off-site experiential and educational workshop twice a year. And by paying for the program, retreat center, and meals for all participants so that staff can attend for free.

In “Helping Care Providers and Staff Process Grief Through a Hospital-Based Program” in the July issue of AJN, Ronit Fallek and colleagues share their experiences in developing this program along with their analysis of feedback about its effectiveness. They offer enough detail to […]

2019-07-25T11:18:15-04:00July 25th, 2019|Nursing, nursing career, wellness|0 Comments

In Nursing, ‘Joy’ and ‘Work’ Are Not Mutually Exclusive

No shortage of workplace pressures.

Photo by Mark Thomas/Science Photo Library.

In virtually any health care setting today, nurses are under pressure to increase efficiencies, improve quality, and cut costs. The nonstop pressure to always do better comes in the midst of staff shortages, repeated changes in clinical protocols, struggles with EHRs that are incompatible with our workflow, and even concerns for our own physical safety. It’s no surprise that nursing turnover rates are increasing.

With all of this raining down on our heads, is it really possible to experience joy at work?

In “Finding Joy in the Workplace” in this month’s issue (free until May 7), Rose Sherman and Cynthia Blum tell us that it is. And, they argue, the work experience of nurses influences the quality of their interactions with patients:

If clinicians don’t feel hope, confidence, and psychological safety in their work, they can’t in turn offer these to their patients.

An evidence-based framework for improving joy.

The Institute for Healthcare Improvement (IHI) is known to most of us as an organization that focuses on patient safety issues like CLABSIs, surgical site infections, falls, and medication errors. But increasingly concerned about clinician burnout (which is, after all, a patient safety issue), […]

2019-04-24T09:26:18-04:00April 24th, 2019|career, Nursing, wellness|0 Comments

As Patient Handling Injury Rates Remain High, Schools Teach Outdated Methods

The old-fashioned way to reposition patients.

I haven’t seen draw sheets in hospitals for years now. “Back in my day,” those narrow sheets we placed across the middle of the bed were considered essential to patient care. Draw sheets were easier to change than the full sheet and they kept the bed neat. They always seemed to be hard to come by—probably because most nurses had stashed their own supply of them in patients’ rooms.

But more importantly, they were what we used to reposition patients. We used to work in pairs on turning rounds—one of us on each side of the bed, rolling the draw sheet tightly to get a grip, then sliding the patient up in bed or turning them on their sides. It was hard work, and no form of “good body mechanics” saved your back or shoulders and neck from strain when you needed to stretch across a bed—or, many times, climb on top of it—to move an unconscious patient. It’s no wonder that nurses and nursing assistants had such high rates of serious musculoskeletal injuries.

The institution of ‘No-Lift’ policies.

Then came electric beds, overhead lifts and transfer stretchers, and “No Lift” policies, which were based on data from the Occupational Safety and Health Administration (OSHA) on the frequency of injuries and supported by nursing organizations. Many hospitals and nursing homes implemented safe patient handling and mobility […]

Reexamining Resilience

Words matter.

As I have been presenting at various nursing gatherings and conferences about the topic of resilience in light of work-related grief, I have been struck anew by the definitions of resilience that I find in the literature.

  • The ability to return to a state of normalcy or to “bounce back” from adversity or trauma and remain focused and optimistic about the future (Dyer & McGuinness, 1996).
  • The “ability to face adverse situations, remain focused, and continue to be optimistic for the future” (Kester & Wei, 2018).

While I understand and very much appreciate the intent (and necessity) behind these definitions, I have to ask whether we are adequately exploring the meanings of the words used within these definitions and the implications for what nurses should expect of themselves in seeking to be resilient.

Does short-term resilience look different from long-term resilience?

For example, in the definition presented by Dyer and McGuinness, a resilient nurse should be able to return to a state of normalcy. There is certainly a need for nurses to be able to maintain a steadfast mind and emotional state in the short-term moments of acute crises with their patients. A nurse returning to work after a difficult shift just the day before has to find […]

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