‘Tis the Season of being Stressed

 

To get us all in the mindset of what I am about to discuss, let’s review the following video:

I am the Grinch in this video when it comes to stress. There’s no Cindy-Lou-Who about it. I became the Grinch, despite this self-righteous proclamation to be a better, more positive person. Last night, I was wrapping gifts and my husband was calmly watching TV. I look up at him,

Me: “Sam”

Sam: “What”

Me: “I can’t do it. I’m trying to be the best I can be in all these different aspects of my life. I’m trying to be a better instructor, a better nurse, a better mentor, a better friend, a better wife, daughter, sister, granddaughter, just better person in general……..and we have to clean, and cook, and wrap the presents, and go to all these family parties, and have you asked you aunt what we can bring? And we have to do the dishes. And vacuum. And mop. And why is my grandmother so hard to shop for. You better help me with chores you know. I just can’t do it.

Sam: “It’s all fine. It will all get done.”

Me: …shedding a tear “Why don’t you talk to me”

Sam: “I am, everything is going to be okay, you worry to much”.

Me: “Ugh! No I don’t”

It’s “humerus” now (get it? RN joke, its what we call the bone in your arm), but last night my shoulders were up to my ears and I could feed the knots forming in my shoulder muscles, and I was having this sense of overwhelming fear of disappointment come over me. First of all, I have an awesome husband – as high and in the clouds as my anxieties, ideas, and dreams are he is oh-so grounded with his engineering black-and-white thoughts, and brings me down to earth, and luckily we end somewhere in the middle. Yet, this stress is all to common for many nurses near and far; especially around the holidays where many competing work, and family needs.

 

How do we get this pattern of stress and worry? Well, with my students, every morning in clinical, after they have received report, I play the “worst case scenario” game. Not to be all “dark and twisty” (Grey’s Anatomy reference); but it helps them critically think on how to be prepared for any situation that may arise. So we are trained from basically day one to think the worst, and not just hope for the best, but follow every protocol and evidenced-based practice we can to make it the best it can be.

 

Oh How Nurses Worry? Let me Count the Ways:

-We worry how much you pee

-We worry about your vital signs

-We worry about your bowel movements (That’s poop- weird/gross I know – but it’s important- trust me I’m a nurse)

-We worry about your pain control

-We worry about your IV sites

-We worry about your labs

-We worry about you or your care takers knowing how to take care of you when you go home.

-We worry about your overall well-being.

 

….and that is just a slice of the worry pie. We worry that our documentation is on time, accurate, and doesn’t say GUAC negative instead of GUIAC negative (although we are hungry so we would probably prefer some guacamole right now rather than checking for occult blood in your stool), or phone calls to physicians include all the information – enough so that you can get exactly what you need ordered, we worry that the blood we just had to take on a 9 month old baby that’s hard to “stick” might be clotted (THE WORST).

 

• The biggest slice of worry pie is that…..We worry that EVERY SINGLE action or decision made by us directly can positively or negatively impact YOU and YOUR health.

 

So there are substantial backings to our worry. Yet sometimes our worry becomes too much and we just have to eat some of that worry pie, and let it digest (Yay for another GI reference!). This can be hard when you are 22 years old and you have previously been on a worry pie-free diet. No bills, no kids, no pets, no mortgage, no one to care or worry about except you and your awesome self.

 

Here’s another truth drop…..Nursing is a culture shock to your life. When you become a new nurse, now every ounce of your worry goes into caring for others, and this can be draining, especially when this hasn’t been your “norm” for 22 years. It’s not like we go through nursing school not knowing this, as we practice taking care of patients all throughout school – but you can only understand this big fat worry pie when you have your first shift on your own, and YOU, yes you now are the nurse and YOU have to fork some worry pie into your care – and that’s just part of being a good nurse.

 

I could keep telling you how many ways I can worry. However, I have a sugar-high from that worry – pie and I think I’ll go into the magical world of ‘Coping”.

 

Cope. It’s a strange concept. It’s meaning automatically suggests there is something BAD that has happened, and as a human we have to deal with it somehow, because it’s so alien to our desire for goodness and normalcy, that we need a mechanism to make it better – and that somehow is called coping.

 

Let me tell you how we were all taught to “cope” with stress. I’ll call this, “Cope-a-licious”. We were taught to:

 

1. Exercise on a regular basis (Ha!)
2. Eat 7-8 servings of fruit and vegetables EVERY-SINGLE-DAY (Okay, does lemon water count?)
3. Get 8 hours of uninterrupted sleep (Okay so if I work 7am-7pm, but its was a busy day so I get out at 830, have 45 minutes to drive home….that’s now 915, but I have to shower because a baby threw-up on me- that’s 945, OMG food, that’s now 10…okay try to relax, deep breaths, sleep by 1030, and have to set my alarm for 4:30-4:45 because I work the next shift)….wait what? Can I have a nap?
4. Do fun things outside of work. (Right after I catch up on sleep!)
5. Breathe (Oh got this one!)

 

Okay okay, but in all seriousness, you need to find things that work for you to cope because it’s not natural to help sick patients all the time. So you must cope or else you will get fatigued, which will lead to a nurse-zilla personality…which is definitely not cope-a-licious.

 

….and that’s not okay.

 

Truth drop: what do I do? I try to exercise, but it’s been poorly executed recently – I plan to work on this – hold me to it. Also, let’s not talk about food yet – that needs another blog – and I work on pediatrics- and it’s the holidays (such a truth drop right there – splash!). However, stressed is desserts spelled backwards, so there’s that.

 

Nurse-speak: Looking back when I was a new nurse… I find it funny now that I used to get stressed when the charge nurse would come up to me and say, “I have an admission for you”. I would actually get angry at them sometimes, because I would be so busy. Now there are still a few times when I am so deeply involved with patient care that I get stressed with a new admission, and hopefully you have a good relationship with your charge nurse that you can say, “Hey I’m so busy right now, trying to provide safe care for my other patients and I would be more than willing to take the next one, but is there anyone alternatively that can take this patient right now?” If that’s not possible, you can also ask your charge nurse to help with getting your new admits vital signs, priming tubing, getting equipment, asking admission questions ect. About a year ago, I adopted the philosophy to expect an admission is coming, which then I don’t get AS stressed (truth drop – I still slightly tense up), and this way it motivates me to push through documentation for my other patients as best as possible. And (this is my optimist-side in me speaking) if you expect another admit and don’t, you walk out of the shift like “Awww yeahhh, anticipation for the win, documentation is on time, so cope-a-licious”.

 

  I find POSITIVE PEOPLE.

 

I realize now when I do get stressed. I can feel my face getting hot, and now this self-awareness has pushed me to say:

 

“Self, get-it-together. You are doing the best you can. Ask for help if you need it. This isn’t forever. Can you delegate? You need to prioritize. Go take a 2 minute break, go pee and think through this”. Also remembering that NURSING IS A TEAM JOB….and if you couldn’t get every non-critical thing done, and it’s headed toward shift change, and it’s 1855… do what you can but don’t be a superhero, don’t try to rush through anything if it’s not critical, and understand that the next nurse has 12 more hours to get some things done that you weren’t able to. It’s not a failure on your part. You might have to look at your own time management skills the next day – but healthcare tasks don’t fit into pre-packaged 12 hour chunks, and this roll-over of tasks needing completion is expected.

 

Another piece that I found helpful, was brought up to me by a member of our chaplaincy team. Her suggestion was to have a mantra. So now I talk to my brain, yup I do – don’t be jealous – we get along great. As I walk in the door I say:

 

“Today, let me be the best nurse I can be”

or

“Let me find one thing positive to tell another nurse today”

or

“Today, let me have empathy for each and every family”

or

“Let me teach something new to another student today”

or

“Allow a nurse / nursing student to teach me something new today”

 

You can make this your own even if you’re not a nurse. Just going in to work with the intention to do these things during your shift/day, can change your entire attitude. TRUST ME. If you are religious, you could also use this as a prayer. I love this suggestion, and I am forever grateful and now pass this along to my students.  – and now to you thanks to this code white blog!

I do the same thing when I leave the unit. I say:

“Let it be”

EVERY SINGLE TIME. This helps me leave what happened at work to be left at work. It allows me to be more present when I get home. It allows me to start fresh the next day. Even if you had the best shift/day ever – saying “let it be” will give it closure, and allow you not to compare a possibly not-as-good shift to this great shift the next day.

Try it out. Let me know how it goes. Or don’t ….just truth drop yourself on how your attitude changes.

I will leave you with this:

“I will breathe. I will think of solutions. I will not let my worry control me. I will simply breathe. And it will be okay. Because I don’t quit”. – Shayne Mcclendon

~Keep on Caring