A few days ago, a friend of mine asked me if I had any tips for managing tension headaches; she’s been experiencing them more frequently from working long hours as an ER nurse. Like many nurses, she spends most of the day on her feet. By the end of her shift, her muscles feel stiff, her head is pounding, and she needs a few, quick tools to relieve her pain. If you experience tension headaches while at work, hopefully, these tips will be useful to you as well.
1. Loosen up your muscles
In an online article, Mayo Clinic recommends the application of heat or ice to loosen up tense neck and shoulder muscles. “Use a heating pad set on low, a hot water bottle, a hot shower or bath, a warm compress, or a hot towel. Or apply an ice pack (wrapped in a cloth) or a cool washcloth across the forehead.”
Although using a heating pad at work might not be practical, resting an ice pack on your neck when you’re at lunch or on a break might be an easy fix to help lessen muscle tension and mitigate your headache.
2. Try some breathwork
In February, we discussed some of the benefits of breathwork, like encouraging relaxation, reducing anxiety, energizing you, and lessening the feelings of physical and mental stress. Additionally, breathwork can decrease muscle tension, particularly if you try The Five Count Breath. This technique, implemented in Pilates exercises, oxygenates your body and reduces muscle tension in the rib cage and thoracic spine. Here’s a recap on how to use this simple breathing exercise:
Start with a slow inhale through your nose to the count of five. Then, exhale your breath through your mouth also to the count of five. Picture yourself wringing all the stale air out of your lungs and replenishing them with fresh air. With each breath, imagine the tension dissolving from your head, neck, shoulders, and back. Repeat this cycle five to 10 times or whenever needed to reduce overall physical and mental stress.
3. Sneak in a neck stretch
The chin tuck is an effective way to stretch your neck muscles. Sit comfortably in a chair with your feet flat on the floor. Draw your shoulder blades together and keep your head facing forward. Gently move your head back, making sure to keep it level; you don’t want your chin to lift up or dip down. Hold this stretch for five seconds and repeat five to 10 times.
4. Treat yourself to a massage
If you’re not finding relief with basic measures, consider getting a massage. The American Massage Therapy Association believes that massage can be used to alleviate tension headaches and improve postural alignment. Looking for an excuse to treat yourself to a little TLC? Now, you have one!
Whether you’re dealing with bunions, blisters, plantar fasciitis, or bone spurs, foot pain is a common complaint among nurses. If you’re monitoring your steps each day with the latest fitness tracker or app, you probably already know you’re walking miles in your shoes each day. No wonder your feet hurt! Below are some do-it-yourself ways to reduce foot pain and help you keep moving–pain-free.
1. Replace your shoes every three to six months.
In an online interview, Dr. Michael Lowe, past president of the American Academy of Podiatric Sports Medicine, notes that a standard athletic shoe is made to last between 350 and 500 miles–which translates to a new pair of shoes about every three to six months. With the number of hours you’re on your feet every day, your mileage quickly adds up. Once a shoe breaks down, it no longer absorbs shock like it’s supposed to and can misalign your foot and cause pain.
2. Regularly stretch your calves.
Tight calves can exacerbate some types of foot pain. To improve the flexibility, mobility, and position of your foot, follow this simple stretch:
Stand about a foot away from the wall, and place your hands against the wall at shoulder height. Keeping your feet hip-width apart, step back with one leg until your foot is flat on the floor. Bend the front leg until you feel a stretch in your back, calf muscle; the stretch should be tolerable for you. Hold this position for 30 seconds and repeat on the other leg. Cycle through this stretch one or two more times.
3. Try an Epsom salt foot bath.
Epsom salt contains magnesium sulfate–the mineral that gives this home remedy its muscle relaxant quality. To create a foot soak, find a bowl or bucket large enough to submerge both feet (I use a bucket). Place one-half to one cup of Epsom salt into the bucket. Then, fill the bucket about two-thirds full with warm to hot water being mindful of the temperature level that is most comfortable to you. Let the salt dissolve and soak your feet for 20 minutes. Dry off your feet and follow up with a moisturizer if necessary. Routine foot soaks can help reduce the inflammation that leads to aching feet.
4. Roll out your foot pain with a tennis ball.
Place the bottom of your foot on the top of a tennis ball. Roll the tennis ball back-and-forth along the whole length of your arch. For a deeper stretch of your foot’s fascia, apply a decent amount of pressure as you roll the ball. If you encounter a spot on your foot that is extra sore, gently massage that particular area until you feel a release in muscle tension or the pain improves.
One final note: If you try these at-home treatments without benefit, consider talking to your doctor about seeing a physical therapist for a customized evaluation and treatment plan for your foot pain.
Do you ever feel like you’re running on empty? Maybe you feel like your workload is taking a toll on your mental or physical health, and you’re just not able to bounce back as you had hoped? You’re probably already aware that compassion fatigue can happen to any nurse at any point along the career path. But when it happens to you, self-doubt and self-criticism can creep into your thoughts. When going through this profound state of stress, it’s valuable to remember there is no stereotypical profile of what a nurse with compassion fatigue looks like, and it’s not a reflection of how committed or competent you are in the profession.
Let’s take a look at some myths surrounding compassion fatigue so you can experience a greater sense of well-being when you’re at home or work.
Myth 1. Compassion fatigue is a character flaw.
This is simply not true. Although your self-identity may be intertwined with your role as a nurse, compassion fatigue isn’t the result of a character flaw in you. You are a hard worker, and you care for your patients with everything you’ve got. However, if your body is showing signs of physical and emotional exhaustion, anxiety and worry, depression, anger, irritability, lack of joy, or any other sign, it’s time for you pay attention to it. Your body is telling you to recharge your internal battery, and, perhaps, scale back on your workload.
Myth 2. You need to work harder to overcome compassion fatigue.
On the contrary. While working harder may be the default setting to get some people through the day, many nurses tend to put others’ needs above their own, further engaging in energy-draining activities. When compassion fatigue creeps up on you, it’s not telling you to do more. Rather, it’s telling you your work-life balance has gotten out of whack, and you need to reexamine it.
Myth 3. I still feel compassion for my patients, so compassion fatigue must not pertain to me.
In an online article, American Nurse Today noted that nurses reported feeling both compassion fatigue and compassion for their patients at the same time. “If anything, the more compassion a nurse feels, the greater the risk that she or he will experience emotional saturation or compassion fatigue,” the article said. Try to recognize the other areas where you may be showing signs of fatigue. Do you find that your colleagues are difficult to work with? Are you thinking about going home as soon as you get to work? Are you concerned you might make an error while on the job? These point to subtler signs that you’re experiencing compassion fatigue, even if you still feel empathetic when caring for your patients.
Myth 4. It’s my job to care for others first and myself second.
For many nurses, this idea seems like a selfless act while working within the health care community. In reality, when you implement consistent self-care practices, acknowledge what things make you feel overwhelmed, and cultivate the support you need both inside and outside of work, you reduce your risk of developing compassion fatigue. “Perhaps the most important way to prevent or reduce compassion fatigue is to take care of yourself. As nurses, we work hard and really need our breaks. We need to eat, and to take time for ourselves without being interrupted by alarms, patients, or colleagues. We also need our time off, for our mental and physical well-being,” stated American Nurse Today.
Bottom line? Understand that compassion fatigue can sneak up on you, and its symptoms vary from person to person. It’s not indicative of how skilled you are as a clinician, and there’s not a one-size-fits-all approach to finding your way back from it. It’s important to know recovery will likely require time along with some adjustments to your lifestyle.
We can all benefit from the wise words of others once in a while. In keeping with the National Nurses Week theme of “Nursing: the Balance of Mind, Body, and Spirit,” we’ve gathered together 15 quotes to uplift your heart and mind. If one of these quotes resonates with you, write it down and carry it with you. If you’re feeling overwhelmed or disheartened by your job, take a moment to read this pearl of wisdom. When you’re in need of an instant, spiritual boost, let these words be a bright spot in your day.
1. Rest when you’re weary. Refresh and renew yourself, your body, your mind, your spirit. Then get back to work.
~ Ralph Marston
2. My heart, which is so full to overflowing, has often been solaced and refreshed by music when sick and weary.
~ Martin Luther
3. I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.
~ Maya Angelou
4.Happiness is not a station you arrive at, but a manner of traveling.
~ Margaret Lee Runbeck
5. In our lives, change is unavoidable, loss is unavoidable. In the adaptability and ease with which we experience change, lies our happiness and freedom.
6. Live with intention. Walk to the edge. Listen hard. Practice wellness. Play with abandon. Laugh. Choose with no regret. Do what you love. Live as if this is all there is.
~ Mary Anne Roadacher-Hershey
7. The ability to be in the present moment is a major component of mental wellness.
~ Abraham Maslow
8. When you awaken love and laughter in your life, your mind lets go of fear and anxiety, and your happy spirit becomes the healing balm that transforms every aspect of your human experience.
~ Jesse Dylan
9. Each day holds a surprise. But only if we expect it can we see, hear, or feel it when it comes to us. Let’s not be afraid to receive each day’s surprise, whether it comes to us as sorrow or as joy. It will open a new place in our hearts, a place where we can welcome new friends and celebrate more fully our shared humanity.
~ Henri Nouwen
10. Follow your instincts. That’s where true wisdom manifests itself.
11. Choosing to be positive and having a grateful attitude is going to determine how you’re going to live your life.
12. To know yourself as the Being underneath the thinker, the stillness underneath the mental noise, the love and joy underneath the pain, is freedom, salvation, enlightenment.
~ Eckhart Tolle
13. Each contact with a human being is so rare, so precious, one should preserve it.
~ Anais Nin
14. You have a right to say no. Most of us have very weak and flaccid ‘no’ muscles. We feel guilty for saying no. We get ostracized and challenged for saying no, so we forget it’s our choice. Your ‘no’ muscle has to be built up to get to a place where you can say, ‘I don’t care if that’s what you want. I don’t want that. No.’
~ Iyanla Vanzant
15. The best and most beautiful things in the world cannot be seen or even touched – they must be felt with the heart.
~ Helen Keller
The CDC states Lyme disease is the most common vector-borne illness in the United States, and each year, an average of 329,000 new cases are reported. As we approach the month of May and Lyme Disease Awareness Month, it’s hard not to take notice of the articles by scientists and ecologists across the country warning that 2017 is poised to be the worst year for Lyme disease yet.
As incidences of Lyme disease grow, nurses play a critical role in helping patients obtain an accurate diagnosis and proper treatment. “Lyme patients are sick, they are complicated, and they have lots of ongoing complaints,” says 30-year, veteran nurse practitioner and Lyme specialist, Ruth Kriz. “They don’t fit in a nice, neat medical textbook where you have symptoms ABC. Therefore, you have a diagnosis of illness X. There are too many things that it mimics,” she says. In fact, Lyme disease is known as the “The Great Imitator” because it mimics conditions like multiple sclerosis, fibromyalgia, lupus, and chronic fatigue syndrome (to name a few).
Knowing some key pieces of information about the complexities of the illness can increase a patient’s chance of early detection. Moreover, a nurse’s knowledge of the disease could assist a previously misdiagnosed patient with accessing the appropriate medical intervention to improve their symptoms and quality of life. When left untreated, Lyme disease can have permanent, irreversible consequences for patients. Here are four things you need to know to help your patients achieve the best possible outcomes.
1. The two-tiered testing process for Lyme disease may be inaccurate.
Most nurses are probably familiar with the ELISA screening test and Western blot test–the two-tiered testing process that is often used to diagnose Lyme disease. The International Lyme and Associated Diseases Society (ILADS), a nonprofit organization dedicated to understanding Lyme disease through research and education, states, “The ELISA screening test is unreliable. The test misses 35% of culture proven Lyme disease (only 65% sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95% sensitivity.” Furthermore, “Of patients with acute culture-proven Lyme disease, 20–30% remain seronegative on serial western blot sampling. Antibody titers also appear to decline over time; thus while the western blot may remain positive for months, it may not always be sensitive enough to detect chronic infection with the Lyme spirochete.”
Although test results may be negative, patients can still be infected with Lyme disease or other tick-borne illness. As Kriz points out, it’s important to understand the symptoms of Lyme disease because, “We want to treat people, not just the lab work.”
2. As the illness sets in, a patient may complain of a broad set of symptoms.
In the initial stages of the disease, a patient may report nothing more than flu-like symptoms. But as the infection disseminates throughout the body, a host of issues could arise that may seem unrelated to one another. Some of the more common complaints a Lyme patient may have include (but aren’t limited to): unrelenting fatigue, joint pain, widespread muscle pain, disordered sleep, depression, brain fog, fevers, chills, sweating, and Bell’s palsy.
3. Not all patients will remember a tick bite or rash.
ILADS reports less than 50 percent of patients with Lyme disease remember seeing a tick bite or a bull’s-eye rash (erythema migrans). If a patient presents with a bull’s-eye rash, the rash is indicative of Lyme disease.
4. There is more than one school of thought when it comes to the diagnosis and treatment of Lyme disease.
The diagnosis and treatment of this illness are contentious points that divides many healthcare professionals. As a result, two philosophies have emerged on how to diagnose and treat this disease–the IDSA and ILADS. The IDSA maintains a strict adherence to their guidelines that those who test positive for the illness should undergo antibiotic therapy. On the other hand, ILADS believes that due to inadequate testing, a clinician’s clinical judgment can assess who needs to be treated and with what means. While the IDSA has expressed concern regarding the overuse of antibiotics, ILADS believes the decision on how to treat patients should be based on factors such as the risks to patients, their quality of life, and financial costs. It should be noted that the ILADS treatment guidelines are the only guidelines currently listed on the National Guideline Clearinghouse (NGC), a public database of evidence-based treatment guidelines for healthcare professionals and insurance companies.
In conclusion, the more information you have regarding signs, symptoms, and treatment options for Lyme disease and associated tick-borne infections, the more you can advocate in the best interest of your patients on this controversial issue.