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.
On a typical workday in the hospital, I was chatting with my coworker (a physical therapist who we’ll refer to as “Robin”) about taking a continuing education class together. Robin wanted to earn some extra income, and she felt the training she’d get from the course would provide her with that opportunity. She was looking for a friend to accompany her to the class and thought I might be interested. I told her I’d think about it and get back to her the next day when we’d both be stuck working the Saturday shift together. Saturday arrived, and with an influx of overnight patient admissions, we were swamped. I’d had no chance to talk with Robin about the continuing education class. When our paths finally crossed, our conversation went something like this:
Me: I’m finished, Robin. I’ll see you next week.
Robin: Aren’t you going to see the patient that just came in an hour ago?
Me: I checked, but there weren’t any orders for occupational therapy. So, I’ll put her on the list for tomorrow.
Robin: Well, you need to see her today!
Me: I can’t see her today. There are no orders.
Robin: Doesn’t matter. But whatever. It’s your head on the chopping block.
Me: I’m not doing anything wrong, Robin. There are no orders for my services, and I can’t see a patient without orders. I’ll see you next week.
When I returned to work the following week, Robin’s whole attitude toward me had drastically changed. She was pointing at me and whispering to others, laughing when I walked passed her, intentionally ignoring me, and not discussing patients’ discharge plans with me. Confused, I kindly confronted her. “Is there something wrong?” I asked her. “Yeah, you,” she responded. “Don’t try to be nice when you talk to me. It’s fake. In fact, don’t talk to me at all.”
I was shocked by her response, but I maintained my composure. Later in the day, I mentioned Robin’s abrupt change in demeanor towards me to my manager. He brushed it off and said, “That’s just Robin.” For the next six months, I endured Robin’s bullying behavior towards me, and I hated going to work. Suddenly, Robin was gone; she’d moved away (thankfully), and we never spoke again. While I never compromised my integrity, I always wished I would have done more to stand up to her bullying in the workplace.
Unfortunately, workplace bullying isn’t as rare as we would like to think, and it’s one of the reasons nurses consider leaving the profession. Below are some tips on how to handle workplace bullying in the hopes that you will be better equipped than I was to handle this challenging situation.
1. Insist that supervisors, managers, and hospital administrators listen to you.
Truthfully, I was embarrassed this happened to me, so I downplayed the seriousness of Robin’s behavior rather than being assertive. Many workplaces have specific policies to address bullying, but those policies can’t be enforced unless your place of employment is aware the problem exists in the first place. While it takes courage to speak up, doing so fosters a culture that says, We don’t tolerate bullying. You may even want to consider filing an incident report.
2. Keep a record of your situation.
Write down your interactions with the bully along with the dates and times the incidences occurred. Also, keep a record of how you handled the situation; you’ll want to try to be as professional as possible, and your documentation should reflect those attempts to maintain a civil working relationship. In the event that you need to present the management with some specifics, your event log can help you do that in a calm and factual manner.
3. Build a support network with your colleagues.
Although being bullied may make you feel like you want to run and hide (and you might need to do that for a few minutes to regain your composure following an incident), one of the best things you can do to feel empowered is to focus on creating healthy relationships with your other coworkers. Having supportive people around you will help you face this situation with greater strength and confidence.
Also, if you are the coworker of someone who is being bullied, speak up on their behalf. Like the old saying says, there is strength in numbers.
4. Prepare yourself in case the situation happens again.
Rehearse what you’re going to say when the bully acts up. Having a few memorized lines will help you feel a sense of control and set a boundary for what behaviors you will and won’t tolerate. For me, I decided that I was going to remain focused on my job despite Robin’s actions toward me. When she tried to attack me verbally, I’d say, “For the sake of the patients in this hospital, I will remain professional towards you.” Then, I’d walk away.
5. If the bully doesn’t quit, you might need to.
If you’ve exhausted all of your options, and your situation doesn’t improve, it could be time for you to consider a new job. Bullying often leads to a spike in physical, emotional, and mental stress, so taking care of your well-being is the utmost priority. No, the bully hasn’t won if you leave. Instead, you’re choosing to find a job in a healthier, more supportive environment.
A 2017 study from RNnetwork, one of the largest, travel nursing companies in the country, shows nearly half of the nurses they surveyed are considering leaving the field altogether. RNnetwork provided an email poll to more than 600 nurses across the nation to assess their views on hot-button issues like the national nursing shortage, increasing workloads, the struggle to find work/life balance, and how respected they feel in their current jobs. Most of the survey’s participants work in hospitals and range in age from 25 to 55. Following are the main reasons nurses are contemplating leaving the profession.
1. They feel overworked.
The feeling of being overworked is the primary reason 27% of the respondents give as to why they want to leave. In fact, almost half the nurses polled report an increase in their workloads compared to just two years ago, likely due to the growing nursing shortage. However, their pay isn’t reflective of the greater workplace demands employers expect of them.
2. They no longer enjoy the job.
This study identified some key factors that contribute to a lack of enjoyment of the job. First, 32% of nurses disclosed they feel disrespected by their administration. Additionally, several nurses revealed they had been the target of workplace bullying and harassment. According to RNnetwork:
- 45% of nurses have been verbally harassed or bullied by other nurses.
- 41% of nurses have been verbally harassed or bullied by managers or administrators.
- 38% of nurses have been verbally harassed or bullied by physicians.
More than half of the employees who experienced this negative job environment are considering quitting the profession. Workplace bullying and harassment seem to be a strong catalyst for why some nurses may feel it’s time to exit this career path.
3. Their place of employment isn’t conducive to a healthy work/life balance.
As stated in the study, 43% of respondents conveyed their workplaces don’t support a healthy work/life balance. Although nurses didn’t report working more hours than two years ago, the additional workload without further compensation is one possible obstacle to cultivating that delicate balance between work and personal activities. Furthermore, 45% of participants are taking extra jobs to augment their current income.
But the study showed some good news as well. A reported 65% of nurses feel respected by physicians in the workplace. Moreover, 63% of participants believe they spend the right amount of time at work, and 61% say they have the same amount or more free time now than they did two years ago.
While there are many more reasons nurses end up leaving their jobs, one question needs to be answered: What can employers do to keep more nurses in the profession?