The American Association of Critical Care Nurses recently named Margaret L. “Meg” Campbell, PhD, RN, FPCN, as their 2018 Distinguished Research Lecturer. The annual award was established in 1982 to recognize nurses whose research has had a significant influence on high acuity and critical care.
Campbell is currently a research professor at Wayne State University College of Nursing in Detroit, MI. She is an internationally recognized expert in assessment of respiratory distress, or dyspnea, and treatment across diagnoses and settings of care. Her prior experience includes serving as director of nursing research, palliative care and advanced practice nursing at Detroit Receiving Hospital from 1988-2012.
AACN immediate past present Clareen Wiencek, PhD, RN, ACHPN, ACNP, tells ACCN.org, “Dr. Campbell’s groundbreaking research has helped shape the way dying patients are cared for in the United States and abroad. She is truly a pioneer in improving hospital-based palliative and end-of-life care for critically ill patients.”
Campbell’s career in nursing spans 40 years in total, and 28 years in palliative care nursing. Her current research focuses on dyspnea assessment and treatment among patients nearing death, including patients in acute and critical care settings. She also developed and tested the Respiratory Distress Observation Scale (RDOS) which has been translated into multiple languages and used at clinical sites around the globe to guide patient assessment and treatment.
As the Distinguished Research Lecturer, Campbell will discuss her career and research in May 2018 at the AACN’s National Teaching Institute & Critical Care Exposition. To learn more about Campbell’s nursing background and research, visit here.
The combination of pain, stress, uncertainty, and a lack of control can be a recipe for conflict. Think about the times in your career you’ve heard things like, “What are we waiting for? Why aren’t you helping me? Do you know what you’re doing? When is the doctor coming? This is ridiculous.”
We encounter difficult patients and experiences all the time. Because of the additional stress that the medical or hospital setting can induce, small stressors can become escalating and potentially dangerous situations. When patients are scared, anxious, or in pain, otherwise benign miscommunications can be amplified. Conversations can quickly become confrontations.
Therapeutic conversations are part and parcel of a nurse’s daily work. One of the most important things we do for our patients is communicate. As the nurse, we often act as liaisons between family, patients, and physicians. Good communication can be the difference between a good interaction and a poor one. Preventing escalating behavior before it starts can keep everyone safe.
Naturally, you cannot control other people’s behavior, but you can control your response to it. Below are some tips for how to defuse and de-escalate conflict interactions.
Start with empathy. When someone first starts to become anxious or upset, try to start by considering why. Are they in pain? Are there precipitating factors that are contributing to their outburst? Try to use your active listening skills to show the person respect. Reflect back to the patient, repeat what they are saying, and really put yourself in their position.
Stand back. Have you ever heard that communication is 7% verbal and 93% nonverbal? Uncross your arms, use an open body stance, and position yourself in a respectful and non-confrontational pose. Approach patients from the side, and try not to back anyone into a corner. Maintain a safe talking distance. Most people are more comfortable with about three feet of buffer.
Be mindful of how you say it. Verbal communication encompasses tone, inflection, and volume. When someone begins to escalate a situation, be sure to use a slow, calm, and low volume for communication. Matching their aggression does not help defuse a situation.
Set limits. When patients get upset or defensive, sometimes it is because they are seeking information. Try to provide information about their care or answer their questions within the context of limits. For example, a statement such as, “When you keep your voice down, I will be able to tell you why we are waiting” can help set expectations of behavior.
Drop your own defensiveness. When a patient starts to get anxious or upset, he or she tends to act irrationally and become very defensive. When someone lacks a sense of control, he or she may start yelling or start actively refusing the plan of care. When you in turn become defensive, this only matches their energy and leads to even greater irrationality. Try not to take actions or words personally and remember to maintain professionalism.
Know when to remove yourself from a situation. There are many reasons that you may need to get a coworker or teammate to “tap in” and help you with a situation. If you are ever truly feeling threatened, do not handle the situation alone. Keeping yourself and your patient safe at all times should be your main priority.
De-escalating anxious or tense situations helps prevent violence or conflict and keeps everyone—staff and patients alike—safe. There are several courses available for certification in therapeutic interventions and crisis prevention. Visit the Crisis Prevention Institute to learn more.
Carpal tunnel syndrome. Low back pain. Shoulder pain. These are just a few of the common, pain-related complaints in all areas of health care. Sometimes, no matter what you try, you can’t find relief with a conservative treatment approach. In this article, I list a few lesser known approaches to ways to manage chronic ailments in the hopes that you can find the necessary tools to work and live free of physical discomfort.
1. Active Release Techniques (ART)
Over 30 years ago, chiropractor Dr. P. Michael Leahy, began ART as a way to correct soft tissue disorders in elite athletes. Before becoming a chiropractor, Leahy was an engineer in the air force. He combined his particular background to develop a therapeutic system of movements to correct musculoskeletal problems associated with the overuse of muscles—problems like back pain, neck pain, and sciatica—which are so prevalent in the nursing community.
According to the website, it’s a “patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia, and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART.”
If persistent pain is affecting your job and your life, ART may be an innovative option to bring your body into balance. Practitioners are located throughout the world and consist of licensed health care providers or massage therapists. To find a practitioner in your area, click here.
2. Anatomy Trains
Created in the 1990’s by author and bodyworker Thomas Myers, Anatomy Trains treats the interconnectedness of the fascial and myofascial tissues throughout the whole body. This holistic approach allows practitioners to understand the relationship between postural stability, coordination, and muscle restrictions and their impact on a person’s movement.
“We look for those places or patterns that have imposed limitations on the person’s movement and work to lift them off. How can we ‘lighten the load’ people impose on themselves? What is revealed is not some robotic ‘perfect posture’ but a return to the person’s original intent, less hobbled by the slings and arrows they have encountered,” says Myers on the website.
If you experience pain every time you do a certain movement, such as leaning over a bed to position a patient from one side to the other, then you might benefit from a practitioner certified in Anatomy Trains to break your current movement patterns and assist your body with creating new ones. Practitioners include health care providers, massage therapists, and mind-body exercise instructors (like Pilates, yoga, and Tai Chi). To locate a practitioner, click here.
3. Feldenkrais Method
The Feldenkrais Method was created by Moshe Feldenkrais, an Israeli physicist and engineer, after an old knee injury flared up. Doctors told him he needed surgery for the injury, but instead, he chose to analyze his movement patterns, and he learned to walk pain-free. This method employs physics, biomechanics, and observation to help a person move with less tension and greater ease. Feldenkrais taught his first training course in 1969.
As stated on the website, “The Feldenkrais Method of somatic education uses gentle movement and directed attention to help people learn new and more effective ways of living the life they want. You can increase your ease and range of motion, improve your flexibility and coordination, and rediscover your innate capacity for graceful, efficient movement.”
Who may be a good candidate for this therapy? Anyone who’s seeking pain relief or battling conditions of the central nervous system. While practitioners come from a wide range of backgrounds, they all must complete 160 days of training over a minimum of 3 years, to obtain eligibility to become certified by the Feldenkrais Guild of North America. To find a Feldenkrais practitioner in your area, click here.
Please note: When one of these therapies is administered by a licensed health care provider, some insurances may cover the cost of these services.
Whether you’re gluten-free due to health reasons or you’re just trying it out to see if you feel more energized during the day, finding quick and tasty breakfast ideas can pose a big challenge for nurses. There are some mornings (or all mornings) where the hustle and bustle of getting ready for work leaves you with mere minutes to eat before you have to fly out the door. Instead of reaching for a bowl of cereal, or worse, skipping breakfast altogether, try these nutrient-dense, gluten-free options to power up so you can give your most energized self to your patients during the day.
1. Gluten-Free Toast with Avocado and a Fried Egg
Who doesn’t love avocado toast? Mash half an avocado, squeeze in juice from half a lime and add in a dash of sea salt to taste. Smash ingredients together with your fork. Spread your avocado mash onto two toasted, gluten-free slices of bread. Top each slice of toast with a fried egg and sprinkle with a little more sea salt, ground pepper, and red pepper flakes as desired. This healthy fat and protein combination will keep you feeling full until your next snack or meal.
2. Maca Root and Nut Butter Smoothie
Smoothies are a great way to make a lightning fast breakfast. This creamy drink will help you forget you’re trying to eat healthier. In a high-powered blender, blend 1 cup of plant-based milk (like flax or hemp) or nut milk (like almond or cashew), 1 small banana, 2 tablespoons of the nut butter of your choice, and 1 teaspoon of maca root powder. Pour into a glass and drink. Maca root powder is known as a superfood and is loaded with essential amino acids, fatty acids, vitamins, and minerals. Want to make your smoothie even more decadent? Add in two tablespoons of the powerful antioxidant, raw cacao powder. On its own, raw cacao is very bitter. But, when mixed with the natural sugars from the banana and the creaminess of the nut butter, raw cacao creates a nutritious, chocolatey beverage.
3. Spinach and Feta Cheese Scramble
If you have a few minutes to spare, this omelet provides you with protein, b vitamins, magnesium, iron, and more to energize your body. Sauté a cup of spinach, add 2 eggs, and ¼ cup of feta cheese. Scramble the mixture until it’s cooked through and dig in. To increase the nutrient profile of this breakfast, serve it with a mixed green side salad drizzled with an all-natural, balsamic vinaigrette.
4. Chocolate-Chia Pudding with Strawberries
If you usually eat oatmeal for breakfast, give the first meal of the day a refresh by trying this chia pudding. Chia seeds are rich in omega 3 fatty acids, fiber, and minerals. Best of all, this dish requires little to no prep time. For ingredients, you’ll need an unsweetened nut milk of your choice, vanilla extract, chia seeds, maple syrup, cocoa powder, and fresh strawberries. In a bowl, combine 1 cup of nut milk, 3 tablespoons of chia seeds, 1 to 1 ½ tablespoons of cocoa powder, ¼ teaspoon of vanilla extract, and maple syrup to taste. Stir the ingredients thoroughly, cover the bowl, and place in the refrigerator overnight. In the morning, remove the pudding, add in some sliced strawberries, mix it up, and enjoy!
You know the feeling. It’s your third shift in a row, it’s a particularly difficult patient or family, it’s a heartbreaking story, it’s an intense diagnosis, it’s short-staffed night on the unit. Nursing is profoundly tiring—physically, emotionally, and intellectually. Our shifts are long: Even on a normal day, by hour number 10 you may be feeling strained. You can pull from your reserves, but sometimes there isn’t anything left. You have compassion fatigue. You’re experiencing caregiver burnout.
These moments on the unit can be tough. You may feel yourself start to become anxious, or more stressed out that normal. An otherwise meaningless interaction with a doctor, colleague, or patient can leave you nearly in tears. What can you do to avoid burnout?
First of all, in the heat of the moment, take a second to breathe. Try to center yourself by inhaling through your nose and breathing out through your mouth for at least five breaths. This can help calm your body and mind, even when you don’t think it will work.
After your shift ends, it’s time to practice self-care. As nurses, it can be incredibly difficult for us to do this. But just like oxygen masks on an airplane, we all know deep down that it is difficult to care for others when we ourselves are in a fragile, fatigued place.
In theory, the easiest two things to control are our diet and sleep. In practice, we know this isn’t always the case. Aim for quality over quantity: If you can’t get enough sleep, try to make it the best sleep possible. Spend time enhancing your sleep environment with room-darkening shades, white noise machines, comfortable bedding, and a great mattress. Use the “do not disturb” feature on your cell phone. If you’re a night shifter, you could write a note on on your front door that anyone who rings a doorbell will be met with fire and fury.
For your belly, try to pack healthy, filling options for meals and snacks. Aim to always eat breakfast. Low blood sugar can easily translate into crankiness, so try to stay ahead of your curve by packing granola bars in your scrub pockets or bringing easy to eat meals for times when you can’t get a lunch break. (Which, let’s be honest, is every day.)
Most importantly, assess yourself. We as nurses are in the business of assessing our patients, but we rarely turn that critical eye on ourselves. Try to really check in with your emotional reserves, and try to find healthy ways to process your stress. Make a care plan for yourself, and re-assess frequently.
People who teach those who come after them often do so because they want to give back or have a positive influence on upcoming students in the field. That’s exactly what Susan Zori, DNP, RN, NEA-BC, an assistant clinical professor in the College of Nursing and Public Health at Adelphi University in Garden City, New York, does.
Zori took some time to explain to us what she does, why she does it, and what she would recommend to those thinking about becoming a professor at a nursing school.
What follows is an edited version of our Q&A.
What does your job entail? Do you specialize in specific topics that you teach? How many courses do you teach each semester?
My job is to inspire the next generation of nurses. I teach theory courses for Fundamentals of Patient Centered Care, Care of Adult 1, and Care of Older Adult, and I teach 2 to 3 courses per semester.
I constantly challenge myself to instill concepts and safety while bridging knowledge to actual clinical situations. I believe in active learning and incorporate active learning into classes.
Why did you choose to teach?
I have had an extensive career in clinical nursing and nursing administration. I am passionate about nursing and love teaching. I love seeing students light up as they make connections and become passionate about caring for patients. I find great satisfaction in “paying it forward” and preparing the next generation of nurses for a very different health care environment.
What are the biggest challenges of your job?
The biggest challenges are preparing students to pass NCLEX, with all that is entailed in writing tests, administering tests, and grading tests.
What are the greatest rewards?
I still work occasionally at a hospital in an administrative role. I sometimes come across an RN that I had as a student. When I do, it is wonderful to see them and know that I had a very small part in helping them in their journey.
What would you say to someone considering this type of work?
Nursing is a wonderful profession that gives one the opportunity to make a difference in patients’, students’, and nurses’ lives every day.
Being successful in nursing requires intelligence, perseverance, and passion. It is one of the hardest courses of study, but it is rewarding and offers one many different opportunities such as masters and doctorate level study as well as opportunities to continually learn, and truly shape health care.
Nurses are the perfect professionals to engage patients in wellness, manage chronic illness, coordinate care, and thus shape the current health care system into one that is accessible and equitable for all. Nurses can and will do this.