Kierkegaard said, “Once you label me, you negate me.” And, so it goes for the many labels we unwittingly assign people in our health care interactions. Those affected by homelessness, who are often labeled as “the homeless,” are no different. People are not their circumstances and as nurses we want to support a forward momentum out of unhealthy situations. Here are 10 ways you can help.
1. Change the language.
Anchoring someone down under a label creates the risk of someone officially taking on that label and identity permanently. It’s time to change the language so that those affected by a circumstance or condition are upheld in the energy of transitioning into a better outcome.
2. Offer frost bite checks in the streets and the shelters.
When I was a city hospital war horse, I took care of more post-operative amputations than seemed reasonable. Many were individuals who experienced one bad night out there on the streets. Frost bite is a killer of digits, ear lobes, and limbs. As we know, prevention is best and early treatment is second best. It can be a slower row to hoe toward amputation from peripheral vascular disease, diabetes, and wound infection.
3. Offer foot gear.
Start a boot and shoe brigade. Foot gear needs to be protective. The average person affected by homelessness walks five miles per day. Even those who stay overnight in shelters cannot stay there during the day. It’s out into the elements in the morning. Try doing that in lousy shoes or boots and paper thin socks. Offer shoes and boots at the shelters and neighborhoods that have been identified as areas of need. Enroll some shoe outlets and podiatrists to set up a “give away” table in neighborhoods of high need, announce a foot gear day at the local church or community center. Shoes don’t have to be new; however, be kind and do not donate anything you would not wear yourself. Dignity needs to be a part of the equation.
4. Offer foot care clinics at shelters or request to use space at a church or community center.
This can be a great monthly event among nurse friends. You can check for peripheral vascular symptoms, diabetic ulcers, the need for nail trimmings, wash feet, moisturize, offer clean socks, and recommend appropriate medical follow-up. Folks are having it hard enough without adding a missing limb to the mix. I became a WOCN board Certified Foot Care Nurse (CFCN) and travel with my nail trimming tools as part of my amputation prevention initiative.
5. Provide socks.
In the winter, wool cotton socks go a long way at preventing frost bite. The wool cotton hikers found in multi-packs at Sam’s Club or BJ’s have been a great resource for my work. While you’re at it, throw in some winter hats, gloves, and scarves. In the summer, give them cotton blend, moisture-wicking socks with comfort cushion. Remember, there is a lot of walking within this population. Throw in some fabric band-aids for blisters.
6. Give them coffee shop cards.
This will get someone out of the elements and into a place where they are a paying customer. Whether it’s the heat of the summer or cold of the winter, imagine being outside and just wanting to sit somewhere out of the extremes. In New England, we use Dunkin Donuts. Five dollar increments prevent folks from mugging each other for a higher value item. Bear in mind, it can be like Mad Max and the Thunderdome on the streets.
7. Donate feminine hygiene products.
Women affected by homelessness get menstrual cycles. It’s tough going enough without dealing with the need for pads, tampons, and wipes. Donate feminine hygiene products to shelters, offer feminine hygiene products in “benevolent baggies” (see #9). Offer neighborhood pharmacy cards so a woman can choose her own products.
8. No judgement, just help.
Do conscious inner work to extinguish the urge to judge what brings a person to be without a permanent residence. There are married couples who both work full time but still cannot afford to pay rent; there are those who served to protect your freedoms in the military who are now affected by PTSD and cannot support themselves; there are children born into extenuating situations; and there are those who find it safer to be on the streets instead of shelters, and if you knew more, you would understand why. There are those with mental health and addiction issues. While I was offering foot care at a shelter, I learned of a fellow nurse staying there. He was in a terrible car accident, had spinal fractures, could not work, and lost his apartment due to an inability to keep up with the rent. The circumstances are as individual as the person. Take time to listen; everyone wants to be known. When we care for others within compassion, we care for ourselves.
9. Offer “benevolent baggies.”
If you see someone panhandling and you don’t want to offer cash, benevolent baggies (as I call them) are a way to go. You can include whatever you personally would appreciate if you were humbled to having to stand on the street and ask for immediate help. Use a small or large freezer weight Ziploc bag, which works better for those on the street. You can include a coffee shop card, neighborhood pharmacy card, snack bar, water, socks, underwear, feminine hygiene products, a quote you find inspiring that may encourage someone else. I keep a small stack of $5 Dunkin Donuts coffee shop cards in the center console of my car. I know many feel uneasy about giving to panhandlers. I hope this will put it in perspective for you: A woman once said, “I would rather panhandle than sell my body or steal.” Let’s all work toward a healthy society where people do not have to make these types of decisions.
10. Work for social change.
Pick any piece of this huge puzzle and go for it. Ask yourself the bigger questions about this issue. Jump on an initiative with some integrity or start your own. You are smart, caring, and a creative problem solver. You’re a nurse who can facilitate healing far reaching into the community. You don’t need any formal permission to bring that to the world.
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?
It happens every time…I’m in a hospital helping a friend or family member navigate their healthcare, and the doctors always asks me if I’m a doctor. No, I say, I’m a nurse.
This just happened yesterday. Last week my mom had a terrible fall, resulting in a bad fracture requiring emergency surgery. She is an elderly woman, frail and medically complex. Most doctors who encounter my mother are not prepared to address all her medical issues because, simply put, there is no way they can possibly “study up” enough to be “caught up” on her many problems. That’s where I come in. I do know my mom’s many, many complex medical conditions, and can speak about her recent surgeries and medical activities, complexities and medications. So when physicians come into my mom’s hospital room, truth is, I’m more an expert that they are—at least when it concerns my mom.
And in this situation, like what happened yesterday, where I am able to give the new physician a comprehensive patient history and post-operative report, he assumed I was a fellow physician…I mean, what kind of nurse could do that?
Nursing Is Actually A Very Technical Profession
The fact is nurses are extremely sophisticated health care professionals whose knowledge spans across all aspects of health care and medicine. Nurses need to understand general physiology, pathophysiology, treatment for diseases, and management of diseases through acute and chronic stages. Not only do nurses need to know these broad reaching medical skills but they also need to understand how to coordinate care, how to ensure the treatment plan for the patient makes sense and ensure that a patient’s care is coordinated and communicated between professionals in a timely manner—both in and outside of the hospital setting. Nurses need to represent the views and wishes of the patient and family to the physicians (and other care providers), as well as make sure the physician’s goals are agreed to by the patient. (Whew—that’s a lot of stuff nurses need to know and do!)
At the center of all health care are nurses. Nursing done right (which it does not always accomplish) is simply one of the most valuable roles in healthcare.
Why Then Is There A Nursing Shortage?
So why does the Bureau of Labor Statistics anticipates a nursing shortage in the coming years?
During my long career as a nurse, I’ve lived through nurse surplus, nurse shortage, nurse identify crisis, nurse role expansion. I think this point-in-time for the nursing profession is the most exciting I’ve ever seen. There are new positions and new roles and positions that have not existed before for nurses to work with patients, with providers, with healthcare systems, with biotech companies.
How Nurses “Make or Break” Care
We (as a society) need to understand extremely valuable the role of nursing, otherwise, fewer bright young people will enter the profession. Nurses are responsible for over 85% percent of patient care and, importantly, they help ensure miscommunication does not occur between the health care providers—and let’s pause to focus on this for one moment. According to reputable sources (The Joint Commission) up to 80% of serious errors are due to miscommunication, which lead to a failure in ordering important tests or reviewing important findings, etc… So properly sharing of information in a timely manner is critical to patient safety. This is where nurses come in: because nurses are the ones most familiar with the patient and help push care along to make sure the “ball is not dropped.”
Nursing is “Fungible”
In financial circles people talk about how money is “fungible.” Meaning it is fluid—a dollar can be used to buy a piece of equipment or to pay a staff salary. Well, I say nursing is fungible since the Registered Nurses’ license allows the nurse to be a bedside nurse, a clinic nurse, a hospice or home nurse, or a care coordinator, or an advisor to technology companies or to health insurance companies, or work with local, state or federal agencies developing new and important public health policies. Nurses can work in real time, remotely, or telephonically. Nurses are running companies and are CEOs of hospitals and health systems.
Nursing Has Been Good To Me
While I think the work of other health care professionals is extremely worthy and at times enviable (I mean, it would be fun to be a surgeon for a few days, or an anesthesiologist…) I think for those of us that imagine many different careers over one life time, there is nothing like nursing.
For decades, scrubs have been used by nurses in health care. They replaced the image of a female nurse decked out in a white dress, with the sensible white shoes, stockings, and white hat. While originally used mainly by surgeons and surgical staff in operating rooms, they are now used by nurses, techs, and other health care workers.
Although you can now find scrubs in all the colors of the rainbow as well as with fun patterns on them—everything from cartoon characters to butterflies and flowers to shapes and the like—one thing has remained the same: they’ve tended to come in sizes small, medium, large, extra- large, and so on. They are comfortable, yet loose.
Now that’s all changed as some companies have started designing fitted scrubs for women and men.
Actress Sofia Vergara launched Careisma, a line of scrubs that is, as the website states, “contemporary medical apparel featuring bold colors, chic prints, and figure-flattering styles.” According to Vergara, Careisma is “designed to bring more personality and style to medical apparel. I’ve always admired nurses and health care workers…Health care professionals deserve fashion options that fit their personalities and figures.”
They come in a lot of unique patterns not normally seen, such as leopard print and lace. The colors are bright as well. The sizes still come in XS-XL, but the scrubs also contain spandex, which would make them more form fitting.
Frank Flores, the owner and co-founder of the FrankyRay line, has been in the medical apparel business for more than 13 years. According to the company’s website, the scrubs are made of premium fabrics, but what sets them most apart is the sizing: the men’s scrub pants have true waist and inseam sizing as well as a button and zipper. Scrub shirts that are athletic fit are also available. They are said to be “fashionable and functional.”
Whether you stick with your old scrubs or want to try something different, you now have more options.
How do you feel about form-fitting scrubs? Let us know in the comments!
Do you feel exhausted, anxious, or dread the thought of going to work each day? In last month’s article, we discussed these subtle signs (and more) which indicate your body may be headed for burnout. Already feeling burned out? Let’s look at some steps you can take to overcome this chronic, stressful state and begin thriving again.
1. Identify the source of the stress.
The Mayo Clinic offers this tip for pinpointing the circumstances that are causing you to feel overwhelmed: “Once you’ve identified what’s fueling your feelings of job burnout, you can make a plan to address the issues.” If you have trouble recognizing the cause, try tracking your job responsibilities for a few days, and write down how you feel after you’ve done each activity. Tracking your feelings will help you concentrate your efforts on the areas that are truly quelling your passion for nursing.
2. Minimize your time with these stressors.
Harvard Business Review (HBR) suggests you may need to consider reducing your workload or taking a vacation as ways to recover from burnout. HBR also recommends limiting your interaction with people who leave you feeling drained and delegating the tasks that don’t require your personal touch to other people. Furthermore, they advise to disconnect from your work when you finish your shift and on your days off. Bottom line: Don’t take your work home with you. What happens at the hospital (or another facility), stays at the hospital.
3. Find a support network.
Perhaps you have supportive colleagues, friends, or family members who can help you through this challenging time. However, for some nurses, the level of burnout requires the assistance of a professional. Try not to view your quest for help as a sign of weakness, but rather, a bold step forward toward creating the life and the working environment you want. Additionally, many employers will offer an Employee Assistance Program to help you resolve personal and work-related problems. Take advantage of whatever services are available to you.
4. Practice self-care.
An article from Sanford Brown College makes this observation regarding workplace burnout in nurses, “Even the strongest nurse who puts too much devotion into her work faces the risk of ‘compassion fatigue.’” It’s easy to get caught up in taking care of others and neglecting your needs. But cultivating a balance between work and your personal activities will go a long way in helping you heal from burnout. Sanford Brown offers these pearls of wisdom for struggling nurses:
“Good self-care for nurses includes eating well, getting enough sleep, avoiding harmful substances and staying physically active. You may be on your feet all day at work, but the rest of your body needs a different kind of workout. Maintaining strong mental and spiritual health (if appropriate) is also essential. Whether it is meditation, yoga or prayer, set aside a part of the day to find a calming moment that belongs only to you.”
5. Find a creative outlet.
When you’re in a state of burnout, you’re more prone to making mistakes, losing focus, and feeling unhappy. Research suggests creative endeavors can enhance your mood, increase your energy, boost your immune system, lower stress levels, and provide a positive distraction from the things that are weighing you down. Been itching to try a writing class? Maybe you’ve been eyeing a community pottery class for several months. Now, is the perfect time to tap into your creative side and reconnect with the joy and wonder of life.
6. Consider your options.
Have an honest talk with yourself. If you’ve tried the above tips to no avail, it might be time for you to consider a job change. While it’s not an easy decision to make, you may find you’re more fulfilled in a less demanding job that supports your values and beliefs.
A good friend of mine used to work shift work, and when the night shift rolled around, she always had problems eating. Some foods made her too tired, while others (like food or drinks with caffeine) gave her problems after her shift was over. She never quite got the balance that she had hoped for, and she also had no idea what to eat for snacks.
For all you nurses working the night shift—and especially those of you who are new to it—here are some ideas to keep in mind and some snacks that you can turn to that will help keep you moving and not make you feel tired.
Get Your Protein
You know that if you eat carb-rich foods or sugary beverages at the beginning of your shift, you will crash in no time. So when looking for snacks, choose those with lots of protein, such as:
Turkey or chicken
Hard boiled eggs
Tuna and crackers
Consider grabbing a handful of nuts at the beginning of your shift to help keep your energy up.
Suppose you took on an extra shift or an extra few hours and are now working at night? If you have time before the extra work, head to the cafeteria and get some high-protein snacks. And if you know about it ahead of time, always try to bring your snacks from home. If snacks from vending machines are your only option, go for the granola bars or even peanut butter crackers. While prepackaged foods aren’t the best, sometimes you have to go with them just to eat something to give your body fuel.
When you get home after a long night of work, then you can eat some carbs. If you want to have some cereal before you go to sleep, feel free. The carbs will help you to relax.