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.
As part of National Nurses Week, we wanted to share some stories with you about how nurses have changed lives and gone beyond what some people stereotypically think: that nurses just take temperatures, clean bedpans, and give shots.
Nothing could be further from the truth…
“Healing Touch is an energy healing therapy used by trained nurses to balance the patient’s mind, body, and spirit, which assists the patient in self-healing. Healing touch was very successful on a patient who was screaming in fear and could not fall asleep. The nurse asked me to help the patient. Not only did the patient need sleep, but other patients in close proximity to his room would benefit too. After five minutes of healing touch, the patient was resting comfortably. Within 30 minutes, the patient was sleeping. No shot was needed.”
—Alissa Perrigo, RN, MSN, Largo Medical Center
A Different Perspective
“One of the best ways to connect with an infant is to get down on all fours yourself and see the world from your little one’s perspective. This empathetic response helps connect a young mom to a child’s early developmental processes, especially visual development. Even physically, when you’re on the floor yourself, it is much easier to imagine the strength that is needed for an infant to hold his head up, turn over, or begin to crawl and pull up.”
—Adelmis Granoderoro, RN, Visiting Nurses Service of New York, who helps first-time Suffolk County moms plan for and navigate the first year of their babies lives
Going Above and Beyond
“I recently began working with a nurse who partners with my office through our Accountable Care Organizations (ACO). She was working diligently to arrange home care services for our patient. The patient was discharged from a sub-acute facility and is currently living with her sister in a room. When visiting the patient at her home, the nurse noticed that the patient was unable to clean herself and her sister was unable to assist. The nurse asked if she could assist the patient, but the patient refused. The nurse knew the patient may develop skin breakdown and pleaded with the patient to let her help. The patient still refused.
“The nurse continued to work to arrange for home services for the patient. Each day, the nurse asked if she could come to help the patient until the services began. Finally, the patient agreed. The nurse, along with a colleague, went to the patient’s home to clean the patient. Upon arriving to the apartment, the patient was found lying in her waste. While maintaining the patient’s dignity, the nurse worked for an hour and a half cleaning the patient, as well as changing the linen and the patient’s clothes. Unfortunately, the patient had skin breakdown on several areas of her body. During the visit, the nurse spoke kindly to the patient educating her on what she can do to prevent further skin breakdown. Eventually, the patient received home care.
‘Christine’ went above and beyond the call of duty for our patient, during her critical transition from sub-acute to home care.”
—Melissa Richardson, DNP, RN, FNP-BD, nurse practitioner/nurse manager at Somerset Family Practice, part of Robert Wood Johnson University Hospital and clinical site supervisor at Monmouth University
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
As much as we appreciate the mug that says “World’s Greatest Nurse” on it, finding practical ways to maintain high morale and work performance while serving others can be challenging. In this business, it’s easy to place the needs of others before ourselves. But experts recognize that work performance improves when caregivers take time every day to care for themselves. “The sad reality is nurses ‘accept’ health problems that come from the physical and emotional demands of the profession, and while caring for others often do not care for themselves” says Susan Letvak, PhD, RN, FAAN.
Along with suffering from higher rates of musculoskeletal disorders, higher risks of acquiring blood-borne pathogen infections, tuberculosis, and allergies, Letvak found that hospital-employed bedside nurses had a 17% depression rate compared to the national rate of only 9%.
With National Nurses Week scheduled May 6 – 12, now is the perfect time for nurses, and those who rely on them, to celebrate the essential role of nursing. Here are seven ways to uncover your best self while you provide the best care for others.
1. Learn to love lavender.
Whether enjoyed as a candle or applied as an essential oil, lavender is popular for its soothing, relaxing properties. For added benefits, try combining a few drops of lavender oil within a small spray bottle of water and spritz your bedsheets, pillows, closet, car seats—anywhere you may enjoy a quick emotional lift.
2. Rediscover bathtime.
Combining essential oils, a relaxing candle, comforting music, and a hot bath is the best diagnosis for pampering and ultimate relaxation. Unlike a quick shower, a lingering bath is the perfect prescription for weary muscles.
3. Schedule a healing massage.
As a popular remedy for treating patients suffering from anxiety or muscle tension, the basic massage can be a secret weapon for igniting much-needed energy to finish your day. “We bring in a massage therapist for students and staff every few weeks where they can receive a 15-minute neck and upper back massage,” says Julie Aiken, CEO of Ameritech College of Healthcare. If you don’t have a massage therapy handy, here are five easy ways to give yourself a quick massage.
4. Hit the trails.
There is something special about nature that helps calm those anxious feelings. A study conducted by the University of Michigan School of Medicine found that “group nature walks are linked with significantly lower depression, less perceived stress and enhanced mental health and well-being.” If you lack the time, take a 30-minute stroll around the nearest park or public garden. The fresh air and physical activity will do wonders for your physical and emotional health.
5. Be still for 15 minutes.
The practice of meditation has been used for thousands of years as a tool for relieving stress and anxiety and providing clarity on our relationship with surrounding elements. “Our nursing philosophies are grounded in caring and the interconnectedness of the mind, body, spirit, social/cultural, emotions, relationships, context, and environment,” Aiken says. “All of these aspects combine to create a person; in order to heal the whole person.” A 15-minute investment in personal reflection and meditation can prepare someone to experience hours of peace throughout the day.
6. Greet the sunrise.
On that same line, waking up early to start the day with the sunrise helps put things in proper perspective. Whatever happened yesterday, it’s a new day—literally.
We hear about the benefits of yoga virtually everywhere—and with good reason. “Yoga is more than just exercise. Its benefits can be realized from within the body and from without the body,” says Kerstin McSteen, BSN, MSN, ACHPN, CNS-BC. “A consistent yoga practice can have a positive impact on body chemistry, disease prevention, symptom reduction or alleviation, and emotional health.” Whether taking a class or enjoying online personal instruction, yoga is a popular and effective addition to your daily routine.
This year, as we celebrate the “Year of the Healthy Nurse,” expand your role as one of our most important caregivers to include self-care. By making your physical and emotional well-being a top priority, you can be sure you are providing the best care for others while you’ve taken the time to care for yourself.
Come, “grow old with me.”
She sat stiffly on the chair in the gym. She had come with her ward for recreation time. Younger patients played basketball and rode stationery bikes. Two of my nursing students were playing table tennis with a twenty-something male patient. This lady looked lonely and isolated among all the younger patients and staff, and she struck a chord in my sixty-something heart. When I asked her if she wanted to play with me, she looked quizzically at me, and said, “Me?” To my great surprise, she got up and returned my volleys slowly, patiently, and pretty accurately.
I had observed this lady on the unit. She stayed in her room whenever possible, and did not interact with other patients or staff. She was refusing to leave the hospital because she believed that she owned a luxurious home north of the city, and wanted to return to it. When the social worker approached her with alternative residence offerings, she became agitated, loud, and accusatory toward the social worker.
The next day the patient greeted me in the morning, and we played table tennis again in the afternoon. As a nursing instructor, I don’t often spend a lot of time interacting alone with patients as my job is to be available to my students, and to facilitate their interaction with patients. However, a case can be made for role-modeling, especially for students who gravitate to patients closer to their own age, as is human nature.
The patient and I discussed topics familiar to our age cohort; difficulty with electronic devices, morning aches and pains, the recklessness of young people, and how older adults can sometimes feel discarded and devalued. We moved on to her desire to have her own residence and although she still believed she has a grand residence north of the city, she did agree to accept housing in a group home, “temporarily, only until the other house is available.” At the core of her anxiety was the desire to remain independent, “to take care of myself.”
When the social worker asked me what magic I had done to change the patient’s mind, I could only tell her that we shared some of the challenges experienced with entry into older adulthood.
When teaching signs and symptoms of mental illness, pharmacodynamics, and a myriad of psychotropic medications and their side effects, it is easy to lose sight of the transformative effect of interpersonal relationships in nursing care. Hildegard Peplau, the, “mother of psychiatric nursing,” viewed self-reflection and self-awareness as an integral process in the nurse-patient relationship. In this case, it was mutually helpful for nurse and patient.
Peplau’s command that we continue to grow, mature, and serve the society in which our practice is embedded is her ultimate gift to us as we progress and grow old in our own nursing practice.
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.