On the heels of National Family Caregivers Month in November, which this year carried the theme of “Supercharge Your Caregiving,” here is a way to carry out that charge year-round. And carry it out we must, because health care can no longer ignore these folks. The Caregiver Action Network estimates that there are over 90 million Americans doing this critical work, which is largely publicly invisible, unpaid, and underappreciated.
The Josie King Foundation recognizes those giant numbers and the outsize importance of the role that family caregivers play in the life of patients. The response to requests from non-nursing staff and family members, they now offer the Caregiver’s Journal, a variation of their signature Nurse’s Journal. Their aim is to provide a low-cost tool that can help alleviate some of the emotional stress of serving patients and loved ones with sensitivity, commitment, and compassion.
The journal was created with the help of experts in therapeutic expressive writing and road-tested in several facilitated writing workshops for caregivers. Here’s what participants had to say about their experience:
“I felt stressed at the beginning of writing and relaxed at the end.”
“I felt purged and able to breathe after writing in my journal.”
“I feel like I understand things better after I write them down.”
The Caregiver’s Journal is a 61-page spiral bound notebook filled with helpful content, such as psychological theories about journaling benefits, before and after stress evaluation forms, and suggested resources for those who want to learn more about expressive writing.
The majority of pages are meant to be used for writing sessions, and offer an inspirational quote with perhaps a guided writing prompt. For instance, one is titled guided writing page is titled When Times Are Difficult, with this prompt:
“Things to consider. What are the current situations causing you stress in our work or in your personal life? How can you alleviate these stressors? What steps have you thought about to make this situation better?”
The page ends with a quote from abolitionist Frederick Douglass, “If there is no struggle, there is no progress.”
Some “free writing” pages are empty except for a short quote, with this instruction about how to use them: The following pages are for you to write about anything that you want. Remember to go deep and really explore your thoughts and emotions. Avoid getting caught up on grammar or spelling. Just write.
Many hospitals buy these journals in bulk as a gift for caregivers or to use in staff training and development programs. For more information about the Josie King Foundation and their specialty journals for caregivers, visit http://josieking.org.
But one of the most powerful (though not effortless) ways to find a positive perspective is through meditation. Meditation may seem off-putting to many people who aren’t familiar with the practice, but it doesn’t have to be. You don’t have to sit on a floor cushion and fold yourself up like a pretzel to meditate. You don’t have to hum or chant, either. But you certainly can and it’s an amazing way to relieve stress, clarify your mind, and improve your life. What nurse couldn’t do with a bit more calm and focus and balance?
If you’d like to give meditation a try, you can start by sitting in your favorite comfy armchair. You could also lie on a bed or floor—but then you might fall asleep. Some nurses struggle to get restful, restorative sleep, what with 10-hour shifts and rotating schedules, so sleep may be what you need for health. But it wouldn’t help you develop a meditation practice.
Next, close your eyes and take a few slow and deep breaths. That will help clear your mind of everyday thoughts and concerns. Then, give your mind something else to think about (that’s what minds do best—think!), such as a soothing word. You may want to silently repeat that word or phrase, sometimes referred to as a “mantra,” if you think that may be calming. Depending on your religious faith or cultural tradition, you could choose “shalom” or “om” or simply “home.” Other popular options include “peace,” “love,” or “calm” or favorite prayers and sacred passages.
One of the first researchers in the area of meditation-based stress reduction, Dr. Herbert Benson, suggests the word “one” silently as you breath out. He offers that as a secular mantra because it doesn’t have strong associations that may distract some meditators. (Also, when he’d originally asked subjects to count up to 10 with each breath, they’d get so relaxed that they’d lose track of where they were in the number sequence.)
Benson wrote the best-seller The Relaxation Response forty years ago while a professor at Harvard Medical School. His work is still the subject of studies on how it can be used to increase the health and well-being of patients and health care providers. He has proven that meditation really does reduce stress as well as improving medical symptoms and promoting wellness.
Start gently with five minutes of meditation and work your way up to 10 minutes, and then preferably 20 minutes, a day. Making this a daily event is how it becomes a transformative practice in the life of a stressed-out nurse.
At this time of year many nurses are wondering how to enter the busy holiday season with more intention and ease. They want to remember the important things about Thanksgiving and bounty and blessings, say, but in the midst of Black Friday madness? Those “gotta get it now” sales can turn anyone’s attention from gratitude to greed. And then the gift-giving holidays kick in, so the focus on materialism becomes even more intense.
Maybe you’ve tried some of the recommended hacks for generating heartfelt warmth, peace, and grace. Oprah popularized one such method, the gratitude journal, when she recommended that viewers write three things they were thankful for each day.
There’s good research to back Oprah but some nurses don’t like to write out their reflections— they want a more active approach. Or they’ve kept a list of three items and it didn’t change how they felt—frazzled, harried, lacking, or just emotionally flat when everyone around seems to be caught up in the spirit of the season.
There are many active and powerful ways to create an awareness (and often the feeling follows) of gratitude which is closely related to compassion. That can be a powerful duo for nurses who may wrestle with compassion fatigue all year long, but feel it especially at the holidays.
The Japanese method of Naikan (translates to “looking within”) provides one. I like to use the end of November through the end of December for this style of structured reflection. It always results in a profound sense of gratitude for blessings that were always there but went unnoticed.
It takes about me 15 to 30 minutes a day to do Naikan, and I get so much out of it that I do it every year.
Daily Naikan practice asks us to examine these three areas of living:
What have I received? [from life, or a certain person, place, or thing.]
What did I give? [same as above—you can time limit it to that day or year or the whole length of employment or relationship, etc.]
What troubles and difficulties did I cause? [ditto]
The first two questions are usually pretty easy to answer and we may be able to go on and on about what we do for others. But slice up your time in uneven sections with 60% of it devoted to the third question. That’s the most difficult one. After all, it’s natural to think that problems are caused by other people while we’re hardly ever responsible for upsets.
Search your conscience for where you missed the mark, even in some small way. Here’s an example of one day’s list:
Troubles and Difficulties I Caused
Sent thank you email a week after dinner party
Snapped at young, inexperienced nurse
Wouldn’t let my youngest use Pinterest
Snide tone to husband on phone call
Checked my social feeds while at work
Ignored my son when he wanted to play
Wasted water by letting shower run for 15 minutes
If you want an active reflection that’s a bit off the wall, I like to do something I call Garbage Naikan. Every time that I throw away or recycle an item, like floss and coffee filters and train tickets … I think about the service I got from that thing, what I gave it, and what problems I caused it. This may sound eccentric to Westerners but maybe not now, after Marie Kondo’s Japanese book on tidying up your home became a mega-bestseller. She recommends thanking any object that you toss out while decluttering.
So, you may feel ridiculous, but give it a go. When recycling a sock, say “Thank you sock for your service in keeping my feet warm. I treated you well by gently folding and setting you in my sock drawer. I’m sorry I caused trouble by walking around on hardwoods without slippers and wearing you out before your time.”
Finding creative ways to examine your life using psychological or spiritual methods (like Naikan) will help make you mindful of the overlooked gifts we receive daily.
The holiday season has almost started and there are less than two months left in 2018. This is the time of year when we can get reflective because it’s always surprising how quickly time passes. It seems like only yesterday when we were all formulating our New Year’s Resolutions.
Are you gobsmacked by how many items still remain on your 2018 to-do list?
Nurses are go-getters. They know how to get things done at work. But sometimes they aren’t as diligent about attacking their own personal goals and dreams. There’s no need to despair if you’re not where you want to be with your resolutions, personal to-do’s, or life “bucket list” items. It’s only common sense that nurses have the option of approaching these final weeks in a couple of ways.
One: you can drive on cruise control for the final days of 2018, resigned to the fact that you probably won’t be getting much accomplished after all. You may even be in a holiday mental fog, simply looking forward to enjoying time off from work, as health care environments generally slow down during this season.
Two: you can put the pedal to the metal and accelerate to reach your goals in the final stretch of this year. And if you’ve already reached your targets (good on you!), then you will try to get a jump-start on the coming year.
Six weeks.
That’s not much time, but it can be plenty of time to reach many goals. From buying a new winter scarf to applying for an advanced nursing degree, there’s still an opportunity to take action during November and December.
Still, the temptation is there to take it easy and not push yourself during what is already the most hectic and stressful season, with family gatherings and all the emotional drama that entails for many people.
Another common mistake? Looking to the future and dreaming about how wonderful it’s bound to be—without actually doing what’s necessary now to make it happen.
There is no easy way out, though. As motivational speaker Jim Rohn says, “We must all suffer from one of two pains: the pain of discipline or the pain of regret. The difference is discipline weighs ounces while regret weighs tons.”
So, take a load off of your shoulders.
Right now, pick up your calendar, a notebook, and a pen. Make a list of what you’re aiming to accomplish. Research proves that lists have power. It can help make you more organized and productive when you “think it and ink it.” Perhaps it’s because writing activates so many different parts of the brain so it’s easier to remember what you want to get done.
Some items on your list are bound to be meaningful while others will be mundane. The biggies on most people’s lists regard daily living (“conquer procrastination”), dream jobs (or how not to go bonkers at work), romantic relationships, health and wellness, family and friends, and the pursuit of happiness.
Some goals are a bit of both—for instance “drink only hot water with lemon or cold water with cucumber slices” could make a major impact on your health if it replaces sugary sodas.
In any case, you’ll feel awesome come January 1st when you’re able to cross off (check off?) your action items, and get a head start on some others for next year. That’s so much better than starting 2019 from a dead stop after six weeks of holiday frenzy or winter hibernation.
Have you heard about the annual health event called Movember (“Moustache” plus “November”)? Men pledge to grow the facial hair above their upper lips and to get donations from their friends, family, and coworkers to fund efforts to address the men’s health crisis.
In addition to fundraising, the Movember Foundation aims to raise global awareness of male-specific diseases such as prostate and testicular cancer, as well as conditions that often hit men especially hard, such as depression, other mental illnesses, and suicide. Their stated mission is simple: to stop men dying too young.
Since Movember was launched in Australia in 2003, the event has grown into a powerhouse health charity and one of the fastest growing non-government organizations. The founders of Movember were inspired by how women had spearheaded fundraising and research efforts towards finding a cure for breast cancer. They sought to do the same to address male health and longevity disparities, and they have—with good humor and tremendous imagination.
In the last 15 years, the Movember Foundation has invested $200 million in 120 research projects to improve health outcomes for American men. They’ve also funded over 1,200 projects in more than 20 countries, with the financial support of over 5 million men and women.
The Movember Foundation will launch their 50 Million Men campaign in early 2019 to empower 50 million American men to self-manage their health in the next five years. Among other disparities, American women outlive American men by an average of five years.
(Worldwide, health outcomes among men and boys continue to be substantially worse than among girls and women.)
Through free digital resources, trackers, and health promotion initiatives, the organization aims to educate American men about healthy living, and to encourage them to seek preventative care and early treatment.
Movember gives nurses a wonderful opportunity to get involved in the effort to close the gender health gap and ensure that men live long lives, with the support of their peers and families. More healthy men mean healthier communities and ultimately, a healthier world.
November isn’t the only national health observances this month. According to Healthfinder.gov, there are many others. Here are a few that may greatly impact men:
Lung Cancer Awareness Month
Pancreatic Cancer Awareness Month
American Diabetes Month
Great American Smokeout (American Cancer Society)
National Child Mental Health Month
Though men may have traditionally been more likely to smoke, drink heavily, or eat convenience foods, that may be changing. With increased awareness, men are starting to be more proactive about taking charge of their own health. By educating men about these issues, whether during Movember or the Great American Smokeout, nurses can help to save 50 Million Men.
