It’s National Influenza Vaccination Week, and if you haven’t yet gotten a flu shot, you still have time. But why is it important to get the shot, especially if you’re not in any risk groups? And how can you encourage your patients and their family and friends to get it without being a nag? Jennifer Femino, FNP-BC, Family Nurse Practitioner/Director of Quality Improvement at North Shore Community Health and member of the American Association of Nurse Practitioners (AANP), explains why and how you can help your community prepare for flu season.
Why is it important for people to get vaccinated against the flu? Who is at the highest risk for having complications from it?
It is important for everyone 6 months and older to get vaccinated against the flu because it is a contagious respiratory illness, which can cause severe illness and even death in some people. Not only will receiving the flu vaccine help protect the individual, but it will also help prevent those they come in contact with from getting the flu, by helping to stop the spread of the virus. The best way to prevent the flu is to get the flu vaccine.
Those at highest risk for having complications from the flu include children under 5 years old, people 65 years and older, pregnant women, and people of any age with certain chronic medical conditions, such as asthma, diabetes, or heart disease.
How can nurses encourage their patients to get vaccinated? What should they say to those who have fears that the shot will give them the flu? What about those who believe that the vaccination will hurt them?
Nurse practitioners can encourage their patients to get vaccinated by addressing any specific concerns the patient has. They can also remind patients the flu can cause severe illness and death in some people, and the flu vaccine is a simple way to prevent this. Nurses can also get vaccinated themselves, and wear a badge advertising this; patients may feel reassured their trusted health care professional also gets vaccinated against the flu.
NPs also educate patients that the flu vaccine does not cause the flu. Flu vaccines are made with either inactivated flu or a weakened flu virus, neither of which can cause the flu. Some people may feel mild symptoms after receiving the flu vaccine, but nurses should emphasize that the symptoms are mild and brief, and are very different from the severity of symptoms of the flu.
Serious reactions to the flu vaccine are rare. People who have a severe allergy to the flu vaccine or any of its ingredients should not get the flu vaccine. Most people with egg allergies are able to get the flu vaccine. However, any patients with a history of an egg allergy or a history of Guillain-Barré Syndrome, should speak with their health care provider about options for flu vaccination.
What about families/friends of patients? How can nurses encourage them to get vaccinated? Suppose the patient has a compromised immune system? What can they say to get visitors to get vaccinated?
Nurses can talk with families and friends of patients about the importance of them getting the flu vaccine in order to help prevent the flu in their loved ones. NPs can also remind family members and friends it is not enough to simply avoid the patient if they are sick because they would likely be contagious with the flu even before they knew they were sick.
This is even more important for family members and friends of patients with a compromised immune system. It is imperative that they get the flu vaccine so that they do not spread the flu to the patient, who will likely not be able to fight it and is at serious risk for complications, including death.
Nurses can talk with patients and families about ways in which they can talk to their visitors about the importance of receiving the flu vaccine and can work with them to perhaps set limits or discourage visitors who have not been vaccinated.
Some people think that it’s fine to get the flu—it’s like getting a cold. It will go away. Explain why the flu is more serious and why vaccinations are crucial.
The flu is much more serious than a cold. The symptoms are much more severe and intense. The most important difference is that the flu can result in serious complications, including death. The flu vaccine is crucial, not only to prevent flu in an individual, but also to prevent the spread of flu to those who may be at higher risk of complications.
Are all health care providers required to get vaccinated?
Health care providers are strongly encouraged to get the flu vaccine. Policies regarding the flu vaccine vary from organization to organization. Many institutions have policies mandating the flu vaccine, and those who choose not to get the flu vaccine must wear a mask throughout the flu season.
What about those who say that they’ve gotten the flu shot in the past and still gotten the flu? How can vaccinations benefit them? How can you encourage them to get vaccinated?
Flu vaccines are not 100% effective, and sometimes the strain of flu circulating is not a perfect match for the flu strains in the flu vaccine. In some cases, people were exposed to the flu before their immune system had time to build a response to the flu vaccine.
There is evidence the flu can be milder and briefer in those who have been vaccinated against the flu. Although flu vaccines are not perfect, they are the best way to prevent getting the flu.
Anything else regarding the importance of vaccinations for influenza that you think is important for our readers to know?
The CDC is an excellent resource for information regarding the flu. They have a wealth of resources for nurses and patients on their website. They also are on Twitter (@CDCFlu).
Flu activity is starting to increase across the United States, so if you have not yet had your flu vaccine, now is the time!
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.
Nurses know that caring for patients and others before yourself can lead to nurse fatigue. An essential first step to taking good care of yourself is finding a healthy outlet for stress. How can you do that? Some of the simple ways that nurses report for dealing with tension include: hiking, biking, crafting, taking a sauna, or spending time with family and friends.
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.
This month we celebrate family caregivers. The 2018 theme for National Family Caregivers Month is Supercharge Your Caregiving. President Clinton signed the first Presidential Proclamation in 1997 and every president since that time has followed his lead by issuing an annual proclamation to recognize caregivers each November, for an entire month. For this year, President Donald J. Trump says “We recognize the challenges of caregiving and celebrate the joys of bringing support and comfort to a loved one. We express our gratitude to them for the work they do daily to ensure their loved ones are able to live in their homes and communities.”
Nurses play an important role in patient care including caregivers, and this role of care will expand with the increasing number of patients needing this care. Nurses are also well-suited to assess, educate, and support family caregivers who care for their loved ones, as well as contribute to evidence-based nursing practice to improve the quality of care for family caregivers. Nurses serve as clinicians, educators, counselors, and researchers who provide support and conduct research that addresses family caregivers’ ability to care for their loved ones.
Demands on caregivers are currently growing as the health care environment changes. Additionally, the number of people with dementia and multiple chronic conditions is rising. Family caregivers can be overwhelmed by multiple responsibilities and seek guidance for taking on the responsibilities of caring and planning for a loved one. Nurses are well positioned to help family caregivers to become more confident and competent providers as they engage in the health care process. Nurses are also an excellent resource for families who need support, guidance, and encouragement. Nurses can connect family caregivers with key resources to simplify the care planning process.
Here are some useful resources to help family caregivers address and cope with the challenges of caring for a loved one.
1. Caregiver Action Network
The Caregiver Action Network (CAN) is the leading family caregiver organization to improve the quality of life for Americans who care for loved ones with chronic conditions, disabilities, diseases, or the frailties of old age. CAN is a nonprofit organization providing education, peer support, and resources to family caregivers across the country free of charge.
This is the leading online destination for family caregivers seeking information and support as they care for aging parents, spouses, and other loved ones. It offers helpful content, advice from leading experts, a supportive community of caregivers, and a comprehensive directory of eldercare services.
3. National Transitions of Care Coalition
The National Transitions of Care Coalition (NTOCC) is a nonprofit organization addressing the issues and concerns related to transitions of care. The NTOCC provides tools to help health care professionals, patients, and caregivers establish safer transitions; and resources for practitioners and policymakers to improve transitions throughout the health care system. Most of these resources are available free of charge.
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.
To learn more, visit www.movember.com.