Wearing PPE full-time can be trying. Acne. Rashes. Bruising. Headaches. Unrecognizable co-workers. PPE has never been comfortable, but now an unprecedented number of healthcare providers are experiencing PPE discomfort, and their misery is prolonged by working conditions related to the pandemic. Shortages and the life-or-death risk of infection often make it impossible to take a PPE break and don fresh equipment every two-to-four hours as recommended; as a result, clinicians all over the world are suffering from sad faces (and sad hands as well).
So far no one has suggested ways to make coworkers more recognizable, but there are measures you can take to help protect your skin from the effects of chafing, pressure, lack of air, and sweating while wearing PPE (spending hours in a tight-fitting N-95 is especially onerous).
1. Drink PLENTY of Water
Rule number one is, hydrate! When you’re not working, be sure to drink plenty of water throughout the day, and make sure you have a water bottle ready at the end of each shift.
2. Your Face and Hands Need Water, Too!
And rule number two is… Hydrate! Keeping your face and hands well-moisturized is always a good idea; when you’re wearing PPE this becomes a must. Use a cleanser for sensitive skin, and gently pat your face dry with a towel. Moisturizer is essential but stick with water-soluble products and avoid zinc, petroleum jelly (whether pure or in a blended ointment such as Aquaphor or Cerave), and heavy creams that can clog your pores. Products such as Aquaphor are useful for protecting your hands, though, and preventing dry hands is an essential part of hand hygiene. In addition to regular applications of skin ointment, make a habit of moisturizing your hands every time you wash them (all hospital hand hygiene stations should provide moisturizing lotions).
3. Make Your Face a Fortress
If your employers permit, experiment with protective cushioning options to prevent chafing and irritation from N-95s. Before putting on a mask and goggles, apply an alcohol-free liquid barrier to provide your face with clear, breathable protection. Thicker barriers such as dressing tapes should be avoided, as they can interfere with the proper fitting and seal of your mask.
Nursing is a unique profession, with major psychological stressors and equally great emotional benefits. Who would have better self-care tips for you than a psychiatric nurse practitioner and DNP candidate? Jonathan Llamas DNP (c), BSN, RN-BC, PHN, is all that, plus a freelance writer for MinorityNurse.com.
Llamas is pursuing his degree at Loma Linda University while also working full-time as a psychiatric-mental health nurse at Kaiser Permanente in Los Angeles, CA. (Obviously, he knows a thing or two about workplace stress!) He is a Filipino-American, a first-generation college graduate, and an emerging nurse leader who aims to help educate the next generation of nurses.
In this Q&A interview, Llamas suggests ways for nurses to practice self-care, while at any point in their career journey.
Jonathan Llamas DNP (c), BSN, RN-BC, PHN
How did you become interested in psychiatry?
I ended up choosing psychiatry because at an early age, I have always been fascinated by the miraculous wonder of the human mind and the inherent beauty and evolution of life that emanates from the adept functioning of the brain.
I developed a profound passion to better understand and treat the psychological, emotional, and spiritual ailments that are often associated with mental illness in contemporary society.
What have you learned—related to stress, self-care, avoiding overwhelm, depression, or burnout—from your psychiatric nurse training that you wish all nurses knew?
The most important concept that I have learned so far during my experience working as a psychiatric-mental health nurse is the importance of self-care. The concept of self-care was never really endorsed until recently, because of the overwhelming influx of individuals suffering from mental illness in recent years.
The interesting part about mental illness that many people tend to forget is that it is non-discriminatory—meaning that it can affect anyone regardless of their race, gender, creed, or socioeconomic background.
I often make it a point to encourage my fellow nurses and colleagues to not be afraid to care for their mental health and address any issues that may produce additional stress and anxiety in the future.
What personal benefits (emotional, psychological, spiritual, etc.) have accrued to you from pursuing this specialty?
Working in psychiatry is a unique experience because it teaches you a lot about the interplay between the emotional, physical, and psychological components of holistic treatment. As a result of this realization, I try to make a concerted daily effort to continue to develop not only creative approaches to my nursing care, but also empathetic techniques that ensure patient safety and satisfaction is achieved across the patient gamut.
You also have previous experience in ICU/trauma and ER settings—what did you learn from those roles, related to stress, overwhelm, and so on?
Although it can be physically and emotionally draining, working in the ER and ICU/Trauma settings—[they] taught me the significance of perseverance, collaboration, and patience.
I have come to learn that the best way to combat stress and burnout is to surround yourself with people and hobbies that energize and remind you as to why you chose to be a nurse in the first place.
Do you have favorite techniques for de-escalating difficult situations, with patients or coworkers?
In the past decade or so, violent incidents have increased dramatically and are now four times more likely to occur in health care than in any other private industry.
Because of this unfortunate reality, one of my favorite de-escalation techniques that I continually perform on a consistent basis is the LOWLINEModel. (Described by Mike Lowry, Graham Lingard, and Martin Neal in a 2016 Nursing Times article.)
LOWLINE is a mnemonic that stands for (L)isten, (O)ffer, (W)ait, (L)ook, (I)ncline, (N)od, (E)xpress.
How has being a minority (gender or racial, ethnic, etc.) nurse played out in your career?
Surprisingly, being a minority male nurse in a predominantly female driven profession has been a positive experience for me thus far. Although I can only speak on my own personal experience, I consider myself blessed and fortunate to be able to care for my patients without fear of being judged or discriminated for my racial, ethnic, gender, or socioeconomic profile.
Since I do work in psychiatry however, I do experience the occasional irreverent name calling from highly psychotic patients, but I do my best to not let it affect me and compromise the type of nursing care I provide.
Listen to Jonathan Llamas on mental health nursing in an “AlumniSpotlight” video clip.