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How to Do Nurse Recognition – During Nurses Week and Beyond

How to Do Nurse Recognition – During Nurses Week and Beyond

I started my career as a nurse 35 years ago. Thirteen of those years I spent up in the air as a flight nurse, responding via helicopter to the most urgent calls. We responded to accidents, shootings, strokes, heart attacks, you name it.

Because we were outside the four walls of our hospital the majority of the time, hospital leaders didn’t have the same on-the-ground visibility into the work that we were doing. And while I’ve never known a nurse who got into the field for the recognition that comes along with the work, the fact that the work we were doing to save lives happened outside the hospital meant that when we pulled off something incredible, we were the only witnesses to it.

Then, one night, around 10 p.m., we responded to a terrible multi-vehicle wreck on a major highway. Traffic was backed up for miles on both sides while we came in and did our job – triaging patients in the dark to find the one in most emergent need (others went by ground), stabilizing him as quickly as possible with intubation, IVs, and packaging for transport before loading the patient hot (helicopter never shut down – blades still turning) into the helicopter, and transporting him to the hospital. There was nothing particularly strange about the accident itself, but as it turns out, the CEO of my hospital just happened to be caught up in that traffic, and he had a front-row seat to watch us do our job.

The next day, the CEO and my director came down to where we were and asked to see us. After seeing what we did in person, he wanted to come and personally thank us for the ‘effortless, yet life-saving’ work that he had witnessed. And now, decades later, that gesture still sticks with me. Just a simple act of recognition, especially coming from the leaders at the head of a hospital, can make a world of difference for an exhausted nurse.

And when we’re talking about our country’s nurses this year, “exhausted” is an understatement. As we mark Nurses Week amid the hopeful winding down of the worst international health crisis in memory, nurse and frontline staff recognition should be at the top of mind of every healthcare executive – not only because it’s the right thing to do, but because happy and engaged nurses reduce turnover and provide objectively better care.

So what can hospital leaders do about it? There are a few key tactics that are important not only during Nurses Week, but year-round:

  • Give time – and space – for self care. Nurses are often the last to take time to care for themselves. Reinforce that from the top to the bottom of your organization, staff members should take the time and resources they need to take care of their physical and mental needs. Allow them to take their well-deserved paid time off so they can recharge, and create an environment in which asking for help and asking for resources is not seen as a sign of weakness, but rather one of strength.
  • Give nurses the opportunity to lift each other up. By giving your nursing staff the ability to nominate each other for recognition – either for going above and beyond, for stepping in and helping whenever needed, or simply for being a positive presence in the unit – you foster a culture that celebrates achievement. Integrate the nomination process directly into ongoing staff rounding processes, making nominations quick and easy. And don’t forget how much recognition and encouragement from the ‘C Suite’ means to the staff.
  • Amplify good patient stories. When you receive positive feedback from a patient about the treatment they received from a member of your nursing staff, share it publicly with your entire staff. Talk about the interventions used, and how caregivers interacted with patients in a positive manner. This too can be integrated directly into patient rounding processes – build opportunities for recognition directly into rounding scripts.

Of course, Nurses Week this year will be marked by special events, meals, public displays of appreciation, nursing excellence awards, and more. But nurse recognition needs to be about so much more than a moment in time – it needs to go beyond a simple “thanks” or “good job.” When recognition is adopted as a cultural value, and when it’s codified into policies and processes, it becomes self-perpetuating and infectious, in the best sense of the word.

6 Ways to Recover After a Rough Shift

6 Ways to Recover After a Rough Shift

Most people in the medical profession agree that a nursing career can often be stressful; it comes with the territory of caring for those who are ill and injured. And on an average day, well-trained nurses are more than capable of managing the day to day stressors that their profession brings. But there are also those occasional shifts that bring nurses to their knees, putting them in need of restorative tactics. Here are some solutions for bringing a nurse back from the brink after a rough shift.

Let’s Be Brief

After a rough shift, it helps to debrief with colleagues  who have also had a tough day. Reviewing what didn’t go well and determining how events could have been better managed can be educational or reinforce that the decisions made were the best possible options. And the opportunity to share the days’ struggles can be a great bonding experience for the team.

Break Up the Monotony

Break up the routine. Take a different or longer route home. Taking the long way home can provide valuable time to clear the mind and break up the “autopilot” to which we tend to default on our commutes.

Take Time to Be Quiet

Play soothing or instrumental music on the radio, or leave it off altogether. Patient care can be extremely noisy, especially in acute and long-term care facilities. After a long shift of constant noise, a little oasis of quiet can be very soothing. After you get home, continue to limit external stimuli for a while. Keep that Zen mode going a little longer if you’re able.

Happiness is a Warm Puppy, or Kitten, or…

Are you a pet owner or lover? It’s a wonderful thing after a long day to be greeted at the door by a faithful companion, but take it a bit further. A long walk with your dog or some snuggle time with your cat, ferret, or another small animal can help you detach from the day. Your focus is shifted from your own worries to the needs and appreciation of your furry friend. If you don’t have a pet yourself, perhaps you can visit a friend or neighbors’ dog. Petting an animal lowers blood pressure and facilitates the release of relaxation hormones.

Sleep it Off

Taking a nap or reading something simple and calming can help bring you back to balance by focusing your mind on something other than the friction of the day you’ve had.

Fresh Start

Even if your work isn’t necessarily as grimy as some careers, most nurses make it a point to bathe after a shift. A shower or a soak in the tub cleanses off the residue of the day and leaves you fresh and ready for bed.

However you choose to spend your time after a rough shift, it’s important to make sure that you know how to take care of yourself. 

Chilling Out: The Importance of Taking Vacations

Chilling Out: The Importance of Taking Vacations

Summer is here, and the time is right…for taking vacations.

Think you don’t have time? Think again. Flo Leighton, MS, RN, PMHNP-BC, a board certified mental health nurse practitioner as well as an adjunct faculty at New York University College of Nursing, has a private practice in Chelsea, New York, where she sees health care professionals, including nurses and nursing students. Leighton’s background also includes working in inpatient psychiatry and the adult ER at NYPH/ Columbia University medical center.

Leighton took time from her busy schedule to answer some questions about why nurses not only should, but also really need to take vacations.

WFlo Leightonhat are the main reasons nurses should take time to take vacations?

Nurses have the type of job that requires a lot of mental clarity, physical demands, and empathy towards patients and their families. Nurses often care for a full load of patients and have to juggle many competing priorities throughout the course of their shift. Many nurses work 12-hour shifts, evening or night shifts, and may be on their feet for several hours at a time. Nurses that work in ICU, Oncology, ER, or other high-acuity areas are repeatedly exposed to stressful events. It is for these reasons nurses need to make time for themselves by taking vacations.

What justifications do many nurses use for why they can’t take time off?

Some nurses may state they cannot take time off due to financial issues, family obligations, being in school while working, having another job, or wanting to save their elective time up for a rainy day. Sometimes nurses may be prevented from taking peak time—summer or holiday—off for vacation due to staffing issues or not having seniority with highly requested weeks.

Suppose nurses don’t have the funds to go away. Is taking a staycation good enough? If so, what limits should they put on them or what tips can you give for how nurses can stay relaxed during a staycation?

A staycation is a great alternative for those who do not have the money to take a big vacation. The most important thing to keep in mind is to set limits for yourself by limiting work-related projects and correspondence while not at work. Refraining from checking work email will help facilitate being more present and connected in what you are doing in your personal time and help create a better work/life balance. It is easier to feel recharged and less burnt out at work this way.

Whether it is taking a day trip, a yoga or spin class, going for a run, lunching with family or friends, or a spa day—there are simple ways to make the most out of a staycation.

How will taking vacations or time off help nurses? What can it do for them physically and mentally?

Taking vacations can be a great tool for managing stress and preventing burnout and compassion fatigue. Nurses who struggle with stress on the job are more likely to make medication errors, not feel engaged at work, have higher turnover, and negative patient outcomes.

If they decide to take vacations, what can they do to make them less stressful? 

Trying to use time off as a mental vacation in addition to a physical location change is really important. We are accustomed to multitasking and doing structured tasks with multiple deadlines. It is good to try not to plan anything that is too structured or choose a location that offers planning of activities so that you don’t have to. Allowing others to plan is a nice departure from a highly structured and stressful job as well.

Is there anything that is important for readers to know? 

Nurses who repeatedly are exposed to stressful situations—deaths, cardiac arrests, violence on the job, etc.—either directly or witnessing through others are at risk to develop symptoms of Secondary Traumatic Stress (STS). Examples of STS may include irritability on the job, frequent call outs, higher turnover, changes in concentration, and avoidance of stressful situations on the job. If not managed properly this can develop into PTSD (Post Traumatic Stress Disorder). Great stress management, including taking time away from work is crucial.

Stress Management to the Rescue: Strategies for Self-Care in Nursing

Stress Management to the Rescue: Strategies for Self-Care in Nursing

Have you ever noticed how many altruistic nurses there are out there in the world or even just in your own community? I’ll bet you dollars to stale breakroom donuts that you’re one of them. It seems as though it’s an inseparable quality inherent in most health care providers. Altruism is a great personality trait to have in many instances. It keeps the compassion in our work evident. It fearlessly upholds our love for our fellow beings and gives us every day heroes to keep our hope in humanity strong. It was likely a driving force that helped move you and many others toward a career in nursing. But once there, have you also noticed how it can be the very detriment to the longevity of it?

By the very selflessness of altruism, one begins to see how it fosters an acceptance of self-neglect and can ultimately wear a nurse down. Don’t let the best of you end up ushering you out of your hard-earned career. After all, if we wish to give our patients and colleagues the best of us, we cannot give from an empty medicine cup. The daily energy depletion from all forms of stress in nursing adds up quickly. You need to be on your toes for yourself, just as you are with your patients or administrative duties. The environments most nurses work in do not support self-care by the very nature of the total demands, so you will have to come forward and be a champion for yourself in all of this.

The good news is that pendulum can come back to center with an empowering consciousness shift. Nurses can certainly thrive while honoring their own needs within their career. Let me show you how by offering a few strategies that will go a long way in keeping you healthy in mind, body, and spirit within your exceedingly high stress career.

Start with the Basics

What follows here serves as a caring reminder, because, let’s face it, we could write the book on this stuff. But there’s something about those whirlwind work hours that somehow make us forget ourselves. Think of me as your best friend reminding you of how important you are.

1. Make time to stay hydrated and make time for the restroom.

Drink plenty of water prior, during, and after your shift. Find a water bottle that makes you tickled in your favorite color or whimsical design. Sponge Bob Square Pants themed? Go for it! The days of nurses holding their bladders for 8-12 hours needs to stop, seriously, today! Check in with yourself hourly and take the 2-3 minutes to visit the porcelain sanctuary when needed. Your bladder matters, you matter.

2. Meal plan in advance of your work week so there is no repeated wasted energy with what and when to eat.

Try not to tell yourself “you’ll figure it out as you go along.” This tends to put yourself last once again and you may not ever come up in queue. Choose high quality foods that are portable and nutrient dense; you are a powerhouse during your shifts and your food choices need to support that. Nix the sugar; it will unplug you faster than anything else. And for the love of all things healing, don’t resort to mutterings when a coworker makes a decision toward self-care. This is not a luxury. Learn sooner than later, that basic self-care in nursing is a priority and a necessity. Being part of an amazing team is great and part of that is respecting individual sovereignty and decisions made for self-preservation within the context of the demands. Support each other always and bring back the normalization of taking a break and having a meal during a work shift. If you are in a position where basic needs are not being honored; it isn’t the right place for you or any human being. Make moves to move on.

3. Lastly, blissful sleep.

So important as you know, but elusive to 50% of Americans. Many nurses have a difficult time forgetting what goes on during their shifts and with the unrelenting demands, many nurses leave fearing they haven’t covered all the bases and the mental list goes on and on until the rooster starts to crow. Add into the mix pre-shift anxiety with nonstop adrenaline surges and you’re dealing with a perfect storm.

Despite all of the bombardment, you’ll need to navigate your way to serenity shores in order to get an optimal eight hours. Being fully functional and keeping your immune system in tip-top shape is non-negotiable. Therefore, quality sleep is an unbreakable deal you need to make with yourself. Commit to remove your mind from the work environment the minute you physically walk out of the door at the end of your shift. Instead, consider taking a walk out in nature; watch a great comedy movie; enjoy being with family, a friend, or pet; express your creative flair with adult coloring books, engage in hobbies; or develop new ones including cooking, photography, knitting, or reading. You get the idea. Just know that if work thoughts start to invade your off time space, kick it down the yard lines like an NFL player, take a deep cleansing breath, and refocus on those things that you love and make life enjoyable. Unwind with healthy options that do not affect sleep quality, such as alcohol or caffeinated beverages. One hour before turning in, disengage from all electronics. Lower lights can ease you into a pre-bed ritual, which can include a bath to help you ramp down. Try augmenting the water with non-toxic bath salts with a couple of drops of an essential oil to the water. Explore unwinding scents such as Lavender, Ylang Ylang, and Bergamot for yourself. Perhaps some light and relevant reading? I recommend A Good Night’s Sleep written by Dr. Brian Luke Seaward.

Relaxation, Breathing, and Movement Will Save You

It’s true, you’ve certainly learned it in nursing school: the ABC’s every living creature needs. When the body, mind, and spirit are in a relaxed state, fully circulating with unrestricted movement, healing and restoration occurs. Instead of bolting out of bed like you’ve been released from the gate at the Kentucky Derby, allow for some time upon awakening to ease into your day. If you arrive to your post amped up on stress you are less likely to be able to easily handle the ensuing compounding stress. Begin and end your day with a variety of options that include meditation/prayer, positive affirmations, guided imagery, and some gentle stretching. Take a couple of initial deep breaths and remember that you are a living, sentient being in need of oxygen. Remind yourself throughout the day to take some deep breaths and shake off all of that shallow breathing.

Import a few yoga moves before getting out of bed, after a shift, and before sleep. These are easy peasy and can be done by almost any exhausted nurse in need of recharging:

  • Before leaving your bed, try Supine Bound Angle Pose (Supta Baddha Konasana) and Supine Spinal Twist Pose (Supta Matsyendrasana).
  • Need to silence your barking dogs after a harrowing shift? Move to a modified Waterfall Pose (Viparita Karani). It really is enough to lie flat on your back with your legs resting up on a wall.
  • Before heading into your next shift, which we all know is like going into battle, take a moment to engage in the Warrior Pose (Virabhadrasana), which will leave your battery juiced up and grounded.

Check out Google Images or Youtube.com for visuals of these elementary and manageable moves. At the very least, you’ll have fun with the names of the yoga poses rolling off of your tongue.

Guided Imagery is Your New Friend

Guided imagery needs to be in every nurses’ stress management repertoire. By going within using custom scripts for relaxation, we can develop a healthy baseline with more resiliency moving through stress and aid in resetting cortisol and adrenaline. This is not only a useful tool for ourselves but can be used in coaching patients through pain, fear, and anxiety. It’s a great way to be there for yourself and your patients in a meaningful way. I recommend anything offered by the forerunner in guided imagery, Belleruth Naparstek. Visit www.healthjourneys.com to learn more.

There are numerous ways that nurses can avoid becoming collateral damage from the stress in their professional environments. Nurses need to explore what pieces of this puzzle work for them personally. Small positive incremental changes add up to create life-affirming routines that navigate away from career-crushing burnout. I’ve provided a starting point. Keeping with internal and didactic wisdom can be there as daily reminders. Sticky notes on your bathroom mirror help as well. Namaste.