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Nurse Burnout: 12 Ways to get Your New-Grad Happy Back

Nurse burnout happens.  No nurse is immune.  If you are a nurse you are at risk for burnout.

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Remember how it felt to be a brand new nurse?

The only thing more shiny than your new stethoscope was your happy face.

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I diagnosed myself with nurse burnout when I started thinking that driving my car off a cliff sounded better than going to work.

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I was able to get back to my nursing happy place and I am in love with nursing again.

Here are some ways to get you back to happy-dancing your way to work.

 

 

1.  BLOG!  I love it and I’m not the only nurse on the interwebs!  If you are not a writer then read nursing blogs.  There are all flavors of nursing blogs, from informative to hysterical.

Some suggestions to get you started: Mine of course!   Adventures of a Labor Nurse   The Nerdy Nurse     Nurse Together     Mighty Nurse     Scrubs     Digital Doorway

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2. Go back to school.  Getting your BSN, MSN or DNP will make you more marketable and open up more options.

Going back to school will reenergize you about nursing.

You will read a LOT about new nursing research, which will get you out of a nursing rut.

You will be so busy making powerpoint presentations and writing discussion posts, you will have no time to think/complain about work.

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3. Get certified in your specialty.  If you are burned out then you probably have been a nurse more than 2 years.  Congrats!

That means that you are qualified to become certified in your specialty.

There is a certification for just about everything nursing related.

Look for your specialty on ANCC or NCC to start.  You will be recognized for your knowledge and add to your credentials.

Maintaining certification means that you will need to keep up continuing education in your speciality, which will prevent you from becoming stagnate.

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4.  Take your vacation days!!  Everyone needs a break.  Nursing is stressful.

If you don’t take vacation for yourself, then take it for your patients.  Being a relaxed and refreshed nurse will benefit them.

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5. Celebrate wins.  We are always focused on what we need to improve and what we are doing wrong.

When you or your team have a win, celebrate!

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6. Take some time for yourself.  Nurses know how important self-care is, but its difficult to find the time. Find it!

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7. Join a committee.  Make changes.  Give your input.  Does your hospital have shared governance or unit representation to make decisions?  If yes, join.  If no, start it! You can change nursing practice.

 

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8.  Be active.  Exercise can help improve mood and is a great outlet for work frustrations.

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9. Go to a Nursing Conference.  

There is nothing better than going to a conference full of nurses.  People think that ComicCon is weird, but they have never been to a nursing conference! We have crazy nurse fun!

It is a great time and it is a place where you are reminded why the heck you became a nurse.

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10.  Spend some time with your work buddies away from the call lights and nurse rounds.

You know you love your team.  An out of work activity can remind you that your work pals are awesome.
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11. Attend a continuing education course or webinar about a topic that interests you.

Will you be inspired by experts talking about the topics that they love.

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12.  Quit.  Not nursing, but quit your job.  Sometimes you really don’t have nurse burnout, but job burnout.

One of the best things about being a nurse is the vast opportunities you have for employment.

If you need a change of pace, location or specialty do it.  Give a proper notice and leave on good terms.

You never know when you may work with those nurses again.  (It will happen.)

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Nursing is a rewarding profession.  If you feel yourself getting disenchanted, actively try to get the magic back.

 

If you are successful you will be back to the new grad feeling which is good for you and your patients.

 

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How do you beat the nurse blues?  Leave your suggestions in comments.

 

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Mission Impossible

The next time a mother or father asks you for something that is not a common practice, take the time to listen.  Ask yourself if it is safe, or could it be safe.  Check to see if her request has research to back it up.  Many practices that we consider standard today were thought to be radical in the recent past.  It is our ethical duty, as nurses, to advocate for our patients and support their autonomy.  Work with a mother to help her make the best choices for her.  Respect her choices even when you would make different ones.

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The Red Tent

novel cover

Poster

The Red Tent of My Heart

(May Contain Spoilers)

I read the Red Tent, by Anita Diamant, when I was in nurse midwifery school.  It was was an assigned book for the last class I took before I switched programs.  I went tent camping with my husband and three children and threw it in my bag so I could keep up in class.  Once I started reading it I could not stop.  I was swept up into Dinah’s life.  Sitting in woods, by a fire I read about the lives of women.  I recognized the women from long ago in myself, my sisters, mother, daughter and friends.  It may have been the romanticism of reading the story while living in a tent, but I fell  madly in love with it.  I was already infatuated with midwifery and birth.  The way that Diamant described the interactions between women, birth and death struck me to the core.  Although I did not pursue the midwifery path, I still feel the burn of the call.  I get a glimpse of it from time to time in the hospital.  Women supporting each other in the most intimate way while walking the line between death and birth.  Although birth has become safer in many ways, birth attendants still feel and fear death lurking in the corners of every delivery room.  I believe that is why a lot of well meaning over medicalization has occurred.  Not all of it, but a lot.  The novel did a wonderful job capturing the beauty and struggle of a guiding women through childbirth.

I was giddy when I fount that the novel was being made into a mini series.  Lifetime did a decent job telling the plot of Dinah’s life.  They were’t able to capture the beauty of birth and midwifery as well as the novel.  The relationships between the women were recognized fully in the last few minutes, but were not given as much development as in the book.

I have recommended this book, over the years, to everyone that has the look of wonder in their eyes.  I recognize the look right away.  It is a look that belongs to a person that is in complete awe of birth and the power of women.  I am not the only woman that loves this story.  Red Tent communities have popped up all over social media and in real life.  Women crave the type of connections found in the red tent.  Many of us have few, if any, sisters, move far from our mothers, do not get along with our mother-in-laws and do not make time for our girlfriends.  Twenty-first century life can feel so isolating.  Births continue to bind us together.  I step into a stranger’s room and become a friend/sister/mother within moments.

The bond of women during the sacredness of birth is strong.  The trust they give me is an honor.  Like Dinah, I will carry all the special women from my life with me.  There is not a red tent for us to take refuge.  I will carry my red tent in my heart.  With it I will create the safe and beautiful places for my sisters to bring their babies into the world.

Generations of women learning, laughing and sharing together.
Generations of women learning, laughing and sharing together.

If you enjoyed the miniseries, read the novel.  You will laugh and cry and love all the things Dinah loves.

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When Pain Ruins a Good Time

Dyspareunia, painful sexual intercourse, is a symptom that people can be reluctant to speak with their health care team about.  It is a difficult to bring up at an appointment, but it can negatively impact quality of life.  Both men and women experience painful sex.   Although men can experience this symptom it is almost exclusively reported by women.  Up to 22% of women will experience it at some point in their life.  Dyspareunia can be associated with vulvar, perineal, or vaginal trauma and repair, but these are not the main contributors.   Postpartum dyspareunia can also occur in women who give birth by cesarean section.   According to the Mayo Clinic up to one in five women experience this symptom before, during or after sexual intercourse.  Half of women resuming sexual activity around the average 6 weeks postpartum point will experience dyspareunia.  Dyspareunia affects persons from all demographics, life stages and gender.  Although in most cases the underlying cause can be treated and this symptom eliminated, it is underreported to care givers.

Pain during sex is common, especially in postpartum women.  Are we talking with mothers and fathers about what it is, why it happens and what to do about it?  Postpartum advice about resuming sexual activity usually consists of wait six weeks and use water based lubrication if you experience dryness.  That doesn’t nearly cover the topic.  The table below is a quick break down of this condition.

 

* Watch the YouTube Video coming out this week for an in depth look into this important topic.

 

Dyspareunia

Risk Factors/ Health Status Disease Injury
Insufficient lubricationSurgeries or medical treatments.Scarring from pelvic surgeries i.e. hysterectomy, episiotomy

Radiation/Chemotherapy

Psychological problems: Anxiety, Depression, Self image, Fear of intimacy, Relationship problems, Stress

Abuse

Reactions to birth control products: creams, foams, jellies, diaphragm, latex

Inflammation, infection or skin disorderUrinary tract infectionEczema

Endometriosis

Pelvic Inflammatory Disease

Uterine Prolapse,

Retroverted Uterus,

Uterine Fibroids Cystitis

Irritable Bowel Syndrome

Hemorrhoids

Ovarian Cysts

Sexually Transmitted Infections:

Gonorrhea, Chlamydia, Herpes

Vaginusmus, Vestibulitis

Injury, traumaAccidentpelvic surgery

female circumcision

episiotomy

congenital abnormality

 

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There are No Guaranties in Pregnancy

Moms are brave.

Pregnancy is a normal function of life.  Most pregnancies proceed on a predictable course and result in a healthy baby. Although it is a normal part of life, pregnancy is unpredictable. There are no guarantees.  Some of the bravest people I have met have been mothers that were facing unknown outcomes.  Women that faithfully endure days, weeks or months of bed rest amaze me.  Mothers whom have lost babies in previous pregnancies bravely try again, and again.  Starbucks and sushi are passed over for the health of the baby.  All these sacrifices and more moms willingly make. Moms bravely face the unknown with faith in the future.

One brave mom checked herself in to the hospital at the request of her obstetrician.  She was late in the second trimester and her baby was not doing well.  While I asked her the standard questions I saw the tears build in her eyes.  I turned away from the computer and sat next to her.  I asked her why she was being admitted.  I knew, but I wanted her to be able to tell me.  She opened up and began telling me, first her diagnosis, then her fears followed by her hopes.  My eyes stung as I forced back my own tears.  This woman had been smiling and laughing moments before.  She was incredibly brave.  I held her hand briefly and I told her that she was in exactly the right place for her baby.  I assured her that we, as her care team, would do all that we could to help her and her baby through the challenges that they were facing.  Those were not empty words.  I believe that we work miracles in OB every day. I am grateful that brave mamas place their trust and hope in our hands.  I never want to let them down.

 

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Free PDF: Caring for the Patient with an Eating Disorder

 

 

Perinatal nurses are now caring for patients that are higher acuity and with more comorbidities.  Caring for a mother with an eating disorder is rare, but does happen.  Your hospital should have policies in place for caring for these patients.  Attached is a free, one page, information sheet as a quick guide when a patient with eating disorders is admitted on your unit.  Pregnancy can be a stressful time in which old behaviors can return.  A better understanding of this disorder can help you care for mothers that are struggling with these issues.

This is general information is for all adult patients with eating disorders.  Each patient and care plan will be unique and take into the specific patient’s needs, assessment and input from the entire healthcare team.

CLICK BELOW FOR FREE PDF (with references):

Adult-Eating-Disorder-Patient-Overview-1

 

Adult-Eating-Disorder-Patient-Overview-1-page-001

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10 Nursing Actions to Bring Compassion Back to the Bedside

Even the most benevolent and happy nurse can forget that every patient is someone’s special person. Some days feel like just another ordinary day at work.  Nurses have bad days just like everyone else. The difference is that a nurse’s bad day can darken a patient and family’s already stressful stay.

When nurses begin to lose sight of the how important their role is a patient’s recovery it is important to recharge, refresh and relearn what it takes to make each day special for patients.

 

Here are 1o ways to bring compassion back to your patient’s bedside:

 

1. Identify something you like about your patient. This may be difficult with some patients, but everyone has some redeeming quality. Find it.

 

2. Smile. If you smile your patient will feel welcome and it can change your attitude as well.  Fake it till you make it.

 

3. Acknowledge and speak to all the people in your patient’s room.  The patient’s family is important and they will appreciate being recognized.  Also they can be recruited to help get ice, hold emesis bags and feed the patient.  The people in the room will be the ones that will be there to support the patient at home when he is tired and needs help. Include the whole family in patient education so that the transition back to home be will be successful.

 

4. Include the partner or loved ones in conversations with the patient. A patient’s support person needs to understand and give input on the patient’s plan of care. The decisions are the patients to make, but they often look to their partner or loved ones for guidance.

Including the partner in the conversations with patient establishes trust and is an element of family centered care.

 

5. Take lunch off the unit. This may be impossible at some hospitals.  If at all possible, leave the unit for your break. Go outside and breathe real air. Take a walk in the sunshine and absorb some vitamin D.

 

6. Use your relaxation skills to relax yourself.  You teach these techniques to patients every day, those same relaxation techniques can benefit stressed nurses!

 

7. Use your vacation days! Don’t hoard vacation days. People that take less vacation days have less job satisfaction.

 

8. Join your professional nursing organization. Keeping up to date on new research is exciting and stimulating.  Challenge yourself and continue to grow in your specialty.

 

9. Go out of your way for your patient at least once a shift. They may not thank you, but you will know that you put in extra effort to make your patient’s stay better.

 

10. When the family is visiting take a few seconds to look away from the IV pump, computer and thermometer.  Witness how the family comforts and supports each other. Watch as a daughter holds her mother’s hand for the last time. See the happiness when a husband is told he can take his wife home.  These moments are what make us human.

 

Take the time to make every day special for your patients.

For nurses it is just another day at work, but for each patient it’s a day that can change their life.

 

 

 

 

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10 Ways to Bring Back the Magic to Labor and Delivery 

All babies are special, but first babies have the unique gift of changing a woman and man into a mother and father.  There is something extra special when a family is welcoming their first child or grandchild. There is also something special about the first baby of the year. Nurses, all over the world, are betting on which mom will deliver the first baby of the new year.  Each hospital wants to be the first in the area to claim the New Years’s baby.  Newspapers will feature photos of the star newborn. The lucky first-of-the-year babies will be showered in gifts from hospitals and companies.

There is a lot of focus on the first baby of the year and nurses ensure that the birth is special and celebrated.  This is a fun tradition, but that feeling fades quickly as the never ending line of pregnant mothers stream in for delivery. Even the most benevolent and happy nurse can forget that every delivery is someone’s special day. Some days feel like just another ordinary day at work.  Nurses have bad days just like everyone else. The difference is that a labor nurse’s bad day can darken a family’s memory of their birth forever.

When labor nurses begin to lose sight of the magic of birth it is important to recharge, refresh and relearn what makes each birth special.

 

Here are 1o ways to bring magic back to labor and delivery:

 

1. Identify something you like about your patient. This may be difficult with some patients, but everyone has some redeeming quality. Find it.

shock

2. Smile. If you smile your patient will feel welcome and it can change your attitude as well.  Fake it till you make it.

 

funny ctm

 

3. Acknowledge and speak to all the people in your patient’s room. The mama is not the only one welcoming a baby into the world.  The patient’s family is important and they will appreciate being recognized.  Also they can be recruited to help get ice, hold legs and fan the patient.  The people in the room will be the ones that will be there to support the mom at home when she is tired and needs help. Include the whole family in patient education so that they can help mom and baby transition successfully.

 

CALL THE MIDWIFE - SERIES 3 - EPISODE 8

 

4. Include the partner or coach in conversations with the patient. A mother’s support person needs to understand and give input on the patient’s plan of care. The decisions are the patients to make, but they often look to their partner or labor coach for guidance.

Including the partner in the conversations with the patient establishes trust and is an element of family centered care.

 

lunch

 

5. Take lunch off the unit. This may be impossible at some hospitals.  If at all possible, leave the unit for your break. Go outside and breathe real air. Take a walk in the sunshine and absorb some vitamin D.

 

6. Use your relaxation skills to relax yourself.  You teach these techniques to patients every day, those same relaxation techniques can benefit stressed nurses!

 

7. Use your vacation days. Don’t hoard vacation days. People that take less vacation days have less job satisfaction.

 

vaca

 

8. Join your professional nursing organization. Keeping up to date on new research is exciting and stimulating. Challenge yourself and continue to grow in your specialty.

 

Call the Midwife - Ep 4

 

9. Go out of your way for your patient at least once a shift. They may not thank you, but you will know that you put in extra effort to make your patient’s stay better.

 

lice

 

10. When the baby is born take a few seconds to look away from the IV pump, computer and delivery instruments. Witness a new person take his first breath. Watch as a mother holds her baby’s for the first time. Look at a father’s complete reverence and amazement at the miracle that has just occurred.

 

Doris Aston CTM

 

My New Year’s wish is for all nurses to be reenergized in 2015.

Take the time to make every delivery special for your patients.

For nurses it is just another day at work, but for each mother it’s a day that she will always remember.

 

 

 

 

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Nurses are on the Nice List

I love the Nativity story. Regardless if you believe the baby in the story is the son of God or not, the story resonates. Picture a young, pregnant Mary searching with Joseph for a place to stay . To complicate matters, Mary’s birth time was near and she surely wanted to get off that donkey and put her feet up. Although there is no mention of Mary’s birth attendants, I’m sure she did not give birth alone. The local midwife, perhaps the lady of the too full inn, would have been called to Mary’s side. In the warmth of the manger the work of labor would be accomplished by a young mother, far from her own mother and sisters. The women around her would act as surrogate mothers, sisters and friends. In this sacred space a baby was born.

Over 2000 years later we continue to celebrate the humble birth. Much like the unnamed birth attendants that witnessed the first Christmas, nurses all over the world are welcoming babies into the world today. Even today there are times that there is not room at the inn. When labor rooms are full mothers are not turned away. Triage and PACU become makeshift labor rooms and when those are full, out come the partitions to provide privacy in the hallways. Nurses know that you can never “max” out on patients in labor and delivery. No matter how many women show up in labor they will be taken care of by the nursing team. Most days there are enough rooms and enough nurses, but even when it gets crazy, nurses meet the challenge and take care of the mothers and their babies.

Santa will make early and late deliveries to many homes. Special people are waiting, in hospitals all over the world, for each Christmas miracle that will be born today. Christmas babies will be greeted by smiling nurses and doctors that are missing their own little ones in order to care for others.

Thank you to all the first responders and healthcare workers that are working today to care for other people’s families. We are thinking about you while we enjoy our time off.

imageDon’t worry….Its your turn to be off next year!

Merry Christmas!

 

 

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The Villain of Labor and Delivery

One of my favorite parts of being a labor nurse is to help a mom through unmedicated labor. Not all experiences are the same. It can be the best of time and the worst of times. The labor nurse has the supporting role in the drama of birth. She plays her part and then melts into the background so that the stars, mom and baby (dad too) can shine.

The best of times.

A mom was having terrible back labor. My arms shook with each contraction as I gave her counter pressure for two hours. Every time my arms would ease up on the pressure she begged me to please keep going. I usually would have her partner take over this physical intervention, but there was not partner in this delivery. That hurt my heart and made it more important that I help my patient in the way that she needed. When the baby changed positions the back labor subsided. She progressed into transition. Transition is the time that women change their minds about wanting an epidural, being pregnant and that they ever liked the baby’s father. Her eyes locked with mine and she reached for my hand. She asked me to not leave her. So I stayed. I stood by her side and tried to forget that I had not eaten all day, that my bladder was full and my charting was getting farther and farther behind. I was present with her through every contraction. I praised her through every break in the pain. When it was time to push she did amazing. Soon she was rewarded with a quick pushing stage and a healthy baby on her chest. It was easy to forget my aching arms when she asked me to lean in and take a picture with her and her new baby. I was pleased with her satisfaction with her birth. I was thankful that everything went well for her and her baby.

I love when I can play my designated part in the story. I don’t like when I am forced into the villain role.

 

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The times that test.

Another nonmedicated mom was not the grateful variety. She was suspicious of everything I did. This is always difficult for me, as a nurse. I am 100% supportive of my patient’s birth plans. I do everything in my power to ensure the safety of the mother and baby, provide an environment that the mother desires, carry out the doctor’s plan, and fulfill my legal and hospital mandated responsibilities. These are difficult responsibilities to juggle at times. When I am crouching on hands and knees, chasing fetal heart tones while a mom is bouncing around, changing positions and barking orders to her family, I deserve a little respect. When I am plunging my hand into the bath water mixed with vernix and other bodily fluids to make sure your baby is not stressed from the heat of the water, I am not trying to control you. When I am holding your hair while you vomit and it gets on me, when I wipe away your poop so you don’t know it happened, when I breathe in your body odor right next to my face because you need someone to lean on, I’m doing it because I am on your side. When you get to the point where you are asking me for narcotics and its dangerous for the baby I am going to say no. When this mom got to her breaking point she demanded I give her medications and it was too late. She was so angry I stepped back a bit because I was afraid she might hit me. I knew that the baby was coming. I knew that if I gave her what she wanted the baby likely would not breathe when he came out. I let her rage and continue to labor. Her baby was born within 30 minutes and was perfect and beautiful and breathing.  She never will never know that I was scared of her or that her words hurt me or that I gave up time with my family to stay late to help her.

Not every birth is fun or rewarding.  Sometimes my thighs hurt from squatting by my patients side. Sometimes I’m exhausted from trying to help.  Sometimes I stay after my shift for an hour to finish the charting that I couldn’t do while I was helping my patient accomplish her goals. When my patient is happy with her delivery it makes me happy.

Mamas thank your labor nurses. We are on your side. It is our job and we love it, but it is not easy.

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