Truth is that this is an extreme example. With almost 20 years in the ED, this extreme circumstance only happened once. But, there were many other difficult days when I wondered if I should have ever become a nurse, or if I should begin to consider other options. If you’re currently a nurse and have not felt this way, brace yourself, it’s coming. If you are not yet a nurse, go into it knowing that there will be days like this. As these days stack up, it’s no wonder that nurse burnout is such an issue.

How do you come back?

After having 3 patients die in 4 hours, it’s really hard to get up the next day and come back to work. Certainly, there was some financial motivation for this, I mean the mortgage company wants to get paid every month and my kids want to eat every single day. But, this sort of motivation can only keep you going for a short time. After all, if it’s just about money, there are other ways to make it. Heck, there are many things that will actually allow you to make more money than being a nurse. The money is important, but it’s not enough.

So, what does keep me going?

For all the really difficult moments and shifts, there are some truly beautiful ones. I’m talking about things more beautiful than even what you might see in a TV medical drama or the chick flicks my wife makes me watch. (Ok, maybe I like them too.) These moments stand out as sources of light in your day and in your career. When things feel dark, it is the light from these moments that keep you going. I have often thought about some of these bright moments when walking through some of the darkest days of my life and career. This is what keeps me going. I think it will also be what keeps you going.

My challenge to you

I wish someone would have told me this many years ago. I really think that this would have helped me so much on some of those dark, difficult days I’ve been talking about. My challenge to you is to do two things. 

First, start a journal

Not like a “dear diary” kind of thing. Not a journal that you write in every day. No, this journal is just for the shining moments in your nursing career. This is for the stories that make your job worth it. In over 20 years as a nurse, I have so many of those stories. Unfortunately, since I didn’t write them down, it’s hard for me to remember them all. There are some really powerful ones that I can remember very well, but I know that there so many others that I simply can’t remember. So, whenever those moments happen that really make your job worth it, write about it. As soon as possible, write that story in your journal. Include as much information as you can, without violating the patient’s privacy. When you get an email from your manager or someone else talking about the gratitude that a patient or visitor expressed to you, write that in your journal.

Keep every card

Nursing is often a thankless job. This is especially true in areas like the ED and OR, among others. In these areas, patients are generally sent somewhere else to get better. By the time they get to where they are feeling better and start to say thank you, they have long since left the ED or OR. Still, there will be cards. There will be notes. There will be emails. There will be things that people give you to show their appreciation for the care you give. KEEP THESE. Get a box now. Start putting these cards and notes in that box. If management posts a card or letter about you in the department, ask about making a copy of it for your own records, then put it in the box.

Open it on your dark days

On those days that make you doubt your qualification to be a nurse, open these things. Open your journal and read some of the stories. Open your box and read some of the cards. Trust me it is these stories that will keep you going. I certainly have enough of them to keep me going, but how many more could I have had if I had been doing these two things for the 20-plus years that I’ve worked in healthcare?

Need help?

This sort of habit is a part of good self-care. Want help knowing where to start, I wrote my book The Restored Nurse to do exactly that, to help you know where to start. Pick up your copy on Amazon today!.

The post Nurses, Remember the Good Days appeared first on Restoring Nurses.

S0, here are 5 tips for better sleep

1 – Have a bedtime routine

It’s ironic. We are often really good at this without kids. We know that if our small kids are going to sleep, then we need to have a routine that tells their little minds and bodies that bedtime is coming. Guess what… Your grown-up mind and body need the same sort of signals. Creating and maintaining a bedtime routine signals your brain and body that bedtime is coming and that it’s time to sleep. Some of the things below are good additions to this bedtime routine.

2 – Plan for tomorrow before going to bed   

Take a few minutes before going to bed to write down the things you want to get done tomorrow. Maybe take a quick look at your calendar so you can get an idea of what the day looks like. Then, set aside those things and forget about them till tomorrow. The idea with this one is that it can keep you from spending time laying in bed thinking about what all you need to get done tomorrow. You’ve already done that mental work. This one may take some practice, but it works.

3 – Be consistent

Go to bed at the same time each night and get up at the same time every morning. It’s no secret that there is a rhythm to our sleep cycle. When we go to bed or get up at different times throughout the week, our body struggles to know when it is time to sleep and when it is time to get up.

4 – Avoid large meals, caffeine, and alcohol before bed

A large meal may make you sleepy, but it will not help you sleep. Ok, it’s obvious why we should avoid caffeine near bedtime. Still, I have people who tell me that coffee doesn’t affect them yet they will be the same people complaining about not getting enough sleep. I don’t know, maybe try avoiding the caffeine for 2-4 hours before bedtime. Just try it and see if it helps.

As for food, sure, a full belly may help you to fall asleep more quickly, but it will also make it difficult to stay asleep. Alcohol is the same way. It can help you to get to sleep, but it makes it difficult to stay asleep. I would also add that if you are using alcohol to help you sleep, I’d have to ask if there is not another concern that you need to deal with.

5 – Get some exercise

Ok, for the nurse still working at the bedside, this one might not apply. If you’re still at the bedside, your shift is probably plenty of exercise. Still, it’s something to consider on your off days. Sometimes the thing that makes it difficult to sleep is the simple fact that your body is not tired. You might be thinking, “Matt, I’m freaking exhausted.” I get that. However, there is a difference between mental or emotional fatigue and physical fatigue. I’ve worked desk jobs that left me feeling drained mentally, yet my body was not tired and I struggled to sleep.

Conclusion

These 5 things just touch the surface of all the things you can do to help you get to sleep faster and stay asleep longer. Here’s what I know, if you are reading this then your current sleep routine is probably not working very well. So, try some of this stuff. Heck, try anything. Change up your routine and see what works.

The post 5 Tips to Help Nurses Get Better Sleep appeared first on Restoring Nurses.

At the same time, depression can make one wonder if the effort is even worth it. Or, make one struggle to even have the initiative to do the self-care we know we all need.

Before I get into this, let me say, if you are struggling with depression, see someone. You may need counseling. You may need medication. There is no shame in either treatment. The habits outlined in the Restoring Nurses Framework can provide some help, but they are not a substitute for professional treatment.

Now, here are 4  ways self-care can help with depression

1 – Have a routine

Having a routine is going to help with self-care in a few ways. First, it’s going to make it easier to actually do the self-care habits that you want to do. Making them a part of your daily, weekly, or monthly routine means you don’t have to build up the initiative to do it. It’s just something you do.

The second way it helps is by helping to ensure that these self-care habits actually get done. As I said above, you don’t have to think about them, you just do them. For most of us showering or brushing our teeth are habits that we don’t even have to think about. They are such a part of our daily routine that they are automatic. Building self-care habits into your daily routine will have the same effect.

One final way that having a routine can help with depression is the satisfaction that comes with completing something, especially something you know is good for you. My wife hates to go to bed with dirty dishes in the sink. She takes great satisfaction from them being completed. Having a routine that includes self-care habits will allow you to look back on your day and know that you completed these things.

2 – Exercise Regularly

It’s well known that exercise is good for your physical health. The truth is that it is also good for your mental health as well. This is not to say that we all need to go out and become gym rats, or marathon runners. The goal of the entire Restoring Nurses Framework is not to encourage drastic changes, but rather to make small, achievable changes that grow as we do. Even adding small amounts of exercise to your weekly routine can help.

One of the benefits of regular exercise that helps across multiple of the Domains of Self-Care is that it makes you less tired. To those that have experienced any degree of depression, you understand that a consistent feeling of tiredness often goes with it. Adding to that actual, physical fatigue just makes it work. Regular exercise can help you feel less tired.

Endorphins… No, that isn’t the strange version of the aquatic mammals we see at SeaWorld. Endorphins are chemicals that have a great influence on our moods and emotions. It is no secret that people who exercise regularly experience a greater release of endorphins. However, we tend to only associate this with extreme athletes. Even regular people like you and me can experience an increase in endorphins when we add even a small amount of exercise to our routine.

3 – Eating Well

Overeating makes you feel bad. Not eating enough makes you feel bad. Eating things too high in sugar make you feel bad. Basically, food has the potential to make you feel bad when you are not intentional about what you eat. Eating well can help you have more energy. Eating well can help to better regulate your glucose levels. Eating well has many potential effects that can help with depression.

4 – Be With People

Ok, I know, you are with people all day at work (or all night for my night shift peeps). The last thing you want to do is spend MORE time with people. I’m not suggesting you spend time with random people. Rather, I’m telling you to make a habit of spending time with the people you love. This time with the most important people in your life can help immensely. Here are some samples of ways to do this:

• Regular date nights with a spouse or partner.
• Date nights with your kids.
• Work on a hobby with your kids, spouse, partner, or friends
• Play games with family/friends
• Have coffee, lunch, or a drink with a friend

Conclusion

While this barrier is completely understandable, it is still a bit ironic. Most of us know that taking better care of ourselves can help.  Still, we struggle somedays to find the energy to do it. We struggle to get the initiative to get up and do the things we know we need to do. Hopefully, knowing that self-care can help with depression will help you to take the initiative to learn to take better care of yourself.

The post 4 Self-Care Habits That Can Help With Depression appeared first on Restoring Nurses.

A few days ago I posted 5 ways to leave work at work. Here are 7 more ways to leave work at work.

1 – Cry

It’s crazy in a field dominated by women and completely focused on caring for others that some of us would feel that we can’t cry. That’s such BS. It’s totally ok to cry. Sometimes in nursing, you need to take a couple of minutes off the floor to cry. That’s ok. Certainly, there are times when we simply can’t leave the unit. That does not mean that we can’t let it out later.

Before you carry the stress, anxiety, and even sorrow from your shift home with you, take a few minutes to just sit in your car and cry. LET IT OUT!!

I’ve done this both after and even before some shifts. I don’t need to tell you this, but crying can be incredibly therapeutic. One shift I can clearly remember even though it was nearly 20 years ago. Over the course of 4 hours on this particular shift, I had 3 patients code and die. Two of those patients came in talking to me and left in a freaking body bag. Yeah, I cried after that shift. I doubted if I should even be a nurse. I seriously considered what other options I might have, all while in the care before I even got home.

2 – Learn, then move on

The unfortunate reality is that sometimes we will make mistakes. We will miss things. We will forget things. We are human. In the vast majority of these cases, no harm will come to our patients because of these things. Still, we will tear ourselves up over them. When we make mistakes, we need to spend a little time thinking about them. If you don’t, you can’t learn from it.

However, think about it, learn what you need to learn from it, THEN MOVE ON!

Running it over and over in your head isn’t going to change anything. You will not learn it any better by dwelling on it. You cannot change what has passed by dwelling on it. All you will do is make yourself crazy and will carry that stress home to your family. Learn what you need to learn, then move on.

The other thing about this is that sometimes bad things happen. It sucks, but it’s true. Sometimes we can do everything right and our patients still die. These might be the hardest ones to let go of because there is often not really anything we can learn from them. We did nothing wrong, so there doesn’t seem to be a lesson hidden in the experience. The lesson to learn in these situations is that sometimes you can do everything right and bad things still happen.

3 – Set boundaries

The entire goal of this post is to help us leave work at home. Yet, some of us will come home and want to talk with our spouse about our day. While there can be value in this and your spouse may really want to support you in this way, sometimes it’s better to not talk with them about it. It can be difficult to leave work at work if you are often coming home and talking about it with your spouse.

I’m not saying that you can use your spouse for support. By all means, tell them that you had a rough day. Tell them that you need a hug. Ask them to rub your feet, bring you a drink, run you a bath, whatever you need. But, they are probably not the best person to talk with about the specific stresses of your day. Doing this brings your work into your house and into your relationship which makes it impossible to leave it at work.

4 – Plan for tomorrow, then stop thinking about it.

There are times when you leave work with things undone. This is often less of an issue for bedside staff but can be true for them as well. These are often things that you do need to do. However, thinking about them as you drive home or as you sit with your family, or as you lie in the bed will not make them get done.

So, make a plan for tomorrow, then stop thinking about it. If you really want to leave work at work, make this a habit before you leave each day. With the different office jobs I’ve had over the years I found it valuable to keep a notepad on my desk to the right of my keyboard. In fact, if you were to look at my desk right now, as I type this, there is a notepad next to my keyboard. One habit I’ve often kept was to take a couple of minutes at the end of my day to write down, on that notepad, a few things that I wanted to get done tomorrow.

I’ve known some leaders that use sticky notes instead. For some, they would write their entire to-do list for the upcoming day on one sticky note. The reality is that you are not likely to get more done than what you can fit on a sticky note. So, writing more than that down doesn’t really help. Others would write each task on a separate note and stick them to their desk, wall, or computer monitor. They got extreme satisfaction from completing a task, wadding up that note, and throwing it away.

For the techy folks, such as myself, you can do the same thing with any of the multitudes of to-do, task management, or project management apps out there. For me, I have a list in the task manager I use called “Today’s Tasks”. This list is not for everything that I have coming up. It is not for every project. It is for the specific things I want to accomplish today. If I don’t accomplish them, then I will review them at the end of the day for tomorrow, adding anything that’s new for tomorrow. I make a point to keep this list to 5-7 items MAX.

5 – Put the phone down

As mentioned earlier I like to ride home with the windows down. Yes, even in the summer in Florida. If I’m driving home and don’t have anywhere else to be I will roll the windows down and ride. While doing so, I’m either enjoying the silence or jamming with the music up loud. In either case, what I’m not doing is talking on the phone.

My wife, on the other hand, likes to talk on the phone while driving home. Depending on who you are talking with this can help you disconnect from work. However, I had to explain to my wife that if I was talking on the phone with her, then it, in essence, brought me immediately from work to home, without any mental separation and, therefore, no time to disconnect from the other. She understood and gave me that time, knowing that it meant I would be much more present when I got home.

Now, the one caveat I would give to this is if the person you are talking with is your debriefing partner. I’m not talking about the coworker that you like to gossip with (Don’t hate me. You know it happens.). AND, if is your debrief partner, then debrief and move on. If you spend the entire drive home complaining about work, then you will bring that work all the way to your little house and right up into your home life with you.

6 – Find a distraction

Throughout my career, I’ve had a few different go-to distractions for when I simply couldn’t get myself to drive home yet. Sometimes you just need a little extra time to decompress before you’re ready to go home. When I worked nights one of my favorite places to do this was a local coffee shop. In fact, we would often combine this with debriefing as a group of us gathered there to debrief and drink coffee.

Another go-to for me was the church we were part of at the time. Obviously, there was nobody there at 7:30 in the morning when I’d be on my way home. That wasn’t the point. Heck, I usually didn’t even go in the building, even though I had a key. You see, this church is on a large lack. So, I’d often drive there. I’d drive up as close to the lake as I could safely get and park there. Sometimes I’d just sit in the car. Other times I’d get out and walk along the shore. Other times I’d sit or lay on the hood of my car and stare out at the water.

The exact location of this distraction isn’t important. The point is simply to find something to allow a little more time before you go home. This is not for every day, but when you need it, it’s there. I would add one thing. If your distraction includes an alcoholic beverage, don’t be stupid and try to drive yourself home. Be safe.

7 – Get a hug

If you read the previous 5 ways to leave work at work then you know that this was on that list. I wanted to include it again because it’s really that powerful.

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In this series, so far, I covered the top two barriers, GUILT and TIME. In this post, I want to cover the third one, exhaustion.

Many of the nurses who responded, listed this as a major barrier to self-care for them. As I read it, I could feel it. There’s a different kind of tired for those of us that spend our lives caring for others. Not only is the work of a nurse physically demanding, but the emotional toll is extensive.

Over the past couple of years, both the physical and emotional factors have grown exponentially. Nursing has always been hard, but it’s gotten even harder over the past couple of years or so.

So, here are 3 reasons why exhaustion shouldn’t stop you from self-care.

1 – Proper self-care will actually make you less tired

I know, I know. Many of you are reading this and wondering how doing yet another thing is actually going to make you LESS tired. Hear me out. As mentioned above, the physical, mental, and emotional toll of nursing are great. How well we are able to bear that weight depends largely on how prepared we are to bear it.

Consider the marathon runner. Nobody just wakes up one morning and decides they are going to run a marathon that day. Rather they decide months in advance and then spend that time training. A marathon is a grueling test of endurance. It’s possible only because of the training done to prepare for it.

The same can be true with nursing. Working to take better care of yourself can make you better prepared to endure the demands of being a nurse. You can endure those long shifts, just a little easier. You can carry that emotional burden just a little better. You might even learn how to set that emotional burden aside and not have to carry it.

I’m not saying that you won’t come home from three 12 hours shifts in a row tired. Heck sometimes just one shift is enough to wipe you out. What I am saying is that you can get to a point where you recover more quickly. Through good self-care, you can actually get to a point where your off days are more than just lounging on the couch taking in entire seasons of your favorite sitcoms or DIY shows. Not that those things are bad, but if that’s all you ever want to do on your off day, it can be a problem.

2 – Self-care doesn’t have to be hard work

Ok, I’m not going to say that self-care requires no work or that it’s easy. YES, it’s work. However, with a little planning, it can doesn’t have to be hard work. As mentioned in the post talking about ways to find time for self-care, one way to make things easier is to bundle activities. Whether this is prepping meals at the beginning of the week, or getting a little work out in while your laundry is running. Or even folding laundry while watching your favorite TV show. Any tasks that you can bundle together will make self-care easier.

3 – Rest is PART of self-care

I can’t help but assume that when people listed exhaustion as a barrier to self-care that they were thinking of self-care as things such as exercise. There have been times in my life when I would work a 12-hour night shift, swing by the gym for a workout, go home for a few hours of sleep and go back that night to do it all over again. There have also been times when I was so tired I wasn’t even sure I was going to be able to drive home. I’ve even had times when I slept in the car because I wasn’t sure I could safely drive home.

So, yeah if your entire concept of self-care is about exercise, then exhaustion could keep you from even thinking about doing it.

However, rest is an important part of self-care. Sometimes what your physical health needs most is to spend a little extra time in bed, or to go back to bed after getting the kids to school. Sometimes what your mental health needs is a day spent on the couch, forgetting about your responsibilities for a little bit and playing video games, or watching movies… between naps.

YES, exercise and some of the other things that make us tired even thinking about them are part of self-care, but so is rest. Don’t feel guilty for resting. You need it as much as you need all the other self-care habits.

This is just one of the barriers

To get the fill top 10 list of barriers to self-care that people shared with me, Read the original post HERE. You can also get links to each of the individual posts where I give some tips for how you can bust through each of those barriers and learn to take better care of yourself in the process.

The post 3 Reasons Exhaustion Doesn’t Have to Keep You From Self-Care appeared first on Restoring Nurses.

In my last post, I addressed the number one barrier, Guilt, and gave 5 reasons you shouldn’t feel guilty for self-care. The second on the list was time. I wanted to address that one in this post.

Before I get into some ways that you can find time for self-care, let me say one thing that some of you might struggle with.  Self-care does not have to take a lot of time. Or at least, not all at once. But, before we get too far into that, let’s look at our list.

Here are 5 Ways to find time for self-care

1 – Break it up

Self-care doesn’t have to be done all in one big chunk. For many of the things that self-care entails, the same benefit can be gained from dividing 30 minutes worth of activity into two 15 minutes sessions, or three 10 minutes sessions, or even six 5-minute sessions.

If it’s physical activity we are talking about, maybe you do 15 minutes in the morning before work and another 15 minutes in the evening before bed. Maybe it’s 10 minutes in the morning, 10 minutes on your lunch break, and 10 minutes before bed. The specifics are not that important. Doing it is.

2 – Bundle tasks

I know that this seems contradictory to number 1. But, here me out. Some self-care tasks can be grouped together to save time. For instance, one thing that my wife and I do is food prepping. We cook all our breakfasts and lunches for the week on Sunday afternoon.

This allows us to eat healthier without having to think about it every morning. We can just grab our breakfast, throw lunch in a cooler, and out the door.

Yes, this takes a little work on Sunday, but it saves so much time and aggravation during the week that it is so worth it. For those of you that still have small children, you know how hectic mornings can be. This can be the solution to that.

3 – Get up earlier

Ok, this one may be a little harder for some folks. After years of working 7 am shifts, I naturally get up sometime between 5:00 and 6:00 every morning, whether I like it or not. I realize that everybody is not like me in this way. For many, this will be a struggle.

The truth is that pretty much everyone can get up earlier. It does, however, take some discipline and practice. You may have to do it for a while before it becomes easy, but for most of us, it will become easier. The one caveat is that you must go to bed at a decent time. Staying up late and then trying to get up early will be counterproductive as the lack of sleep will offset whatever good thing you are getting up early to do. Make sure you are still getting 7-8 hours of sleep, but get up early and take care of yourself.

4 – Create rituals

Ok, routines may be a better word. Whatever you want to call it, build some rhythms in your life that help you move towards your self-care goals. For me, one area that I was greatly missing was hydration. I probably wasn’t drinking even half of the water I should have been drinking each day. To help with that

Now, as soon as I get up, I grab a bottle of water. I prefer it at room temperature that early. So, to help with this new routine, my wife now stocks some in the pantry in addition to the ones we keep cold in the fridge. To take this even further, I don’t allow myself to have my first cup of coffee till I’ve finished that bottle.

This routine, ritual, habit, whatever you want to call it helps me get a head start on my water intake. As a side benefit, it actually seems to help me wake up more than my morning coffee ever did. I mean, I’m still gonna have my coffee, but this helps. It also helps in another way… let’s just say it gets things moving…

5 – Set achievable goals

There is much talk these days about SMART goals. This is an acronym that stands for Specific, Measurable, Achievable, Relevant, and Time-Bound. The achievable part is big when it comes to finding time for self-care. If you are doing almost nothing for self-care right now and think that next week you are going to be able to spend 45 minutes every day in some sort of physical activity, 30 minutes tending to your mental health, 30 minutes on spiritual habits, one-hour sending time with family, and then 15 minutes balancing your checkbook every day, then you are going to fail.

These sorts of goals are simply not achievable. Ok, they might be, but they are so far from your current state that the chance of you achieving them and, even more importantly, maintaining them is almost zero.

Right now you are likely doing almost nothing for self-care, at least if you’re like most of us. So, set small goals that you can achieve. Then when that becomes a habit, build on that success.

The truth is that self-care can be very difficult. But, it’s also true that it is worth it and necessary. Download your free self-care guide below to start your own self-care journey today.

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