I have a bad habit of doubting myself. I second guess many of my thoughts, ideas and decisions. I often rely on others to influence many apsects of my life.
This disclosure is painful to admit, yet it's important for me to do so.
Because I am not alone in this.
Also, it hinders my ability to succeed and feel fulfilled.
Everyone needs to find their own way out of this pattern or any other they may be living in. I found mine through running, which is part of the reason this blog includes RUN in the title.
You see, running is the a very individual activity. You can compete against others OR you can compete against yourself or some combination in between. I took up the sport at thirty-seven years of age, therefore, I only compete against myself. Yet even when running I doubt my ability, strength, stamina and determination EVERY SINGLE TIME I RUN. So this year, I have resolved to stop that. I joined a very supportive running group and receive their words with open ears. I repeat positive phrases while I run and remember to have fun during the activity. As result, I just ran my fourth half marathon in a time that beat my personal record. I refused to doubt myself. I pushed my body to the very limits, even when my mind told me to stop. It paid off.
Now, I am empowered to do that in other areas of my life.
Was self doubt ever a problem for you? If it was, how do you address it? Are there any techniques or phrases that you have used to overcome a similar type challenge?
In nursing school, I was taught patient advocacy is a fundamental piece of nursing. But over the years, I found it to be more of a challenge than I could handle. It seems that too often, there was no one available to listen to and/or address my concerns. It was frustrating, disappointing and, I believe, the number one reason I fell into burn out. I withdrew into myself. Resentment grew in my heart. I nearly quit the profession I once loved so dearly.
I admired people who had passion and wondered if I would ever feel a fire like that again.
Fortunately, I do feel that fire today, but it took time, an open mind and a serious look at myself.
The first thing I did was let go of the anger and resentment. I forced myself to acknowledge all of the things that had changed over the course of my career. I allowed myself to mourn the losses I felt. By that, I mean I accepted that my dream of nursing didn't comply with the reality. In fact, my dream never would be my reality. I needed to stop fighting the truth--nursing is NOT what I thought it was. Once that occurred, I was able to see other things I needed to grieve--the loss of paper charting and the decrease in time at the bedside related to technological changes, just to name a few.
Next, I opened my ears to things my colleagues said about me. In doing so, I learned a perspective that I hadn't previously considered--I have leadership capabilities.
That's where I began the "serious look at myself". Could I do it? If I could lead, did I even want to try? The thought intrigued me. I exlored my options, and that's when I found a tiny source of passion in teaching. I latched onto that flicker. It grew into a small flame.Opportunites suddenly became available.
Today, I am a Clinical Practice Manager. My primary role is education and training. I consider the staff I work with my new "patients".
It's been quite the journey, but I am glad I embarked on it. Without first admitting burnout, I would not have been able to push forward inot a newer version of me.
What do you need to acknowledge before you can contemplate change?
DISCLAIMER: This particular post is for entertainment purposes only. It is not intended to diagnose, treat or cure any ailment. May the following words serve to brighten your current winter blues.
The world needs to brace itself for the next big thing. I have seen it before, but I fear this year may be worse than ever.
Last year, we experienced the Polar Vortex.Spring fever existed but no one noticed.
This year, it's so cold and snowy that we don't even have a name for it!
I believe this is going to lead to a potentially virulent episode of SPRING FEVER for many humans.
Symptoms include sudden surge in energy, an urge to burn snowboots and wear flipflops--even when it's still snowing, uncontrollable outbursts of singing, profuse sweating, and joyful dancing.
Employers--be prepared for a sudden shortage of staff as sick calls will increase.
The is no determining how long symptoms will last.
There is no cure, though I suspect green grass, sunny days and fragrant flowers will help symptoms to be more bearable.
Happy Spring everyone. Winter is almost over.
February is American Heart Month. It's a time when everyone should think about ways to change their lives to be more heart healthy--diet, exercise and stress reductions are great ways to decrease your risk of a heart attack.
But what is the greatest life saver of all? High quality CPR ranks highest on my list with fast activation of Emergency Medical Services a close second.
I've been an Emergency Department nurse for over thirteen years. In that time, I have watched CPR and Advanced Cardiac Life Support (ACLS) change their focus from breathing assistanct to rapid defibrillation to the current trend of "hands only CPR". And I have seen more people survive cardiac arrest with each improvement. It still amazes me to watch the process unfold and see a heart spontaneously beat again on the monitor.
When I was first a nurse, it was rare to see someone comeback from cardiac arrest. But so far this month, I have seen two survivors of sudden onset cardiac arrest not only survive, but live tell their story. One event occurred within the hospital and one was in the community. The person in hospital had a full team of emergency staff on him right away. CPR was initiated immediately while other team members applied the defibrillator, obtained IV access and gave medications. The community survivor also had a team attend to him right away, but not all people were medical. But all knew CPR and performed it well. In fact, CPR was performed so well in the community, the person woke up enough to resist CPR even though his heart rhythm was not compatible with life.
So, please, if you love someone, learn CPR. It could save their life. You can't always tell when someone's heart is ready to stop beating. You don't know when the "BIG ONE" is going to hit--though I think we like to believe we can see into the future. High quality CPR can keep blood circulating and give that person a fighting chance. Early defibrillation and medications are very important, but meaningless without CPR.
Learn CPR today.
According to Google, privilege is define as:
- a special right, advantage, or immunity granted or available only to a particular person or group of people.
- grant a privilege or privileges to.
I have been hearing a lot of discussion lately around the word "privilege". This led me to wonder if that word might apply to me--am I privileged?
Working in an emergency department, I see all types of people from celebrities (not so often) to the homeless (a little more often). I've met many types of different people who speak a plethora of different languages. Is my life really at an advantage because of my circumstances?
I grew up in a nice a suburban town, near the school I attended and a park.
My grades in high school were pretty good. I worked hard, but not that hard. Learning was pretty easy for me. I even got some scholarships to attend college. But mostly, my nursing degree was paid for via grants, loans and my own money. The truth is, my parents' income was fairly low due to the size of our family and poor economic times.
Every semester was a struggle for me to make ends meet. I fought my way through a difficult system, sometimes not knowing if I could afford to finish another semester.
But I did finish. And then, I started my nursing career at the very bottom rung of the profession. I didn't have family in the field or know any other nurses, therefore I knew only what had been taught to me in school. I muddled my way through, hoping I could succeed. Exerting a lot of effort, care, professional development and mentorship through the years, I grew into the nurse I am today.
I feel that I succeeded and am still succeeding.
Am I a success because of privilege, though? Or is it possible I made myself (with the support of others) into what I am today?
I don't think I have been granted special rights because of my circumstances. In fact, I was told a few times I'd never become a nurse, but I persevered and did it anyway. I chose to override labels that others gave me. I refused to let society dictate how my life is going to turn out.
Is it possible to teach or inspire others to rise up above their perceived circumstances and become more?
I had a conversation with a person who recently experienced significant loss in her family. She said, in retrospect, she was most taken aback by the realization that bad things can happen at anytime. She also repeated the importance of appreciating those we love everyday, "because you never know what can happen."
I feel that my job in nursing reminds me of those concepts everyday. As nurses we see the end of life on a regular basis. We hold hands and wipe the foreheads of those moving on. We share in the grief of those left behind. It's beautiful and tragic at the same time. Whenever I experience a difficult shift, I always hug my family harder and make a little more effort to show my love to everyone around me.
Recently, I heard a news report about a prominent businessman who is diagnosed with a terminal illness. He has been given nine months to live.
This will be his last Christmas.
What if this were my last Christmas? Would I do anything differently? I'd like to believe I wouldn't, but I know I can't say for sure.
What would you do differently if you knew you wouldn't be with your family on your next holiday?
A new nurse messaged me the other day with a request for support regarding nurse bullies. Concurrently, I was brainstorming strategies to increase membership activity in my local chapter of the Emergency Nurses Association (ENA).
This led to what I call a concept collision--a question that arises when two previously unrelated problems present themselves at the same time. This time the question that came to my mind was:
Is it possible the younger generation of nurses are not active in associations because of the way seasoned nurses treat them?
Let's think about this....I often hear the statement "Nurses eat their young". I have seen this happen. I have experienced it as well. In particular, in my first role as a nursing assistant I was repeatedly set up for failure by the nurses, then reprimanded, then called names behind my back. The same thing repeated itself in my first job as an RN and my second. It wasn't until I wrote off other nurses that I felt somewhat able to survive in the nursing world. I isolated myself to protect myself.
This led me to hate nursing. I wanted to quit. I feared I participating in any meeting because I was bound to be insulted or ridiculed for my inexperienced position.
I became apathetic.
Is this what seasoned nurses interpret as a lack of drive to work hard? Because, I hear all the time that the younger nurses are lazy. I hear we need to tap into the next generation, but they won't come to meetings because they don't care.
Why should they care if they are treated like garbage?
What do you think? Do you think lack of engagement is caused, at least in part, by nurses bullying each other? Is there a way to inspire younger/newer nurses to participate in associations? Are you a younger nurse who wants to get involved but is afraid to try?
Early in 2014, I ran my first 10k. I found it to be less of a challenge than I expected. Suddenly, a half marathon became a realistic goal. The spring included many fun and fast 5k races. I got faster with each one, but turned to longer runs more often, because that is where I found true relaxation. As summer wore on, I realized I thought more about my half marathon goal. Thirteen miles translates into more than two hours of running. I needed to prepare my body for the challenge. More than that, I needed to prepare my mind. So, I booked my first half marathon race for October 25th.
But vacation, the heat, summer storms and life in general interfered with my training plans. Before I knew it, I had six weeks left, half the time a normal plan lasts. Sure, I'd advanced my mileage and worked on strength training, but I didn't feel I ready. I considered canceling. A half marathon could wait until spring. I wouldn't be any less of a person or runner if I postponed.
My runner friends talked me out of that. They convinced me I was ready. I believed them, even when I didn't believe in myself.
On race day, I cried at the start line. Fear of the unknown and insecurity consumed me. Why did I think I could do this? After a big hug from my husband, I lined up in the corral with over a thousand other runners. I felt so alone among the chatter and excitement.
The canon went off minutes later, signaling the start. I plugged in my earbuds and let my heart guide me.
The course led me through the Cape Cod town of Falmouth. Most of it was along the ocean. It more beautiful, peaceful and inspiring than I could have imagined. The sun shown brightly. There was little wind. The day was perfect.
It didn't take long for my feet to fall into cadence. My body led me up the first hill without effort. Before I knew it, four miles passed. I felt assured everything was going to be okay. I settled in, ready to enjoy the experience.
As the miles passed, I realized I had trained more than I thought. My body knew what to do, how to respond. I knew what to do when my body needed something. I fell in love with running all over again.
The second half of the race went by quickly. As I approached the finish line, the crowds grew thicker and louder. People cheered for me--something I've never before experienced. The elation of succeeding in my goal filled me. I was stronger than I believed. I completed a challenge I didn't think I could complete.
I learned something about myself that day, a lesson I keep relearning with every step I take: I am capable of more than I realize.
I think this is true of everyone. We all have to potential to be more; it's just a matter of trying.
So, what challenge have you attempted lately. Or, what do you think you can't do? I'd love to hear what obstacles you face everyday.
It's impossible to turn on the television, radio or look at the internet without the virus EBOLA staring you in the face. And now, two health care workers have been infected at the same hospital.
Blaming the nurse was the first reaction . It was assumed the nurse broke protocol. Now, workers are coming forward with reports that the hospital did not provide the right equipment and training. But what if both scenarios share thread of truth?
I am a nurse. I know MRSA, CDIFF, VRE very well. I protect myself everyday from these "superbugs." However, when faced with tuberculosis, measles, mumps and even chicken pox, I have to stop and review the precaution information. Often, I am not confident that I know how fully protect myself or other patients in my ED, but I do the best I can.
But these infections are still spread, even though we use PPE every day to prevent it.
Why? Nurses aren't careless. Hospitals aren't wreckless.
I believe it's because many people take PPE for granted. We work in a high demand environment that forces us to move faster than we should, with less help than we require. We gown and glove mindlessly, like we do with many other nursing tasks. But with Ebola, we can't be mindless. We owe it to ourselves, our patients and our communities to don (dress) and doff (undress) our gear with care.
But do we really know how? Personal Protective Equipment we are unfamiliar with can cause more harm than good. We deserve experts at our side to support and educate us.
It looks like that time has come for that hospital in Dallas. According the the Center for Disease Control's most recent fact sheet:
"The single most important aspect of safe care of Ebola is to have a site manager at all times who oversees the
putting on and taking off of PPE and the care given in the isolation unit. A site manager is now in place and will
be at the hospital 24/7 as long as Ebola patients are receiving care."
Do you feel this is an appropriate response? Would you feel more comfortable caring for an Ebola patient with an expert from the Center for Disease control by your side? Do you think this will set a precendent for future outbreaks of illness?
When I was in nursing school, the movie Outbreak (1995) was released. That prompted me to read a book with the same name, Outbreak (1987). Though the story was different, the epidemic concept was the same. I was also taking a microbiology class.
I freaked out and swore I would never again watch another movie or read another book even remotely related to Ebola.
I stuck by that rule until July of this year, when someone enticed me into watching 28 Days Later (2002) while on vacation. Though it was categorized in the zombie genre, it made me think of Ebola. I shuddered while remembering my college years and the coincedental fictional stories that paralleled the last Ebola outbreak. In the time that followed, my creative brain hijacked my rational thoughts. Suddenly, I worried Ebola was going to make a resurgence.
And then, it did.
Thanks to a very proactive Infectious Disease Department, the hospital I work at has already begun training emergency staff in the use of protective equipment. We have a plan in place, should a patient arrive with symptoms and a potential exposure. Though I am still concerned, I feel prepared and confident we can handle it. The training was performed by our local Fire Department. The planning has been in collaboration with our larger hospital.
Has your hospital done anything to prepare? Do you think they should?
Robin William's death will not alter my every day life. I loved his movies and laughed at his comedy, but I didn't know him personally. His pain and his struggles, however, I do know. I know them all too well.
I know that sometimes the only place of comfort is a dark cavern, where no one can reach you.
I know that pushing people away is much easier than letting them help.
I know that help isn't what most people think it is.
I know that my insurance company THINKS they know what help is. They don't.
I know that this type of suffering is mocked, ridiculed and belittled on a regular basis not only by society but by the voices that echo through your head.
I know that showing happiness makes others feel better and they will likely leave you alone to feel safe in that comfortable dark cavern. So you fake it.
I know you know suicide is not the answer, but you already feel dead and worthless and don't want to burden those that you love anymore. So you do it.
I know others think you are selfish because you can't share these truths, but really, you don't want to bother people with your nonsense.
The tragedy in suicide is that it takes these truths with the people who carry them. Those of us who survive suicidal thoughts figure the rest of world doesn't want to hear about them anyway. Because, let's face it--you don't. No one wants to hear about the disease that poisons our brains and thoughts. No one believes this could possibly be an illness, similar to heart disease or cancer.
I know suicide is a symptom of a disease that needs attention. I see it every day at work. I've lived it.
Please, can we finally start treating it as such?
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I have worked per diem for much of my career, by choice. It has nothing to do with my desire to work hard. It had more to do with my ability to commit, or rather my perception of it. Over the years, I was offered full time and part time jobs. I was chided, coerced and threatened by leaders. Still, I stood my ground, remained flexible and refused to give in.
Earlier this year, I accepted my first full time job.
A few things changed to make this possible. My family is now older; they don't need me as much. My husband works from home now. And finally, I wasn't being forced into sacrificing weekends and holidays away from my family. But mostly, I have learned that committing isn't nearly as horrible as I imagined.
As a runner, I see commitment in a whole new way. It's not a burden. It's a challenge. And who am I to turn away from that? I also see that it doesn't have to be all or nothing. Committing means giving something attention while blending it in to the rest of your life, in other words--not letting it consume me. Every mile opens my eyes to new destinations, more possibilities. The more miles I run, the better I feel.
So, in addition to committing to full time work, I have just signed up for my first half marathon. It's been on my mind for a long time. I've been loosely training for it since last year. But yesterday, I paid the fee. I am committed.
On October 25th, I will run my first half marathon in Falmouth, MA. And I am committed to training for it.
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I have always been an expressive person. There are many adjectives to describe that part of me. Some of them are positive, but not all. When I was younger, I thought my passion was bad. I ignored it, denied it, suppressed it. Ultimately, I made myself feel pretty awful. Eventually, ALL of my thoughts would explode, causing massive destruction. After, I would back down into my silence and the cycle would begin again.
Then, something happened. My daughter was born. She, too, is expressive. At first, I found myself frustrated and angry. She cried a lot that first year. Then that crying turned into temper tantrums. Just before I was about to lose my mind, I found the greatest word ever: passionate.
I mulled that concept over. I let the word settle on my tongue and my brain. Soon, I was able to see my daughter as a passionate person who needed guidance to express what I could not. As I taught her, I learned.
She is eleven. I am now in a leadership role at work.
Over the past ten years, I have struggled to name my passion. I react strongly to many things, but couldn't quite figure out why. I searched for my foundation on which to stand tall. I needed to grasp exactly what it was I believed in.
What I have found, is that I stand for honesty, fairness and doing the right thing. When a situation makes me angry, I work to discover what is triggering it. When I realize what is upsetting me, I face it with the proper tools--words of evidence. I have found utilizing these tools have made me very effective.
My passion has now become productive versus destructive. This has not been an easy road. I still battle the fears of ridicule and rejection I faced when younger. But in trying, I have found an amazing strength inside of me. I feel more at peace. I feel productive. Burnout has left me and I feel satisfied working as a nurse once again.
Have you ever tried to turn around a perceived weakness and make it your strength? Tell me about it below.
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Last night, I held a Manager's Forum meeting as the Pioneer Valley Chapter President of the Emergency Nurses's Association. Our topics included crucial conversations, sharing difficult conversations with your manager and how to advocate for yourself without whining. The premise was to offer a safe place for managers and staff to find common ground. As a new leader in nursing, I feel it's important for both sides to share perspectives, otherwise empathy is lost, and ultimately, the patient suffers.
Our discussion went on for an hour and a half. It was lively, friendly and very informative. Here are a few things I took away:
1) If management wants to take credit for success, then it's only fair they accept responsibility for failure. In other words, I heard staff asking leaders to please stop blaming them when things go wrong. There are many parts to the system, each one needs to carry their own weight. It's difficult to work in an environment when management rarely or never admits to being wrong. It leads to staff hiding their mistakes and a punitive culture. No one can win, even when things are going well.
2) People don't always know they are unhappy or behaving badly. If people don't know what is expected of them, they will create their own rules. Expectations of behavior must be set and enforced, otherwise accountability is useless. Often, it takes one person's honest observation to curb or cure another's unhappiness. Both leaders and staff have a role in changing a department's culture. Individuals need to own their emotions and move on if they are that unhappy.
3) Transparency is valued by both staff and leaders. Trust and a sense of safety are key to growth and development for both the individual and the group. Each must trust the other. The only way to build trust is to extend it. Often it's the leader who is responsible for demonstrating it first. This comes from being up front with info, updates and data at all times.
4) ED nurses don't feel allowed to complain. When we talked about "whiny" conversation, everyone in the room agreed that ED nurses tend to be more stoic than emotional when it comes to expressing needs. Often, we feel the stressors are "just a part of the job". Most of asked if this was caused by leadership. We agreed it depended on the situation, but overall, ED nurses tend to compartenalize their issues. This is great protection, but also the leading cause of burn out, in my opinion.
5) Everyone wants to do a good job, for the most part. Managers don't set out to upset staff. Staff isn't trying to make life difficult for their boss. Everyone has a job to do and strives to do it well. Staff want and need a leader who can make their jobs more fulfilling, not necessarily easier.
6) Staff desires managers who can work clinically with them. We had a nice long debate regarding clinical skills of leaders. Many managers felt they couldn't do as good of a job leading if they are in the trenches. Staff felt they couldn't be evaluated by managers who couldn't do the tasks of the bedside nurse. It seems there must be a happy medium. Maybe a manager can't work the trauma room, but they can triage or take vital signs. A presence during a time of crisis can be invaluable and build respect, even if the leader is a little rusty.
What would you say to your manager or leader, if you had the chance?
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I have heard the term "evidenced based nursing" since the day I started nursing school. It's not a new concept, but it's one that is important to everything we do. It's proof that we are providing the most up to date care for our patients based on evidence collected via research and provides a means of improvement for facilities.
I am all for utilizing research in my practice, but I think it is even more important for nurses is to feel confident in what they do. Research and evidence is great, but it can change quickly. New products come out. Different studies disprove what previous studies swore was the best thing.
Sometimes we even find out we were hurting patients with our evidence based practice.
That is a confidence killer.
As an educator, I often wonder how to build confidence in an ever changing climate. I often utilize three tools. One, I listen. Change is scary. I let my staff verbalize all their thoughts. Then, I empathize. It's important to let people know they are heard. Finally, I am as honest as I can be. I can't always tell them how I really feel about something, but I can provide a rationale . I try to fall back on evidence based reasons as much as possible. When I can't, I offer up all the reasons I have been given during the discussion leading up to the change.
How do you build confidence in an unsure environment. I'd love to hear thoughts, stories and suggestions.
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