Nevada RNformation - December 2020

December 2020, January, February 2021 Nevada RNformation • Page 3
Trickle Charge Your Self-Care During This Ongoing Crisis
Sherry Stofko, MSN, RN
Sherry practicing self-care in fresh air
A few months ago, I wrote an article about
how nurses were crumbling under the weight and
uncertainty of the COVID outbreak. I asked that you
give yourself “permission to fall apart.” Nurses were
down back then, but we typically don’t stay down
long. Has there been healing and growth since that
time? In the mild “downtime” over the summer, did
we use that time to build resilience and count our
blessings? Did we restore our psychological reserves?
Or did we waste time tallying our complaints against
weak institutional leadership and governmental bodies,
further eroding morale. Did healthcare administrators
use that time to plan and prepare for COVID 2.0, AKA
flu season PLUS an increase in coronavirus patients
fueled by more indoor activities and large-scale political
rallies? Seriously, it’s not like we didn’t know this wave
was coming.
Collectively, nurses are burning out in
unprecedented numbers. Eight months of tough
circumstances with little improvement will do that.
We are sick of seeing our coworkers kept alive on
ventilators. We can no longer bear to hold the cell
phone while families cry their goodbyes to our intensive
care patients. The smiles that used to soften our bad
days are obscured by tattered, poorly sealing N95's
that have been re-sterilized countless times since April.
Nurses are generally empaths and people-persons who
crave meaningful and unbridled relationships with
friends, family, co-workers, patients, and patients’
loved ones. The barriers of the face masks and
restricted physical contact further the loss of human
connection nurses so yearn for. To top it off, we are
now getting crash courses in crisis standards of care,
team nursing, disaster charting, and managing patients
on ventilators.
In the Spring and Summer, nurses felt dejected.
Now, talking to nurses on the front lines, they express
intense anger and frustration. They are “past the
sadness,” as one colleague stated, and understandably
so. Patients are incredibly ill. Units and hallways are
full. Patient-to-nurse ratios are worsening an already
intolerable situation. We're forced to work with
strangers floated to our unit who are not experienced
in our specialty and with whom we have no trusting
relationship. We work in unfamiliar locations with
equipment we’ve never seen before. Despite all this,
we still hold ourselves to the highest standards and
beat ourselves up when patient outcomes are less than
stellar, and the guilt decimates our soul. We dutifully
go back in for an extra shift, even though our crisis pay
bonuses are shrinking as the pandemic lingers on. We
complain about the staffing shortages, and when the
organization brings in travelers, we complain about
that as well.
What I see as the biggest issue is the relentless
feeling of anger fueled by being overwhelmed,
disrespected, devalued, disempowered, silenced. I feel
the same, and I no longer provide direct patient care.
I hear the cries of the bedside nurses who tell similar
stories: reusing single-use protective gear, supervisors
who won’t replace unsafe masks, broken equipment
not repaired. Many nurses who work in institutions
that are not being honored with comparable crisis pay
feel financially undervalued. Of course, hospital bottom
lines have been hit hard by this pandemic, and millions
of unbudgeted dollars have been spent on all sorts of
items and staff. We know that healthcare institutions
code for COVID and receive extra reimbursement
for COVID patients and COVID-related projects. We
ask, “Where is all this governmental funding going?”
because it’s certainly not being funneled to the
frontline staff working in the trenches, risking their lives
and the safety of their families. Healthcare has never
been so much a business as it is right now.
What to do about all this? Even with vaccines on the
way, we have a very long way to go in this pandemic.
We use our cherished thirty-minute break to complain
to and commiserate with staff about the horrible
situation we’re in. We pick up extra shifts when our
supervisors send the guilt texts about how the patients
or our co-workers need us. We are banging our heads
against the walls. We have virtually no control over
corporate America, government, and big pharma who
run this country’s healthcare system, so we need to
take charge when and where we can.
We do have control over our own thoughts,
actions, and reactions. Many nurses are leaving the
profession all together, tossing away their incredible
skill set to start a craft business on Etsy. Uncountable
healthcare workers are jumping ship and swimming
over to the hospital across town or on the other side
of the country. That other hospital is likely suffering the
same woes because American healthcare is broken,
not just your institution. The other facility may manage
differently with seemingly better administrators and
higher pay, but if we don’t have a handle on our own
way of managing uncertainty, anger, and our feelings
of being undervalued, we will find ourselves with the
same complaints in a new setting six months from
now. I wonder if all the people jumping on the travel
nurse band wagon understand what they’re getting
into. Having been a traveler from 1997 – 2006, I know
very well the isolation, insecurity, incessant floating,
bullying, and lack of support that comes with those fat
paychecks. It’s not all rainbows and unicorns.
What are the alternatives? How do we survive
through this horrible pandemic and poor leadership?
Building your resilience and prioritizing your self-care
are paramount. Explore and practice ways to defuse
your anger or respectfully direct it at the appropriate
target. Start using your vacation time before mandatory
overtime is instituted. Don’t answer the calls or read
the texts on your off days. Exercise, stretch, meditate.
Eat decent foods and treat yourself to the cupcakes
now and then. Express gratitude. Tell your co-workers
how valuable they are to you, and why. Try finding
the silver lining; make a game of it. There must be
something good about being floated from NICU to
surgical-telemetry for 12.5 hours. Maybe it’s time
to explore nursing positions in new specialties away
from the bedside, far from the clutches of the Joint
Commission, corporate, unsafe staffing matrices, and
inadequate PPE. Most of the jobs outside direct patient
care require higher levels of education, especially the
ones that allow work from home. Academic degrees
seem to be a huge divider in this, now more than
ever. Maybe it’s time to seriously consider professional
development and growth through programs such
as Duke University’s Nurse Leadership Certificate or
Grand Canyon University’s RN-to-BSN program. Is your
head full of legitimate complaints about how poorly
healthcare is run? Get involved politically or with your
union, or you could write well-crafted letters to the
Nevada Hospital Association.
No matter how you choose to continue in your
career, there’s no question it will be stressful, and the
pandemic will be clouding our sunny skies for a while
longer. Self-care with a focus on learning to handle
recurrent adversities in a healthful way is vital. We
bash administration for not properly planning for 2.0,
but how well have you prepared? We don’t need a
jump start on self-care; it’s too late for that. We need
a trickle charge. What are you doing to trickle charge
your health and wellness?