Tennessee Nurse - May 2021

Page 10 Tennessee Nurse May, June, July 2021
Nurses Well-Being
Please Tell Me Your Story
Brittany Haskell, DNP, PMHNP-BC, CNE
Vanderbilt University School of Nursing
“Since COVID arrived at
our doors in February 2020, I
have been taking care of this
patient population. Initially,
you had that heightened sense
of anxiety and apprehension
of not knowing what to
expect. A lot of that was due
to the fact that it was new,
just that situational anxiety.
A lot of it also was the fact
that so much was going on Brittany Haskell
in the news, like information
overload. The anxiety wasn’t just for me. It was also
for my husband and also worrying that I might expose
somebody. Workwise, everyone was kind of on edge
just trying to figure out what to expect in general.”
Critical care nurse Chelsea Riddlespur has spent
the last year working between a medical intensive
care unit (MICU) and coronavirus 2019 intensive care
unit (COVID-19 ICU) at Vanderbilt University Medical
Center. This is a snapshot of her story during the
COVID-19 pandemic. She continues on to explain
the stress of initially not knowing how best to care
for patients, the emotional toll of caring for patients
without the support of their family, and the grief over
difficult patient losses. Meanwhile, in her personal life,
Chelsea was navigating a custody arrangement with
their stepchild and starting graduate school.
While working with COVID-19 patients has been
challenging, Chelsea notes that some aspects are
rewarding, such as meeting the social and emotional
needs of her patients creatively and celebrating health
improvements. Chelsea has been fortunate to work on
a unit with a strong culture of supportive collaboration,
including clear communication and adaptability to
change. One of those changes is offering psychological
support for nurses through a scheduled time for
connection and storytelling. During a year when nurses
have experienced so much, it is time to share and listen
to those stories.
Psychological effects of COVID-19 on nurses
Over the past year, the COVID-19 pandemic has
presented unique challenges for nurses in both
their professional and personal lives. Repeatedly,
the nursing workforce around the globe has
been found to be psychologically affected by the
COVID-19 climate. Nurses have and continue to
experience increased stressors, including limited
access to personal protective equipment, increased
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patient volume and intensity at work, ever-changing
healthcare protocols, social isolation, and caregiver
role strain. These factors create a perfect storm for
an increase in mood symptoms, like depression and
anxiety, and trauma responses, like post-traumatic
stress disorder (PTSD). After a year of working during
a pandemic, chronic stress is leading to an inevitable
increase in compassion fatigue and burnout, which
has the potential to negatively impact patient care
and health outcomes.
Healthcare executives, healthcare systems, and
communities are aware of the psychological effects
COVID-19 has had on nurses, which has led to an
increasing call for support. While they recognize
that psychological support is needed, they are
still struggling to find the best ways to offer that
support.
A Renewed Interest in Mental Health
A benefit of the pandemic has been a renewed
emphasis on the psychological well-being of the
nursing workforce. National and global healthcare
related organizations, such as the Centers for Disease
Control and Prevention, American Nurses Association,
and World Health Organization, have launched or
enhanced resources to aid healthcare employee
mental health. In addition, healthcare organizations
have taken an interest in broadening accessible
psychological support services for employees, such
as offering continuing education, informational
emails, and access to mental health resources. While
these structural supports are beneficial, they do not
provide concrete and applicable tools that nurses
can use to support each other on a daily basis.
Nurses have the potential to serve as a source of
psychological support to each other, but they need
the time, space, and healthy workplace culture to do
so.
What is storytelling?
Storytelling, also called narrative pedagogy, is an
approach to teaching and learning resulting from lived
experiences. Storytelling is not a new phenomenon,
having been used by nearly every culture dating back
to 1000 BC. Storytelling in nursing has been found
to engage listeners, promote empathy, enhance a
feeling of community, allow exploration of shared
experiences, and enhance discussion. All of which are
desperately needed for nurses working during the
COVID-19 pandemic. Naturally, storytelling is combined
with reflection, which uses contemplation to create
meaning from lived experiences for enhanced learning.
Storytelling is frequently used in nursing education
but is underutilized for nurses in practice experiencing
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a chronically stressful work environment, like nurses
working during COVID-19. During a workday, a nurse
may listen to dozens of patient stories, but rarely have
an opportunity to share and listen to the stories of
their peers, which needs to change. Nurses need to be
empowered to take time to share their stories, which
necessitates support by healthcare administration,
hospital systems, and communities.
Implementing Storytelling
When COVID-19 cases decline in the future, the
experiences and stories of nurses like Chelsea’s will still
exist. Nurses have lived experiences over the past year
that have the potential to start the healing process
through storytelling and listening, but they need a safe
space to be able to share. For storytelling to begin,
the nursing work environment needs to normalize
sharing nursing experiences, which includes decreasing
stigma surrounding the stressors and subsequent
psychological distress presented by COVID-19. Nurses
and nurse managers are integral parts of that process
to shift to a culture of experience inclusion. Storytelling
can happen in many different ways – in person during
scheduled meetings or debrief times, through a virtual
format, or even through videos or journaling. Chelsea
shared that her unit started Compassionate Caregiver
Stress Sessions, which is a weekly designated time
for nurses to share stories and provide support to
each other. She also noted that storytelling can be
embedded into unit activities through debrief sessions
after difficult patient situations. Any participation is
beneficial. Not every nurse is going to want to share
their story, but healing can still happen through
listening. In addition, nurses are not going to be
the only ones benefitted by sharing their stories.
Through storytelling, nurse managers and hospital
administration can gain a better understanding of the
needs of nurses, which will allow them to adapt to the
evolving needs of nurses.
Conclusion
COVID-19 has strained the psychological wellbeing
of nurses. While hospital administration and
hospital systems have tried to provide the support
that nurses need, nurses can also serve as a source
of support for each other through storytelling. Space
and time dedicated to storytelling can improve the
psychological well-being for nurses now and into the
future. Implementing storytelling should be considered
for every healthcare setting.
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