New Jersey Nurse - January 2022

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Page 10 New Jersey Nurse & Institute for Nursing Newsletter January 2022 RAMP Oversight Body The Oversight Body (OSB) was established at the September 2020 meeting of the NJSNA Board of Directors meeting. The Oversight Body, an independent body, was the recommendation of the RAMP task force and the RAMP subcommittee of the same year. The OSB is a progression of the RAMP Advisory Board established with the New Jersey Board of Nursing, NJSNA, and the Institute for Nursing (IFN) in 2011. The purpose of the OSB is to secure and maintain trust in the operation of the Recovery and Monitoring Program (RAMP). The mission of RAMP is to protect the public and support nurses with the disease of addiction who are engaged in their own wellness. RAMP achieves its mission through a treatment and recovery program for nurses, advocacy for nurses, education of nursing and consumer communities, and ongoing program evaluation to assure the implementation of best practices and outcomes. Recommendations of the OSB assist with the improvements to RAMP protocols and participants services. A call went out for members of NJSNA who were interested in serving on the OSB to submit a consent to serve form and a resume. At the November 2020 NJSNA Board of Directors meeting eight NJSNA members were appointed to the OSB. These volunteer members are: Eleanor Dietrich-Withington Co-Chair Linda Gural Co-Chair Heather Ashfield Lisa Laphan-Morad Margaret Pipcheck Rosemary Smentkowski Dorothy Grandjean Smith Susan Rux The first meeting of OSB was March 19, 2021. The OSB has met biweekly to review all RAMP documents. Based on the review the Body recommended the following updates: RAMP personnel job descriptions, update of policies and procedures, criteria for awarding scholarships, grievance procedure for participants in the RAMP program, evaluation of the program. Meetings were held with Terri Ivory Director of RAMP, Judy Schmidt CEO NJSNA, and Elizabeth Temple CEO of Birchwood, a provider of nurse support groups, in order to inform them of the results of the OSB reviews. In October 2021, the OSB transitioned the meetings to occur monthly. Susan Rux is no longer a member of the Body therefore currently there are three positions available for qualified candidates to serve on the OSB. Call for appointment will go out March 1st, 2022. Interested NJSNA members in good standing should contact Jennifer Chanti at jennifer@njsna.org for consent to serve form. Form and updated resume to be returned to NJSNA by April 15th, 2022. Materials submitted will be reviewed by the NJSNA board at the May 2022 meeting. The Importance of Practicing “Mindfulness” in Nursing Donna L. Castellani, MSN.Ed, RN, CNE By its very demanding nature, the environment of healthcare requires the need for stress reduction and resilience building for its nurse workforce. The American Nurses Association’s Health Risk Appraisal report found that 82% of nurses believe they’re at a significant level of risk for illness due to workplace stress (Penque, 2019, para1). There has been a great deal of literature which speaks to the physiological and psychological benefits of incorporating the practice of “mindfulness” into our daily nursing practice. Mindfulness is claimed to have a proven reduction in stress, anxiety and burnout as well as enhancing resilience (van der Reit, et.al., 2018). Certainly, addressing the issues surrounding stress management in the work environment is crucial to help recruit and retain qualified professional nurses. Workplace wellness initiatives often focus on decreasing an intuition’s employee health care while at the same time increasing productivity (Sos & Melton, 2020). However, stress and its effects also lead to increased absenteeism- adding additional stress for those who must now shoulder additional patient assignments. Occupational stress manifests itself in physical and psychological ways such as chronic fatigue, lack of concentration, “burn-out”, and emotional exhaustion (Sos & Melton, 2020). Managing work stress becomes important therefore not only to ensure patient safety, but to also to improve nurses’ overall health and job satisfaction. It is important that institutions look to incorporate stress management and mindfulness programs into their existing employee wellness programs. One solution to this issue is to develop a program of “mindfulness.” Mindfulness has been described as “an awareness of the present moment” (Penque, 2019, para. 3). Nurses often encounter stressful situations during encounters with patients, families, and fellow healthcare team members. Developing a program of mindfulness may help foster self-compassion and serenity, as well as providing a means to put situations in perspective and promote positive responses to stress (Penque, 2019). Techniques such as focused breathing, meditation, focused visualization, taking a short walk down the hall or outside, or simply pausing for reflection can easily be employed during the workday to help cope with stressful situations or to deal with a build-up of stress. Such mindfulness techniques have been shown to be as effective as yoga in decreasing stress (Sosa & Melton, 2020). Mindfulness can help redirect negative thinking and reframe difficult situations (Penque, 2019). The more one practices mindfulness techniques, the more one can begin to separate negative emotions and gain better insight into the situation (Penque, 2019). Nursing is an extremely stressful occupation. Stress is taking a toll on our nurse workforce. Developing and implementing mindfulness-based programs will help nurses develop the skills needed to manage workplace stress and improve their overall health and wellbeing. Mindfulness programs can be incorporated easily into existing wellness programs. This in turn will increase job satisfaction leading to increased productivity, patient safety, and staff retention, while decreasing absenteeism and burn-out. Mindfulness is a valuable tool in the nursing toolbox. References Penque, S. (2019). Mindfulness to promote nurses’ well-being. Nursing Management 50(5): 38-44. Sos, T., & Melton, B. (2020). Incorporating mindfulness into Occupational Stress Management programming for nursing staff. Workplace Health & Safety 63(4): 203- 203
January 2022 New Jersey Nurse & Institute for Nursing Newsletter Page 11 My Reflections About Nursing During COVID-19 Gina Monk, BSN, RN, CCRN Working through a pandemic is not something that can easily be taught. There is no way to prepare for the emotional, physical and spiritual distress that comes along with caring for innocent people all affected by the same evil. There is no way to teach how to handle the haunting memories you are left with once the units have been cleaned and normal work functions have resumed. It is impossible to forget the sights of the units in which we worked so tirelessly. It is hard to know if we will ever be able to walk by a room without picturing the faces of patients we fought so hard for when they were unable to fight for themselves. The truth is, no one really knows what we went through. It is impossible to describe the extreme physical and emotional exhaustion we felt after a shift of one emergency after another, or the heartbreak we felt every time a new patient came in because we knew the sequence of events that were about to occur. There is no way to describe the way we treated our patients with dignity even in the midst of chaos. And in the peak of this chaos, we took nurses under our wings to teach them to care for the critically ill. Even though our spirits were weak and our bodies were tired, we stayed strong and positive for our newly trained nurses, because soon enough they too would understand the sheer panic, the fear and the heartbreak we had been experiencing all along. But most of all… I will never be able to describe the moment that I realized that this was truly a pandemic… when I looked up and saw “DNR” written across a glass door. In this moment I knew that this pandemic was bigger than us, bigger than OMC, and bigger than the policies and procedures that were previously engrained in our minds. We were in survival mode. We were adaptive, creative and innovative when we had to be. Even though our spirits were breaking, and our bodies were tired, on my darkest moments, and on my hardest days, I would think back to the “DNR” written on the glass door and know that everything we were doing was for a purpose. It was not something that was taught, but something we knew we had to do. We were advocates when no one else could be. We were the ones who went in the rooms when nobody else would. We were the ones who adapted to the everchanging “rules,” even though no one knew what it actually looked like behind closed doors except for us. COVID-19 hit us like a hurricane and the residue from the storm will never be fully washed away. And now, even though the “sun has come out,” there will always be a cloud of darkness that lingers above to remind us of a time that broke us, but somehow in the end made us more resilient than ever. Reflections: Caring at End of Life During COVID-19 Jacqueline A. Tierney, MSN, RN, CHPN Hospice and Palliative Care, Simon 3 Morristown Medical Center I am a hospice and palliative care nurse. My calling is to comfort patients at the end of life, along with their families, and allow for a peaceful and dignified death. During the height of the COVID-19 crisis, I was tasked by my manager to aid in the opening of an off-site palliative care unit, for patients who required end-of-life care throughout our health system. I collaborated to secure staff who had been displaced from their usual practice areas. Once they were onboarded, I needed to determine their training needs, coordinate their schedule, and ensure they understood their new daily responsibilities. I worked closely with leadership, Informatics and Nursing Education to develop an innovative way to train the staff on donning PPE, charting in our EHR, administering comfort medications, and practicing the skill of communicating in unique and extreme circumstances. As a practicing hospice nurse, the most difficult component of this was not being able to provide physical touch and comfort to patients and their families. We were restricted in the duration we were able to spend inside a patient’s room and family members were not permitted to visit at all. This provided a great deal of emotional distress for nurses and families, as they were unable to participate in their final days and hours and share their goodbyes. It was essential that I was able to convey to families that I was there to provide comfort to their loved ones, to bear witness to their passing, and that I was able to convey their love in their absence. Communication was key and we instituted a plan, that the nurse would call the family scheduled intervals throughout each day, as well as offering regular opportunities to use video technology. We created a personalized narrative about each patient which alleviated a great deal of moral distress for all of us and enhanced our connections to our patients. I felt that my greatest contribution to the staff was the gift of resiliency. When staff was experiencing the death of so many people, it was important that I stand with them at the bedside and help them to care for the patient, providing them with encouragement and support, and helping them to get off the unit to decompress when they needed it the most. We cried together and celebrated through group discussions, gatherings, and planting a “Garden of Souls” in remembrance of all those we lost. Throughout this experience, I reflect that my purpose is to bring comfort to others at the end of life and in turn, I am comforted as well. Through the use of effective communication, collaboration, resilience, and innovation, we crafted a caring environment that brought together an amazing and dedicated group of nurses who provided the very best care to our patients when their families could not be by their side. Help INS Celebrate National IV Nurse Day Susan H. Weaver, PhD, RN, CRNI, NEA-BC National IV Nurse Day is every January 25th, a day to recognize infusion nurses. As infusion therapy has been a critical component in patient care during the COVID-19 pandemic, it is especially important to recognize infusion nurses this year. While caring for patients with COVID-19, nurses—especially infusion nurses—have been challenged as never before. The Infusion Nurses Society’s (INS) theme for this year, “Strong I(nitiatives), N(urses), S(tandards),” honors the characteristics that nurses exemplify. It also recognizes the importance of the 2021 Infusion Therapy Standards of Practice (the Standards) in infusion nurses’ practice. The Standards, which INS now releases every three years, are based on the most current evidence available, and infusion nurses are now incorporating the Standards into their organizations and clinical practice. “While infusion nurses are integral members of the patient’s health care team, during the pandemic their clinical expertise has been invaluable as they have addressed some unusual circumstances such as insertion of peripherally inserted central catheters with patients in the prone position and management of infusion pumps outside of patients’ rooms. Especially on IV Nurse Day, INS acknowledges the contributions these nurses have made to patient care,” said Mary Alexander, MA, RN, CRNI®, CAE, FAAN, Chief Executive Officer of Infusion Nurses Society. In 1980, the US House of Representatives designated January 25 as a day each year to honor and recognize the accomplishments of the nation’s infusion nurses—as well as a day to honor and recognize the National Intravenous Therapy Association, now known as Infusion Nurses Society. Then Massachusetts congressman Ed Markey called the specialty “a vital branch of our nation’s nursing profession.” INS is a nonprofit organization dedicated to the specialty practice of infusion nursing. The organization was founded more than 48 years ago to support infusion health care professionals by providing educational programs, establishing standards of practice, and disseminating research through its peer-reviewed publication, the Journal of Infusion Nursing. Today, INS has over 5,500 members in 33 different countries, and over 2,700 nurses certified in infusion nursing. As the premier association for infusion nursing, INS is dedicated to exceeding the public’s expectation of excellence by setting the standard for infusion care. The mission of INS is to develop and disseminate standards of practice, provide professional development opportunities and quality education programs, advance the specialty through evidence-based practice and research, promote the importance of certification, and advocate for the public, our patients. So whether you have a certificate for completing an intravenous therapy course or specialize in infusion therapy and have obtained national certification as a certified registered nurse of infusion (CRNI®), all infusion nurses are recognized on IV Nurses Day. For more information about INS and to learn how to participate in their IV Nurses Day social media campaign, visit www.INS1.org.
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New Jersey Nurse - January 2022

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