Healthcare Archives - Integral Nursing Solutions

By:padma
April 8, 2017
3

Practicing Gratitude is Self Care

Gratitude is a form of Self care that benefits yourself and can be shared. My 22 year old client PS was pouting, sulking and complaining because something he wanted did not arrive in the mail. He was sharp in his responses to his parents who did everything they could think of to cheer him up to no avail. Mindful of what I was experiencing physically, emotionally and mentally as I completed my usual nursing tasks- med administration, trach care, bath, and whatever else was needed, I was acutely aware that this was an emotionally painful situation for everyone.

What a surprise at the end of that day for us all when I asked PS to tell us something for which he was grateful.
PS did not know what I was talking about as he and his parents focus on him, his needs, wishes, wants and health. I defined gratitude and shared mine setting the stage for everyone to share. His parents shyly participated. PS could not find anything he was grateful for. After a few visits, PS was willing to agree with a gratitude his mom suggested. Over time, he has become willing to think of something he is grateful for at the end of each visit. PS’s physical health has not changed as gratitude does not reverse chronic debilitating, genetic conditions. It can however, influence how he handles the challenges he faces. PS is learning to focus on what is working and to nurture himself a little with the experience of gratitude. Practicing gratitude on the days I am there, seems to bring some emotional balance to the ongoing trials they face individually and as a family.

There is no way to measure what has happened in this home, but it’s my felt sense that there is enjoyment in the sharing. There is an increased sense of intimacy among the family members and myself, and they now have a tool to shift a negative emotional spiral. The Self care tool of gratitude opened the door for more information about the brain and the neuroscience of gratitude, which they seem interested in. I have no idea where this will lead the family over time. In retrospect, for me, it was a matter of Self care to bring it up initially- shifting the focus to something positive.

The topic of self-care is now something that we talk about. The parents still have not changed any of their self-destructive patterns to date. However, they are working on the more subtle dimensions of growth and healing as they deepen and support the neural pathways for happiness in their brains by developing a gratitude practice. Healing happens in its own way, in its own time and sometimes is so subtle it is not measurable.

Please share with us about your gratitude practice. Have you brought it to the bedside? Maybe you practice with your family. Maybe you have been considering developing such a practice. It is a great way to boost your spirits and move to seeing a half full glass rather than a half empty one. It is an integral aspect of our Vitality in Progress: Healing and Preventing Burnout for Nurses program which begins on May 7, 2017.

It is also a practice we use in the Self Care for Vitality Free Virtual Connecting Weekly Call-in for Nurses Join us on our weekly phone call. There is a short guided relaxation, followed by a short time for silence in community and optional sharing. Phone 712-432-3066 Pin 177444

With Love,
Padma

By:padma
March 19, 2017
5

Vital Exhaustion

When I heard Roshi Joan Halifax use the term Vital exhaustion I had a visceral experience of recognition. A profound part of me resonated with those two descriptor words which are also a metaphor. Experimenting with the term, trying it on so to speak for the last few months, I am sharing it with you to help you nuance your understanding of where you may be at in terms of Self care, burnout, compassion fatigue and compassion satisfaction. Next week’s blog will address the last 3 experiences and working with assessments of these experiences to begin addressing the symptoms and underlying causes. The term is not new and it has an interesting history, let’s take a peek.

Vital Exhaustion

Metaphors help us articulate and understand our experiences as sentient beings. Merriam-Webster defines vital as, “concerned with or necessary to the maintenance of life”. The term Vital exhaustion touches all of our interpenetrating fields: physical, emotional, mental and spiritual- and maybe especially the last. When I heard the term Vital exhaustion it was as if the spiritual part of me felt heard too.

In the early 1990’s the concept of Vital exhaustion was explored by cardiologists Appel and his associates. They reported three defining characteristics: (1) feelings of excessive fatigue and lack of energy, (2) increasing irritability, and (3) feelings of demoralization that precedes myocardial infarction and sudden cardiac death. “Therefore, it was suggested that Vital exhaustion is a mental state at which people arrive when their resources for adapting to stress break down.” (my italics)

In 2010 it was reported that European psychiatrists have been using the term Vital Exhaustion as a possible way of defining a nervous breakdown “which is defined by its temporary nature, and often closely tied to psychological burnout, severe overwork, sleep deprivation, and similar stressors, which may combine to temporarily overwhelm an individual with otherwise sound mental functions.”

Research in Heart Math, in “the past two decades has shown that the heart is an information processing center that can learn, remember, and act independently of the cranial brain and actually connect and send signals to key brain areas such as the amygdala, thalamus, and hypothalamus, which regulate our perceptions and emotions.” Though we don’t know where Spirit lives, it is based in a unitive experience and sages refer to the wisdom of the heart. Vital exhaustion seems to relate to the organ of the heart, and to other fields of human experience. Maintaining Vital energy needs to be ongoing and planned. By putting Self care into my calendar daily it has become a habit. Otherwise, it is easy to act on automatic pilot focusing on lengthy “to do lists” moving to exhaustion and becoming drained of Vital energy.

When you contemplate the term Vital exhaustion, what is your experience? What part of you responds- your mind, body, emotions and/or spirit? Over time you may notice that it takes on different meanings depending upon different stressors in your life and your ability to tune in and care for your Self.

Next week we will contrast Vital exhaustion with burnout, compassion fatigue and compassion satisfaction and look at measuring them. In the meantime, notice your experience of your Vital energy. Can you give it words? What strategies and tools do you employ to manage the stress in your life? What do you do to maintain your Vital energy? Do you take time in nature? Maybe you meditate, pray, journal, spend time with pets… Share with us what do you do to nourish your beautiful, kind, generous, courageous Self?

Some find our Self Care for Vitality a free Virtual Connecting Weekly Call-in for Nurses a form of nourishing Self care. There is a short guided relaxation, followed by a short time for silence in community and optional sharing.

Wednesdays 6:30-7:00 pm EST Phone 712-432-3066 Pin 177444 You are welcome to join us.

References:

Vital Exhaustion, pp 2032-2033, ©2013, Douglas Carroll, http://link.springer.com/book/10.1007/978-1-4419-1005-9

Benedict Carey, http://www.nytimes.com/2010/06/01/health/01mind.html

Awareness Begins in the Heart, Not the Brain, http://www.mindfulmuscle.com/heart-has-consciousness-knows-before-brain/

By:padma
January 15, 2017
2

Healthcare: A Right or A Privilege

Yes or No: Do you agree with Dr. Martin Luther King, Jr. “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

In 1948 the Universal Declaration of Human Rights was created. Article 25 states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services.” Wikipedia https://en.wikipedia.org/wiki/Right_to_health

The 115 Congress and President-elect Trump speak of removing the Affordable Care Act (ACA) and privatizing Medicare and Medicaid. As a citizen and a nurse, you are called to consider: is health care a right or is health care a privilege? As a nurse in North Carolina, I see the inequities and feel the pain of the injustice as the state legislature refused to accept the Medicaid expansion funding that came with the ACA. (There are now 1/2 million without health care because of this.) The ripple effect touches every aspect of life in this state. The economy has fewer jobs, an increase of more than 24% of children under 18 living below the poverty level in the last 5 years. There are fewer health care providers and consequently, there is less care provided with the already worn caregivers shouldering more responsibilities. Perhaps most especially nurses…

The National, Economic, Social Rights Initiative writes:

The human right to health guarantees a system of health protection for all.
Everyone has the right to the health care they need, and to living conditions that enable us to be healthy, such as adequate food, housing, and a healthy environment.
Health care must be provided as a public good for all, financed publicly and equitably.

Take a minute and breathe. Contemplate privatizing health care. What are your thoughts and feelings about this? Is there a difference between health care and insurance care? What are the physical, emotional, mental and spiritual costs and benefits of each for our families, friends, our neighbors and the public in general? How does it impact your work?

Dr. Don McCanne

writes a daily health policy update, taking an excerpt or quote from a health care news story or analysis on the Internet and comments on its significance to the single-payer health care reform movement. On January 10, 2017 he commented on an interview of President Barack Obama by Ezra Klein and Sarah Kliff of Vox Video.

He writes:

Virtually everyone wants affordable access to health care, for themselves at least. Most want a better system than what we have under the Affordable Care Act. But the nation is divided as to whether ACA needs to be repealed prior to improving the functioning of our health care financing system.

So the point is that there is broad agreement that we want the system improved, but the Republicans, who are in control, are hamstrung by their anti-government ideology which prevents them from offering the government solutions that we would need that would actually be effective in improving the system.

Repealing ACA would further impair the functioning of our system, so the Republicans would have to introduce effective policies that would more than compensate for the deficiencies that would be created by repeal. Almost any piecemeal solution would require greater regulation and more government spending, anathema to the Republicans. Suggestions to date coming from their camp would leave us worse off than what we currently have. It is no wonder that they refuse to tell us what their replacement proposal would be.

If they really do want to improve the system, and they say they do, then they have two choices. Either provide beneficial tweaks to the current system, which will cost more and require greater regulation, yet fall far short of reform goals, or replace the current system with a single payer national health program – an improved Medicare for all. The latter would greatly improve the financing of health care, ensuring true universality, improved access, greater choice in care, and affordability for each and every individual. And we could do that without increasing spending above our current level.

The Republicans have an opportunity to provide us with a replacement program that would be vastly superior to building on our current dysfunctional system. Both President Obama and President-elect Trump have acknowledged the clear superiority of a single payer system. Most progressives, a majority of moderates and a plurality of conservatives agree. Now all the Republicans need to do is show us.

Engaging in these conversations is not easy. I work with nurses who say, “I‘m not political.” However, health care is not a spectator sport. It is about people’s lives- the quality, the safety, and the sanctity of life. If you believe that healthcare is a right, then figuring out how to make it affordable and accessible is a priority and you need to be at least informed and when you are moved by your conscience become active.

Medicare is not perfect, but it has made health care accessible to many of our loved ones. Why not expand it so our full society benefits? The slogan, “Medicare from womb to tomb” gives me hope.

Video: https://www.whitehouse.gov/videos/2017/January/20170106_President_Obama_Interview_with_Ezra_Klein_HD.mp4

Transcript: https://www.whitehouse.gov/the-press-office/2017/01/06/remarks-president-vox-live-interview

With love,

Padma