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Four Rivers Endings and Beginnings

We know the quality of one’s nursing practice, the presence and authenticity one brings to those in our care is influenced by our understanding of the events that happen in our lives. How you end your day is as important as how you start your day. You can affect the start of your next day and even your next 24 hours, by your preparation for restoration and sleep.

I am excited to share with you a beautiful new practice I am using that is a nourishing way to end the day. It extends the positives from the day, ties up loose ends so that the next day is truly fresh. Rick Hanson reminds us, that it is as if our brains are Teflon for the positive and Velcro for the negative. If you want to increase the neural networks for the positive, it is important to extend the time you spend with positive and beneficial experiences. You may be doing this during the day as you experience gratitude or moments where you refocus upon your breath, coming back to your center. However, how often do you brush your teeth, plop into bed, fall asleep as your head is hitting the pillow and wake up with an alarm, feet barely touching the ground, as you dash off into the day? I have changed my nighttime routine. I now answer the following 4 questions from Angeles Arien, cultural anthropologist, educator, and award winning author. She speaks of the Four Rivers of life that nourish us and help us to grow.

1. River of Inspiration. What and/or who inspired you today? In what way or how?
2. River of Challenge. What challenged you to leave your comfort zone? Did you accept the challenge?
3. River of Surprise. What “came out of the blue” today for you?
Staying aware of these mysteries of life can help you move in new directions.
4.  River of Love. How or in what ways did love touch you today?

These questions encourage your reflections on the mystery of being alive, discerning what is important and guiding you to explore your own depths. In the process of answering these  questions regularly, you develop a new intimacy with your Self. Angeles Arien says,  “Intimacy  is, ‘Into Me See’ “.

This practice has added focus to my nursing practice and added a new dimension of closeness with my husband as we share our experiences of the Four Rivers. I also discovered one of my biggest challenges is my shyness around “putting myself out there” in the social media world. And, here I am doing it!

By ending your day in this nourishing way, you too may experience good sleep and a rich next day with focus and clarity. It benefits not only you, but your clients, students, colleagues, patients, family and friends. Perhaps you will enjoy your life and daily experiences even more as you open to your Four Rivers- Love, Surprise, Challenge and Inspiration.

Please share with us what comes up for you as you explore the Four Rivers of Love, Surprise, Challenge and Inspiration. How does this exploration affect your nursing practice and your personal life? What does the practice feel like for you?

We support your Four Rivers exploration here:

  
With love, Padma

Saying No Is Saying Yes to Yourself

Nurses week has come and gone. How do you keep alive the celebration of yourself and the beautiful work you do as a member of the health care community? Once again it comes back to your own Self care which means sometimes saying No without feeling guilt or shame. You are a family member and a friend as well as all of the other roles you may have. Remember, saying no to another person is in fact saying yes to your Self.

After the “terrible twos” and/or the rebellions of adolescence, you may have stopped speaking up on your own behalf when it comes to scheduling; especially if you are a people pleaser. Saying No can feel risky if you don’t feel confident in your skills for saying No or, if you worry about what others might think or feel.

When you follow the pathway of your resistance to saying No, or your habit of saying yes, you will probably discover fear. Fear is not a comfortable emotion to feel. It is often irrational, and based in the past. Facing your fears builds your courage muscle. Sit quietly for a few minutes and reflect on the last time you did not say No when you really wanted to. Explore your fear of saying No to see where it takes you. Do you fear that you will lose your job or that someone will not like you?  Are you trying to get someone to like you? Do you want to please the person making the request because they control your schedule? Maybe it feels easier to say yes knowing you will be bullied into a yes. or perhaps you are used to saying, “no one else will do it, so I will”. Are you a martyr? Do you fear being criticized, disliked or punished?

The good news is that saying No can also leave doors open for friendship, connection and confidence. It is something that you can, with practice become adept at. When your No is grounded in your integrity, you are staying true to your Self, your commitments and your values.

Although saying No is not always easy, there are skillful ways that honor you and the other person.

Awareness is the first step. How often do you say yes and then realize that you did not want to say yes? For some saying yes is a habit. Remember, you always have choices.

Embrace your priorities and set boundaries that reflect them, honor yourself and others. To not abide by your priorities and values is not only disingenuous, but harmful to both you and the other person. After all, caring for your Self makes it possible for you to genuinely care for others.

What are your priorities?
Reflect upon this question and perhaps you can list them.

Empower yourself by taking the time you need to make the choice. This can mean saying, “let me get back to you after I have checked my calendar”, or “I need some time to consider this”. Your ability to say this improves and reflects your self esteem.

Express your gratitude for the offer.  Without making excuses- just stating the facts, you can say “no”. “Thank you for asking, but that is not possible at this time.” Remember that the part that comes after the “but” is the part that will stay with the person. … And the “Thank you” softens the message. Depending upon the situation, you may choose the order of what you will say first.

Offer a suggestion. When you can, help the requester to meet their need, if it is a genuine possibility. “I’m not available for this but maybe you can contact…” This shows your consideration of the other person’s situation.

Deepen your relationship, when it is appropriate through your No. Sometimes the other person, (my children come to mind) becomes relentless in the request, as if you can be worn down into a yes. At that point, you might want to say, “I am not going to change my mind. Please stop asking me.” However, then there is often an opportunity to ask them what they are feeling since you are not going to meet the request. This can be a time for a deepening of the relationship as you show your caring about the impact of your statement on the person. Whatever they say, this is not a time for you to feel guilty. You are giving them the opportunity to express their feelings, thoughts and concerns. Your listening is a gift.

As you develop your No muscle, deepening your relationship with your Self, you build your courage and become empowered to align yourself with your priorities and values. Go for it! The world is waiting for you to show up in your fullness! Please share with us your challenges and the ways you say No that empowers you and also cares for the other person.

Each week there is an opportunity to practice tuning into your Self.
Self care strengthens your self esteem and competence.

Self Care for Vitality
Free Virtual Connecting Weekly Call-in for Nurses
Phone 712-432-3066
Pin 177444                    Wednesdays 6:30-7:00 pm EST
There is a short guided relaxation, followed by a short time for silence
in community and optional sharing.
We present tips and strategies for Self care on a variety of topics such as:
Setting boundaries, balance, healing, self love, vulnerability, and other topics as they arise.
 Have a great week honoring your Self by saying No if that is what is called for. Self care strengthens your self esteem, competence and makes the world a safer place if we all know you are telling your truth.
With love, Padma

 

 

 

 

 

Creativity- A Key To Your Wellbeing

Today’s health care institutions need creative and innovative solutions.
Nurses need to think creatively, to experiment, to take risks, and to innovate.

You are creative because you are human. Humans are infinitely creative. Throughout history in groups and as individuals we have invented tools, developed ways of survival, produced beautiful pieces of art, literature, theatre, music and dance. We celebrate concepts with theories and ritual. We study the cosmos to discover how and where we fit “into the scheme of things”. We design health initiatives and at the same time we create weapons to kill.  Innovation, discovery and creativity are forms of Self care or self preservation, motivated by different states of awareness that are experienced as feelings.

Making time to tune into your inner self, to feel, to notice, to breathe, to heal and to feel comfortable in your own skin is a way of supporting your creativity. Tuning in to deal with fears and anxieties in new situations is also a way to support your creativity. Your creativity is one of the keys to your wellbeing. When you are exhausted, driven by external demands that come from the outside- by the employer, family or friends, or inner demands in the forms of perfectionism or pride in “doing it all without help”,  your mind gets dull, you cannot solve simple problems, you may over eat or abuse some other substance. Small issues become magnified and out of proportion. Your ability to creatively address situations decreases.

Laura jumps out of bed, checks her email, gets ready for work, drinking a cup of coffee as she prepares for her work day. Since she no longer takes time to prepare her lunch or dinner, which her husband now brings home from fast food places she ended up in the ER with stress induced hypertension. She started to cry while describing her latest hamster wheel of working 92 hours in a 7 day stretch. She also bemoaned the loss of her creativity.

That was the note that began our discussion of her journey towards meeting her needs. Based upon her schedule, what she can and is willing to do at this time, she created a Self care plan that starts with 5 minutes of meditation 5 days a week and time on her treadmill before checking her email. Never having meditated, she was fearful that she would not be able to sit still for 5 minutes and worried about her mind that “never stops”. The first session “went by so fast, and it was so good”. Then she used her treadmill. I instructed her to download the Insight Timer app  that she can use in the future. Laura said, “I always said ‘charity begins at home’, as she pointed to herself. Starting Self care may initially be challenging, however when you respond to the call, new ways of seeing situations appear, and you create ways of responding to challenges and opportunities. Additionally a new sense of wellbeing and hope can arise, which I heard in Laura’s voice.

A few years ago I committed to “walking the talk” that I gave my patients and caregivers about Self care. After working 60 hours a week and getting paid for 37.5, for years, I began a regular routine for Self care, setting a good example for my daughters and husband. It is from this practice that Integral Nursing Solutions, PLLC has evolved~ supporting my passion for empowering others to take good care of themselves so that they can continue to shine their beautiful lights in the world with innovation, creativity and ease.

How do you protect and celebrate your creativity? What does your creativity at work look like? Are you happy with your nursing career? Are you comfortable taking risks, trying the new and sharing your innovations? You can look forward to receiving later in the week a video on creativity, and at least one article that is stimulating and short.

August 27, 2017 we will begin the next Vitality in Progress: Healing and Preventing Burnout for Nurses creating and supporting individualized Self care plans for nurses.

In the meantime, give yourself a dedicated 1/2 hour weekly for Self care.
Please join us

 

 

 

 

 

 

Have a beautiful week, filled with creativity and clarity.

With love, Padma

 

 

 

Refreshing Yourself, Boosting Your Energy and Improving Your State of Mind

 

Water, beautiful , clear, fresh water— a wonderful source of a health for you at work, for our friends and neighbors far and near and for our Beloved Earth.  April 29,  2017 was  the date of the People’s Climate March in Washington DC and one of the hottest days in April on record in our capital.  There were signs everywhere. Small cardboard signs, billboards, electric signs and people with microphones reminding everyone to, “Stay hydrated”. Staying hydrated with clean water is essential for our patients, for ourselves and for our dear Earth.  As nurses, part of caring for our patients is caring for the environment. Protecting Earth’s water, Earth’s circulatory system, is essential for all life on this precious planet. Staying hydrated with clean water is an aspect of your own good self care and healthy habits at work and elsewhere.

Nella Pineda-Marcon of the NYSNA spoke to 100’s of people at the People’s Climate March on Washington this past week. Sharing wisdom and compassion from her nursing experience she reminded us of how changes in Earth’s climate are impacting people and their health care  in the US and around the world. As nurses we have always taken care of people when they are challenged by disease, and assisted those living in war torn areas. Today the most vulnerable people everywhere are feeling the impacts of climate change first and hardest. Climate change effects mental health as well as physical health. The higher and more intense winds and storms with flooding, extremes of heat and cold makes growing food and survival even more challenging. For the poorest, there is nowhere to move to. Nurses make a difference when we speak up with scientific evidence to support our wisdom and understanding. The the current political trends towards austerities based in the lack of awareness that we all share only one planet make for fewer resources to help the vulnerable get back on their feet, and our jobs harder. We are proud of our nurse colleagues who are proactive in caring for themselves and others as you continue to advocate for healthy environments, healthy life styles and equitable health care for all .


Speaking up for water today let’s look at some facts to support you in caring for yourself, your patients and your planet Earth.

Up to 60% of the human adult body is water, the brain and heart are composed of 73% water, and the lungs are about 83% water.

About 71 percent of the Earth’s surface is water-covered, and the oceans hold about 96.5 percent of all Earth’s water. Water also exists in the air as water vapor, in rivers and lakes, in icecaps and glaciers, in the ground as soil moisture and in aquifers, and even in you and your dog.

Staying hydrated on your busy shift is as important as keeping Earth’s hydration in balance. 

  1. The time you spend drinking water is a pause that can reset your mental clarity and give you a moment to rethink what has been going on.
  2. Your body needs water and by keeping your fluids balanced, so your body can continue doing its job­–transporting nutrients, digesting, regulating temperature, removing toxins, etc.
  3. Drinking water helps you to focus, think and concentrate thereby improving alertness. Dehydration causes shrinkage of brain tissue. So when you haven’t been drinking enough water, your brain has to work a lot harder to perform at the same level.
  4. Drinking water aids digestion and can be helpful in preventing constipation.
  5. Bringing your own water saves you money rather than drinking whatever is in the vending machine.
  6. You can flavor your water with lemon, crushed basil, an herbal tea bag, crushed fruit, or even a few drops of a fruit concentrate.
  7. Flushing out toxins through sweat, urination and feces you fight infections, prevent UTI’s and other ailments.
  8. You can prevent lightheadedness and headaches caused by dehydration.
  9. When you drink water before a meal, it becomes a natural appetite suppressant if you are trying to lose weight.
  10. Staying hydrated protects your joints and cartilage by keeping them lubricated- so you can move with greater ease.

Staying hydrated on your busy shift is as important as keeping Earth’s circulatory system in balance.

Drinking a glass of water before you start your day and as you end your day is a great way to connect to your gratitude. Remembering that water comes not only from pipes and bottles, but from streams, lakes and reservoirs awakens us to our connection to our essential nature and to others.

Another easy to tune into this awareness is when you join our
Free Virtual Connecting Weekly Call-in for Nurses
Wednesdays 6:30-7:00 pm EST
Phone 712-432-3066
Pin 177444

There is a short guided relaxation, followed by a short time for silence
in community and optional sharing.

Water makes up about two thirds of who we are, and influences 100 percent of the processes in our body.     Doug Casa, PhD.

Finding Your Peeps- Belonging Is An Inside Job

The feeling of belong is yours and it is inside of you. It makes a difference in your happiness.  Love and belonging follow the basic physiological and safety needs in Maslow’s hierarchy of needs. Working collaboratively, on interdepartmental teams or interdisciplinary groups can be painful and consequently stressful if you’re feeling like you are on the outside. Do you wonder, “Do I really belong here?” How often do you feel like you are not a part of the team, or not a part of the culture of where you work? have you hidden your wisdom and light by not participating with enthusiasm because you were feeling disconnected? Here are 3 steps to explore your sense of belonging. This process can be a useful guide to decrease the stress of feeling on the outside.

  1. Awareness– Using your mind and intuition, tune in to the voice within yourself to check your physical, emotional and mental experiences for your truth. Does your stomach get tight thinking about the meeting/group/gathering? Do your shoulders tense; maybe on the days that you meet you don’t sleep well. Your symptoms are unique messages for you. They can be gifts. If you choose to understand them, you can  move to a deeper understanding of yourself and your situation. What is your body saying to you? Perhaps you are feeling listened to, but not heard, tolerated and not appreciated, or just plain excluded. What makes the symptoms pass?
  2. Acceptance– Being in acceptance means that you are no longer wishing things to be different. You recognize your situation as it is and you contemplate your role in it. If you feel on the outside, is it because you are new, and need to give yourself some more time? Or is it because you have not been welcomed and don’t feel accepted or included? Are you being bullied? Is feeling on the outside an old habit and this is an opportunity to work through it? Do you need to understand the culture of the group more deeply? Recently I found myself working with a group who had been working together for a long time. I was replacing a nurse co worker who had retired. When I realized that the nurses were experiencing resentment for some recent managerial decisions and were missing their friend I had clarity about my situation. I can not change their situation. They have to grieve and adjust.  With this understanding I choose to feel a part of rather than on the outside. My happiness is again, an inside job.
  3. Action– Based upon your assessment and acceptance of the situation as it is, you now have options for action. Perhaps you are keeping yourself on the outside because you don’t really want to be there.  Suppose you discover you need to find another place to work where there are people who have values similar to yours. Will you give yourself permission to reduce the stress and take the action of making a change? Do you need to find for yourself common ground with members of the group or team? This might mean reaching out to individuals to create for yourself a sense of belonging. If feeling on the periphery is a habit, then you need to answer the question, “Do I want to change this habit?”  The Vitality in Progress: Healing and Preventing Burnout for Nurses can help you make habit changes like this.  For example, the networking group I joined  was very welcoming and friendly, nonetheless, I felt on the outside. An old habit- discomfort with being new changed when I discovered that  in creating opportunities to get to know them as individuals, my inside experience changed.

The others did not change but my experience of belonging changed by working with the 3 above steps which empowered me to reach out and address the need to feel a sense of belonging. Belonging is an inside job that comes with your honest appraisal of your situation and making choices that support your need to feel like you are a member of, a part of, and belonging to the group.  When you work with the above 3 steps, you move your focus from outside of yourself to inside. You are enhancing your relationship to yourself, making choices from inside, rather than outside and you are empowering yourself. Bottom line if you don’t belong in that group, you do belong to yourself, and you will find a group, community, others you do belong with. Such is sometimes the process of finding your peeps.

Please share with us any tips or strategies that you use to create the experience and feeling of belonging at work or elsewhere.

On that note, this is your invitation to join us:

Self Care for Vitality

Wednesdays 6:30-7:00pm EST
Free Virtual Connecting Weekly Call-in for Nurses
Phone 712-432-3066
Pin 177444

Sending you lots of love,
Padma

 

INS on A Mindful Emergence Radio Show

Every Monday evening on WPVM FM 103.7, Eddie LeShure and Margaret Kirschner present A Mindful Emergence from 7:00 to 8:00 pm. I was the guest this week and what a wonderful time I had discussing this work. Here is a link to this week’s program for those of you who’d like to get an idea of what the program is like. Program # 69  http://wpvmfm.org/show/a-mindful-
A Mindful Emergence provides an in-depth and informative look into addiction recovery, trauma relief, and compassionate self-care, featuring conversations with specialists in the fields of mindfulness meditation, therapeutic movement, addiction treatment, post-traumatic stress disorder, and self-compassion therapies.

With Love, Padma
Sign Up For information and invitations here:
integralnursingsolutions.com

 

 

Nurses and Bees: Care of Pollinators Is Essential

The parallels between the nursing profession and bees begin with the need to understand both through the lens of holism, as I discovered when I became a beekeeper last year. Both are mostly female, hard working and essential to the well-being of large groups of people. Nursing is the nation’s largest health care profession with more than 3.6 million registered nurses practicing nationwide. Most health care services involve some form of care by nurses. Honey bees are responsible for 80 percent of the pollination of about one-third of the human diet . Many of the tastiest flowering crops we enjoy, apples, nuts, avocados, soybeans, asparagus, broccoli, celery, squash and cucumbers are pollinated by honey bees as are citrus fruit, peaches, kiwi, cherries, blueberries, cranberries, strawberries, cantaloupe and other melons.

Bees are considered super organisms. The colony of bees is the organism and the bees within the colony have prescribed roles they evolve through as they age. Eventually, all the worker bees, which are all female become foragers, going out to collect water, nectar, and pollen to make honey and to feed the hive. Bees have been dying in large numbers causing colony collapse which is affecting our food chain. Colony collapse seems to be related to the bees’ compromised immune systems resulting from the use of the carcinogenic and neurotoxic chemicals neonicotinoids and glyphosate, which people spray on crops.  Subsequently, the bees have become more susceptible to viral and bacterial infections.  When enough individual bees become sick from infections the colony becomes vulnerable to attack by beetles and/or moths and the colony dies. So beekeepers care for the hive by watching for signs of disease in individual bees, doing their best to keep the bees strong and healthy and trying to treat the causes of the symptoms.

Coming back to nursing, the profession might also be considered a superorganism, made up of many subspecialties which depend upon the evolution of professional nurses. All nurses graduate, take the NCLEX and go through Brenner’s prescribed stages as they develop professionally. Nurses start off focusing on the skills and techniques and after mastery, they begin to practice the art of nursing. In the current health care climate, it is essential for each nurse to learn ways to stay healthy and strong, setting boundaries that honor themselves, employers and patients. When nurses don’t care for themselves like bees, their survival is at risk. They can develop burnout, compassion fatigue, and Vital exhaustion.

Today the profession depends upon supporting nurses’ vitality and keeping up our numbers. If you don’t practice Self care, if the educators and leaders of the profession, like the bee keepers, do not make concerted efforts to provide support and education in the prevention of unhealthy and unsafe situations, the profession is weakened and becomes at risk of losing its prominent role in designing and delivering optimal health care. Over the years other health care workers have nibbled away at the edges of nursing roles because we did not care for our boundaries and the profession as a whole. To mention a few, social workers, physical therapists and med techs now perform what were once nursing duties and tasks. Today there are health care navigators and coaches who are not nurses providing similar services but without a nursing focus on holism and a deep theoretical background to support their work.

Since Florence Nightingale, nurses have provided care  “focusing on wellness and the interrelationship of humans, events and the environment” p 51 CarlaMariano Holistic Nursing 5th edition. Using the nursing process you do your best to prevent untoward situations. You look at the spiritual, emotional, mental, physical, environmental, and economic aspects of situations and create with your client a plan of care that addresses the well-being of all. No other group of professionals has such a varied, holistic and comprehensive vision. Just as the honeybee has the glorious job of pollinating flowers, creating beauty in the process of sustaining our planet, you have a powerful role to play in the emerging global healthcare paradigm, creating a sustainable future for
all.  Like the honey bee sustaining the web of life, you have an integral role in improving human health, improving the system in which you work and making a difference in the world by sharing your wisdom developed from evidence-based care, supported by theory, self-reflection and devotion to optimal outcomes. You pollinate by sharing authenticly at work with your colleagues, other professionals, your clients and in your personal life by providing healing energy, wisdom, theory, clinical expertise, and laughter.

2 ways to let us support your Self care.

1. Join our   Self Care for Vitality, free Virtual Connecting Weekly Call-in for Nurses.  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

2. Sign up for the next Vitality in Progress: Healing and Preventing Burnout for Nurses which begins May 7, 2017. For more information contact Padma 828-620-0521

Have a great week and we look forward to hearing from you about how you care for yourself, your colleagues and the nursing profession- all forms of caring for pollinators, the sustainers of the web of life.

With love, Padma

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

 

Compassion Satisfaction ≠ Vital Exhaustion , Burnout or Compassion Fatigue

Let’s clear up any confusion about the terms we have been using in the last 3 weeks. You explored Vital exhaustion–  you were encouraged to see what comes up for you in terms of your experience. Then you addressed measuring your experiences of compassion satisfaction, compassion fatigue, burnout, and Vital exhaustion to receive an objective reflection of what you might be experiencing, undoing any shackles of shame, fear and denial to move into the solution. The experience of healing or preventing these states is very empowering.

Burnout

In the 1970’s Herbert Freudenberger coined the term burnout, based on his observations of the drug addicts he worked with- sitting with blank looks, staring at cigarettes until they burned out. In that same decade, psychotherapists began using the term describing their own overstressed condition where there is “Total and incapacitating exhaustion; inability to go on”.  In addition to signs of exhaustion, the person with burnout exhibits an increasingly negative attitude toward his or her job, low self-esteem, and personal devaluation. There is a conflict between what needs to be done and what can be done, so the work environment is part of the equation.

Compassion Fatigue

Compassion fatigue, also called “vicarious traumatization” or secondary traumatization (Figley, 1995) is the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events. Michael K. Kearney et al. have considered compassion fatigue to be similar to PTSD posttraumatic stress disorder except that it applies to those emotionally affected by the trauma of another (eg, client or family member) rather than by one’s own trauma. Compassion fatigue can occur due to exposure to one case of trauma and/or there can be a cumulative effect. When Mother Teresa mandated that her nuns take a year off every 4-5 years to allow time to heal from the effects of their caregiving work, she demonstrated understanding compassion fatigue.

Distinguishing

Compassion fatigue and burnout are not the same. They both occur over time, and can co-exist and produce very similar symptoms. An important factor that distinguishes them is that a person experiencing compassion fatigue does not loose their ability to empathize and desire to help whereas those experiencing burnout become cynical, inefficient in their job roles and loose their ability to empathize. The American Institute of Stress succinctly distinguishes between the terms.”Burnout is the cumulative process marked by emotional exhaustion and withdrawal associated with increased workload and institutional stress, NOT trauma-related.”

Dr. Rachel Remen, nuances our understanding with, “We burn out not because we don’t care but because we don’t grieve. We burn out because we’ve allowed our hearts to become so filled with loss that we have no room left to care.” Here I would suggest that she is actually referring to compassion fatigue within a burnout context.  If your workplace does not recognize the value of affording staff time and space  to decrease some of the stress,  burnout and compassion fatigue become greater risks. Left unmitigated Vital exhaustion can ensue.

I have noticed that nurses can start with either burnout or compassion fatigue. If left untreated  Vital exhaustion can happen.  Subsequently they may leave the profession which is a loss. If they stay in the profession, they are unhappy colleagues creating difficult work relationships and climates.

Moving into Healing and Engagement 

Nurses and other practitioners in the human services fields are at great risk of burnout, compassion fatigue and Vital exhaustion in part due to the high-stress work environments, and the emotional demands of our jobs.   With information, intention, and support you can assess your self-care practices, compassion satisfaction, compassion fatigue, burnout, and Vital exhaustion.  Then, using our beloved nursing process, you can empower yourself with interventions that nourish your well-being and compassion satisfaction. We know that a supportive work climate positively impacts compassion satisfaction because it encourages relationships, mutual learning, and self-care (Harr, 2013) and thereby empowers the staff. Maybe you will want to share your discoveries, thereby empowering not
only yourself but others.

Maybe you’d like to join our   Self Care for Vitality a free Virtual Connecting Weekly Call-in for Nurses.  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

 

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