Vitality In Progress Archives - Integral Nursing Solutions

By:padma
February 22, 2018
0

Self Care~ Sleeping For Success

Your long and short term success is impacted by your sleep. Getting adequate sleep is an essential self care activity that optimizes your potential by detoxing your brain and healing body organs and systems such as your heart and blood vessels. Let’s look at the new information about how and why getting enough sleep influences your body, mind and emotions. With this information about your precious brain, you may no longer believe and behave as if sleep is negotiable.

Physiology of the Glymphatic System

Your glymphatic system, similar to the body’s lymph system, removes toxins and metabolites from the brain, while you sleep. Researchers have observed that noradrenaline a fight-or-flight hormone is released in bursts when brain needs to become alert. Awake, your brain cells are busy processing information which creates waste products. The cells swell and are consequently closer together. And then, while you sleep there is an increase in cerebrospinal fluid (CSF) to your brain. Your brain’s glia cells, part of the glymphatic system, helps control the flow by shrinking the cells in your brain by 60% during sleep, thereby creating more space between the cells. Your CSF can wash through the brain tissue with greater ease,washing away harmful waste proteins like beta amyloid and tau proteins, and other molecules that build up between brain cells during waking hours. The glymphatic system carries the waste to the brain’s blood stream, which then transports them into the larger circulatory system to be removed through the liver and kidneys. Upon waking beta amyloid concentrations are decreased. Maybe it is no wonder that when we say “let me sleep on it”, we have a clearer mind to work with upon waking.

Effects of Sleep Deprivation on You Physical, Emotional and Mental Abilities

Body

When you don’t get enough sleep your reflexes are slower, you are at risk for high blood pressure, a weakened immune system, diabetes, low sex drive, heart disease, poor balance and weight gain. Here’s a fun fact: Dr. Helene Benveniste and her colleagues at Stony Brook University School of Medicine discovered that side lying is the best position for ridding the body of metabolic waste.

Emotional

When you are tired, not getting enough sleep, you are emotionally off balance and your decision making becomes poor. You may experience pessimism, anger, sadness, depression and grumpiness. Sleep deprivation does not feel good and you may find yourself eating for emotional reasons because the chemicals that make you hungry are in excess and chemicals for a healthy appetite are at low levels. Remember, sleep deprivation, taken to extreme, is a form of torture.

Mental

You may experience a mental fog if you are not getting enough sleep to detoxing your brain. Lack of sleep affects both your long and short term memories, which shows up as forgetfulness. Concentration, creativity and problem solving skills are dulled. Your decision making becomes poor. This is when accidents such as med errors and car accidents are likely to happen.

!Woops!

Ignorant about the importance of sleep, and mistakenly believing that multitasking was something to be proud of, I once was grazed by a car while working 3rd shift-not paying attention to the lights. Another time, I called the police because I forgot my daughter was at a class. We all got a good laugh later, but at the time, it was not funny. I was exhausted from not sleeping. I make better food choices and my dietary habits are healthier when I get enough sleep. In fact in 12 step programs,tiredness can be a trigger for addictive behavior as indicated by the term HALT ( hungry, angry , lonely and tired). So dear sister or brother nurse, I ask you honestly, “are you getting enough sleep?”

Getting enough sleep, essential to self care is a helpful tool in both a burnout prevention and burnout healing toolbox. And whether or not you sleep alone, healing happens best in a community who support you in your self care efforts to develop strong habits that maximize your potential. The next Vitality in Progress- Healing and Preventing Burnout for Nurses Program ( VIP program) starts May 6, 2018. Give yourself the gift of a supportive community and personalized mentoring as you develop a keystone practice that supports your happiness and well-being. Good nurses become great nurses when they take great care of themselves.

Sending blessings to you for deep sleep and sweet dreams~~ waking refreshed, ready to start your day with enthusiasm, creativity and ease.

With love, Padma

By:padma
March 31, 2017
2

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

By:padma
March 24, 2017
0

Increasing Your Compassion Satisfaction

Last week I suggested we would compare Vital exhaustion, compassion fatigue and burnout. Now, I think it might be better to do the measurements first, so you can get into the solution and then come back to discussion. Compassion satisfaction is a sweet and happy place to be. Some of us live in that space a lot and for others it is fleeting. It is that sense of fulfillment and well-being. It is the positive feeling you experience as a result of knowing you did a good job. You have the sense that you make a difference in your work setting. You enjoy knowing you have a positive impact in the lives of those you care for. In fact, your compassion satisfaction may motivate you to continue your work.

On the other hand, you intuitively know if you are experiencing burnout, compassion fatigue, Vital exhaustion and compassion satisfaction. However, in our evidence-based world, you can measure your experience and your risk for these states which can be very useful to corroborate your felt sense.

So, why, how and what do we measure? Everything changes including compassion satisfaction. Many nurses become paralyzed by fear, shame and denial, tolerating experiences of burnout, compassion fatigue and Vital exhaustion for very long periods. This discomfort is stressful and impacts others- colleagues and those we care for. Having an objective reflection of your experience can help reduce shame and confusion and help with moving into the solution rather than staying in the problem.

For some nurses burnout starts in nursing school. When was your first experience of one of these states and what did you do about it? Are you now happy at work? The sooner you identify an unhappy situation, which might mean measuring your professional satisfaction, the sooner you can mitigate it.

My first experience was 2 years into my first job and my responses were typical- changing jobs (geographical solution) and getting more education. Those changes did not give me tools to heal or prevent the burnout, compassion fatigue and Vital exhaustion experiences which would come and go several times in my 40-year career. Now I have tools to prevent burnout and I use them because it makes a big difference in my happiness. Regardless of your position or status in the nursing world, measuring your professional satisfaction is informative, helpful and a form of self-care.

The PROQOL (Professional quality of life) measures Compassion Satisfaction and Compassion Fatigue, Burnout, Secondary Traumatic Stress, Vicarious Tramatization, and Vicarious Transformation. “Professional quality of life is the quality you feel in relation to your work as a helper. Both the positive and negative aspects of doing your work influence your professional quality of life. Understanding the positive and negative aspects of helping those who experience trauma and suffering can improve your ability to help them and your ability to keep your own balance.”

We use the PROQOL as a measure in the Vitality In Progress: Healing and Preventing Burnout for Nurses prior to the program in the middle and again at the end as a measure for participants to track their progress.

It is free and is available to individuals and organizations.

Another measure that could be used is The Maslach Burnout Inventory (MBI) which addresses three general scales:

Emotional Exhaustion measures feelings of being emotionally overextended and exhausted by one’s work.
Depersonalization measures an unfeeling and impersonal response toward recipients of one’s service, care treatment, or instruction.
Personal Accomplishment measures feelings of competence and successful achievement in one’s work.

Maslach and her colleague, Michael Leiter, defined the antithesis of burnout as engagement. Engagement is characterized by energy, involvement, and efficacy, the opposites of exhaustion, cynicism, and inefficacy.

Where are you on the continuums of compassion satisfaction, compassion fatigue, burnout, Vital exhaustion, engagement? Have you taken the PROQOL? It is free. Will you consider it? If you have taken it recently, what do your scores tell you? Do they match your felt experience of your professional life? When was the last time you did an inventory of the beautiful ways that you care for yourself? Even that measurement could be useful to increasing your compassion satisfaction. A few tweaks to your current habits could make a big difference in the joy and happiness you experience in your life.

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 177444We are looking forward to your answers and comments to the above questions~~

With love, Padma