Using Perspective As a Tool Against Nursing Burnout

The death rate for humans on the planet Earth is currently 100 percent. I know this is not a pleasant thing to read while enjoying your first cup of coffee this morning, or perhaps you’re enjoying a calming glass of wine later this evening. It’s unpleasant enough that perhaps you will not finish reading this post, but it’s true nonetheless.

Ravens by jparadisi

Ravens by jparadisi

Running parallel to our fear of dying is our pursuit of eternal youth. Cosmetic surgery and procedures are a billion dollar industry. Many men and women consider regular treatments for balding, teeth whitening, the prevention and removal of wrinkles, and coloring gray hair part of normal maintenance. Some choose to have  the evidence of time wiped from their faces by a surgeon’s scalpel.

The struggle nurses face in striking the right balance between hope and realistic outcomes for our patients is in part due to society’s mythical belief that death is preventable, when in fact, it’s inevitable. As humans, nurses buy into the myth to some extent also.

Discussing this, a nurse friend and I joked about gray hairs and wrinkles. She remarked, “Getting old is terrible.”

“No,” I said, “It’s not. It’s what nurses do for a living. We help people stay alive so they can grow old.”

See? It’s a matter of perspective.

Whenever someone asks, “Is it hard being a cancer nurse working with dying patients?” the above thoughts come to mind. The answer is, “I don’t see oncology nursing from that perspective.”

Yes, oncology nurses work with the dying, but I perceive our practice as helping people live to their fullest capacity.

Nurses cannot guarantee patients a cure or how long they’ll live, but by promoting prevention, treatment, and providing tools for managing chronic disease, we encourage them to pursue their best life possible as things stand. If nurses lose this perspective, how can we hope to share it with our patients?

There is balance in the realization that death is part of life. Death and loss cause grief, a normal response. Grief and loss are painful. We fear death and loss, but they are a natural occurrence of living. Maintaining a realistic perspective is a tool for burn out prevention among nurses.

All people die. Nurses are here to help patients live until that day.

I grieve their loss, and mine, because I glimpse my mortality too in the faces of the dying.

Thank you for reading this entire post.

Vacation!

At The Pool photo by jparadisi 2013

At The Pool photo by jparadisi 2013

JParadisiRN is on vacation this week. I’ll write a new post soon from a refreshed perspective. Meanwhile, if you haven’t read my oncology blog for TheONC, or latest post for AJN Off The Charts, this is a good week to catch up.

Cheers!

Ten Points to Ponder

I received this list via email. Suddenly, my entire day made sense. Unfortunately, the author is unidentified:

TEN POINTS TO PONDER!

Number 10
Life is sexually transmitted.

Number 9
Good health is merely the slowest possible rate at which one can die.

Number 8
Men have two emotions : Hungry and Horny. If you see him without an erection, make him a sandwich .

Number 7
Give a person a fish and you feed them for a day. Teach a person to use the Internet and they won’t bother you for weeks, months, maybe years.

Number 6
Health nuts are going to feel stupid someday, lying in the hospitals, dying of nothing.

Number 5
All of us could take a lesson from the weather. It pays no attention to criticism.

Number 4
Why does a slight tax increase cost you $800.00, and a substantial tax cut saves you $30.00?

Number 3
In the 60′s, people took acid to make the world weird. Now the world is weird and people take Prozac to make it normal.

Number 2
Life is like a jar of Jalapeno peppers–what you do today, might burn your ass tomorrow.

And The Number 1 Thought
- – - as someone recently said to me:
“Don’t worry about old age – it doesn’t last that long.”

Nurses and Pharmacists: For Valentine’s Day All We Want Is Respect

I’ve written before that I am happily married to a pharmacist. Sometimes when we come home from work, we commiserate together in shorthand about our hospital shifts. When we are grumpy, we play “I work harder than you do,” in which we childishly throw out episodes from our day to prove who had a harder shift and should buy dinner. Usually I win, because as a nurse, I am the one working hands-on with patients. However, I concede that being responsible for every medication calculation, preparation, and drug interaction (and more) is a tough and stressful job. Safe medication administration is a foundation of patient care. I also acknowledge that nurses are occasionally a little difficult to work with (I  was actually once present for a code blue when a stool softener was ordered STAT).

Anyway, for David and all my pharmacist friends, this one’s for you. Special thanks to the friend who brought this video to my attention.

Late Entry: I did have the Pharmacy Respect video here earlier, but I have removed it. Unfortunately, I cannot unlink it from the YouTube playlist that I do not want to post to this site. So, watch the Pharmacy Respect video, click the link or go to YouTube and type Pharmacy Respect into the search bar. It will come right up. Sorry for the inconvenience, but it is a cute video.

Miracle on Hoyt Street

If It Fits It Ships photo: jparadisi 2010

Trudging out of an Oregon rainstorm into the Post Office, I found a line of 30 people like me with Christmas packages to mail. In a poorly ventilated building, a crowd of wet people smells like wet dogs, but less so. John Lennon’s voice sounded scratchy singing “And so this is Christmas” from a poor quality speaker. I knew the late afternoon was a bad time to go, but I’ve never been a morning person, a characteristic that served me well for twelve years of night shifts.  I started thinking that a busy hospital is a model for Post Office chaos during the holiday season. Each type of health care provider or patient personalities exists in this parallel universe, the Post Office.

For example, attempting to speed things up, a woman wearing a name badge triaged the swelling line of package bearing humanity, asking who needs insurance forms to fill out. Someone at the back of the line asks her what time the Post Office closes. She says she doesn’t know, because she usually doesn’t work in this area. Apparently postal workers float to unfamiliar departments like nurses do during staffing shortages.

In front of me, a woman with silver hair converses with a younger woman. I suspect the silver-haired woman is a retired nurse, because she hands out an endless supply of clicky-pens to other customers in the line in need of writing implements, then pulls a Sharpie out of the same pocket for her own use. The younger woman has long hair pulled back in a barrette. She is sans makeup and wears what we call in Oregon, “tree-hugger” shoes. She is overweight, but kindly attentive to the silver-haired woman. While she speaks, a similar looking man I take for her husband appears and gives her a peck on the mouth. It makes me happy.

I watch a woman wrapping packages in tissue paper and bar code stickers. In front of her, a man loudly complains on a cell phone, “Those #$*#-ing doctors give you a bunch of pills and then you can’t get a hold of them!” He never stops talking the entire time the clerk processes his packages. When he’s finished, she says “Merry Christmas, Sir”, which I think is more than he deserves.

Finally, it’s my turn. Oh no, it’s that clerk, the one who is Newman to my Jerry Seinfeld. She annoys the hell out of me because she doesn’t ask if the contents of a package are dangerous, instead she asks, “What’s in the package?” Once, David and I got into a disagreement when he told her what was in my package. I insisted she was violating my privacy. I’m not special: In the past, I’ve heard her say rude things to other customers and her coworkers too. I brace myself for the encounter, because I have to get these damn packages in the mail in time for Christmas and I’ve been in line for an hour.

She does not ask what’s in my packages. “Anything hazardous, flammable, toxic or a combination thereof?” is all she asks. I say “No.” “How do you want this posted?” she asks. I say “First class,” but she informs me that anything over 13 ounces cannot be First Class. “Priority?” I say as nicely as possible. She pulls out some tape, and fixes a loose corner on one of my packages. “Sorry,” I say, “I never get it perfect.” “Forget perfect, my dear,” she says to me while I pay for the postage. Then she hands me a candy cane. “It’s always a pleasure to serve someone who comes in with a smile. Merry Christmas.”

The Season of Poverty and Thanksgiving

Street Art (unknown artist) photo: jparadisi

You know it’s going to be a long shift when you open your first chart of the morning, and the doctor’s orders are written on a Post-It.

I admit it: I’m feeling kind of overwhelmed this week. November begins what I fondly dub “The Season of Poverty.” I’m not really impoverished. It just feels that way in November, as soon as the property tax bill arrives, followed by Thanksgiving, a couple of family members birthdays, then Christmas, then more family members birthdays clear through the end of February. *  Before spinning out of control, I remember Maslow’s Hierarchy of Needs and regain my perspective. Holiday anxiety is a luxury.

In the midst of this angst, something happened last week and I keep replaying it in the YouTube of my mind.

I was walking on a downtown street, minding my own business, when seemingly out of no where a man walked up to a metal street sign and, with his bare fist, slammed it with such violence I thought he was going to bend it. Shouting obscenities, he hit it again and again, barely a few feet in front of me. I froze where I stood, looking for the nearest exit to safety, as the man came forward in my direction. From behind, a woman wearing dirty clothes said, “Ma’am, come here, behind this chain,” as she lifted the chain blocking off a driveway. Grateful, I did as directed, waiting until the man I was afraid of passed by.

That’s it, nothing more. But I keep thinking about the concern this woman showed for my safety. If someday she seeks help in the emergency department of a hospital or becomes a patient, I hope she receives the same concern and courtesy she gave to me. She didn’t judge me by my clothes for not belonging in her neighborhood. She did not think that I deserved to suffer violence for being in the wrong place at the wrong time. She simply extended safety to me.

Happy Thanksgiving.

*Dr. Dean Burke offers financial advice to nurses at The Millionaire Nurse Blog.

You can show your concern for the homeless in Portland, Oregon by donating to Sisters of the Road.